Peds Flashcards
1
Q
MC finding in child abuse
A
bucket handle fracture (metaphyseal fracture)
2
Q
most distal part of bone
A
epiphysis
3
Q
bowed appearance with an intact cortex
A
plastic deformation (bowing fracture)
4
Q
complete fracture on tension side of bone with buckling of compression side
A
greenstick fracture
5
Q
where do torus fractures most commonly occur
A
distal radius
6
Q
system used to classify physeal fractures
A
salter harris
7
Q
apophysitis at tibial tuberosity
A
osgood schlatter disease
8
Q
what distinguishes a simple febrile seizure from complex febrile seizure
A
simple= 1 seizure, complex= 2-3 in 24 hours
9
Q
risk of developing epilepsy in kids with febrile seizures
A
febrile seizure- 2-3% chance
normal= 1% chance
10
Q
what are the concerning features of a complex febrile seizure
A
> 15 min duration, >5 min duration plus benzo, focal features, medication required, failure to return to baseline
11
Q
empiric treatment for PNA in 1-6mos
A
rocephin or cefotaxime; azithro if concern for chlamydia
12
Q
empiric treatment for PNA in >6 months (uncomplicated)
A
ampicilin or penicillin or cefotaxime or ceftriaxone
13
Q
empiric treatment for complicated PNA in >6 mos
A
azithromycin OR erythromycin OR levfloxacin
14
Q
treatment for pediatric complication PNA/abscess
A
rocephin/cefotoxime PLUS clindamycin (or vancomycin if allergy)
15
Q
nosocomial pediatric PNA treatment
A
gentamicin or amikacin PLUS zosyn, meropenem, ceftazidime, cefepime, OR clindamycin
16
Q
MCC death for children aged 1mo to 1 year
A
sudden infant death
17
Q
initial pediatric defib dose
A
2-4J/kg
18
Q
associations with coarctation of the aorta
A
- turner syndrome
2. intracranial aneurysms
19
Q
rib notching on CXR
A
coarctation of the aorta
20
Q
figure 3 sign on CXR
A
coarctation of the aorta
21
Q
MC intra-abdominal complication of HSP
A
intussuseption
22
Q
MCC LOWER GI bleeding in infants
A
meckel diverticulum
23
Q
rule of 2s for meckel diverticulum
A
- 2in in length
- 2 years old
- 2x more prevalent in males
- 2% of children
- 2 feet from ileocecal valve
24
Q
MC congenital malformation of GI tract
A
meckel’s diverticulum
25
differences in presentation of epiglottitis and bacterial tracheitis
epiglottitis- sudden onset
| tracheitis- URI symptoms, then intensify
26
MC pathogen in bacterial tracheitis
s. aureus
27
treatment for strep pharyngitis with PCN allergy
clarithromycin, azithromycin, clindamycin, cephalexin
28
MC time for midgut volvulus to present
first month, most in first week of life
29
gold standard for diagnosis of malrotation with midgut volvulus
upper GI study (straight to ex-lap if HD unstable)
30
corkscrew appearance on GI series
malrotation with midgut volvulus
31
Necrotizing enterocolitis, duodenal atresia, jejunoileal atresia all cause what
bilious vomiting
32
sudden onset bilious vomiting with hypotension and abdominal distension
malrotation with midgut volvulus
33
MC bacteria in AOM
haemophilus influenzae
34
platelet count in HSP
normal
35
erythroderma, fever, conjunctivitis, blisters at dependent site, nikolsky +
SSSS
36
treatment for SSSS
nafcillin/oxacillin or vanc if treatment resistant area
37
why can't adults develop SSSS
develop anti-staph antibodies and have better renal clearance of the exfoliative toxin
38
splenomegaly in kid with SC disease concerning for
sickle cell sequestration crisis- rapid sequestration of RBCs in the spleen causing splenomegaly and severe anemia
39
MC of death in children with sickle cell disease
s. Pneumoniae sepsis
40
treatment of pinworms
single 100mg dose mebendazole or 400mg dose albendazole
41
enterobius vermicularis
pinworm
42
symptoms of kawasaki
```
Conjunctivitis
Rash
Adenopathy
Strawberry tongue
Hand/foot edema
```
43
virus responsible for most causes of croup
parainfluenza
44
MCC cyanosis in the first week of life
transposition of the great vessels
45
egg on a string CXR
transposition of great vessels
46
patient with PDA and TGC- when will symptoms of TGC begin to show themselves
hours to days of delivery- cyanosis starts when PDA begins to close
47
MCC meningitis in ages 16-21
n. meningitidis
48
waterhouse-friedrichson
adrenal hemorrhage after disseminated meninogococcemia
49
meningitis associated with sensorieneural hearing loss
h. influenzae
50
ppx for n. meningitidis
rifampin
51
when does is fetus at higher risk of teratogenicity
days 21-56 of gestation
52
cyanotic cogenital heart lesions
(1) transposition of the great vessels
(2) tetralogy of Fallot
(3) truncus arteriosus
(4) total anomalous pulmonary venous return
(5) tricuspid atresia
(6) pulmonary atresia
(7) Ebstein anomaly of the tricuspid valve
53
first treatment for cyanotic baby a few days after birth
PGE1
54
MC congenital heart defect
VSD
55
posterior cervical LN with rash that spreads from face downwards
rubella
56
neonatal conjunctivitis in first five days of life
gonorrhea
57
neonatal conjunctivitis in days 6-10
chlamydia
58
treatment for gonorrhea conjunctivitis
IV abx as it can be disseminated and can cause corneal perforation
59
most common cause of heel pain in athletic boys aged 8-12
sever disease (calcaneal apophysitis)
60
most common TEF
proximal esophageal atresia with distal anastamosis
61
abrupt onset of fever that for 3-4 days goes away followed by rash
roseola HHV6
62
slapped cheek followed by maculopapular rash on trunk and extremities
parvovirus B19, erythema infectiosum
63
painless fluctuant mass at midline of neck that moves with movement of tongue
thyroglossal duct cyst
64
treatment of thyroglossal duct cyst
surgical incision
65
rule of 80 for pediatric neck masses
80% of them are benign
66
MCC croup
parainfluenza virus
67
most common cause of idiopathic CM in kids
idiopathic
68
sudden onset of bilious vomiting within first year of life
intestinal malrotation
69
double bubble sign
intestinal malrotation
70
most common congenital heart defect
VSD
71
MV type for neonates
pressure controlled ventilation
72
4 acyanotic peds heart lesions
VSD, ASD, PDA, coarctation of the aorta
73
treatment for neonatal seizure
phenobarbitol 20-30mg/kg
74
what medication should be given to neonates with seizures refractory to multiple medications
pyridoxine
75
at which age is tetrology surgically corrected
3 years old
76
abnormalities found in ToF
PROVe: Pulmonic stenosis, RV hypertrophy, overriding aorta, VSD
77
what portends a poor prognosis in NEC
portal vein air
78
side effects of giving prostaglandin
apnea, fever, hypotension
79
what is the hyperoxia test
put neonate on 100% FIO2 for 15 minutes and then check and ABG, paO2 after 15 minutes less than 150 suggests cardiac problem
80
trwatment for pda
indomethacin
81
fixed split s2
ASD
82
indication for racemic epi with croup
stridor at rest
83
thickened prevertebral space at C2-C4 on a soft tissue lateral neck XR
retropharyngeal abscess
84
rash on anterior mouth and hands and palms
hand, foot, mouth disease
85
posterior pharyngeal lesions
herpangina
86
benign, raised, non-painful nodule on palate of neonates
epstein pearl
87
who should get a needle cricothyroidotomy
age <10 years
88
renal complications of impetigo
PSGN
89
MCC impetigo
s. aureus
90
options for treatment of tet spells
knee to chest, morphine, bicarb, phenylephrine
91
most useful lab test to assess degree of dehydration in child
bicarb
92
most common infection <7d
pneumonia >meningitis (opposite in >7d)
93
most common salter fracture
salter II
94
dose of IM epi for asthma
0.01 mg/kg to a maximum of 0.5 mg subcutaneously.
95
staccato cough + eye findings
c. trachomatis
96
buzzword PNA in 0-3mos
GBS
97
PNA in 3 weeks to 3 montsh
chlamydia trachomatis
98
DiGeorge syndrome
```
CATCH-22
Cardiac abnormalities
Abnormal facies
Thymic absence, t cell abnormality
Cleft palate
Hypocalcemia
Chromosome 22
```
99
3 day measles
rubella
100
Course of rubella
day 1. race on fash that spreads downaward to involve to chest
2. rash on trunk becomes coalescent
3. rash disappears
101
when are patients contagious with measles
from 1-2 days before symptoms and 4 days after rash appears
102
viral illness treated with aspirin
reye syndrome
103
small sports on the tongue and mouth taht then develop into sores and spontaneously rupture
small pox
104
what drugs that can be given in peds through ETT
```
LANE
Lidocaine
Atropine
Naloxone
Epi
(no vasopressing like adults)
```
105
pediatric PNA with shaggy right heart border
pertussis PNA
106
MCC of AOM in kids (bacteria)
h. influenzae (non-typable-> NOT type b anymore)
107
describe what toddler fracture looks like on XR
minimally or non-displaced spiral fracture of distal tibia
108
age range for toddler's fracture
9mos to 3 years
109
management of toddler's fracture
CAM boot or short leg case
110
calculation to estimate weight in kids based on age
(2 x age in years) + 8
111
what dextrose should be given to kids 1-8yo, and at what dose
D25 @ 2cc/kg
112
what dextrose should be given to kids >8yo, and at what dose
D50 @ 1cc/kg
113
what dextrose should be given to kids <1yo and at what dose
D10 @ 5cc/kg
114
peak age for kawasaki disease
18-24 months (all less than 24 months)
115
five findings in kawasaki disease
1. conjunctival injection
2. oral mucus membrane changes
3. peripheral extremity changes
4. polymorphous rash
5. cervical lymphadenopathy
116
treatment of kawasaki disease
IVIG/steroids
117
treatment of pertussis
azithromycin
118
most common cause of cyanotic CHD
ToF
119
what is considered an inappropriate response on an ABG to the hyperoxia test
rise of paO2< 20 suggests cyanotic heart defect (right to left shunt)
120
most common ages for bacterial tracheitis
age 3-5
121
most common ages for RPA
ages 3-5
122
position of comfort in transient synovitis
flexion, abduction, external rotation
123
position of leg in SCFE
held in external rotation with decreased or loss of internal rotation, abduction, and flexion
124
how to tell a SCFE on XR
using the klein line- straight line drawn along lateral aspect of the femoral neck normally intersects the femoral head, whereas the line passess outside the epiphysis in SCFE
125
management of SCFE
ortho consult- operative to precent osteonecrosis
126
distinguish bacterial tracheitis and RPA
bacterial tracheitis- sick croup suddenly gets sick, normal neck XR
RPA- sore throat, develops over a few days, widening on XR
127
what measure can you use to guide your resuscitation in pediatric sepsis
UOP, goal >1cc/kg/hr
128
compare herpes gingivostomatitis vs hand food mouth
herpes- prodrome followed by oral lesions (vesicles and friability of gingiva, usually posterior)
HFM- begins abruptly with body rash, anterior mouth lesions
129
under what circumstances should an LP be considered in febrile seizure
1. 6mo-12mo bc not fully vaccinated
2. sick bacterial contacts
3. on abx which may mask meningismus
130
lithium can cause what fetal anomaly
ebstein anomaly
131
indications for HD in ASPGN
pulmonary edema, hyperkalemia, uremia (pericardial effusion)
132
progression of measles
three Cs followed by rash 2-5 days later
133
MCC of AKI in children
HUS
134
most common cause of HUS
E. coli O157:H7
135
management of HUS
supportive care, avoid abx
136
describe chlamydia trachomatis in baby
5 days to 5 months (unlike ophthalmic version)
| usually causes pneumonia
137
MCC neonatal chemical conjunctivitis
erythromycin
138
What blood types most commonly cause hemolytic disease of the newborn
Type 0 mom with Type A/B baby (IgG antibodies in O type blood are able to cross the placenta)
139
serious complications of hand, foot, mouth disease
meningoencephalitis, pneumonia, myocarditis
140
test to differentiate maternal from fetal blood
apt test
141
MC joint affected by hem A
Ankle
142
How to calculate normal bp in kids aged 1-10
70 + (2xage)
143
Hypotension in any kid older than 10
<90mmHg
144
most common bony tumor in children
osteosarcoma
145
bone with sunburst pattern or codman triangle- dx
osteosarcoma
146
benign tumors of bone with soap bubble appearance
giant cell tumor
147
bony spur arising from bone
osteochondroma
148
what is considered a positive urine culture for a bag sample/clean catch
>100,000 cfu
149
what is considered a positive urine culture for catheter specimum
>50,000 cfu
150
what is considered a positive urine culture for suprapubic aspiration
>1,000 cfu
151
MCC bulbous myringits
H. Influenzae, s. Pneumon before vaccine
152
MC bug involved in bacterial tracheitis
S. `Aureus
153
What extra fluid should be given to kids less than 5 with burns
Maintenance IVF
154
estimate weight in kids
(2xage in years)+8
