Peds Flashcards
This is a severe life threatening airway obstruction causing fever, dysphagia, respiratory distress. Patient presents with drooling, absence of hoarseness, and sitting forward with neck extended. Dx? Cause? Tx?
Epiglottitis. Strep pyogenes, staph aureus, mycoplasma. Treat by securing airway, IV ceftriaxone, prevention.
This is a viral infection causing severe inspiratory strider, barking cough. What bug causes? Sign on X-ray and treatment?
Croup -laryngotracheobronchitis. Steeple sign on neck X-ray, parainfluenza common cause. Treat with humidified air, nebulized epi and corticosteroids.
Two clinical findings of epiglottis.
Cherry red epiglottis, thumb sign on lateral X-ray.
This bug causes whooping cough.
Bordetella pertussis.
Which phase of pertussis is the paroxysmal cough?
Second phase or paroxysmal phase.
How do you treat whooping cough/pertussis?
O2, hydration, azithromycin or erythromycin.
Who do you avoid giving erythromycin to and why?
children under 1 month because of the risk of infantile hypertrophic pyloric stenosis.
MC cause of bronchiolitis?
RSV.
Signs of respiratory distress in kids!
Nasal flaring, intercostal retractions, prolonged expirations.
If a child has a hx of congenital heart dz or chronic lung dz and gets bronchiolitis what med can you give?
Ribavirin
Bronchiolitis age, pathogen, treatment.
<2, RSV, bronchodilator and hydration.
Croup age, pathogen, treatment.
1-6 yrs, parainfluenza, dexamethasone, racemic epi
MC location for foreign body aspiration?
Major bronchus
Choking followed by wheezing think?
Foreign body aspiration
Where is the CF gene located?
Long arm of chromosome 7
What does the CF gene do?
Directs production of the cystic fibrosis transmembrane conductance regulator protein. (CFTR)
A child presents with failure to thrive, large appetite and fatty stools think?
CF
Test of choice to dx cystic fibrosis?
Sweat chloride test
Acute CF exacerbation treatment?
Ciprofloxacin, steroids. NSAIDs, chest pt, mucomist.
Obese teenager presents with knee pain and lack of internal rotation. Dx? X-ray finding? Tx?
SCFE. Ice cream falling off cone. Tx by preventing further slippage, may need fixation
This is ideopathic avascular necrosis of the capital femoral epiphysis.
Legg calfe perthes dz.
Classic presentation of legg calve perthes dz? Treatment?
Painless limp. Self healing, abduction cast and orthoses.
Over use injury of the anterior tibial tubercle presenting with knee pain after injury. Dx? Tx?
Osgood-schlatter dz. intermittent pain? Avoid causative activities and ice to area for 15 min after playing. Severe pain? Complete joint rest for wks. Gradual return to activity.
What is the most common genetic cause of osteoporosis?
Osteogenesis imperfecta
What causes osteogenesis imperfecta?
Defects in type 1 collagen
Classic triad of osteogenesis imperfecta?
Fragile bones, blue sclera, early deafness.
Nursemaids elbow is a subluxation of what ligament? Tx?
Annular ligament, supinate forarm then flex elbow.
Cryptorchidism is related to what? How to dx? Tx?
Undescended testes. Increased with prematurity. Most testes descend by 3 months. Maternal use of steroids is common. Tx with hormonal therapy or orchidoplexy.
This cancer derives from mesenchymal stem cells.
Osteosarcoma.
X-ray shows a sunburst pattern and bone changes. Dx? Tx ?
Osteosarcoma, dx with bone bx. Treat with surgery, chemo, RT
Malignant tumor from neural crest cells.
Ewing sarcoma.
X-ray shows onion skin pattern. Dx? Tx?
Ewing sarcoma. Surgery, RT, chemo.,
Child under age 5 presents with a firm painful abdominal mass that crosses the midline. Dx?
Neuroblastoma.
Lab findings in neuroblastoma?
Increased urine catecholamines.
Treatment for neuroblastoma?
Surgery #1, chemo, RT
Under 5 presents to clinic with painless abdominal mass from flank toward midline. Does not cross midline?
Wilms tumor, nephroblastoma.
Tx for nephroblastoma?
Nephrctomy with preop chemo, radiation to lungs. Likes to mets in lungs.
Child presents with bilious vomiting, peristaltic waves and jaundice. Double bubble sign on X-ray With no distal gas. Dx? Tx?
Duodenal atresia. Tx with decompression, fluids and surgery.
Common syndrome associated with duodenal atresia?
Downs
At 30 months child height and weight?
30 lbs 30 in
At 4 yrs child weight and height?
40 lbs, 40 in
Double birth weight at?
6 months
Triple birth weight at?
12 months
Most common site for intussuception?
Ileal colic
Child with sudden onset of recurrent paroxysmal sharp abdominal pain. Vomiting, currant jelly stool and sausage mass in upper abdomen. Dx?
Intussuception. Dx with ultrasound. Barium enema is treatment.
This is diffuse hypertrophy of pyloric sphincter muscle.
Pyloric stenosis.
