peds first aid Flashcards
most common congenital heart disease
VSD
which closes PDA and which opens?
indomethacin closes
PGs open
most common cyanotic congenital heart disease in newbrown vs child
newborn: transposition of great vessels
child: tetralolgy of fallot
CXR of tetralogy of fallot
boot shaped heart with decreased pulm vascular markings
timeline of rolling, sitting, crawling, walking, stairs
roll: 4-5 mo
sit: 6
crawl/stand: 9-10
walk: 12
stairs: 24
timeline of 3 finger vs 2 finger pincer grasp
3: 9-10 mo
2: 12 months
cutoffs for precocious vs delayed puberty in boys vs girls
girls: <8, >13
boys: <9, >14
klinefelter treatment
testosterone to help remove gynecomastia and improve male sex characteristiscs
dx and tx of intusseception
dx: US target sign
tx: air insufflation enema, replete lytes, surgery if periotneal signs
dx and tx of meckel diverticulum
dx: technietium 99 m scintragraphy scan
tx: surgery
what is this: failure to mass meconium within 48 hrs, and explosive discharge of stool following rectal exam
hirschprung disease
dx and tx of hirschprung
dx: barium enema (narrowed colon with proximal dilatation
; rectal biopsy confirms
tx: 2- stage surgery with diverting colostomy
necrotizing enterocolitis dx and tx
dx: radiographs- pneumoatosis intestinalis
tx: NPO, TPN, IV abx, surgery if perf or worsening
what is the earliest and most sensitive vital sign change in bronchiolitis?
increased resp rate
dx and tx of bronchiolitis
dx: clinical
tx: supportive, ribavirin if high risk
dx and tx of croup
dx: clinical; steeple sign
tx: mild- OP cool mist therapy
mod: supp O2, steroids, nebulized epi
severe: neb epi, intubation
dx and tx of epiglottitis
dx: clinical; definitive by direct fiberoptic visualization, x -ray shows thumbprint sign
tx: emergency! secure airway with intubation, IV ceftriaxone
kernig vs brudzinski sign
kernig: reluctance of knee extension to hip flexing
brud: hips flexed in response to flexion of neck
tx of meningitis for neonates vs older children
neonates: amp and cefotaxime or gent; acyclovir
kids: ceftriaxone and vancomycin
which child resp disorders makes kid want to sit in a neck extended tripod position?
epiglottitis and retropharyngeal abscess
age of retropharyngeal vs periotonsillar abscess
r: 6-mo-6 years
peritonsillar: >10 yrs
most common bacteria for both retropharyngeal and periotonsillar abscess
group A strep
dx of retropharyngeal vs periotonsillar abscess
r: lateral neck x -ray; contrast CT
p: clx
treatment for conjunctivitis: chlmaydia vs gonococcal vs HSV(vesicular eruptions)
chlamydia: topical AND oral erythromycin
gon: 3rd gen ceph
HSV: oral acyclovir and topical
3 stages of pertussis
1) catarrhal - mild URI 1-2 weeks (contagious!)
2) paroxysmal: 2-3 mo
3) convalescent- sxs wane
dx of pertussis
nasopharyngeal culture
rash spreads how in measles and rubella
head to toe
interpret apgar scores
8-10: healthy
4-7: observe for possible resuscitation
0-3: immediate resuscitation
kernitcterus
complication of unconjugated bili (>25) deposition in basal ganglia, pons, cerebellum
can be fatal
is phototherapy for all types of hyperbilirubenemia?
no- only unconjugated
conj can lead to skin bronzing
which type of bili is physiologic?
unconjugated
how to prevent resp distress syndrome in premature fetus
<30 weeks: pretreat mom with corticosteroids
> 30 weeks: monitor lecithin:spingomyelin ratio and phosphatidylglycerol in amniotic fluid
resp distress syn confirmed how?
CXR- air bronchograms, ground glass
CXR of transient tachypnea of newborn
perihilar streaking in interlobular fissures
two categories of cerebral palsy
pyramidal (spastic)- also ID- more common
extrapyrimdal (dyskinetic)= ataxic, choreo, or dystonic
definite hand preference before 1 year is a red flag for
cerebral palsy
treat spasticity sxs with
baclofen, dantrolene, diazepam
febrile seizures occur in which ages
6 mo- 5 years
differentiate simple vs complex seizure
simple: short, generalized, 1/day, high fever, return to bl
complex: long, focal, >1/day, low fever, not return to bl
no work up needed for first time simple seizure if infant is older than
18 mo
which can cross abdominal midline? neuroblastoma or wilms?
neuroblastoma
which has systemic sxs? ewing sarcoma or osteosarcoma?
ewing
locations of ewing sarcoma vs osteosarcoma?
both long bone!
ewing: midshaft
osteosarcoma: metaphyses, + mets
ewing sarcoma or osteosarcoma: onion skin or sunburst
ewing: onion skin
osteosarcoma: sunburst
most common fractured long bone in kids
clavicle
greenstick fracture
imcomplete fracture- 1 side of cortex
nursemaids elbow
radial head subluxation- 2/2 being pulled/lifted
torus fracture
bucking of cortex 2/2 trauma (distal radius/ulna)
most common pediatric elbow fracture in kids 5-8
supracondylar humerus fracture
complications of supracondylar humerus fracture
- brachial artery entrapment
- volkmann contracture - from compartment syn
osgood schlatter is overuse of the
tibial tubercle
salter-harris is fracture of the
growth plate in kids
which is painful and which painless? slipped capital femoral epiphysis vs legg calves perthes
painless- leg calves perthes
painfuk: slipped
which is self limiting and can be observed and which needs immediate surgical screw fixation? slipped capital femoral epiphysis vs legg calves perthes
self limiting: legg
surgery: slipped
treatment for various degrees of scoliosis
<20: observe
20-49: brace
> 50: surgery
keep water heater at
<48.8 C or 120 F
no solid food before ___ months. No cows milk until ___ months.
6
12
strabismus is normal until ___ months
3
lead is screened (fingerstick) at
12 ane 24 months
presentation of lead poisoning
intermittent abdominal pain
peripheral neuopathy- eg wrist drop
irritable, N/V
treatment of lead poisoning at various levels
<45: asx- retest in 1-3 mo, remove sources
45-69: chelation- IP EDTA or OP DMSA
> 70: chelation- IP EDTA + BAL
dx of vesicoureteral reflux
voiding cystourethrogram
for kids 2-24 months with multiple UTIs, have US first
vesicoureteral reflux is caused by
- posterior urethral valves
- urethral or meatal stenosis
- neurogenic bladder
risk factor for cryptorchidism
low birth weight
