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.
