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Pediatrics > Test #1 > Flashcards

Test #1 Flashcards

1
Q

APGAR Scoring System

A

Activity: Absent (0), Arms&legs flexed (1), Active motion (2)

Pulse: Absent (0), <100 bpm (1), >100 bpm (2)

Grimace (facial reflex): flaccid, grimace, Cry

Appearance: blue/pale, body pink/extremities blue, all pink

Respiration: absent, slow/irregular, vigorous cry

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2
Q

APGAR Value Indications

A

0-3 = Severely depressed

4-6 = Moderately depressed

7-10 = Excellent condition

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3
Q

Embryonic Period

A

First 8 weeks

All major organs formed during this period (organogenesis)

Particularly vulnerable during weeks 3 and 4

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4
Q

Fetal Period

A

Remaining 30 weeks

Organs get larger and more complex

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5
Q

Ductus Venosus

A

Connects umbilical vein to inferior IVC

Oxygenated blood from mom bypasses liver, goes directly to heart

Sensitive to [O2] of blood - increase in oxygenation after birth causes vasoconstriction/closure

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6
Q

Ductus Arteriosus

A

Channel between main pulmonary artery and aorta

Bypasses pulmonary vasculature to get blood directly to systemic

Disappears w/in 2 weeks after birth, becomes ligamentum venosum

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7
Q

Kernicterus

A

Chronic/permanent BIND

Indirect bilirubin > 20-25 mg/dL in newborn

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8
Q

Acute Bilirubin Encephalopathy

A

Early symptoms

Hypotonia, seizures

Reversable BIND

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9
Q

Estimating bilirubin levels in newborns

A

Jaundice progresses from head to toe

Head = TSB 5

Upper Chest = 10

Abdomen = 12

Palms/Soles = >15

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10
Q

Pathological Jaundice

A

Appears w/in 1st 24 hours of birth

Jaundice in newborn older than 2 weeks

Direct bilirubin >1mg/dL with TSB < 5 OR >20% TSB is direct

Increase in bilirubin >0.5 mg/dL/hr

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11
Q

Mottled skin

A

Cutis Marmorata

Will disappear at birth

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12
Q

White/Waxy covering of skin

A

Vernix Caseosa

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13
Q

Downy hair

A

Lanugo

More common with prematurity

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14
Q

Benign erythematous rash with papules/pustules

A

Erythema Toxicum

Appears in 1-14 days, resolves in weeks

Eosinophils in the pustules

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15
Q

Benign flat red markings

On upper eyelids or back of neck

A

Nevus Flammeus/Vascular Nevi/Salmon patches

Upper eyelids = crows nest

Back of neck = stork bites

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16
Q

Permanent discoloration

Arteriovenous malformation

A

Port-wine stain

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17
Q

Small yellow papules

A

Sebaceous gland hyperplasia

Disappear spontaneously

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18
Q

Smaller, white papules

A

Milia

Disappears in weeks

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19
Q

Acne from maternal hormones

A

Acne Neonatorum

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20
Q

Bluish-black lesion over lumbosacral area

A

Mongolian Spots

Common in Native American, Blacks, and Asians

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21
Q

Elevated collection of capillaries

A

Strawberry/Capillary hemangiomas

Worrisome skin findings

Grow for 3-7 months, stabilize, then usually involute by 5 years old

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22
Q

Cavernous hemangioma

A

Less predictable collection of large blood vessels

May be associated with thrombocytopenia

May resolve on own or need steroids/radiation

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23
Q

Neonate

A

First 30 days of life

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24
Q

Infant

A

1 month to 1 year old

25
Q

Child

A

1-12 years old

26
Q

Adolescent

A

12-18 years old

27
Q

Most common pediatric overdose drugs

A

Iron supplements (vitamins)

Acetaminophen

28
Q

Drugs to avoid in peds

A

Propylene glycol - hyperosmolality (IV drugs)

Benzyl alcohol - metabolic acidosis and neuro damage (IV fluids)

Fluoroquinolones

Tetracyclines

29
Q

Acetaminophen dosing in pediatrics

A

Tylenol

10-15 mg/kg q4-6h

30
Q

Ibuprofen dosing in pediatrics

A

Motrin for >6 months old

5-10 mg/kg q6h

31
Q

1 tsp = __mL

A

5 cc = 5 mL = 1 tsp

32
Q

TORCH

A

Toxoplasmosis

Other (HEP-VHS) - HIV, Enterovirus, Parvovirus B-19, Varicella, Hepatitis, Syphilis

Rubella

Cytomegalovirus

Herpes simplex

33
Q

Other from TORCH

A

HIV

Enterovirus

Parvovirus B-19

Varicella

Hepatitis

Syphilis

34
Q

Toxoplasmosis triad and treatment

A

Triad: Chorioretinitis, Hydrocephalus, Intracranial calcifications

Tx: pyrimethamine & sulfadiazine or Spiramycin

Dx: IgM = acute infection, IgG = previous infection

Safe to treat during pregnancy

35
Q

Leading cause of sensorineural hearing loss?

A

Cytomegalovirus

36
Q

5 T’s of congenital cyanotic heart disease

A

Tetralogy of Fallot (TOF)

Transposition of great arteries

Tricuspid atresia

Truncus arteriosus

Total anomalous pulmonary return

37
Q

Corresponding murmurs for the following:

VSD

ASD

PDA

Aorta coarctation

TOF

A

VSD: loud, pansystolic murmur

ASD: soft, systolic ejection murmur w/ fixed split S2

PDA: continuous machine-like murmur

Aorta coarctation: systolic murmur upper left chest

TOF: loud, harsh systolic ejection murmur with Tet spells

38
Q

Marfan’s Syndrome mutation, treatment, and typical death

A

FBN1 gene mutation (fibrillin protein)

Beta blockers (1st line), Losartan (ARB)

Typically die from aneurysm rupture

39
Q

ADHD Treatment

A

Stimulants are 1st line

-BBW: sudden death w/ CV problem, dependency

2nd line: Atomoxetine

3rd line: Wellbutrin, Tofranil, Norpramin, Catapres, Tenex

40
Q

ADHD Stimulants

A

Methylphenidate (Ritalin, Methylin)

Dextroamphetamine (Adderall)

Start on short-acting, titrate up doses

41
Q

Depression Treatment

A

SSRI (selective serotonin reuptake inhibitors)

Fluoxetine (Prozac) - 8-17 yo

Escitalopram (Lexapro) - 12-17 yo

BBW: Increased suicidal risk <24 yo

42
Q

Pediatric Leukemia

A

Bone pain, anemia, fatigue, fever, infection, petechiae

ALL and AML (auer rods)

Down’s Syndrome increases risk of AML

43
Q

Hodgkin’s Lymphoma

A

painless lymphadenopathy, mediastinal mass, constitutional symptoms

B symptoms diagnostic: weight loss, night sweats, FUO > days

44
Q

Non-Hodgkin’s Lymphoma

A

B symptoms are not prognostic

Treatment depends on exact type

Looks like HL with emergent presentation common

Overall survival is high

45
Q

Wilm’s Tumor

A

Big belly, not sick

Tumor spill (biopsy) will upstage it to 3 -> requires radiation

46
Q

Most common malignant brain cancer

A

Medulloblastoma

47
Q

Bilious vomiting DDx in newborns

A

Partial/Complete bowel obstruction

48
Q

Nonbilious vomiting DDx in newborns

A

GERD -> most common

Milk protein intolerance

Pyloric stenosis

Gastritis

49
Q

Abdominal pain DDx

Newborn

Infants

A

Newborn: GERD, Necrotizing colitis, Volvulus

Infant-2yo: Intussusception, Meckel’s diverticulum, Bacterial enteritis

50
Q

Colic rule of 3’s

A

Greater than 3 hours crying per day

More than 3 days a week

Lasts for more than 3 weeks

Infants less than 3 months

51
Q

Chronic Diarrhea DDx

A

Bloody: Irritable bowel disease, milk protein intolerance

Non-bloody: Inflammatory bowel syndrome, cystic fibrosis/malabsorption, Immunodeficiency, lactose intolerance

52
Q

Acute Diarrhea DDx

A

Tender abdomen/mass: Appendicitis, intussusception, toxic megacolon

Non-tender: bacterial enteritis, parasites

53
Q

Enuresis temporary treatment

A

Desmopressin acetate

Suppresses ADH

Only works when taken, no longer term effects

54
Q

Tanner Sexual Maturity Scale

A

Stage 1: Pubic hair, breast, penis, testes all preadolescent

Stage 2: sparse downy hair; breast bud; penis/testes enlarge

Stage 3: increased pigment, curly hair; enlarged breast/areola w/o contour; increased length and size testes

Stage 4: adult hair but less; areola forms secondary mound; glans enlarge, testes darken

Stage 5: adult hair distribution; nipple elevation; adult size penis and testes

55
Q

Delayed Puberty DDx

Primary and Secondary

A

Primary: Hypogonadism or membrane receptor defect on gonadal cells

Secondary: gonads intact; hormonal secretion issue (LH, FSH, GnRH)

  • hypopituitarism, hypothyroidism, hyperprolactinemia
56
Q

Russell’s sign

A

Erosions on inside of front teeth from vomiting

57
Q

Sleep Disturbance Screening

A

BEARS

Bedtime issues

Excessive daytime sleepiness

Night awakenings

Regularity and duration of sleep

Snoring

58
Q

Infant vision development

A

Visual fixation shortly after birth -> 20/400

Follow an object by 3 months old

Stereopsis and binocular vision by 6 months old

20/20 vision by 3-5 years old

Pediatrics (6 decks)

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