Peds

Question 1

mc cause of pneumonia in cystic fibrosis kid

Answer 1

Pseudomonas

Question 2

Caput seccundaneum

Answer 2

conehead baby DOES cross suture lines

Question 3

Cephalohematoma

Answer 3

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

Question 4

Kawasaki’s: dx criteria

Answer 4

Fever >4 days +4/5 of these:

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

Question 5

Kawasaki’s tx:

Answer 5

IVIG, ASA

Question 6

after receiving IVIG patients need to wait 3 months for this

Answer 6

Live vaccines

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

Question 7

APGAR stands for?

Answer 7

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

Max of 2pts each

Question 8

Nevus sebaceous

Answer 8

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

Question 9

Galactosemia vs PKU

Answer 9

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

PKU - musty odor, athetosis

Galactosemia - at risk for Ecoli sepsis

Question 10

Galactosemia

Answer 10

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

Question 11

PKU

Answer 11

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

Question 12

Physiologic Jaundice

Answer 12

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

Question 13

Breast feeding vs Breast Milk jaundice

Answer 13

• 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

Question 14

Pathologic Jaundice

Answer 14

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

Question 15

Biliary atresia

Answer 15

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

• Why? bile ducts cannot drain
• will need surgery

Question 16

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

Answer 16

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

Question 17

Inherited Indirect Hyperbilirubinemia

Answer 17

• Gilberts - decr in glucoronyl transferase
• Crigler-Najjar - total glucoronyl transferase deficiency

Question 18

Inhereted Direct Hyperbilirubinemia

Answer 18

• Dubin Johnson (black liver)
• Rotor (liver normal looking)

Question 19

Ananomalies assocaited with TE fistula

Answer 19

VACTERL

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

Question 20

Anomalies asocciated with choanal atresia?

Answer 20

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

CHARGE

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

Question 21

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

Answer 21

• 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)

Question 22

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

Answer 22

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

Question 23

Ear pits think?

Answer 23

Beckwith Wiedemann syndrome

• large tongues
• large babies
• hypoglycemia

Question 24

big tongue baby ddx?

Answer 24

• Beckwith Wiedemann
• hypothyroidism
• infant with DM mom

Question 25

What is umbilical hernia assocaited with?

Answer 25

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

Question 26

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

Answer 26

Malrotation/volvulus

Question 27

Gastrograffin vs Barium enema for dx/tx?

Answer 27

Gastrograffin = Meconium ileus Barium = intussesception

Question 28

poop explosion on DRE

Answer 28

Hirschprungs

Question 29

Mom with pre-existing DM and pregnancy; complications?

Answer 29

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

Question 30

Complications of macrosomic baby (gestational DM mom)

Answer 30

* polycythemia * jaundice * hypoglycemia * hypocalcemia * resp distress syndrome (increased insulin interferes with surfactant production)

Question 31

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

Answer 31

Chlamydia conjunctivitis can lead to pneumonia

Question 32

Brutons agammaglobulinemia

Answer 32

* B cell deficiency * low levels of all Ig's * no tonsils

Question 33

Combined variable immune deficiency

Answer 33

* acquired * B cells are normal * decreased Ig's * increased risk for lymphoma bc its a lymphoid tissue defect

Question 34

DiGeorge

Answer 34

CaTCH 22 * Cardiac abnormalities (most often truncus arteriosis) * T-cell defic/thymic aplasia * cleft palate, micrognathia * hypocalcemia/hypoparathyroidism

Question 35

When to use the Nitrotetrazolium blue test?

Answer 35

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 --\> (+)

Question 36

Prolonged bleeding after circ. Often bruising, petechia, eczema

Answer 36

Wiskott Aldrich syndrome low IgM high IgA, IgE IgG can be wherever

Question 37

cough, coryza, conjunctivitis, koplik spots

Answer 37

rubeola/measles

Question 38

German Measles

Answer 38

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