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Peds Flashcards

1
Q

Normal RR for a newborn

HR

A

40-60 BPM

120-160

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2
Q

What does the 1 min apgar evaluate?

5 min?

A

Labor and delivery

Response to resuscitative efforts

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3
Q

What are the 5 apgar criteria?

A 
Appearance
Pulse
Grimace
Activity
Respiration
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4
Q

What is the most likely cause of eye redness on day 1?
Day 2-7?
>7 days?
>3 weeks?

A

Chemical irritation
Gonorrhea
Chlamydia
HSV

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5
Q

What 2 Abx are given babies to prevent eye issues?

A

Erythromycin or tetracycline ointment

silver nitrate solution

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6
Q

What are 8+1 screenings that occur prior to discharge for newborns?

A 
PKU: treat w special diet
CAH: replace steroid deficiencies, repair genitalia
Biotinidase 
Beta thalassemia
Galactosemia: eliminate lactose
Hypothyroidism
Homocysteinuria 
CF: initial sweat Cl, accurate CFTR genetic test
Hearing test
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7
Q

What children get the HepB vaccine?

What kids get the HepB IG?

A

Every newborn

HbSAg + mothers

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8
Q

What is transient polycythemia of the newborn?

A

Hypoxia during delivery stimulates EPO to increase RBCs

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9
Q

What is transient tachypnea of the newborn?

A

C section babies who have fluid in their lungs but should only last less than 4 hours

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10
Q

Why does transient hyperbili occur in newborns?

A

Infant spleen removes express RBCs carrying HbF

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11
Q

What are the 3 types of skull fracture in newborns?

A

Linear (common)
Depressed
Basilar (fatal)

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12
Q

What are the 2 scalp injuries and their difference

A

Caput Succedaneum: crosses suture lines

Cephalohematoma: sub periosteal bleeding that does not cross

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13
Q

What are the 2 types of diaphragmatic hernias?

A

Morgagni: retrosternal or parasternal
Bochdalek: more common –> posterolateral on left side

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14
Q

What screening is associated with omphalocele?

What genetic disease is highly associated?

A 
elevated AFP (most common cause is incorrect dating)
T18
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15
Q

WAGR syndrome=?

A 
Cr11
Wilms
Aniridia
GU malformations
Retardation
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16
Q

What is the initial test for Wilms tumor?

Accurate?

A

U/S

Contrast CT

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17
Q

What is a hydrocele within?

Does it resolve?

A

Remnant of tunica vaginalis

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18
Q

What is the most common cyanotic heart defect in kids?
What are the characteristics?
What is the chromosome assn?
What is the murmur?

A

Tetralogy of fallot
Pulmonary stenosis > VSD > RVH > overriding aorta
Cr22 deletion
Holosystolic at LLSB

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19
Q

What is the most common congenital defect in T21?

A

Endocardial cushion defect of the AV canal

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20
Q

What are the only 3 causes of holosystolic murmurs?

A

mitral regurg
Tricuspid regurg
VSD

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21
Q

What is the most common cyanotic lesion in neonates?
What murmur is heard?
What is seen on CXR?
What is the treatment?

A

TOGV
Single S2
Egg on a string
PGE1 to keep DA open –> surgery (only 25% survive)

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22
Q

What is pulses alternans?
Bigeminus?
Bisferiens?
Tardus et parvus?

A

LV systolic dysfunction
HOCM
Aortic regurg
AS

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23
Q

What are the Sx of TA and when do they occur?

Why do you want to operate early?

A

Severe dyspnea + respiratory infections

Prevent pulm HTN

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24
Q

Define Eisenmenger Syndrome and when it occurs

A

LtoR shunt caused by VSD reverses to RtoL because of hypertrophic RV

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25
Q

What are the 3 types of ASD?
What is the Sx?
What are 2 tests?

A

Primum (mitral V issues also), Secundum (common), Sinus venosus (rare)
Fixed wide S2
Cath vs ECHO

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26
Q

Where do mitral lesions radiate?
Tricuspid and pulmonary?
Aortic?

A

Axilla
Back
Neck

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27
Q

What does a pear shaped CXR mean?
Boot shaped?
Jug handle?
3 appearance or rib nothing?

A

Pericardial effusion
Tetralogy of fallot
Primary pulm HTN
Coarctation

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28
Q

What are 3 signs of long QT

A

Family hx of sudden death
Hearing loss
Syncope

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29
Q

What are 5 signs of pathological hyperbili?

A 
Appears on 1st day of life
Rises over 5mg/dl/day
Rises over 19.5 in term child
Direct rises above 2 at any time
Persists in 2nd week of life
30
Q

What is kernicterus?

Sx?

A

Bilirubin in the basal ganglia

Hypotonia/seizures/choreoathetosis/hearing loss

31
Q

When do you consider a transfusion (what bili level)?

A

20-25

32
Q

After delivery what are the next steps?

A

Mouth/nose suctioned
Clamp/cut cord
Newborn dried/wrapped/warmed

33
Q

What electrolyte issue would you expect to see with pyloric stenosis?

A

HypoCl, HypoK, MetAlk (low K made worse by increasing aldosterone to maintain fluid)

34
Q

What is the initial test for pyloric stenosis?
Accurate?
Tx?

A

U/S
Upper GI series
Myotomy

35
Q

What is the CHARGE syndrome of congenital defects?

A 
Coloboma of eye, CNS anomalies
Heart defects
Atresia of choanae
Retardation of growth/development
GU defects
Ear issues
**commonly these come together!
36
Q

How does a child with choanal atresia present?

How do you diagnose?

A

Blue with feeding and pink with crying

CT scan

37
Q

How is Hirschprung Disease diagnosed?

A

Full thickness biopsy showing lack of submucosal ganglionic cells

38
Q

What comprises VACTERL?

A 
Vertebral anomalies
Anal atresia
Cardiovascular issues
TEF
EA
Renal anomalies
Limb anomalies
39
Q

What is DA often due to?

A

Lack or absence of apoptosis causes improper canalization of the duodenal lumen

40
Q

Where does a volvulus most commonly occur?

What is the best initial therapy?

A

Ileum

Endoscopic decompression

41
Q

What is the initial test for intussusception?
What is the most accurate test for intussusception?
When do you not do that test?
How do you treat?

A

U/S
Barium enema
Peritonitis/shock/perforation
Barium enema

42
Q

What is the classic Meckel presentation?

What is the most accurate test?

A

Painless rectal bleeding

Tech99 scan

43
Q

What 3 Abx should be used in suspected NEC?

When does NEC occur?

A

Vanc/Gent/Metronidazole

Premature infants

44
Q

What is the major disorder in CAH 21?
17?
11?

A

21=hypoTN
17=ambiguous genitalia boys
11=HTN + ambiguous genitalia girls

45
Q

What is rickets due to? (3)

A

Lack of VitD
Inability to convert 25OH to 1,25OH2
XL hypoP: inability to retain P

46
Q

What children should get a VitD supplament?

When does it start?

A

Exclusively breastfed

2 months

47
Q

What are the most common causes of neonatal sepsis? (2)
What are the most common organisms? (4)
What are diagnostic tests? (3)
What are the treatments? (2)

A

Pneumonia, meningitis
GBS, Ecoli, Saureus, Listeria
Blood culture, urine culture, CXR
Amp + Gent

48
Q

How does Toxo present?
Initial test?
Accurate?
Tx?

A

Chorio retinitis + ring enhancing lesions
IgM
PCR
Pyrimethamine + Sulfadiazine

49
Q

How does rubella present?
Initial test?
Treatment?

A

PDA, cataracts, deaf, blueberry muffin rash, hyperbili
maternal IgM
Supportive

50
Q

How does CMV present?
Initial test?
Accurate?
Treatment?

A

Peri ventricular Ca, microcephaly, chorio, hearing loss
Urine or saliva titers
Urine or saliva PCR
Ganciclovir

51
Q

HSV presentation in a neonate?

A

Week 1: shock + DIC

2: vesicular lesions
3: encephalitis

52
Q

What is the Pentad of scarlet fever?

A 
Fever
Pharyngitis
Sandpaper rash on trunk and extremities
Strawberry tongue
Cervical lymphadenopathy
53
Q

What are the top 2 causes of croup?
How is mild croup treated?
How is moderate to severe croup treated?

A

Parainfluenza 1 and 2 > RSV
Steroids
Racemic epinephrine

54
Q

What is the treatment for epiglottis?

A

Intubate in OR
Administer Ceftriaxone for 7-10 days
Rifampin for all close contacts

55
Q

What are the 3 stages of whooping cough?

A

Catarrhal stage: 14 days=severe congestion
Paroxysmal stage: 14-30 days=severe cough/whoop
Convalescent stage:14 days=decreasing cough

56
Q

How is whooping cough treated?

A

Erythromycin or azythromicin in Catarrhal stage only

57
Q

How is strep pharyngitis diagnosed?

Treated?

A

Rapid DNAse antigen test

Oral penicillin x10 days or macrolide

58
Q

How is diphtheria diagnosed?

Treated?

A

Culture of membrane (no scraping!)

Antitoxin (Abx do not work!)

59
Q

How is congenital hip dysplasia treated?

A

Pavlik harness

60
Q

What ages is Legg Calve Perthes?

How is treated?

A

2-8

Surgery on both hips

61
Q

How does a SCFE present?

What is the treatment?

A

Externally rotated leg

Internal fixation and pinning

62
Q

VitA deficiency

Toxicity

A

Poor night vision, hypoPTH

Pseudotumor cerebri, HyperPTH

63
Q

B1 low

High

A

Beriberi, wernickes

-

64
Q

B2 low

High

A

Angular chelosis, stomatitis, glossitis

-

65
Q

B3 low

High

A

Pellagra (diarrhea/dementia/dermatitis/death)

-

66
Q

B5 low

High

A

Burning feet

-

67
Q

B6 low

High

A

Peripheral neuropathy –> prevent by giving with INH

-

68
Q

B9 low

High

A

Megaloblastic anemia

69
Q

B12 low

High

A

Megaloblastic anemia, peripheral neuropathy from DC

-

70
Q

VitC low

High

A

Scurvy

-

71
Q

VitD low

High

A

Rickets in kids

HyperCa, polyuria, polydipsia

72
Q

VitK low

High

A

Increased PT/INR, bleeding

Rare

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