Peds Test 1 Flashcards
Categories of APGAR test
- heart rate
- respiratory effort
- muscle tone
- response to cath in nose
- color
APGAR scores
- 7-10: excellent
- 4-6: fair
- < 4: poor
When is APGAR test performed?
- 1 min
- 5 mins
- 10 minutes in severely depressed infants
Most common autosomal chromosomal abnormality causing mental retardation?
Down’s Syndrome
Down’s patients make up what percentage of mental retardation cases?
about 1/3
Disorders that are associated with Down’s
- hypothyroidism
- hearing loss
- leukemia
- atlanto-axial instability (ligament laxity)
- developmental hip dysplasia
Patau Syn
Trisomy 13
Edward’s Syn
trisomy 18
disorder involving only one X chromosome
Turner’s syndrome
disorder involving multiple X chromosomes of a male
Klinefelter’s syndrome
cause of Fragile X syndrome
chromatin gap on the X chromosome
defects associated with Fragile X syndrome
- mitral valve prolapse
- strabismus
- connective tissue defects
- moderate to severe mental retardation
- hyperarousal, anxiety, mood swings
what is the most common inheritable cause of mental retardation in males?
Fragile X syndrome
Most common drug-induced congenital defect
Fetal alcohol syndrome
3rd most common cause of mental retardation
-fetal alcohol syndrome
Congenital syndrome associated with:
- dysmorphic fetures
- heart defects
- short stature
Down’s syndrome
Congenital syndrome associated with:
- webbing of the neck
- edema of the hands and feet
Turner’s syndrome
Congenital syndrome associated with:
- tall stature
- diminished male pattern hair
- female type pubic hair
- gynecomastia
Klinefelter’s syndrome
Congenital syndrome associated with:
- growth retardation
- microcephaly
- flattened mid-face
- short nose
- indistinct philtrum
- thin upper lip
Fetal Alcohol syndrome
Cause of Marfan Syndrome
-genetic mutation resulting in reduced production of fibrillin
Congenital syndrome associated with:
- long, spindly extremities
- spider fingers
- joint hyperreflexia
Marfan Syndrome
What should you think if you observe decreased femoral pulses in a neonate?
coarctation of the aorta
what should you think if you observe bounding pulses in a neonate?
Patent ductus arteriosis
Bilirubin levels associated with physiologic jaundice
- > 5mg/dL
- Usually peaks at 14-15mg/dL by day 3-5
Bilirubin levels associated with significant jaundice
> 20mg/dL
Cause of breast milk jaundice
- prolonged increased circulation of bilirubin
- may be due to increased fatty acids in the milk
History associated with “Breast feeding associated jaundice”
- decreased stooling
- crying from hunger
- weight loss of 10% from birth
Follow-up recommended for jaundiced or breast-fed neonates?
2-3 days
When do you give Prevnar?
2, 4, 6, 12-15 months
When do you give DTAP?
- 2, 4, 6, 12-15 months
- And 4-6 years
When do you give TdaP?
11-13 years
When do you give IPV vaccine?
- 2, 4, 6-18 months
- and 4-6 years
When do you give HIB vaccine?
- 2, 4, and 6 months
- booster at 12-15 months
When do you give Hep B vaccine?
- 2, 4, and 6 months
- given ASAP when mom is positive
- given within 12 hours if mom in unknown
When do you give MMR?
- twice at 12-15 months
- then again at 2-6 years
When do you give varicella vaccine?
12 months - 12 years
When do you give Hep A vaccine?
- 1st injection at year 1
- 2nd injection 6 months later
When do you give MCV4 vaccine?
11-18 years
When do you give Gardasil?
- First dose at 11-12 years
- second dose 2 months after 1st dose
- third dose 6 months after 1st dose
Most common pathogens for otitis media
- S. pneumococcus is #1
- H. influenza
- M. catarrhalis
Pathogens associated with Swimmer’s ear?
- S. aureus
- Pseudomonas
Pathogens associated with acute sinusitis?
- pneumococcus
- H. influenza
- M. catarrhalis
Pathogens associated with pharyngitis/tonsilitis?
- 90% viral
- group A beta hemolytic strep
oral motor period
0-6 months
infant-parent bonding period
1-3 months
infant-parent attachment period
3-6 months
manipulative play period
6-12 months
Stranger anxiety period
6-9 months
Separation anxiety play
9-12 months
Functional play period
12-24 months
Imaginary play period
> 24 months
supplementation recommended for strictly breast fed babies?
Trivisol
Reflexes that disappear by 3-4 months
- rooting
- palmar grasp-curl
- placing-stepping
Reflexes that disappear by 4-6 months
- Moro startle
- asymmetric tonic neck
What is a “white pupil” called?
Leukocoria
Onset of neonatal conjunctivitis caused by gonorrhea?
2-4 days
Onset of neonatal conjunctivitis caused by chlamydia
3-10 days (most by day 5)
Onset of neonatal conjunctivitis caused by HSV
2-16 days
most common pediatric ocular problem
bacterial conjunctivits
treatment for bacterial conjunctivitis?
Ocuflox or vigamox drops
pathogens causing bacterial conjunctivitis?
- pneumococus
- S. aureus
- H. influenzae
What eye pathology should you think of when you see pre-auricular lymphadenopathy?
viral conjunctivitis
What sort of conjunctivitis should you think of when you see cobblestoning?
allergic
allergic conjunctivitis treatment
- vasoconstrictors
- topical cromolyn
- oral antihistamines
inflammation of the lid margins
Blepharitis
treatment for gonorrhea conjunctivitis
single dose of Ceftriaxone
treatment for chlamydia conjunctivitis
oral and ointment erythromycin
treatment for HSV conjunctivitis
-viroptic solution
acyclovir
infected gland of Zeis at the base of the eyelash
hordeolum (stye)
chronic inflammatory lesion involving hte Meibomian gland
-Chalazion
infection of the nasolacrimal duct
dacrocystitis
Infecting pathogens associated with orbital cellulitis
- H. influenza
- S. pyogenes
- pneumococcus
- S. aureus
Orbital cellulitis treatment
-IV ceftriaxone, vancomycin, ampicillin
Abdominal mass + distension of the abdomen
celiac disease
olive-shaped mass to the right of the midline
pyloric stenosis
nephrotic syndrome definition
excessive urinary excretion of plasma proteins sufficient to cause hypoalbuminemia
hallmarks of nephrotic syndrome
- edema
- proteinuria
- hypoproteinemia
- hyperlipidemia
Treatment of GER and GERD
- rantidine
- metoclopramide
bacteremia etiology
- strep pneumo: 50-80%
- H. influenza 2nd cause
bacteremia treatment
IV ceftriaxone in the hospital
neonatal bacterial meningitis treatment
- Ampicillin
- Cefotaxime
Child bacterial meningitis treatment
- cefotaxime
- ceftriaxone
lumbar puncture location
-between 3rd and 4th vertebrae
preferred asthma treatment
-corticosteroids and B2 agonists
is croup bacterial or viral?
viral
croup most common cause
parainfluenza virus
Chromosome mutation for cystic fibrosis?
7
what is the most common lethal genetic disease?
cystic fibrosis
cause of bronchiolitis?
main etiology is RSV
most common cause of epiglottis?
H. influenza B
x-ray identification of epiglottitis
thumb sign
cause of pertussis?
Bordetella pertussis
neonate pneumonia pathogens
- GBS
- chlamydia
- cytomegalovirus
1-3 months pneumonia pathogens
- RSV
- parainfluenza
- influenza
- S. aureus
- aspirated anaerobes
4month to 5 year pneumonia pathogens
- RSV, parainfluenza, influenza, adenoirus, measles, HIV
- pneumococcus, H. influenza, S. aureus, B. pertusses
pneumonia pathogens in older children/adolescents
- mycoplasma
- chlamyida
- influenza
- measles
- pneumococcus
- S. aureus
where is pneumonia usually located in babies?
upper lobes
where is pneumonia usually locatd in older children?
lower lobes
What should you think when you see tea-colored urine?
glomerulonephritis
Berger’s disease
IgA nephropathy that presents 1-2 days after febrile URI
progressive HTN, deafness, renal failure
Alport’s syndrome
