PEDS Review Flashcards
Neonatal jaundice with breast feeding< 6 times/d:
breastfeeding jaundice.
TTT Of breast feeding jaundice:
increase frequency of breast feeding.
Neonatal jaundice with breast feeding>8 times/d:
breast milk jaundice.
TTT of breast milk jaundice:
temporary cessation of breast feeding for 2ds then resume breast feeding.
Jaundice at 1st day:
hemolytic disease of new born(DT Rh incompatability).
Jaundice at 3rd day:
physiological jaundice.
Direct Jaundice after 7th day:
biliary atresia.
1st step in management Of neonatal jaundice:
total & direct bilirubin.
Bilirubin> 270 micromol/L :
phototherapy.
Bilirubin> 340 micromol/L :
exchange transfusion.
Asymptomatic Indirect hyperbilirubinemia in healthy adult:
gilbert $.
TTT of neonatal hypoglycemia… 1st line:
IV glucose.. if failed: IM glucagon.
Cyanosis with feeding which improve with crying… Dx:
choanal atresia.
Test of choice if choanal atresia suspected:
catheter test.
Inv. Of choice for Dx of choanal atresia:
CT scan with contrast.
1st step in management of choanal atresia:
airway to keep mouth open.
Neonate with microcephaly, pigmented retina:
congenital CMV infection.
Inv of choice of congenital CMV infection
urine antigen
innocent murmur management:
reassure; BUT, refer to pediatrician is the right answer if found.
MCC of omphalitis :
staph. Aureus.
MC source of infection in omphalitis:
umbilicus.
MCC of cleft lip, cleft palate:
genetic.
Fused labia:
leave it alone (if DOC is asked: estrogen cream)… never to pull them apart.
MCC of club foot:
postural (esp. in primigravida).
3 days of fever followed by maculopapular rash.. Dx:
roseola infantum.
VURTI+ koplik spot on buccal mucosa then maculopapular rash.. Dx:
measles.
After Dx of measles, you must notify.
Most imp. Complication of measles:
OM.
Most imp. Vitamin to be given in measles:
vit. A.
VURTI+ slapped check… Dx:
erythema infectiosum. CO: parvovirus B19.
Parvovirus B19 infection in pt with SCA or HS:
aplastic anemia.
Parvovirus B19 infection in pregnancy:
hydrops fetalis in fetus.
No school exclusion for pt with parvovirus B19 inf. (pregnant teacher shouldn’t go to school).
Strawberry tongue circumoral pallor sandpaper rash=?
scarlet fever.
Ulceration on post. Pharynx, uvula, palate only:
herpangina.
The same+ ulceration on hand and foot=?
hand foot mouth disease.
School exclusion in hand, foot and mouth disease
till all lesions crust
Organism causing herpangina & hand foot mouth diseases:
coxsackievirus.
Ulceration on lips only:
HSV infection.
Wheezes in child<2ys with URTI… Dx:
bronchiolitis …… CO: RSV.
Child with bronchiolitis is at greater risk of bronchial asthma.
TTT of bronchiolitis:
only supportive (O2 by nasal cannula& fluid)…. No abs.
Inspiratory stridor worse on lying down+ barking cough =?
croup.
Organism of croup:
parainfluenza virus.
TTT of Mild to moderate croup:
inhaled cortisone.
TTT of severe croup:
inhaled “nebulized” adrenaline.
Very high fever, expiratory stridor, drooling of saliva..Dx:
epiglottitis.
Organism of epiglottitis:
H.influenza.
TTT of epiglottitis:
admission & intubation.
Fever for 5ds+ 4 of the following (CREAM; Conjunctivitis, Rash, Erythema, Adenopathy N MM involvement) = ?
Kawasaki disease.
Most imp. Inv for kawasaki?
echo
Most serious complication of kawasaki
myocarditis, coronary aneurysm.
1st line of TTT of Kawasaki:
IVIG
2nd line of TTT of Kawasaki
aspirin.
Child with fever, crying pulling on his ear… Dx:
OM.
MCC of OM:
stept. Pneumonia.
Most specific finding on otoscopy:
loss of mobility of ear drum.
Drug of choice of otitis media ( current updates)
paracetamol only
If no response……….amox
If still no response,………amox-clav
Most imp test after recovery :
hearing assessment.
Swelling behind the ear after PM.. Dx:
mastoiditis.. inv of choice: CT scan.
TTT of chronic OM:
aural toilet.
Drug of choice for chronic OM
ciprofloxacin drops
Varicella post-exposure proph:
vaccine for immune-competent within 72 hs & IVIG for pregnant immune-compromised.
School exclusion for varicella:
until blisters dried or at least 5 ds after the rash.
MC compl of mumps in children:
encephalitis.
MC compl of mumps in adult:
orchitis.
30 yrs old Pt on sulfasalazine with H/O mumps when he was a child. now he has abnormal semen analysis.. cause:
sulfasalazine.
Long standing H/O dry cough esp. at night :
BA
Long standing H/O dry cough with fever:
pertussis.
Inv of choice at 1st 3 Ws of pertussis presentation:
PCR of nasopharyngeal swab.
Inv of choice after 3 Ws:
seology.
Prevention of pertussis:
vaccine.
School exclusion for pertussis:
at least 3Ws of cough or 5ds of Abs TTT.
Regardless of age or immunization status, all close contact to a case of pertussis must receive erythromycin.
Give vaccine to non-immunized & those who received last dose in >10 yrs.
Accidently discovering of abdominal mass in a child:
nephroblastoma.
INV. Of choice of nephroblastoma:
CT scan.
Painful mass which may crosses midline periorbital ecchymosis
neuroblastoma.
Uneven thigh skin folds, discrepancy of leg length… Dx:
DDH.
Diagnostic tests of DDH:
barlow test, ortolani test.
Inv of choice of DDH:
<4 ms: US …. >4 ms: x-ray.
TTT of DDH:
pavlik- harness maneuver.
Painless limp with collapsed femur head in x-ray:
perthe’s disease.
Painful limp in obese male teenager with limitation of movement:
SCFE.
x-ray of SCFE:
displaced femoral head medially and posteriorly.
TTT of SCFE:
emergently surgery. (DT fear of avascular necrosis).
Limitation of movement in perthes SCFE:
abduction and internal rotation.
1st step in management of any child with limping:
x-ray EXEPT in clear cases of transient synovitis; 1st step: US.
H/O camping then malabsorption $… Dx:
giardiasis TTT: meronidazole.
Best inv. Of giardiasis:
intestinal biopsy.
Newborn with frothy saliva & milk regurge.. Dx:
esophageal atresia.
1st step in esophageal atresia
passage of wide bore catheter following by x-ray.
TTT of esophageal atresia:
surgery.
Inflammation of penis+ inability to retract in backward=?
phimosis.
TTT of phimosis:
cortisone cream.
Inflammation of penis+ inability to retract in forward=?
para-phimosis.
TTT of paraphimosis:
urgent manual reduction… if failed: incision.
Whitish discharge on glans penis in a child=?
TTT:
balanitis;
cortisone.
From medical point of view:
circumcision is NOT recommended.
Urethral opening at the ventral surface of penis:
hypospadias… next step: never to do circumcision (the foreskin will be used in the surgery).
Child with Difficulty in initiation of micturition s H/O urinary cath.=?
urethral stenosis.
Inv. Of choice for Dx of urethral stenosis:
urethroscopy.
TTT of urethral stenosis?
repeated dilation…. If failed: surgery.
Diarrhea in a complete healthy child<5ys old with normal inv:
toddler diarrhea.
Excessive fruit juice:
tooth caries, obesity, and diarrhea.
MCC of constipation in pediatric:
diet
Maximum timing of constipation
after weaning
Constipation since birth
Meconium ileus or hirschsprung
Cp……in functional constipation
full rectum with stool
MCC of anal fissure in infancy
constipation
MCC of rectal prolapse in kids
constipation
TTT of acute constipation
enema
Most effective Tx of acute constipation?
bowel training
MCC of rectal prolapse in children:
constipation.
Rectal prolapse recurrent chest inf.+ FTT =?
Cystic fibrosis
Most imp Q to be asked in a child with rectal prolapse:
bowel habit.
Abdominal cramping + diarrhea after lactation/dairy products = ?
lactose intolerance.
Inv. Of choice of lactase intolerance:
hydrogen breath test.
TTT of lactase intolerance:
lactose free diet (lactose free formula in infants).eg: soy based formula
MCC of epistaxis in children :
hot weather.
Healthy Child with leg pain that may awaken the pt from sleep, all inv. Are normal….. Dx:
growing pain… management: reassure.
Healthy child crying & pull his leg to his abdomen, all inv are normal.. Dx: infantile colic…. Management:
reassure and diet modification.
Crying followed by cyanosis and then convulsion.. Dx:
breath holding spells.
Convulsion then cyanosis:
epilepsy.
Involuntary passage of stool> 4yrs = ?
encopresis.
TTT of encopresis?
toilet training… if failed: diet modification… if failed: laxatives.
Involuntary passage of urine> 5yrs =?
enuresis.
MCC of enuresis:
psychological BUT, urine culture MUST be done 1st.
MC organic cause of enuresis:
UTI.
Most imp inv. To be done in enuresis:
urine culture.
Pt with enuresis, ‘ll go camping after 1-2 ds, best management:
desmopressin.
Best long term TTT of enuresis:
alarm clock.
Inv of choice of hydrocephalus:
CT scan (not US) “MRI>CT>US”.
