Peds Flashcards
otitis media –> when is tympanoplasty indicated?
- 3 episodes in 6mo
- 4x in 12mo
otitis media –> PCN allergy –> abx of choice?
- cefdinir (if no PCN anaphylaxis)
- azithromycin (if PCN anaphylaxis)
what is a potential serious complication of otitis media?
mastoiditis
what PE findings suggest mastoiditis?
- acute otitis media
- swelling behind ear
- anteriorly rotated ear
otitis externa –> what is tx if tx is necessary?
abx + steroid drops
sinusitis –> at what point do you presume a bacterial rather than viral infection?
> 10 days
What scoring system is used to determine next step for possible GAS pharyngitis?
Centor criteria
what are the components of Centor criteria?
- absent Cough
- tonsillar Exudates
- anterior neck Nodes
- Temp >38C
- <14 OR >44
Centor criteria –> how to interprete score?
<1: no further testing
2-3: rapid strep test
>4: empiric abx
baby –> blue at rest or feeding –> pink when cries –> what diagnosis?
choanal atresia
mastoiditis –> tx?
surgical decompression + abx for AOM
childhood snoring –> what dx?
choanal atresia
failure to thrive –> organic causes (4)
- genetic (cystic fibrosis)
- cardiac disease
- pyloric stenosis
- GERD
failure to thrive –> non-organic causes (3)
- formula
- feeding
- frequency
developmental milestones –> 2mo
- lift head/chest
- track
- alert to sound
- coo
- recognize parent
- social smile
developmental milestones –> 4mo
- roll
- grasp
- orient to voice
- enjoy looking around
- laugh
developmental milestones –> 6mo
- sit
- transfer objects
- raking grasp
- babble
- stranger anxiety
developmental milestones –> 9mo
- crawl
- pull to stand
- 3finger grasp
- mama/dada (non-specific)
- wave
- play pattycake
developmental milestones –> 12mo
- walk
- 2 finger grasp
- mama/dada (specific)
- imitate actions
developmental milestones –> 18mo
- run
- kick ball
- tower 2-4 cubes
- name common objects
- copies parent in tasks
developmental milestones –> 2yr
- stairs w help
- jump
- tower of 6 cubes
- 2word phrase
- 2 step commands
- remv clothes
developmental milestones –>
3yr
- tricycle
- stairs
- circle
- utensils
- 3 word sentence
- brush teeth
- wash hands
developmental milestones –> 4yr
- hop
- cross
- count to 10
- cooperative play
Klinefelter synd –> pathophys
XXY
Klinefelter synd –> presentation
- gynecomastia
- infertility/hypogonad
- elongated extremities
- normal cognition
diabetic mother –> newborn –> 2hr after birth –> irritable, tremor –> dx?
polycythemia
neonatal polycythemia –> Hct level?
> 65%
upward lens dislocation –> assoc w what condition?
Marfan
downward lens dislocation –> assoc w what condition?
homocystinuria
5M –> hearing problems for 1wk –> recent otitis media trted w amoxicillin –> exam shows air fluid level behind TM, no erythema or bulging
dx?
serous otitis media without active infection
serous otitis media without active infection –> tx
self-resolves –> follow
9F –> R eye droopy, severe pain w eye movement, mild proptosis –> h/o recurrent sinus infect
dx?
orbital cellulits
3wk M –> persistent nonbilious projective vomit –> lethargic, visible peristaltic waves –> hypoCl hypoKmet alkalosis
dx? next step?
pyloric stenosis
next step: fluid resuscitation & correct electrolytes
next step is NOT abd US
Turner synd –> assoc w what cardiac abnormality?
coarctation of aorta
Turner synd –> amenorrhea
pathophys?
ovarian dysgenesis (nonfxal ovaries) –> low estrogen
Turner synd –> FSH level is decreased or increased?
ovarian failure –> increased FSH
lead poisoning –> lead level?
> 5mcg/dL
Beckwith-Wiedemann synd –> presentation
overgrowth synd:
- macrosomia
- macroglossia
- hypoglycemia at birth
- organomelgaly
Beckwith-Wiedemann synd –> assoc w what other condition?
nephroblastoma (Wilms tumor)
3M –> AMS, sz, microcytic anemia –> dx?
lead poisoning
6M –> insidious antalgic gait –> dx?
legg-perthe-calves dz
legg-perthe-calves dz –> how dx
XR
legg-perthe-calves dz –> tx
cast
slipped femoral capital epiphysis –> how dx?
frog-leg XR
osgood-schlatter’s –> aka?
osteochondrosis
bone pain –> XR shows lesion on mid-shaft of bone –> onion skin
dx?
ewing’s sarcoma
bone pain –> XR shows lesion on distal femur –> sunburst pattern
dx?
osteosarcoma
osteosarcoma –> assoc w what other condition?
retinoblastoma
developmental dysplasia of hip –> how dx?
hip US at 4wk
9moF –> dc breastfeeding –> develop periorificial/acral dermatitis, alopecia, diarrhea
dx?
acrodermatitis enteropathica –> AR –> inherited form of zinc deficiency
neonate –> abd distention, bilious vomiting, fail to pass meconium
what condition?
Hirschsprung dz
Hirschsprung dz –> pathophys
rectum –> absence of autonomic innervation –> loss of peristalsis –> obstruction
- congenital port wine stain in V1 & V2 trigeminal distribution
- eye abnormality
- neuro abnormality
dx?
Sturge Weber synd
mom is HBV positive –> next step
baby –> stat –> HBV vaccine + HBV Ig
mom is HBV status unknown –> next step
baby –> stat –> HBV vaccine
mom –> check HBsAg
- scrotum & testes enlarge
- scrotal skin –> red, texture
what tanner stage?
Tanner stage 2
- penis enlarge
- testes grow
what tanner stage?
Tanner stage 3
peds –> fluid bolus?
20-60ml/kg
- recurrent infection
- silver hair
- oculocutaneous albinism
what condition?
Chediak-Higashi synd
6F –> c/o vag bleed –> Tanner 2 breasts, skin unilat light brown macular lesions –> pelvis U/S large b/l ovarian cysts
what condition?
McCune-Albright synd
McCune-Albright synd –> pathophys
mutation –> receptor for FSH/LH/other pit hormones –> constitutively active –> precocious puberty
McCune-Albright synd –> presentation
- precocious puberty
- fibrous skeletal dysplasia
- cafe au lait spots
