Pedes Case Files 2

Front 1

Rales: wet or "crackly" inspiratory breathing

Back 1

PNA or CHF

Front 2

staccato cough

Back 2

pertussis or chlamydial PNA

Front 3

PNA within first few days of life, oganism?

Back 3

Enterobacteriacea or GBS

Front 4

tx for PNA within first few days of life

Back 4

Amp/gent

Front 5

staccato cough, conjuctivitis, eosinophilia, bilat infiltrates on CXR

Back 5

chlamydia trachomatis PNA

Front 6

tx for chlamydia PNA

Back 6

erythromycin

Front 7

tx for HSV pna

Back 7

acyclovir

Front 8

after newborn until 5 yo, what is most common PNA?

Back 8

viral

Front 9

viral PNA

Back 9

adenovirus, rhinovirus, RSV, parainfluenza

Front 10

most common PNA in kids up to 5yo

Back 10

pneumococcus & Hib

Front 11

perihilar intertsitial infiltrates on CXR

Back 11

viral pna

Front 12

most common PNA in kid OVER 5yo

Back 12

mycoplasma pneum

Front 13

what PNA does kid over 5yo NOT have?

Back 13

GBS and Listo

Front 14

PNA in kid who is intubated or has CVL

Back 14

pseudomonas or candida

Front 15

PNA in patient with CF

Back 15

pseudomonas or aspergillus

Front 16

retinitis and PNA

Back 16

CMV

Front 17

"fungal ball" on CXR and PNA

Back 17

aspergillus

Front 18

cough and increased resp. effort in AFEBRILE 6 wo with eye discharge*

Back 18

chlamydia

Front 19

why do some kids get abd pain with PNA

Back 19

irritation of diaphragm by pulm infection or coughing

Front 20

next step to do with patient who is obviously having a hard time breathing

Back 20

pulse ox to see if getting enough O2

Front 21

common finding in kids with TB pneumonia

Back 21

LAD in neck (or mediastinum/perihilar)

Front 22

"walking pneumonia" mild, worse when walking outside in cold air*

Back 22

mycoplasma

Front 23

PNA for

-neonates

-toddlers

-tweens

Back 23

-GBS

-RSV

-mycoplasma

Front 24

kid was playing in field with insectisides, now is incontinent with trouble breathing

Back 24

organophosphate poisoning

Front 25

Dx of organophosphate poisoning

Back 25

low pseudocholinesterates and erythrocyte cholinesterase levels

Front 26

Tx organophosphate poisoning

Back 26

atropine/pralidoxime

Front 27

common stool softener used for constipation in kids

Back 27

PO polyethylene glycolate

Front 28

2 mo boy has bloody streaks in bm and more frequent. Happy, afebrile. Eats standard formula.

Back 28

Allergic proctocolitis. Stop formula because milk protein. And don't do soy either because cross-reacts. Tx: elemental formula and tell Mom not to eat dairy either cause it goes into breastmilk

Front 29

intermittent PAINLESS* rectal bleeding in 2yo

Back 29

Meckel's

Front 30

preschool kid with ear pain, fever, but eating ok and activity ok

Back 30

O.M.

Front 31

what does ear look like in O.M.?

Back 31

-red, opaque, doesn't move well, BULGING t.m.

Front 32

pathogens causing O.M.

Back 32

-strep pneumo

-Hib

-moraxella

Front 33

tx for O.M.

Back 33

amoxacillin

Front 34

if resistant to treatment, try:

Back 34

amoxacillin/clavulanate

Front 35

kid with red and swollen ear canal, pain of ear with mvt*, normal T.M.

Back 35

otitis externa: treat with topical Polymyxin* and Corticosteroids*

Front 36

pathogens that cause otitis externa

Back 36

-pseudomonas

-staph

-candida/aspergillus

Front 37

kid with O.M. takes amoxacillin but not getting better, ear gets more swollen, red behind, ear lobe is pushed to the side. Otherwise ok

Back 37

MASTOIDITIS*

Front 38

Tx for mastoiditis

Back 38

myringotomy and parenteal Abx

Front 39

3rd line agent for tx of OM

Back 39

intramuscular ceftriaxone

Front 40

1mo with FEVER, fussy*, immobile red T.M. with pus behind it, what to do?

Back 40

ADMIT and w/u for sepsis!

Front 41

if you give Mom MEPERIDINE* during labor, what can this anesthetic cause in the newborn?

Back 41

APNEA*==>blue, floppy baby

Front 42

tx for meperidine narcosis

Back 42

NALOXONE*

Front 43

Tx for neonate born with diaphragmatic hernia

Back 43

INTUBATE!!! (in resp distress from pulm hypoplasia, DON"T BAG)

Front 44

scaphoid abdomen, cyanosis, resp distress, low breath sounds on Left, heart sounds on right

Back 44

diaphragmatic hernia

Front 45

neonate had HR of 40 when born, then given PPV (bag mask) but HR still <60, now what?

Back 45

30sec of chest compressions, then IV EPI if still low HR

Front 46

neonate is pink when crying, but blue and resp distress when not crying, what's up?

Back 46

Choanal atresia: pass NG and see if it goes, it won't. Tx: intubate

Front 47

previously healthy boy now presents with "scissoring" when he sits at 12mo and drags his feet

Back 47

Cerebral palsy

Front 48

cause of bacterial PNA in CF

Back 48

staph aureus, then pseudomonas

Front 49

vitamin E def

Back 49

peripheral neuropathy & anemia

Front 50

night blindness

Back 50

vitamin A def

Front 51

mucosal bleeding

Back 51

vitamin K deficiency

Front 52

electrolytes in CF

Back 52

hypoCl (lost in sweat), hypoNat met ALKALOSIS

Front 53

vit K deficiency

Back 53

high PT

Front 54

vit E deficiency

Back 54

anemia with high retic count

Front 55

6yo boy with 1wk of leg pain and limping. No swelling etc. low-grade fever, hepatosplenomegal*, petechia* on face/chest

Back 55

Acute Lymphoblastic leukemia :(

Front 56

who has an increased risk of ALL?

Back 56

Downs & Fanconi syndrome

Front 57

low plts*, bruising petechia*

Back 57

ITP: everything else is ok

Front 58

pancytopenia & fever

Back 58

aplastic anemia: everything else ok

Front 59

atypical lymphocytes

Back 59

mono

Front 60

kid has fever, joint pain, arthritis, limp, splenomegaly, anemia, luekocytosis: how to tell if it's leukemia or juvenile arthritis?

Back 60

bone marrow

Front 61

leukocyte count in ALL

Back 61

<10,000*

Front 62

Dx of ALL

Back 62

by bone marrow with 25%+ of blasts*

Front 63

workup for ALL

Back 63

-LP to see if CNS involvement

-CXR to see if mediastinal mass

Front 64

how does juvi arthritis and ALL differ on CBC with diff?

Back 64

-Juvi: normal (or high) WBC & PLT

-ALL: blasts on peripheral smear

Front 65

LARGE newborn, gray in color with resp distress

Back 65

most likely mom was DIABETIC*

Front 66

poorly controlled maternal hyperglycemia (gestational diabetes) results in what?

Back 66

macrosomia & fetal HyperInsulinsm===> increased O2 requirements & hyPOGLYCEMIA after birth!

Front 67

other results of gestational diabetes in baby

Back 67

-hypoMag, hypoCa

-polycythemia with hyperviscosity

-hyperBili

Front 68

why is kid born to diabetic mother so big?

Back 68

growth hormone effects of insulin

Front 69

why do gestational diabetes kids have polycythemia?

Back 69

macrosomia===>increase O2 requirements===>more EPO to carry more O2

Front 70

polycythemia leadsto high Bili & hyperviscosity

Back 70

w/o for kidney/sinus thrombosis

Front 71

AFTER delivery, infant is

Back 71

HYPOglycemic

Front 72

12 day old formula fed male has jaundice (dad has hx of mild bili elevation), otherwise ok

Back 72

Gilbert's because FHx and no symptoms (low activity of UDP gluco transfease)

Front 73

when does NON-physiologic jaundice present

Back 73

1st 24 hours or 10-14 days later

Front 74

baby has physiologic jaundice, what could mom have done during prego to reduce this risk?

Back 74

phenobarbital (it conjugates bili)

Front 75

Gilbert's

Back 75

pesistence* of physiologic jaundice. Asx

Front 76

EXTREME deficiency of UDP transferase

Back 76

criggler najar tx: light