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step 2 > Peds > Flashcards

Peds Flashcards

1
Q

mc cause of pneumonia in cystic fibrosis kid

A

Pseudomonas

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2
Q

Caput seccundaneum

A

conehead baby DOES cross suture lines

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3
Q

Cephalohematoma

A

does NOT cross suture lines subperiosteal hemorrhage ddx: depressed skull fx

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4
Q

Kawasaki’s: dx criteria

A

Fever >4 days +4/5 of these:

  • b/l conjunctival inj
  • mucus membr involvement
  • distal extrem changes (peeling, edema) -
  • cervical lymphadenopathy
  • rash
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5
Q

Kawasaki’s tx:

A

IVIG, ASA

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6
Q

after receiving IVIG patients need to wait 3 months for this

A

Live vaccines

  • MMR
  • varicella (herpes)
  • zoster (herpes)
  • flu mist
  • yellow fever
  • (rotavirus?)
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7
Q

APGAR stands for?

A
  • Appearance (color)
  • Pulse (>100 = 2pt)
  • Grimace (do they pull away from stimulation? cough with suction?)
  • Activity (muscle tone?)
  • Respirations

Max of 2pts each

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8
Q

Nevus sebaceous

A
  • area of alopecia with orange/nodular skin
  • need to remove it before adolesence bc it can become malignant
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9
Q

Galactosemia vs PKU

A

galactosemia you will see signs right away bc galactose can x-placenta

PKU - musty odor, athetosis

Galactosemia - at risk for Ecoli sepsis

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10
Q

Galactosemia

A
  • see: MR, direct hyperbili, jaundice, cataracts, low glucose/seizures
  • high risk of E.coli sepsis
  • tx: lactose free diet
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11
Q

PKU

A
  • see MR, vomiting, seizures, athetosis (writhing hand mvmt)
    • signs develop over the first few months of life
  • musty odor
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12
Q

Physiologic Jaundice

A
  • bili = 10, i-bili 0.5
  • baby eating and pooping well
  • bc liver conjugation is not yet mature
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13
Q

Breast feeding vs Breast Milk jaundice

A
  • Breast feeding = baby not getting enough feeding; signs of dehydration, not gaining weight
  • Breast milk = bc of the glucuronidase in breast milk, this deconjugates bilirubin; no signs of dehydration
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14
Q

Pathologic Jaundice

A

1 day old, if you see bili greater than 12 or direct bili greater than 2 (do not need both to qualify)

  • next best test = Coombs test
    • (+) = antibodies on baby’s RBC is the problem
    • Rh, ABO incompatibility
    • (-) = twin/twin or baby/mom transfusion, spherocytosis, G6PD defic
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15
Q

Biliary atresia

A

ex: bili @12, d-bili @ 8, incr LFTs

  • Why? bile ducts cannot drain
  • will need surgery
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16
Q

What do you need to do if you see high d-bili in a baby?

A

rule out sepsis. Its as if baby has a fever. May even want to do LP

17
Q

Inherited Indirect Hyperbilirubinemia

A
  • Gilberts - decr in glucoronyl transferase
  • Crigler-Najjar - total glucoronyl transferase deficiency
18
Q

Inhereted Direct Hyperbilirubinemia

A
  • Dubin Johnson (black liver)
  • Rotor (liver normal looking)
19
Q

Ananomalies assocaited with TE fistula

A

VACTERL

  • vertebral
  • anal atresia/imperforate
  • cardiac
  • TE fistula
  • renal
  • limb anomalies/agenesis
20
Q

Anomalies asocciated with choanal atresia?

A

Choanal atresia - baby can’t breathe out of their nose

CHARGE

  • Coloboma
  • heart defects
  • atresia of choanae
  • retarded growth
  • GU anomalies
  • ear anomalies/deafness
21
Q

When to give surfactant? Ratio that tells you how surfactant is doing?

A
  • 24-34 weeks
  • if L:S ratio is less than 2; high risk for RDS

(remember to check LS ratio on infants born to DM moms bc insulin interferes with cortisol/surfactant)

22
Q

You suspect a baby had meconium aspiration. Next best step?

A

Suction or intubate prior to drying/stimulating to prevent further aspiration

23
Q

Ear pits think?

A

Beckwith Wiedemann syndrome

  • large tongues
  • large babies
  • hypoglycemia
24
Q

big tongue baby ddx?

A
  • Beckwith Wiedemann
  • hypothyroidism
  • infant with DM mom
25
Q

What is umbilical hernia assocaited with?

A

Hypothyroidism

(should recede, surgery if it persists 2-3y/o)

26
Q

1wk old baby, biliouus vom, draws up his legs, abd distension

A

Malrotation/volvulus

27
Q

Gastrograffin vs Barium enema for dx/tx?

A

Gastrograffin = Meconium ileus

Barium = intussesception

28
Q

poop explosion on DRE

A

Hirschprungs

29
Q

Mom with pre-existing DM and pregnancy; complications?

A
  • IUGR
  • caudal regression
  • short L colon
  • Congen Heart disease (mc: transposition of great vessels)
  • neural tube defects
30
Q

Complications of macrosomic baby (gestational DM mom)

A
  • polycythemia
    • jaundice
  • hypoglycemia
  • hypocalcemia
  • resp distress syndrome (increased insulin interferes with surfactant production)
31
Q

complication of Neonatal mucopurulant eye discharge, days 7-14 of life?

A

Chlamydia conjunctivitis

can lead to pneumonia

32
Q

Brutons agammaglobulinemia

A
  • B cell deficiency
    • low levels of all Ig’s
    • no tonsils
33
Q

Combined variable immune deficiency

A
  • acquired
  • B cells are normal
  • decreased Ig’s
  • increased risk for lymphoma bc its a lymphoid tissue defect
34
Q

DiGeorge

A

CaTCH 22

  • Cardiac abnormalities (most often truncus arteriosis)
  • T-cell defic/thymic aplasia
  • cleft palate, micrognathia
  • hypocalcemia/hypoparathyroidism
35
Q

When to use the Nitrotetrazolium blue test?

A

When you suspect Chronic Granulomatous Disease

  • recurrent swollen infected nodes, s.aures skin abscesses
  • problem with catalase (+) bugs
  • dx: nitrotet blue test
    • turns from yellow –> blue : (-)
    • stays yellow –> (+)
36
Q

Prolonged bleeding after circ. Often bruising, petechia, eczema

A

Wiskott Aldrich syndrome

low IgM

high IgA, IgE

IgG can be wherever

37
Q

cough, coryza, conjunctivitis, koplik spots

A

rubeola/measles

38
Q

German Measles

A

Rubella

  • rose spots on mouth
  • sore throat
  • joint pain
  • pinpoint rash starts on forehead
  • scary if mom is preggo

step 2 (19 decks)

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