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Pediatrics > Peds - general > Flashcards

Peds - general Flashcards

1
Q

Ages of well-child checks

A 
2 weeks
2 months
4 months
6 months
12 months
15 months
18 months
2 years
Then every year until age 18
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2
Q

When does baby acne begin to resolve?

A

By 6 months to 1 year

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3
Q

Congenital spot, usually on the lower back, that looks similar to a bruise

A

Mongolian spot

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4
Q

By what age do mongolian spots usually resolve?

A

2-5 years

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5
Q

Tool used to screen eyesight for ages 2-3

A

Allen “E” chart

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6
Q

Tool used to screen eyesight after age 4

A

Snellen letter chart

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7
Q

Leading cause of death through 4 months of age

A

SIDS

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8
Q

Leading cause of death after 4 months of age

A

Trauma

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9
Q

Second leading cause of death in childhood

A

Drowning

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10
Q

Leading chronic illness in childhood

A

Dental caries

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11
Q

By what age should the full set of 20 primary teeth erupt?

A

25-33 months

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12
Q

What is associated with weak and/or delayed femoral pulses as compared with the right brachial pulse?

A

Coarctation of the aorta

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13
Q

Where would you expect to best hear a murmur associated with “normal” delay of ductus arteriosus closure?

A

Continuous murmur over the 2nd left ICS

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14
Q

When does the umbilical cord “dry” and then fall off?

A

Dries within days and falls off within 3-4 weeks

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15
Q

A cord that’s still attached after what time period could indicate a neutrophil disorder?

A

8 weeks

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16
Q

Abnormal urethral opening along the ventral surface of the penis - what’s it called?

A

Hypospadias

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17
Q

Fixed fibrotic ventral bowing of the penis, often associated with hypospadias

A

Chordae

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18
Q

Term used to refer to undescended testicle

A

Cryptorchidism

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19
Q

Congenital blockage of the posterior nasal airway by a membranous or bony obstruction

A

Choanal atresia

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20
Q

Neonate holds his right arm close to his body, extended at the elbow, internally rotated, with the forearm fixed in pronation. His hand movement is normal. What do you suspect?

A

Erb palsy - Damage to the C5-C6 nerve roots

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21
Q

Neonate has weak hand movement and grasp reflex is absent. What do you suspect?

A

Klumpke paralysis - Damage to the C7, C8, and T1 nerve roots

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22
Q

What do we call medial curving of the forefoot?

A

Metatarsus adductus

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23
Q

Three important and major reflexes to check for during the neonate exam

A
  • Rooting
  • Palmar grasp
  • Moro startle
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24
Q

MCC of polyhydramnios

A

Impaired fetal swallowing, which may occur due to congenital GI obstruction/malformation, conditions that interfere with normal neural function, and certain other congenital conditions

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25
Q

MCC of oligohydramnios

A

Renal disease (renal agenesis, widespread multicystic disease, severe obstruction)

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26
Q

Normal respiratory rate of a newborn

A

30-60

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27
Q

Normal HR of a newborn

A

100-160

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28
Q

Normal BP of a newborn

A

60/35

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29
Q

Normal rectal temp of a newborn

A

99.1

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30
Q

What does respiratory distress syndrome result from?

A

Deficiency of surfactant

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31
Q

When is fetal lung maturity generally attained?

A

34 weeks’ gestation

32
Q

How do infants with respiratory distress syndrome normally present?

A

With grunting, tachypnea, nasal flaring, chest wall retractions, and cyanosis in the first few hours of life

33
Q

CXR findings with respiratory distress syndrome

A

Ground-glass pattern

34
Q

MC pathogens responsible for neonatal pneumonia

A
  • Group B strep
  • E. coli
  • Klebsiella sp.
35
Q

What should you think if a neonate has abdominal distention and constipation?

A 
Celiac disease (gluten allergy)
-Usually presents under age 2 with failure to thrive, malabsorption, bloating, and foul, explosive stools and vomiting
36
Q

Patient presents with projective vomiting. You palpate an olive-shaped mass to the right of the child’s midline. What do you suspect?

A

Pyloric stenosis

37
Q

In neonates, jaundice becomes clinically apparent when serum bilirubin levels rise past what point?

A

> 5mg/dL

38
Q

Which type of hyperbilirubinemia, conjugated (direct) or unconjugated (indirect), is always pathologic and never physiologic?

A

Conjugated (direct)

39
Q

What type of jaundice is due to indirect hyperbilirubinemia which occurs in the absence of any underlying abnormalities in bilirubin metabolism?

A

Physiologic

40
Q

With physiologic jaundice, when do indirect bilirubin levels usually peak and at what values do they peak?

A

Between days 3-5 at or below 12-15mg/dL

41
Q

Most common cause of nonphysiologic unconjugated hyperbilirubinemia?

A

ABO incompatibility

42
Q

Common causes of nonphysiologic conjugated hyperbilirubinemia?

A

Diseases involving the liver (biliary atresia, neonatal hepatitis) and congenital infections

43
Q

Test that detects maternal antibody on the surface of neonatal RBCs and is positive in ABO incompatibility

A

Direct Coombs test

44
Q

Test used to identify the specific type of maternal antibody present on neonatal RBCs in ABO incompatibility

A

Indirect Coombs test

45
Q

On physical exam, how does jaundice progress in a neonate’s body?

A

Progresses in a cephalopedal direction and disappears in the opposite direction

46
Q

In neonates with unconjugated hyperbilirubinemia, what treatments are available after hydration status is normal?

A
  • Phototherapy

- Exchange transfusion

47
Q

What total serum bilirubin levels require exchange transfusion in a neonate?

A

> 25mg/dL

48
Q

Is phototherapy effective in treating conjugated or unconjugated hyperbilirubinemia?

A

Unconjugated only

49
Q

What respiratory rate is necessary for a diagnosis of tachypnea in a neonate?

A

> 60 breaths/min

50
Q

Tx for pertussis

A

Erythromycin or Azithromycin can shorten duration of illness if given early in the catarrhal phase - not after the coughing begins

51
Q

1 month-old WF presents with tachypnea (60 breaths/minute), irritability, poor feeding, and low-grade fever. What do you suspect?

A

Pneumonia (tachypnea out of proportion to fever)

52
Q

You suspect a patient has meningitis. As part of your PE, you have the patient lie on his back while you extend his leg at the hip. You then extend his lower leg at the knee and he gasps in pain. What is this sign?

A

Kernig sign

53
Q

You suspect a patient has meningitis. As part of your PE, you have the patient lie on his back with his arms and legs straight. You then flex his neck and he reflexively flexes his legs at the knee. What is this sign?

A

Brudzinski sign

54
Q

What antibiotics are used to treat bacterial meningitis in infants and older children?

A

Vancomycin plus a 3rd-gen cephalosporin (Cefotaxime, Ceftriaxone)

55
Q

What antibiotics are used to treat bacterial meningitis in neonates?

A

Ampicillin (to cover GBS and L. monocytogenes) and Cefotaxime (for gram - coverage)

56
Q

What infection causes profuse, rice-water stool (clear and flecked with mucus)?

A

Cholera

57
Q

What viruses are major causes of gastroenteritis that involves profuse diarrhea, vomiting, and low-grade fever?

A

Rotavirus and Norovirus

58
Q

Commonly water-related, this GI disease causes frequent, foul-smelling, watery stool, abdominal pain, nausea, vomiting, anorexia, and flatulence.

A

Giardiasis (parasite)

59
Q

Retention cysts along the gum line and/or at the junction of the hard and soft palate present in newborns

A

Epstein pearls

60
Q

When does the rooting reflex disappear?

A

3-4 months

61
Q

When does the traction response reflex disappear?

A

2-5 months

62
Q

When does the palmar grasp reflex disappear?

A

3-4 months

63
Q

Describe the placing reflex

A

Rub the dorsum of one foot on the underside of a surface. The infant will flex the knee and bring the foot up

64
Q

When does the placing reflex disappear?

A

3-4 months

65
Q

When does the Moro startle reflex disappear?

A

4-6 months

66
Q

Describe the tonic neck reflex

A

Forcibly turn the infant’s head to one side. The arms and leg on that side will extend while the arm and leg on the opposite side will flex

67
Q

When does the tonic neck reflex disappear?

A

8 months

68
Q

Describe Hirschsprung disease

A

Caused by a failure of neuronal migration of the myenteric plexus of the distal bowel so that the distal bowel lacks ganglion cells, causing a lack of peristalsis in that region with a functional obstruction

69
Q

What should you think if a newborn presents with bilious vomiting and no distention or tenderness?

A

Malrotation with a midgut volvulus

70
Q

In what type of patient do you see meconium ileus?

A

Those with cystic fibrosis

71
Q

Omphalocele

A

Membrane-covered herniation of abdominal contents into the base of the umbilical cord. The sac may contain liver and spleen as well as intestine

72
Q

Gastrooschisis

A

This is when the intestine extrudes through an abdominal wall defect lateral to the umbilical cord. There is no membrane or sac and no liver or spleen outside the abdomen.

73
Q

Achondroplasia

A

Disorder of bone growth that causes the most common type of dwarfism

74
Q

Most common breast mass in female adolescents

A

Fibroadenoma

75
Q

Where are fibroadenomas most commonly found?

A

Upper outer quadrant

76
Q

Medical management of hyperprolactinemia

A

Bromocriptine (Dopamine agonist which suppresses secretion of prolactin)

77
Q

Painless, rubbery, cervical lymphadenopathy

A

Hodgkin Lymphoma

Pediatrics (16 decks)

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