Peds Flashcards
BRUE
age greater than 60 days born greater than 32 weeks gestation no CPR performed by a trained medical provider event lasted less than one minute first episode
Seizure treatment in order
- Lorazepam, diazepam, midazolam
- Phenytoin, valproic acid, Keppra
- Phenobarb, propofol
Febrile seizure criteria
Generalized
6m-5y
<15m
No recurrence
Croup treatment
Everyone: Oral dexamethasone 0.6 mg/kg once
Severe: nebulized epinephrine
Infantile spasms
Clusters of myoclonic seizures when waking, hypsarrhythmia on EEG, developmental delay
Sx start at 4-8m of age
Give ACTH, pregnisone and antiepileptics
Defibrillation
2 j/kg follow with 2mins CPR and recheck pulse
4 j/kg for each shock after
Cardioversion
0.5 J/kg
Double after first attempt
Epi doses
IV/IO: 0.01 mg/kg
ET: 0.1 mg/kg
Adenosine dose
- 1 mg/kg (max 6) initial
0. 2 mg/kg (max 12) subsequent
ET tube size in peds
(Age/4)+4
Estimate blade length for intubation
Edge of incisor to angle of mandible
How old do kids need to be for surgical cricothyrotomy?
10
<10 gets needle cric
Bradycardia in a neonate
Hypoxia/respiratory failure
Empirical abx in a neonate suspicious for septicemia or meningitis
Ampicillin and gent
Avoid rocephin due to kernicterus
Neonatal hypothyroidism
Constipation, difficulty feeding, weak cry, large anterior fontanelle, hypothermia, hypotonia, peripheral edema
Start PALS
HR<60 w/ hypotension despite fluids, AMS despite oxygen
Metaphyseal fx
Pathopneumonic for non-accidental trauma
Intussception
Intermittent abd pain, legs to chest
Target sign and telescoping on US
Associated with HSP, rotavirus
Treat with air contrast enema
Necrotizing enterocolitis
Premature infants in first 3 weeks of life
Abd distension, poor feeding, vomiting, bloody stool
Pneumatosis intestinalis
NG decompression -> bowel rest -> abx for enteric bacteria
HSP
IgA vasculitis
Complications: intussusception; periarticular disease of knees and ankles
Hematuria, proteinuria, elevated BUN/Cr
Normal platelets
Croup
Tracheolaryngitis
Parainfluenza
Worse at night
Steeple sign
Pretreatment for intubation atropine dose
0.02 mg/kg
Most common dysrhythmia in children
SVT
Croup
6m-3y
Peaks day 3 and 4
Dexamethasone 0.6 mg/kg
Recepi for mod/severe
Retropharyngeal abscess
Usually <4
Retropharyngeal space at C2 is 2x diameter for vertebral body
Zosyn or clinda
Displacement of tonsil in peritonsillar abscess
Anterior and medial
ToGV
Most common cyanotic defect in 1st week of life
Egg on a string heart on XR
Toddlers fracture
Spiral fracture of tibia
TEN-4
Bruising to torso, ear or neck under 4m
Hirschsprung Diseaee
Most common cause of distal bowel obstruction in neonates
Failure of neural crest cells to migrate
M>F, often with other congenital issues
Bilious emesis, failure to tolerate feeds, failure to pass meconium
Rectal suction biopsy
Neonatal omphalitis
3-5d old
Increased risk w/home birth
Umbilical stump with purulent discharge, erythema, warmth
Triple coverage abx: PCN or vanco, aminoglycicide and aneorobic (flagyl) if mother has chorioamnitis
Hirschsrpung disease
Lack of colonic ganglion cells usually go the rectosigmoid segment
Delayed passage of meconium
Cone shaped transitional zone
Holliday-Segar for Maintenace fluids
4/2/1
Bronchiolitis
<2 yo
7-14d w/ 3-5d peak
RSV
Ankylosing spondylitis
Anterior uveitis (most common), IBS, psoriasis, aortic regurg, restrictive pulmonary disease
Neuroblastoma
Adrenal gland mass, non-tender
Proptosis, periorbital ecchymosis, periorbital edema
Opsoclonus-myoclonus; VMA
<1 y good prognosis
Neonatal hypoglycemia treatment
5ml/kg 10% dextrose
Estimate lowest BP in kids
2x age + 70
Most common cancer seen in peds
ALL
Anemia, neutropenia, thrombocytopenia
Tetralogy of Fallot
Overriding aorta, pulmonic stenosis, rt ventricular outflow obstruction, VSD
Major Jones criteria
Carditis, polyarthritis, chorea, subcut nodules, erythema marginatum
Hypertonic saline dose
2-6 ml/kg
Most specific for neonatal cardiogenic shock secondary to CHF
Hepatomegaly
