Peds Flashcards
Meconium illeus assoc with which dz
CF- resp inf
Plain x ray shows dilated gas bowel with a ground glass MASS on r side (meconium)
Chlamydia trachomatis is culprit for neonatal conjunctivites and PNA which happens when and how?
Conjunctivitis - up to 2 wks
Pna- cxr w hyperinflation, rales, stacato cough (dry and short)
Tx –> oral erythrmycin for 2 wks
Adhd preschool kids
First is behavioral therapy. Next is stimulant.
Adhd kid who is on adderral max dose but minimal improvement. What is next option?
Switch to norepi reuptake inh like amoxetine or clonidine (a 2 agonist)
Should see effect w these meds within weeks
What should u do if child is Called FTT (Inadequate calorie intake, absorption or increased calorie requirements)
Should rec diet modification - need to introduce solid food by 4-6 mo.
Most common causes of acute otitis media and with purulent conjunctival discharge in someone who just finished abx?
Tx?
Nontypeable haemophilus influenzae (not hib since we give vaccine), moraxella, strep pneumonia. Most commonly recurrence by these bugs bc initial tx was resistant
Initial tx is amox
recurrent –> augmentin
Choking child- what manuever if 1 yr?
Back blow if baby
Abdominal thrusts aka heimlich maneuver
Diagnose hirshsprung disease with
Tx?
Rectal SUCTION biopsy. If fail to pass meconium in 2 days.
First get KUB w/ contrast enema
Tx is anastamose normal bowel to anus
10% of pts with down syndrome
3-6 wk old with projectile vomiting, olive mass in ruq and signs dehydration has? What should u do next?
Assoc with which abx?
Hypertrophic pyloric stenosis. Need to correct electrolytes before pyloromyotomy bc decr risk if postop apnea
Assoc w/ Erythromycin (given for postexposure pertussis)
16 yo w low lh, fsh, low testosterone, bone age of 12, and fam hx
Constitutional pubertal delay relates to bone age
Kallman syndrome anosmia with failed gnrh and thus hypogonadism
Ash leaf spots and new onset seizures is what dz?
Tuberous sclerosis
Can also get benign tumors of brain and kidney
thus need –>brain MRI, EEG, Abd. US
Die usually from epilepsy (tumor burden on brain)
Baby is breast only up to age 1 with no supplements has anemia. What kind?
Iron defi. anemia bc need supplement with iron fortified food (rich in vitC) or pureed meat after 6 mo.
TX: oral iron supplement
Be aware that cow milk/soy milk before one yr can cause chronic GI bleed!!
How do you diagnose bronchiolitis in babies? Any labs?
Which kids need vaccination?
Clinically!
The kids who need ag testing of nasal or pulm secretions are those who received the pavilizumab vaccine bc preterm
Vs croup due to parainfluenza and have barky cough, inspiratory stridor
Obese kid w hip pain, cant bear weight and externally rotated hip. Tx?
Scfe- slippe capital femoral epiphysis which should tx with internal fixation w a screw immediately bc risk if AVN
By what age should a boy reach puberty?
If not, what is next test?
Delayed puberty if no testicular enlargement or testicle
Lethargic baby w fever, jaundice, and uti should get tx for what and with what?
Sepsis! Can cause indirect hyperbili
Tx w/ –> cefoxitime (UTI) and ampicillin for listeria
Kid w painless hematochezia and tectnetium scan showing incr uptake in rlq
Meckels diverticulim which may also be painful
Due to failed vitelline duct obliteration means ectopic gastric tissue
Baby/toddler w abd pain, palpable sausage shaped mass on r side of abd, hematochezia has? Diagnose with?
What is risk of the tx?
Intussuception bc telescoping of bowel causes bowel ischemia
Dx w ultrasound BUT when problem is obvi then go straight to solution w air or water enema!!
Risk of tx is bowel perf!
Tx for lead poisoning? Mild, mod, severe
> 15 inform the health department
45 chelation
Houses built before 1978 have lead
Note that penicillamine is chelating agent for wilson dz
down syndrome incr risk of what
Leukemia, alzheimer, seizures, depression
What is criteria to dx neurofibromatosis 1? What is next eval after dx?
First degree relative w/ dz and development of more than 5 cafe au lait spots
Need opthalmic eval to check for 15% risk of optic nerve glioma
Dont need generic test bc 30% false neg
Baby w webbed neck, cardiac murmur, hand edema. Barr body. Has what? What is risk of transmission?
Xo turner syndrome. Risk is same as general population
Baby w hyperk, hypona, hypoglyc, hyPOtension gets genetic testing and positive for?
21 hydroxylase (most common congenital adrenal hyperplasia
Due to high mineralocorticoids and glucocoricoids incr androgen and thus ambiguous genitalia in females
High 17-hudroxyprogesterone
Vs 11b hydroxylase and 17a hydroxylase have HTN
Tx –> hydrocortisone (glucocorticoid) and fludrocortisone (mineralocorticoid)
13 yr old w persistent sinusitis (3rd ep in 7 mo). No other complaints, parents smokers. Why does she keep getting it?
Smoking exposure damages cilia preventing mucus movement through sinuses.
Not kartageners which is sinus inversus, bronchiectasis, sinusitis.
What is erbs palsy
Diaphragmatic palsy due to phrenic n injury injuring brachial plexus
Baby suspected of shaken baby syndrome w retinal hemorrhage should next get what test?
CT will find mixed dense pattern of subdural hematoma vs a homogenous hyperdense pattern in accidental head trauma
Eventually do a skeletal survey but not before CT!
Baby born to HBantigen positive mother should get hbv ig, hepb series and then when should their hbv be checked??
9 mo-15 mo. This is when they have finished the hbv vaccine series
Kid who had tick bite 3 mo ago now w monoarticular knee pain, swelling, warmth BUT can bare weight. Next thing to check
Tx?
Serum elisa!!! Not arthrocentesis bc higher chance of lyme athritis in kids
Check w elisa and then western blot
Arthrocentesis shows 25k wbc
Tx is amox (kids
Tx of croup
Croup or laryngotracheitis - see steeple sign which is subglottic narrowing in xray
Tx is humidifed air and Oral STEROIDS
If moderate, ie stridor at REST should get steroids and nebulized epi!!!
It fail initial tx then that is when u hospitalize!!
Which steroid to give to preterm baby mama and when?
Betamethasone- 24-34 wks
Reduces infant resp distress by stim surfactant
6 mo w constipation, poor sucking, lethargy and ate honey will have what on physical exam?
Infant botulism- check for gag reflex
No neck muscle rigid
Baby born breech w r leg shorter and dislocated and positive batlow test needs what fu?
Us (no xray in baby whne cartilage) refer to ortho surg and they place hip in aduction and flexed
Baby premature w developmental delay not yet walking at 19 mo, spastic, hyperreflex should get what test done?
Mri bc has cerebral palsy diagnosed clinically. Will likely find abn
Not emg
Tx of pediatric constipation after lifestyle modification?
Mg hydroxide!! Not bisacodyl suppository which is strong
Betamethasone or dexamethasone for premie administered how?
IM to avoid the troughs and peaks
Decr infant rds and intraventricular hemorrhage
Kid w acute otitis comes a month after visit on ear exam w normal TM
And decr mobility. What to do?
Effusion - watchful waitig for three months unless pt has symptoms
Dont even need audiometry exam unless after three months
Suspect sexual abuse in baby dont discuss w parents. What do u do
Report to cps!!
Discussing w parents may endanger kids life
Maternal dm causes what change to fetal heart
Hypertrophic iv septum from glycogen deposition and also causing chf
Will resolve after birth spontaneously!!
When can u break confidentiality w teen
Self harm risk ie taking too much adderrall
Abuse, injuries
Things like preg, contraception, std, substance abuse, mental health prob
Teen w low bmi and picky eater w constipation. What should u ask
About stool, freq and caliber color
About menses
Menses!!
