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PANCE Questions > Peds > Flashcards

Peds Flashcards

1
Q

Major embryonic derrivatives and what they become (occurs up to 8 weeks then fetal stage begins) ectoderm, endoderm, mesoderm

A

Ectoderm: Epidermis, hair, nails, glands of skin, brain and spinal cord
Endoderm: Epithelial lining of glands and digestive/respiratory tract
Mesoderm: notocord, somite (vertebra and ribs), kidneys, gonads, heart and blood vessels

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2
Q

When babies should return to birth weight ***

A

by 2 weeks

weight loss of 5-10% is normal

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3
Q

APGAR scoring

A

Activity: active movement, some flexion of arms/legs, absent
Pulse: greater than 100, less than 100, absent
Grimace (reflex irritability): crying/acitve, grimace/some flexion, no response/flaccid
Appearance: pink, body pink/extrem blue, pale
Respiration: good/cry, slow/irregular, absent
Max score of 10… normal is 7-10, intubate if 0-3, 4-6 bag O2

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4
Q

Adverse effects of neonatal jaundice

A

Acute bilirubin encephalpathy
Kernicterus: unconjugated bilirubin crosses the blood-brain barrier and damages brain cells if levels above 20-25 mg/dL…s/s: poor feeding, decreased moro, tx exchange transfusion

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5
Q

Mechanisms of physiologic jaundice (peaks at 3 days of life)

A

bilirubin production is higher
bilirubin clearance by the liver is decreased
increased enterohepatic circulation
NOT physiologic if baby gets jaundice in first 24 hours (hemolysis)

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6
Q

Indirect Coomb’s test is a measure of…

A

RBC agglutination

tests the presence of blood type and antibodies in the serum

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7
Q

At one year of age how much should the child weigh?

A

triple their birth weight

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8
Q

Neonatal head exam (4)

A

Caput succedaneum: common! Crosses suture lines, normal finding
Cephalohematoma: blood collected below periosteum and DOES NOT cross suture line (usually parietal bone)
Craniosyntosis: premaute closure of sutures (usually sagittal which leads to A/P lengthening)
Craniotabes: ping pong ball feel of skull

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9
Q

Infant reflexes

A

Moro: Drop baby get symmetric abduction of extremeities, disappears in 5-6 mo’s
Grasp: finger in palm, dissapears by 2-3 mo’s
stepping: hold baby and wants to step
rooting: stroke cheek and will turn head towards, dissapears by 2-3 months
parachute: stomach in air will splay arms out, have for life
Positive babinski (toes splay) up to 1 year

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10
Q

4 month milestones

A

rolls over, laughs, orients voice, smiles

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11
Q

6 month milestones

A

sits independently, babbles, recognize faces, transfer block

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12
Q

9 month milestones

A

crawls, says mama, dada, waves bye, holds bottle

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13
Q

12 month milestones

A

walk, fine pincer grasp, a couple of words

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14
Q

24 month milestones

A

walks up and down steps, build block tower, 50 word vocabulary

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15
Q

3 year milestones

A

ride tricycle, copies circle, 250 word vocabulary with 3-word sentances

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16
Q

4 year milestones

A

hops, skips, knows colors

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17
Q

TORCH congenital infections

A 
Toxoplasmosis
Other (syphillis, HIV, varicella, Hepatitis)
Rubella
Cytomegalovirus
Herpes Simplex
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18
Q

Congenital Toxoplasmosis triad

A

corioretinitis, hydrocephalus, intracranial calcifications
found in cat feces
Treat with Pyrimethamine (antiparasitic) and Sulfadizine

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19
Q

Childhood manifestations of congenital Syphilis

A

interstitial keratitis (blindness), hutchinson teeth (notched), 8th cranial nerve deafness, rash on hands and feet, snuffles (rhinitis with blood)
Tx Penicillin G
Dx IgM FTA-ABS (fluorescent treponemal antibody absorption)

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20
Q

Blueberry muffin rash seen in

A

Congenital Rubella

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21
Q

Congenital CMV features

A

Can cause deafness (sensorineural hearing loss)

most common congenital viral infection

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22
Q

Deletion 22q11 pertinent electrolyte abnormality

A

hypocalcemia

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23
Q

Turner syndrome features

A

XO
females only
webbing of neck, short stature, amenorrhea, failure of secondary sex characteristics

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24
Q

Klinefelter Syndrome

A

XXY
hypogonadism
boys with small testes and breast development, wide hips

25
Q

Phenylketonuria (PKU) features

A

diagnostics at birth
hypopigmentation, seizures, mental retardation
Dietary restrictions of red meat, chicken, fish, eggs, cheese, dairy
AVOID Aspartame

26
Q

Most common childhood cancer age 0-14

A

ALL

27
Q

AML peripheral smear***

A

Auer Rods

see increased blast cells on smear

28
Q

Hodgkins Lymphoma smear

A

Reed Sternberg cells

29
Q

Routine Autism Screening at…

A

18 and 24 months

30
Q

Sign of intestinal obstruction on XRay

A

Air fluid levels

31
Q

1st line treatment for constipation in peds/ review of laxative agents

A

**Osmotic Laxatives: Polyethelene glycol (Miralax), Lactulose
Stool softeners (docusate sodium/colace) do not work
Bulking agents: psyllium (metamucil)
peristalic inducers: Senna (Ex-Lax)

32
Q

Treatment of Enuresis

A

Despopressin
Imipramine (anticholinergic)
Enuresis alarm

33
Q

Cover uncover test is for…

A

strabismus (misalignment of the two eyes)
esotropia: inward
exotropia: outward
Children will be esotropic until 5-6 months of age

34
Q

Tanner Stages of Sexual Maturity

A

I: Preadolescence
II: Pubic Hair: sparse, downy Breast: buds and papilla Penis: slight enlargement Testes: enlarged scrotum
III: Pubic Hair: Increased pigmentation, more curly Breast: enlarged with no contour separation Penis: Increased length Testes: Increased size
IV: Pubic Hair: Adult type but less Breast: secondary mound Penis: glans enlarged Testes: enlarged, darker
V: Adult distribution

35
Q

1 Cause of mortality in adolescents (5-15)

A

MVA

36
Q

Preventable risk factors with SIDS

A

1: SMOKING cessation

pacifier use at night
“back to sleep”

37
Q

Lead Poisoning presentation

A

ataxic gait, anemia, constipation, headache

Treat with chelating agent: Succimer

38
Q

Most common etiology of Otitis Media

A

Strep Pneumo
PE: non mobile TM, bulging TM, decreased landmarks
Tx amoxicillin

39
Q

***Scarlet fever presentation

A

Sunburn appearing maculopapular rash… sandpaper on erythematous base
occurs post strep

40
Q

Epstein-Barr virus presentation***

A 
Beefy  red tonsils plus exudate
posterior cervical lymph nodes 
splenomegaly
afebrile 
Dx with HETEROPHILE antibody testing (monospot) CBC with increased lymphocytes
41
Q

Hand foot and mouth caused by

A

Coxsackie virus

42
Q

Croup casued by

A

Parainfluenza virus

43
Q

Mumps presentation

A

Parotid gland swelling, aseptic meningitis, orchitis

can cause sterility in males

44
Q

***HETEROPHILE antibody testing used to diagnose

A

Epstein Barr Virus (mono)

45
Q

Koplick spots are pathopneumonic for…

A

Rubeola (Measles)

Rash is dark and mobiliform that starts at hairline and spreads to trunk arms and legs

46
Q

Rubella (German Measles) features

A

Togavirus

presents with arthritis and arthralgia and a rash that does not coalesce

47
Q

Roseola

A

HHV 6

high fevers followed by a rash

48
Q

Fifth disease (erythema infectiousum)

A

slapped cheek disease
Parvovirus B19
NOT contagious once rash appears

49
Q

Pertussis presentation

A

cough for over 2 weeks
paroxsysmal whoop
“cough so hard vomiting occurs”
Treat with erythromycin

50
Q

Live virus vaccines

A

MMR
Varicella
Zoster
Nasal-Spray flu vaccine

51
Q

Salter-Harris Classification

A 
I: Nondisplaced through metaphysis
II: fx into metaphysis
III: fx through epiphysis
IV: fx through metaphysis and epiphysis
V: Crush injury
52
Q

*** Presentation of Impetigo

A

Honey colored crusts
strep or staph
Treat: Topical Bactroban… coverage against staph and strep, PO: Septra, Clinda, Augmentin

53
Q

Syphilis Features

A 
Caused by Treponema pallidum
primary: painles sore/chancre
secondary: copper penny rash on hands/feet
tertiary: brain, hear, nerve damage
Tx: IM penecillin G
Dx: FTA-ABS
54
Q

Most common bacterial STI in the US

A

Chlamydia

75% are asymptommatic

55
Q

***N. Gonorrhoeaee gram stain

A

Gram negative intracellular diplococci

56
Q

HPV of genital warts and cervical dysplasia

A

Warts: 6 and 11

Cervical cancer: 16, 18, 31, 33, 35

57
Q

Diagnostic testing for contact dermatitis

A

Atopy patch testing (for delayed hypersensitivity T-Cell mediated reaction)

58
Q

Drug absorption in Peds

A

Increased absorption: Penecillins, Erythromycin
Decresased absorption: Acetopmenophen, Phenobarbital, Rifampin, Carbamezapine
Need HIGHER dosing in aminoglycosides

59
Q

SCFE presentation

A 
limited internal rotation of hip
Presents with groin pain
males 10-15, obese
dx with XRay
Tx surgical pinning

PANCE Questions (10 decks)

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