PreTest Pediatrics: "General Pediatrics" Flashcards
What percent of cases of Bell palsy resolve completely?
85%
10% resolve with some residual effects, while 5% do not resolve at all.
In addition to occurring after Borrelia burgdorferi infection, Bell palsy can also follow ______________.
viral infection
When do kids smile spontaneously?
At one month –before they smile socially or in response to cues
When can kids track past midline?
Three months
Balancing on one leg is usually done by what age?
Four years (for two seconds) and five years (for longer)
The most common systemic manifestation of juvenile idiopathic arthritis is ______________.
anterior uveitis (20%)
Because of this, kids with JIA should get slit-lamp exams routinely.
Scalded-skin syndrome presents with what symptoms?
- Desquamating rash
- Fever
- Exquisitely tender skin
- Circumoral crusting
The AHA recommends that kids with a history of endocarditis should be given ______________ as prophylaxis.
antibiotics for dental procedures
Infected human bites require antibiotics and ______________.
surgical debridement
True or false: pityriasis rosea generally does not require treatment.
True
It usually self-resolves in 2 to 12 weeks.
Another name for Henoch-Schönlein purpura is ____________.
anaphylactoid purpura
Inappropriate passage of feces is called ____________.
encopresis
The two types of encopresis are ________________.
retentive and non-retentive
How is retentive encopresis treated?
Disimpaction of the stool followed by 3-6 months of stool softeners and behavior modification
Describe Blount disease.
Blount disease is characterized by congenital genu varum that worsens with age. Many kids are bow-legged but grow out of it. In Blount disease, a problem with the tibial epiphysis leads to progressive genu varum. Bracing and even surgery may be required.
What three tests/situations can be diagnostic of diabetes?
- Fasting glucose greater than 126
- Random glucose greater than 200 with symptoms
- Two-hour glucose challenge greater than 200
How can you tell the difference between milia and acne?
Acne will have an erythematous base, while milia will not.
Permathrin treats what dermatologic condition?
Scabies
Importantly, scabies presents differently in infants: ______________.
while in older kids and adults scabies is thread-like burrows, in infants it presents with large bullae over the whole body
Strabismus in a young child should prompt _____________.
referral to an ophthalmologist
Why do you need to admit a child with orbital cellulitis?
Orbital cellulitis is most often caused by paranasal infection. Infection of the intracranial sinuses can result. As such, you need to admit for CT scanning (to determine the extent of the infection with possible drainage necessary) as well as IV antibiotics.
What kind of rash might be described as an ““erythematous, papulovesicular, weeping eruption”?
Eczema / atopic dermatitis
One contraindication to vaccines is encephalopathy within ___________ days of receiving a prior dose of the same vaccine.
7
This can be evidenced by seizures.
List the treatment guidelines for lice.
- 1:1 vinegar to rinse to remove nits from hair
- Get rid of used brushes and combs
- Wash clothing and bedding in hot soapy water
- Use permethrin cream in hair
- Lindane cream can be used but not in infants due to transdermal absorption with neurotoxicity
Describe the presentation (three stages) of tuberculous meningitis.
- First stage: lethargy, vomiting, anorexia, and fever
- Second stage: seizures, hypertonicity, and focal neurologic deficits
- Third stage: coma, posturing, decompensation, and death
True or false: cholesteatoma presents as a hole in the membrane.
False
Cholesteatomas are epithelium-lined sacs that grow out of the tympanic membrane.
Describe nonspecific vulvovaginitis in children.
Many young girls get irritated vulva without a clear cause (thought to be from soap or irritating panties in some cases). Recommend that parents stop using bubble bath soaps and switch to only cotton panties.
Note: Foreign bodies will usually present with either bleeding or discharge. Bacterial infections will also present with discharge.
How can you differentiate septic arthritis from osteomyelitis of nearby bones?
Septic arthritis will present with the inability to move the joint passively or extreme pain while passively flexing the joint.
How does wound care differ for cat and dog bites?
- Cat bites are usually deep punctures and frequently become infected. Prophylactic antibiotics are indicated.
- Only 4% of dog bites become infected, so prophylactic antibiotics are controversial.
Naloxone is used to treat what somewhat surprising toxicity?
Clonidine
The best screening tool for lead toxicity is ________________.
the blood lead level; toxic levels are often clinically silent –they don’t cause anemia, neurologic symptoms, or protoporphyrin elevation –for a long time
Dilution of formula can lead to _________________.
hyponatremia with seizures
Describe erythema toxicum.
ET is a benign rash on newborns that goes away in a couple weeks. The lesions are erythematous with occasional pustules. Aspiration will show eosinophils.
What are flame nevi?
Flame nevi, also called salmon patches, are benign macular lesions that appear on the eyelids and the occiput. They get redder with crying or heat. Typically the eyelid lesions go away but the occipital lesions can persist.
Describe pustular melanocytosis.
More common in black people, PM is a benign rash of the newborn period. It is a hyperpigmented base with a pustule that can be wiped away. It usually goes away by a couple months of life.
Sebaceous nevi are ______________.
hairless, scaly, yellow lesions on newborns; they can persist to adolescence
Describe the following cold injuries: •Frostnip •Frostbite • Chilblain • Cold panniculitis
- Frostnip: small, white, hard patches in exposed areas
- Frostbite: frozen tissue that becomes destroyed which results in aching and numbness; when rewarmed, the area becomes blotchy and painful
- Chilblain: small, ulcerated lesions on the ears or fingers
- Cold panniculitis: frozen fat
Remember that in addition to convulsions and numbness, B6 deficiency also causes ______________.
hypochromic anemia
Riboflavin deficiency causes cheilosis, __________, _________, and ___________.
irritated eyes; photophobia; blurred vision
What disorder is referred as “happy puppet” syndrome because the odd gait and stereotypical happiness?
Angelman syndrome
Random factoid: it was once thought that all kids with Angelman syndrome were blond-haired and blue-eyed, but now it’s recognized that there are all different complexions.
The antidote to acute aspirin poisoning is ______________.
sodium bicarbonate
Don’t forget that ____________ can also treat bacterial vaginosis.
tinidazole (a related medication to metronidazole)
Note: tinidazole is contraindicated in pregnancy.
Fever, headache, pallor, and splenomegaly in a child after a trip to a third-world-country should make you think of ________________.
malaria
Food poisoning with subsequent prolonged diarrhea is a symptom of _____________.
Cyclospora cateyensis
An “intensely pruritic, serpiginous lesion on the foot” that occurs after walking on the beach is likely ______________.
Ancylostoma, a hookworm that comes from dog feces
Treat with Ivermectin.
In addition to cleaning and corticosteroids, ___________ can also be used to treat seborrheic dermatitis.
selenium sulfide
Congenital heart block can arise from maternal _____________ during pregnancy.
lupus
The best screening test for suspected Wiskot Aldrich syndrome is _____________.
platelet count
Most babies are obligate ______________.
nose breathers
When should babies be given VZV-IG?
If the mother got varicella within five days prior to delivery or two days after.
