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538 Cards in this Set
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Age @ which cows milk can begin
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1 y/o
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age @ which breast feeding should cease
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1 y/o
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top 2 phys exam Sx of dehydration
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dec skin turgor
inc cap refill time |
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Inborn error of metabolism that make pt more prone to E. coli sepsis
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Galactosemia
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LLN of glc in newborn
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40 mg/dL
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first-line topical Tx of mild acne
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benzoyl peroxide
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best joint to x-ray in w/u for rickets
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AP of knee (bowing of legs)
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F < 8 y/o pubarche but no Sx of CAH or other Sx of puberty
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idiopathic isolated pubarche
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PPx for baby if mom is HBV+ 2
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HBV vax & Ig for baby
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If have > # congenital anomalies, get a karyotype
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3
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mode of inheritance of Vit D resistant rickets
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X-linked dominant
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Hematologic causes for physio jaundice of newborn 2
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cephalohematoma
polycythemia |
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induce short absence sz by? sens?
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hypervent test
90% |
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anal fissures in child < 1 y/o or not at midline considered
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Crohn's dz
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Dx suggested by rash:
multiple oval, slightly scaling, pruritic in christmas tree distribution on back |
pityriasis rosea
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most common presenting Sx of Meckel's diverticulum
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painless rectal bleeding
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serology considered in neonate with HSM +/- thrombocytopenia
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IgM titers for TORCHES, esp Toxo, CMV
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ash-leaf macule & infantile sz suggest
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Tuberous sclerosis
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cause of sz in tuberous sclerosis
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cortical tubers (primitive neuro-like cells)
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Common long-term finding in pt c meningitis
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sensorineuronal hearing loss
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imaging w/u for Dx of chronic sinusitis
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CT scan
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Most common & concerning morbidity of JRA?
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Blindness 2/2 anterior uveitis = iridociclitis
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Iritis is seen in what dz?
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JRA, HLA-B27 spondyloarthropathies, sarcoid
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season when rhinovirus peaks
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Autumn, spring
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kernig's Sx is?
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Resistance to knee extension
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most reliable means to determine peds dehydration
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Wt loss
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3 things to carefully replenish in DKA
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Fluids, insulin, K
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Microbe implicated in peds osteomyelitis/septic arthritis
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Staph aureus
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How do peds pt get osteomyelitis/septic arthritis
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hematogenous
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which abx for MSSA?
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Naficillin
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Typical presentation for congenital diaphragmatic hernia
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severe resp distress immediately after birth
Scaphoid abdomen |
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mortality rate for congenital diaphragmatic hernia
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as high as 50%
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Tx for babies born to mom with HBV status unknown
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give baby HBV vax & HBIg
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In children weighing 3-10 kg, daily caloric intake is?
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100 kcal/kg
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Tx of choice for croup complicated by partial airway obstruction
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nebulized racemic epi
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Elements of APGAR score
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Appearance/color
Pulse > 100 Grimace - response to pain stimuli Activity - moving all 4 extremities Respirations - good cry |
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age at which baby should start Fe-fortified foods
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6 months
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age at which babies present with Fe def anemia if don't get Fe-fortified foods
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1 y/o
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Intermittent asthma rules of 2
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<2 daytime episodes/wk
<2 nighttime episodes/month <2 rescue inhaler episodes/wk |
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rescue inhaler is?
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short-term beta agonist
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in US, polio vax is which kind? 2
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inactivated, by injection
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Dx test for lactose intolerance (besides removing dairy)
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elevated hydrogen breath test
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Test of choice to determine origin of blood found in emesis or poop
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Apt test
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Apt test based on?
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Fetal Hb properties vs Hb A
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delayed puberty defined after what age in M
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15 y/o
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delayed puberty defined after what age in F
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13 y/o
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most common cause of chest pain in adolescent
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precordial catch syndrome
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Type of pain described in precordial catch syndrome 4
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sharp,
L-sided Lasts 1-2 min Doesn't occur with activity |
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Bruzinski Sx
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Neck flexion causes flex of knee and hip toward chest
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most common age of presentation for osteosarcomas and Ewing's sarcomas
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adolescent
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which is small blue cell tumor: osteosarcoma or Ewing?
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Ewing
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Maintenance levels of IV Na and K are calculated as?
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2.5 mEq/100 kcal
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most common cause of acute bronchiolitis in children
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RSV
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other viruses besides RSV that cause acute bronchiolitis 2
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Flu, parainfluenza
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Tx for acute bronchiolitis
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Supportive care
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Endocrine dz of NB:
jaundice puffy face thick protruding tongue developmental delay umbilical hernia |
congenital hypothyroidism
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Dx test to perform on child with nephrotic syndrome - single v. multiple episodes
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Single - supportive
Recurrent - renal Bx |
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Pulse for NB to receive 2 pt for APGAR
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> 100
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pubertal growth spurt of boys is which Tanner stage?
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Tanner stage IV
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besides CBC, most cost effective screen for T cell def?
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Candida skin test
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Dz seen in T cell def d/o 4
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Recurrent candidiasis
Recurrent PCP Diffuse CMV inf Fungal meningitis |
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Sickle cell pt gets routine PPx of PCN until what age
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5 y/o
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PNA in children < 8- bact or viral?
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Viral
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Top viruses causing PNA in young children 4
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RSV
Flu Parainfluenza Adeno |
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first test to order in suspected intraventricular hemorrhage
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head U/S
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% of children with CF who will develop DM
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up to 20%
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typically length a tick must be embedded to get Lyme dz
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24-48 hrs
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Rx used for JRA? 4
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NSAIDs
Cyclophosphomide MTX ?hydroxychloroquine |
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endocrine hallmark for onset of puberty
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pulsatile LH secretion
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major sugar found in human breast milk
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lactose
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lactose is dissacharide of
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glucose, galactose
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major protein found in human breastmilk 2
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whey, casein
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Features of rotovirus inf 4
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watery diarrhea
vomitting Fever URI Sx |
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top 2 concomittant Axis I psych d/o in pt c eating d/o
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OCD
Depression |
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Complete latching during breastfeeding defined by
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covers entire aerola with mouth
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components of Denver II screening tool 4
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Gross motor
Fine motor Language Social |
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DSM IV requires what GYN finding for anorexia
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Amenorrhea
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patho for amenorrhea in anorexia
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dec fat tissue -> dec aromatase activity -> dec estrogen
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M/A for neonatal hypoglycemia c DM mothers
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fetal pancreatic islet cell hyperplasia in utero
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epicanthal folds most commonly assoc with what 2 major syndrome
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FAS
Down's |
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Epicanthal folds are
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Extra folds in eyelid medially
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Dx suggested by jaundice @ 3 WOL and increasingly pale stools
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biliary atresia
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Tx for biliary atresia
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urgent surgery
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Dx suggested by:
serious refrac seborrheic dermatitis diffuse LAD HSM osteolysis on X-ray |
Histiocytosis:
Langerhans, Hand-Schuller-Christian dz, etc. |
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Diffuse LAD and dermatitis in young child should raise alarm for
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HIV
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Femoral pulse after radial pulse is pathological for
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Aortic coarctation
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Imaging modality for child's first UTI
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None! VCUG with second
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AAP suggests breastfeeding for how long
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until 6-12 MOL
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erythromycin eyedrops are PPx for which conjunctivitis
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GC > chlamydia
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Common triggers for asthma in young children 4
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viral URI
allergen expo exercise psycho-social stressors |
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Tx for atopic dermatitis 3
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Topical steroids
Emollients Antihistamines |
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blood-streaked stools < 3 m/o suggest
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milk allergy
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Drug of choice for atypical PNA
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Azithromycin
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most common type of childhood Sz
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Febrile seizures
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most common cause of hematochezia in children
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anal fissures
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baby with new onset jaundice and poor maternal milk intake is which type
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breast feeding jaundice
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Dx suggested by
high pitched cry irritability jaundice opisthotonus |
Kernicterus
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Kernicterus is
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Build up of bilirubin in brain, especially basal ganglia
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opisthotonus is
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stiff neck posturing
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CP classifications 3
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Spastic
Dyskinetic Mixed |
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prune belly syndrome a/w which drug
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cocaine
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prune belly is
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huge, edematous wrinkled belly
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first test to perform on toddler with developmental delay in language
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hearing
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cyanotic heart malformation that is most likely to have L-axis deviation on EKG
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Tricuspid atresia
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which EKG deviation do most cyanotic heart dz have? Why
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R-axis 2/2 RVH
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why is neonatal jaundice more concerning if septic?
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breakdown of blood brain barrier -> more infiltration
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Dye going past this point on VCUG is required for Dx of reflux
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Into ureters (anything prox to bladder)
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most likely cause of encoparesis in child
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functional constipation - kid is holding it in because he's a dummy
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encoparesis is
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stool overflow
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Organic dz that must be r/o in encoparesis
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Hirschsprung's dz
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2 meds that sickle cell kids must take chronically
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PCN
Folate |
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broad spec abx in <3 m/o
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amp/gent
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pauciarticular or polyarticular is more common and has better prognosis
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pauciarticular
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Soft doughy skin seen with
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hypernatremia
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typical age of presentation for physiologic anemia of the NB
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6-8 WOL
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cyanotic congenital heart lesions that have decreased pulm vasc markings on CXR
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TOF: overriding aorta gets some RV blood flow
Tricuspid atresia, severe pulm stenosis: less flow to lungs |
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only FDA uses for growth hormone replacement 4
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turner's
Prader Willi Chronic renal failure IUGR |
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rule of 3 to ID colic in baby 4
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crying < 3hrs/d
< 3d/wk <3 wk/m in first 3 MOL |
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2 most common findings in children c duodenal atresia
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premature
down's syndrom |
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most common env poison in urban areas
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Pb
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who should u screen for Pb levels
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if in at-risk env only
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level of Pb in blood considered dangerous
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10 mcg/dL
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caloric content of breastmilk
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20 kcal/oz
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#1 cause of ARF in children in US
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HUS
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+ direct coombs test in NB indicates
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Ab present on fetal RBCs
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Fluid bolus given for hypovolemic hypotension
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20 mg/kg
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Tx for dehydration s hypotension
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oral rehydration if possible
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Dx suggested by:
sore throat salmon colored sandpaper rash on trunk and clusters in axilla, groin |
Group A strep
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top 3 reasons why babies cry
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hunger
soiled diaper sleepiness |
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asthma Sx usu worse at what time of day
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@ night
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most common cause of myocarditis in children 2
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coxsackie B
adenovirus |
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IVF maintenance is to replenish what forms of water loss
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urine
insensible H2O loss |
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% of kids with sickle cell dz who will experience a stroke by 15 y/o
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10%
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typical location of port-wine stains in Sturge-Weber syndrome
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V1 distribution
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when can Sturge-Weber cause Sz?
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if AVM found in brain
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what is a port wine stain
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cutaneous AVM
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Struge weber inheritance
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Sporadic
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topical drug of choice for scabies
|
permethrin cream
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classic triad of DI, exopthalmus, lytic bone lesions of head
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Hand-Schuller-Christian Disease
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HEADSSS assessment screens for death due to what cause?
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unintentional injury/accidents
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most common cause of nephritic syndrome in children
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post-streptococcal glomerulonephritis
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presenting Sx of nephritic syndrome
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HTN
hematuria RBC casts in urine |
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phototherapy indicated for which level of bilirubin
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15 mg/dL
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mode of transportation of dislocated adult teeth
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in the mouth of victim
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Dx suggested by
significant painless bleeding per rectum No diarrhea |
Meckel's diverticulum
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live attenuated vax given at 12 m/o and 4-5 y/o 2
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VZV, MMR
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top 4 items on DDx for neonatal respiratory distress
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RDS
cyanotic heart disease TTNB lung hypoplasia/abnormalites like congenital diaphragmatic hernia |
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other congenital anomalies to look for in TE fistula
|
VACTERL
Vertebral Anal Cardiac TE fistulas Renal Limb |
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top 3 causes of death in children 5-9 y/o
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1. unintentional injury
2. malignancy 3. congenital anomalies |
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live attenuated viruses c/in in pt c severe egg allergy
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influenza
MMR |
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vitamins and mineral absent in breastmilk 4
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Vit D
Vit K Zn Fe |
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Rx of choice for acute OM
|
amoxicillin
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children's pneumovax consists of what Ag
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heptavalent polysaccharide conjugated to protein
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Neuro finding present in almost all Down's syndrome newborns
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hypotonia
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Ebstein pearls are
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benign inclusion cysts on palate midline that regress spont
present at birth in most babies |
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Hirschsprung's pt have constipation s urge to defecate because
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absence of stool in rectum
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Stridor indicates obstruction at what level of resp system
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Extra-thoracic
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Immunization for which viral illnesses are c/in in children with immunodef
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VZV
MMR oral polio |
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top 3 causes of death in children 1-12 m/o
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1. congenital anomalies
2. SIDS 3. unintentional injury |
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Tx of choice for NB born to mom with VZV inf
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IV Ig
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body metric most concerning when eval child with suspected malnourishment
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head circumference
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Beneficial immuno agents in breastmilk
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IgA
Macrophages Complement Lysozymes |
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Breastmilk jaundice caused by
|
inhibitory substance in breastmilk interfere with hepatic metabolism of heme
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jaundice of breastmilk jaundice is conjugated or unconjugated
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Unconjugated - competes for spots on glucouronyl-transferase
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administration of what med prior to delivery dec chances of RDS and IVH in premies
|
betamethasone
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Dx test of choice for suspected diaphragmatic paralysis
|
Flurouscopy
|
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pyloric stenosis is more common in M or F?
|
M
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typical age of presentation for pyloric stenosis
|
2-4 WOL
|
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Rx of choice for GAS pharyngitis
|
PCN
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If pt is PCN-allergic, what can use to Tx GAS?
|
Macrolides
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In Tanner stage 2, pubic hair has what characteristics
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long, straight, starting to become coarse, confined to genital region
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sepsis eval in child < 1 m/o req 8
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CBC/D, BCx
UA, UCx LP, CSF Cx Hospitalization +/- CXR |
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Circumcision may benefit in which types of inf? 3
|
UTI in kids
STI in adults Penile HPV |
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most common bacterial cause of PNA in children 5-15 y/o
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Mycoplasma pneumoniae
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numerical cutoff to Dx UTI in clean-cath specimen
|
> 100K
|
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numerical cutoff to Dx UTI in cath specimen
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> 10K
|
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numerical cutoff to Dx UTI in suprapubic tap
|
> 1K
|
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basic labs to order in pt c short stature
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ESR, CBC, UA
TSH |
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Polysaccharide vax given at 2, 4, 6, 12 m/o 2
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HIB
Pneumococcus |
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Slightly tender testicular swelling in adolescent boys with "bag of worms" on palpations
|
Varicocele
|
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H&P red flags for jaundice infants: 7
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1st 24 HOL
@ 10 DOL + Direct coombs test Lethargy, listlessness Vomitting Fever FHx of hemolytic dz |
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Most common cause of non-AG acidosis in children
|
Diarrhea
RTA |
|
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Children should not take swimming lessons until this age
|
4 y/o
|
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Tx of choice for acute rheumatic fever 3
|
Corticosteroids
PCN ASA |
|
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2 conditions when can give ASA to a child
|
acute rheumatic fever
Kawasaki's dz |
|
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most UTI in newborn due to what seeding
|
Hematogenous seeding
|
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Dx suggested by
Lip fissues Peeling of skin at finger tips Prolonged F Conjunctivitis Urticarial rash Cervical LAD |
Kawasaki's
|
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route and dose of epi in Tx anaphylaxis
|
IM, 1:1000 dilution (0.01 mg/kg)
|
|
|
Most common solid CNS tumor seen in children < 18 y/o
|
astrocytoma
|
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|
FUO in NB is bacterial how often
|
<10%
|
|
|
Dx suggested by
6-8 y/o M Limp Pain in ant thigh |
Legg-Calve-Perthes disease
|
|
|
What is Legg-Calve-Perthes disease
|
avascular necrosis of femoral head
|
|
|
2 most commonly implicated microbes in children c sinusitis
|
Pneumococcus
non-typable H. flu |
|
|
Wt loss from birthweight that's concerning
|
> 7-8% in first WOL
|
|
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most common cause of dehydration in pediatric pt
|
GI loss
|
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1st choice Tx for acute otitis media
|
expectant management
|
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timeframe when baby should be back to birthweight
|
within 1-2 WOL
|
|
|
lab test of choice for suspected spherocytosis 2
|
PBS
osmotic fragility test |
|
|
AAP recommendation for breastfeeding in infants c diagnosed unconjugated hyperbilirubinemia
|
continue breastfeeding
|
|
|
PDA is cyanotic/acyanotic?
|
Acyanotic
|
|
|
Most common cause of delayed/late puberty
|
constitutional growth delay
|
|
|
Lab tests to order in children 5-18 y/o c suspected PNA 4
|
CBC/D, CXR, Sp Cx
Cold hemagluttins |
|
|
Dx of flu include which lab studies 2
|
Flu Cx
Rapid Ag testing |
|
|
Tx of choice for HSV encephalitis
|
IV acyclovir
|
|
|
Most common cause of spont viral encephalitis in children
|
HSV
|
|
|
most commonly implicated microbes in cellulitis 2
|
staph aureus
GAS |
|
|
most commonly implicated microbes in impetigo 2
|
staph aureus
GAS |
|
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% of sexually active teens that will acquire STI in high school
|
up to 25%
|
|
|
phys exam findings a/w Kwashiokar 4
|
Edema
ascites brittle hair Sx of heart failure |
|
|
CDC recommendations for annual flu vax in which pt
|
ALL peds pt
|
|
|
RSV PPx in susceptible infants
|
Palivizumab = human mab
|
|
|
Indications for Palivizumab 4
|
Premies
< 2 y/o c BPD < 2 y/o c cyanotic heart dz immunocompromised |
|
|
Multiple congeital anomalies c 1 common cause is called?
|
Syndrome
|
|
|
How achieve 2 pt for Grimace in APGAR?
|
1 - grimace
2 - screaming |
|
|
Dx test of choice for atopic child
|
Skin testing
|
|
|
Tx for mod persistant asthma is which 2 classes of meds
|
SABA
Inh corticosteroids - fluticasone LABA - salmeterol |
|
|
Progression of puberty in M
|
Testicles enlarge -> penile enlargement -> growth spurt
|
|
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preferred abx for UTI/pyelo in newborn
|
ceftriaxone
|
|
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most important factor in good childhood eating habits 2-4 y/o
|
family eating habits
|
|
|
step before admin syrup of ipecac
|
call poison control
|
|
|
2 c/in to syrup of ipecac
|
impaired conciousness
ingestion of caustic substances |
|
|
most common cause PNA in <5 y/o
|
viral - RSV, para flu, flu
|
|
|
most common presenting Sx of CF
|
meconium ileus
|
|
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location of tenderness in Osgood-Schlatter dz
|
tibial tuberosity
|
|
|
Healthy baby feeds how often at end of 1st MOL
|
q 2-3 hrs about 20 min/breast
|
|
|
AOM that fails augmentin Tx should be Tx c? 2
|
cephalosporins
empiric clinda |
|
|
HAV vax consist of what Ag
|
inactivated virus
|
|
|
T or F: over the counter meds help with common cold Sx in kids
|
False
|
|
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age at which baby-proofing house should begin
|
6 MOL
|
|
|
Viral exathems most likely to present c concurrent generalized LAD 2
|
Rubellla
Measles |
|
|
biggest RF for IVH
|
prematurity
|
|
|
what meds given prenatal reduces risk of IVH
|
betamethasone
|
|
|
findings of triple screen in trisomy 18 (3)
|
all low:
aFP, beta-HCG estriol |
|
|
empiric abx combo if suspected bact meningitis < 3 m/o 2
|
amp
gent |
|
|
atopic derm Tx c what topical Rx 2
|
topical steroids
tacrolimus |
|
|
most common presenting Sx of roseola (HHV-6)
|
profound fever preceding rash 4-5 d
|
|
|
Gilbert's and Crigler-Najjar syndrome affect which enzyme
|
Glucouronyl transferase
|
|
|
Which is more benign? Gilbert's or Crigler Najjar?
|
Gilbert's
|
|
|
Most common bacterial cause of PNA in peds pt > 5 y/o
|
M. pneumno
|
|
|
time frame for fever post-vaccination
|
24-48 hrs
|
|
|
Radio evidence of subdural hematoma c no h/o trauma suggest
|
child abuse
|
|
|
Swelling that cross suture lines = cephalo or caput?
|
Caput
|
|
|
Tx of choice for Kawasaki's
|
high dose ASA
IVIG |
|
|
Natural Hx of untreated food allergies
|
Typically regress
|
|
|
Why sickle kids need cholecystectomy
|
hemolysis -> stones
|
|
|
most common abd surg in sickle pt
|
splenectomy
|
|
|
top 3 vit/min to supplement in exclusively breastfed babies
|
Fe
Vit D Flouride (@ 6 MOL) |
|
|
elements of female athlete triad 3
|
amenorrhea
disordered eating early onset osteoporosis |
|
|
Dx suggested by loud S1, fixed split S2, acyanosis
|
VSD
|
|
|
why fixed split S2 in septal defect
|
always same volume in RV no matter what the pulm stage is
|
|
|
fluid loss in peds pt is described how?
|
% of body weight loss
|
|
|
roseola (HHV-6) occurs in pt < what age?
|
< 2 y/o
|
|
|
which type of hyper-bilirubinemia is always considered pathologic
|
Conjugated hyperbilirubinemia
|
|
|
WHO recommend what supp in measle-inf children
|
Vitamin A
|
|
|
HBV vax consist of what Ag
|
Surface Ag (HBsAg)
|
|
|
First dose HBV given when?
|
at birth
|
|
|
age at which post fontanelle closes?
|
4 MOL
|
|
|
age at which ant fontanelle closes
|
2 YOL
|
|
|
Most likely Dx in 3-6 m/o infant c:
atelectasis hyperinflation Sx of upper resp inf |
RSV
|
|
|
Pk incidence of AOM at what age
|
Age 6 m - 2 y/o
|
|
|
avg wt gain in first 4-6 months
|
20-30 g/day
|
|
|
What do Fe study levels look like in thalassemias
|
NL serum Fe, NL TIBC, NL ferritin
|
|
|
What is abnl in thalassemia 3
|
Low Hgb/HCT
PBS -> hypochromia, target cells, microcytosis Hb electrophoresis |
|
|
Children c encoparesis should be eval for what dz? 3
|
ADHD
psych stressors Hirschsprung |
|
|
NPH insulin has what duration of action
|
12-16 hrs
|
|
|
how long does glargine last?
|
24 hrs
|
|
|
precocious puberty is defined before what age in boys? in girls?
|
9 in M
8 in F |
|
|
heart murmur easily detectable & palpable thrill has what rating?
|
4/6
|
|
|
c/in in oral rehydration therapy in dehydrated pt 3
|
shock
recalcitrant vomiting altered mental status |
|
|
Most commonly used abx in Tx acne vulgaris 2
|
Tetracycline
Erythromycin |
|
|
what for of acne vulgaris responds to abx
|
pustular
|
|
|
1st line Tx for mild acne 2
|
topical benzoyl peroxide
topical retinoids |
|
|
Dx of autism delay in social interaction/language/imaginative play by what age?
|
3 y/o
|
|
|
most sens test to detect rotavirus 2
|
ELISA
latex agglutination |
|
|
Sx that neonate is hypothermic 2
|
Incr resp rate
acrocyanosis -> vasoconstriction |
|
|
Nissen procedure corrects what?
|
GERD
|
|
|
Natural Hx of strawberry hemangiomas
|
Expand a little, then regress
|
|
|
should start veggies or fruits first?
|
Veggies
|
|
|
systolic or diastolic murmurs are almost always pathologic in kids?
|
diastolic
|
|
|
innocent systolic flow murmur heard at LUSB
|
Still's murmurs
|
|
|
mid-parental height calc in boys
|
mom's ht + dad's ht + 5 in
all divided by 2 |
|
|
mid-parental height calc in girls
|
mom's ht + dad's ht - 5 in
all divided by 2 |
|
|
premature adrenarche has assoc risk for? 2
|
PCOS
T2DM |
|
|
simple Dx test for deficient respiratory burst
|
Nitroblue tetrazolium test
|
|
|
imaging technique for osteomyelitis early on 2
|
?bone scan
MRI |
|
|
Penile enlargement in M occur at what Tanner stage?
|
3
|
|
|
Deepening voice occur at which Tanner stage in M?
|
3-4
|
|
|
PPx in children c > 3 cases AOM in 6 m period
|
sulfamethoxazole
Amox |
|
|
lab value to Dx precocious puberty
|
Increased LH
|
|
|
To get child to release LH, can give what hormone
|
GnRH analog
|
|
|
Tx of choice for lung abscess 2
|
Augmentin
usu don't need to be drained |
|
|
nasal polyposis + malabsorptive diarrhea consider what dz
|
CF
|
|
|
acute cellulitis Tx 2
|
elevate limb
Abx |
|
|
Sx of ADHD fall into what categories? 3
|
hyperactivity
inattention impulsivness |
|
|
Neuroblastoma arise from what part of nervous system
|
sympathetic chain
|
|
|
where find neuroblastoma
|
thorax to lower abd
|
|
|
empiric abx indicated in bact meningitis in older children 2
|
ceftriaxone
vanco |
|
|
large or bumpy kidney in neonate suggest? 2
|
infantile PKD
Wilm's tumor |
|
|
Tx of choice for hydrocarbon poisoning
|
supportive care
|
|
|
Joint/soft tissue bleeding more commonly seen in collagen defect or clotting def?
|
Clotting def
|
|
|
Simple v. complex partial differ by?
|
Complex will lose consciousness
|
|
|
Mortality of bact meningitis despite aggressive Tx
|
5%
|
|
|
AAP recommendation for baby walkers?
|
No
|
|
|
Most likely cause of white mucousy d/c + swollen labia
|
maternal estrogen expo in utero
|
|
|
Xs vomitting produce what acid-base disturbance?
|
hypochloremic metabolic alkalosis
|
|
|
Tx of choice for vomitting
|
fluids c KCl
|
|
|
DTAP consists of which Ag
|
Diphtheria toxoid
Tetanus toxoid acelluar pertussis |
|
|
pk incidence of bronchiolitis
|
2-6 MOL
|
|
|
most common cause of bronchiolitis
|
RSV
|
|
|
Dx study for high conj bilirubin
|
RUQ abd U/S -> r/o biliary atresia
|
|
|
baby c jaundice skin below ankles has what conc
|
15
|
|
|
Infusion rate for moderately dehydrated pt:
|
maintenance rate + fluid def dose
|
|
|
Fludrocortisone is used for what peds Dx?
|
Addison's
Congenital adrenal hyperplasia |
|
|
Drug used for recurrent crisis of sickle cell dz
|
hydroxyurea
|
|
|
quad screen results in down's
|
aFP low
beta-HCG high estriol low inhibin high |
|
|
definition of oliguria in infant
|
< 1 mL/kg/hr
|
|
|
definition of oliguria in older children
|
< 0.5 mL/kg/hr
|
|
|
hydrolysate formulas indicated what formulas are allergenic?
|
cow's milk
soy's milk |
|
|
how many doses needed for polio vaccine?
|
4 doses
|
|
|
age at which meningococcal vaccine given?
|
11 or 12 y/o
|
|
|
what serotype of meningococcus not found in vax?
|
serotype B
|
|
|
top 2 etiologic factors for asthma
|
env expo
recurrent viral inf |
|
|
Gold standard to Dx congenital CMV
|
UCx or saliva Cx
|
|
|
% of babies with congenital CMV that are asymptomatic
|
90%
|
|
|
Dx suggested by:
purulent conjunctivitis @ 7-14 DOL interstitial PNA @ 6 WOL |
chlamydia trachomatis
|
|
|
Tx for lyme
|
tetracycline
Benefits > Risks |
|
|
top Dx to consider in 3 y/o c
vomitting mental status change lethargy deep rapid breathing ketonuria |
DKA
|
|
|
non-inf Dx to r/o in afebrile cough, wheezing, altered breath sounds in young child
|
aspiration
|
|
|
cornerstone for chronic asthma mgmt
|
steroids
|
|
|
most common viral cause of infantile hospitalization
|
RSV
|
|
|
menarche corresponds to what Tanner stage?
|
Tanner stage 4
|
|
|
typical age for menarche
|
11-12
|
|
|
most common cause of oliguria in peds pt
|
volume depletion
|
|
|
Tx of choice for head lice in children v. infants
|
children: lindane 1%
infant: permethrin 1% |
|
|
mod-severe asthma that is not responsive to LABA and corticosteroids req what add'l med?
|
montelukast
|
|
|
spastic CP charcterized by what tonia?
|
hypertonia
|
|
|
Dx of MR require what IQ 2
|
< 70 (< 2 STDV from mean)
|
|
|
Med used to Tx:
minimal change disease acute lupus Duchenne's muscular dystrophy |
oral steroids
|
|
|
characteristics Tanner stage 2 breast
|
subaeorlar mound
|
|
|
Tanner stage 3
|
breast tissue extend beyond areola but no secondary mound yet
|
|
|
classic physical finding of intussception
|
sausage mass in R side of abdomen b/c @ ileo-cecal jxn
|
|
|
Lab value prolonged in hemophilia A
|
PTT (measures intrinsic pathway)
|
|
|
organophosphate poisoning involves brady or tachycardia?
|
bradycardia
|
|
|
organophosphate poisoning involves tetany or fasciulation?
|
fasiculations
|
|
|
organophosphate poisoning involves myosis or mydriasis?
|
Miosis
|
|
|
organophosphate poisoning involves drooling or decreased oral state?
|
Drooling
|
|
|
how reverse organophosphate poisoning?
|
atropine
|
|
|
Dx test for Hirschsprung dz? 3
|
rectal exam
KUB/barium enema rectal Bx |
|
|
top 3 causes of death in teens
|
unintentional injuries
homicide suicide |
|
|
typical age at which stranger anxiety begins
|
~ 1 y/o
|
|
|
3 organ systems implicated in Henoch-Schenolien purpura
|
Skin -> purpura
Kidney -> nephritic GI -> vomitting/GI bleeds |
|
|
Drug of choice for increasing excretion in salicylate poisoning
|
alkalinize urine c
acetazolamide bicarb |
|
|
2 maneuvers used to look for hip dislocation
|
Barlow, Ortalani
|
|
|
% babies c first-degree relative c cleft lip/palate that will be born with it
|
4%
|
|
|
how Tx cleft palate?
|
surgery
|
|
|
when do surgery for cleft palate/lip? why?
|
palate: 1st YOL so can have NL speech
lip: 3-6 MOL |
|
|
patho cause of ACS in sickle cell
|
vaso-occlusion of lung parenchyma
can have fat emboli can have infectious pneumonitis |
|
|
most common cause of death in sickle?
|
ACS
|
|
|
Tx for ACS in sickle? 4
|
analgesia
O2 abx transfusion |
|
|
Autism is extreme form of what spectrum of mental d/o?
|
pervasive mental d/o
|
|
|
rotavirus is given in what form?
|
live pentavalent reassorted vax
|
|
|
recommended Dx test for clinical Dx of asthma
|
spirometry
|
|
|
if initial spirometry testing is negative in asthmatic, what test can do?
|
methacholine test
|
|
|
how confirm reversibility of asthma?
|
check spirometry after albuterol
|
|
|
mech of direct coombs test that explains why ABO incompatibility give + result?
|
Direct checks the pt RBC and Coombs reagent (anti-Ig Ab) -> will agglutinate
|
|
|
5 T's of cyanotic congenital heart lesions
|
TOF
Truncus arteriosus TGA Tricuspid Atresia total anomalous pulm venous return |
|
|
First tests to order in suspected DM in peds pt
|
serum glc and UA
|
|
|
Inexpensive test to distinguish TTNB from RDS
|
CXR
|
|
|
cushing's dz or syndrome more likely to respond to high dose dexamethasone suppression test
|
Dz
|
|
|
IgA against blood vessels
|
HSP
|
|
|
avg age of thelarche in caucasians
|
9
|
|
|
avg age of thelarche in African Americans
|
8
|
|
|
most common childhood motor disability
|
CP
|
|
|
incidence of CP
|
0.2-0.3% live births
|
|
|
galactosemia/lactose intolerance require what type of formula
|
soy milk (contain fructose and sucrose)
|
|
|
Tx of what comorbidities can help asthmatic child? 4
|
allergic rhinitis
GERD sinusitis stress/depression |
|
|
2 major causes of hypernatremia hypovolemia
|
DI
Xs sweating/lack access to free water |
|
|
Rationale for hospitalization x 24 hrs after anaphylaxis
|
late phase allergic response
|
|
|
most common cause chronic diarrhea in children
|
IBS
|
|
|
most common cause acute scrotal pain
|
torsion
|
|
|
2 points in male life when most likely to have torsion
|
early life
puberty |
|
|
efficacy of VZV vax in preventing chickenpox
|
20% do get it
|
|
|
which form of hyperbili causes kernicterus if untreated
|
unconj hyperbili
|
|
|
months when RSV peaks
|
Nov-April
|
|
|
leading cause of death 1-44 y/o
|
unintentional injuries
|
|
|
malformations assoc c maternal phenytoin use
|
distal phalangeal hypoplasia
|
|
|
malformations assoc c maternal valproate use
|
NT defects
|
|
|
fixed widely split S2 most suggestive of
|
ASD > VSD because ASD is more common
|
|
|
3 org causing AOM
|
h.flu (non-typeable)
s. pneumo m. catt |
|
|
congenital midline hernia that includes enclosing sac
|
omphalocele
|
|
|
Sac in omphalocele includes 2
|
peritoneum
amnion |
|
|
classic triad of precocious puberty, fibrous dysplasia of bones, cafe-au-lait spots
|
McCune-Albright syndrome
|
|
|
Double bubble Sx on X-ray + bilious vomitting indicates 2
|
duodenal atresia
malro |
|
|
Next step after KUB if suspect duodenal atresia?
|
Down's karyotype w/u
Contrast enema |
|
|
hormones to check when w/u growth hormone issues 3
|
IGF-1,
IGF-binding proteins GH after glc bolus |
|
|
provocative test for GH def
|
Insulin bolus
|
|
|
W/u for GH adenoma
|
Glucose bolus should suppress GH levels
|
|
|
Importance of + glc bolus test for GH adenoma
|
indicates that it will be amenable to surg
|
|
|
medical Tx of choice for GH adenoma
|
Somatostatin analog - ocreotide
|
|
|
most common peds endocrine d/o
|
DM
|
|
|
Dx suggested by:
profound F x several days generalized mild rash < 2 DOL |
Roseola
|
|
|
2 primary c/in to DTaP
|
previous anaphylatic reaction
recent encephalopathy |
|
|
primary cause of injury in adolescents
|
Sports
|
|
|
tx of choice for most cases of SCID
|
BMT
|
|
|
Drug of choice for campylobacter inf 2
|
none
can give cipro |
|
|
if child falls behind in vaccines, what do?
|
catch them up
|
|
|
do u need to restart vaccine series if haven't had one in a long time?
|
no
|
|
|
primary recent for rubella vaccination
|
worry about congenital rubella syndrome
|
|
|
Sx of congenital rubella 4
|
glaucoma
cataracts deafness PDA |
|
|
reasons for symmetrical growth restriction
|
prematurity
genetic anomalies aneuploidy IUGR |
|
|
ADHD Tx
|
stimulants
|
|
|
how effective is stimulants for ADHD?
|
up to 90% effective
|
|
|
DDx for short stature but NL head circumference
|
constitutional growth delay
familial short stature |
|
|
Drug of choice for neonatal apnea
|
caffeine
|
|
|
Typical first solid food introduced to baby
|
fortified grains (usu rice) at 6 MOL
|
|
|
Dx suggested by
diffuse petechial rash, hematuria, NL plt ct, NL coags, NL VS |
anaphylactic pupura
|
|
|
Dx suggested by:
White forlock deafness Heterochromic iris |
Waardenburg syndrome
|
|
|
top 2 causes of morbidity in adolescence
|
substance abuse
sexual activity |
|
|
early forms of rotavirus vax increased risk of what GI dz?
|
Intussusception
|
|
|
labs test to distinguish type 1 v. 2 DM? 2
|
insulin
C-peptide |
|
|
DTaP require how many doses
|
5 doses
|
|
|
lifetime prevalence for anorexia nervosa
|
1-2%
|
|
|
abd pain & diarrhea that occur at night and awaken child from sleep suggest?
|
Infl bowel dz
|
|
|
preferred Tx for moderate scoliosis 3
|
orthosis
stretching exercises (20-40 degrees) serial X-ray |
|
|
characteristic facial features of fetal alcohol syndrome 7
|
microcephaly
micropthalmia micrognathia smooth filtrum thin upper lip low flat nasal bridge epicanthal folds |
|
|
most common cause of central precocious puberty in F
|
idiopathic
|
|
|
common bone manifestations of rickets include 4
|
box-shaped head
enlarged wrists & ankles bowing of legs rosary at costo-epichondral jxn |
|
|
ADHD require Sx for how many months
|
6 months
|
|
|
primary justification for w/h vax in children c severe febrile illnesses
|
vax may cause F and localized rash that can complicate mgmt
|
|
|
all children Dx c T1DM are annually screened for?
|
thyroid dysfxn -> Hashimoto's
|
|
|
most common inherited bleeding d/o
|
vWD
|
|
|
hyponatremia hypovolemia DDx
|
osmotic diuresis (DM)
salt-wasting endocrine/nephropathies metabolic alkalosis (GI loss) 3rd spacing |
|
|
new onset diurinal/noctural enuresis in previous potty trained child
|
DM
|
|
|
Dubin-Johnson characterized by increase of what kind of bili?
|
conj
|
|
|
what is the defect in Dubin-Johnson
|
defect in transport of conj bili
|
|
|
Defect in Gilbert syndrome
|
unconj hyperbili
|
|
|
amt of fluid that needs to be replenished in peds pt per 100 kcal expended
|
1 mL/1 kcal
|
|
|
pharmacotherapy for anorexia
|
SSRIs
|
|
|
rules of 2s for Meckel's
|
2 ft from ileocecal valve
2 y/o 2% of gen pop 2 tissues: panc, gastro 2 cm long |
|
|
H/o rhinorrhea & pharyngitis that precedes PNA suggests what kind of inf
|
viral URI
|
|
|
Inf that are absolute c/in to breastfeeding:
|
HIV
HTLV-1 active HSV on/near breast TB |
|
|
w/u for tetany in NB should r/o what syndrome
|
CATCH-22 -> DiGeorge
|
|
|
CATCH-22 stands for?
|
Cardiac anomalies
Abnl facies Thymic hypoplasia Cleft lip/palate Hypoparathyroid/hypocalcemia Chr 22q deletion |
|
|
Dx suggested by:
poor bone mineralization poor growth high PTH |
Pseudo-hyperparthyroidism
|
|
|
short 4th/5th digit suggest
|
pseudo-hyperparathyroidism
|
|
|
nevus flameus (stork bites/salmon patches) refers to
|
benign nevi on face
|
|
|
children c learning disabilities tend to have low, NL, or high IQ
|
NL
|
|
|
BW < 85% NL and perceptions of being overweight
|
anorexia nervosa
|
|
|
> 3 m/o, most common cause of bact meningitis
|
pneumococcus
meningococcus |
|
|
Still's murmur is heard how/where?
|
systolic at LLSB
|
|
|
quality of still's murmur
|
twangy/musical in nature
|
|
|
How Still's murmur changes when lying down
|
Increases because increase return to heart
|
|
|
Tx of choice for mild vWD
|
Desmopressin
|
|
|
M/A desmopressin for vWD
|
endothelial release of vWF
|
|
|
lab values in vWD 2
|
slightly prolonged bleeding time
NL plt ct |
|
|
typical presentation of vWD 3
|
epistaxis
gingival bleeds heavy periods |
|
|
most common means by which rotavirus is spread
|
fomites
|
|
|
food allergies effect how many children
|
2-5%
|
|
|
baby that sweats during feeding usu inv what organ system
|
cardiovascular dz
|
|
|
hearing test for NB relies of what principle
|
Otoacoustic emissions from outer hair cells
|
|
|
only approved medication for migraine PPx
|
propanolol
|
|
|
role of inhaled corticosteroids in acute viral-induced wheezing
|
very little
|
|
|
congenital heart malf most assoc with fetal alcohol syndrome
|
ASD
|
|
|
location of infantile form of aortic coarctation
|
prox to ductus arteriosus
|
|
|
classic cardiovascular malf of DiGeorge
|
truncus arteriosus
TOF |
|
|
Mab against IgE
|
Omalizumab
|
|
|
Which of following proven to be effective in Tx common cold:
Antihistamines Antitussives Zn Abx herbal remedies |
Antihistamines - no
Antitussives - no Zn - no Abx - no herbal remedies - no |
|
|
RAST is more sens or spec than skin prick
|
More sensitive, less spec
|
|
|
what is RAST
|
Allergen-specific IgE Ab
|
|
|
Clinical tetrad to predict likelihood that pharyngitis caused by GAS
|
sore throat
exudate cervical ant LAD febrile no cough |
|
|
rapid Ag testing for strep missing how many cases?
|
5%
|
|
|
maternal smoking during or after preg yields greater risk for developing asthma
|
during
|
|
|
1st line medication for T2DM in kids > 12 y/o
|
Metformin
|
|
|
initial steps in Dx & Tx of osteomyelitis 4
|
CBC/D
BCx Plain films IV abx |
|
|
Dx suggested by umbilicated vesicles superimposed on pre-existing ezcema
|
Eczema herpeticum
|
|
|
what causes eczema herpeticum
|
HSV
|
|
|
when is eczema herpeticum threatening
|
In younger children (they can die from it)
|
|
|
how is eczema herpeticum Tx
|
IV acyclovir
|
|
|
Vaginal white d/c in teen girl not accompanied by pain, pruritis, foul odor or lesion
|
physiologic leukorrhea
|
|
|
Dx test if phys exam suggest congenital hip dysplasia 2
|
< 4 m/o: U/S
> 4 m/o: hip X-ray |
|
|
if battery swallowed, what do?
|
X-ray
Prox to LES -> retrieve |
|
|
Dx suggested by:
Toxic appearence Lethargy Fever Petechial rash in axilla, wrist, ankles |
Meningococcal meningitis until proven otherwise
|
|
|
most cost effective meds for noctural enuresis
|
imipramine
desmopressin |
|
|
pinworm inf present c intense pruritis where? 2
|
anus
vulva |
|
|
Tx for pinworm
|
Mebendazole
|
|
|
Bug most commonly implicated in aerosyphilis
|
Group A strep
|
|
|
leukocoria represents what til proven OTW
|
retinoblastoma
|
|
|
classic presentation of chronic upper airway compression by vasc ring
|
look like refrac asthma present since birth
improves c neck extension |
|
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Tx for vasc ring
|
surgery
|
|
|
infantile spasms (West syndrome) characteristic for which dz
|
Tuberous sclerosis
|
|
|
what do infantile spasms look like?
|
random spasmotic movement of limbs
|
|
|
route preferred if IV not available
|
IO
|
|
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Todd's paralysis is
|
post-ictal hemiparesis that resolve spont
|
|
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what does Todd's paralysis suggest about Sz?
|
caused by focal lesion
|
|
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Dx suggested by:
Asymmetric Moro's reflex + crepitus Macrosomia |
Clavicular fracture
|
|
|
1st like drug for cystic acne, nodulocystic or serious scarring
|
isotretinoin
|
|
|
labs to check before starting isotretinoin 2
|
preg test
cholesterol levels |
|
|
dacylitis may be presenting Sx of what dz
|
Sickle cell
|
|
|
why do sickle pt get dacylitis
|
vaso-occlusion
|
|
|
Autosomal recessive dz
hypopigmentation pan-cytopenia defects in DNA cross-link repair |
Fanconi's anemia
|
|
|
Dx suggested by
recurrent epistaxis nasal mass adolescent boys |
Juvenile angiofibroma
|
|
|
Tx of choice for vaso-oclusive dz in sickler 5
|
Oxygen
hydration analgesia abx hydroxyurea |
|
|
cyanosis exclusively during feeding suggest? 2
|
Choanal atresia
congenital heart lesion |
|
|
what is a tet spells?
|
acute cyanosis during times of high stress
|
|
|
movements restricted in avasc necrosis of femoral head 2
|
abduction
internal rotation |
|
|
ocular hypertelorism
|
excessive space between eyes
|
|
|
HSP is most likley to be complicated by what GI disturbances
|
intussuception
|
|
|
most common cause of b/l white reflex on ophtalmoscopic exam
|
congenital cataracts
|
|
|
Tx of choice for club foot 2
|
orthosis and serial casting
|
|
|
why Tx club foot aggressively
|
can correct totally s surg
|
|
|
Tx of choice for undescended testicle 2
|
can watch for 1 yr
orchioplexy |
|
|
nursemaid elbow is what dislocation
|
subluxation of radial head thru annular ligament
|
|
|
Tx for nursemaid elbow
|
hold elbow in slight flexion
supinate arm |
|
|
2 viruses most implicated in Reye's syndrome
|
Flu
VZV |
|
|
Indications for surg correction of VUR 2
|
high grade and b/l
|
|
|
imperforate anus is a/w what malf?
|
rectovaginal fistula (perforates in wrong spot)
|
|
|
measures that reduce risk of SIDS
|
back to sleep
stop smoking no pillows/soft blankets |
|
|
familial assoc for pyloric stenosis?
|
10%
|
|
|
imaging modality of choice to confirm Dx of hypertrophic pyloric stenosis 2
|
U/S abd
upper GI barium follow-through |
|
|
% of children c pyloric stenosis who present c olive-like mass
|
approx 50%
|
|
|
Dx presenting c
gait ataxia early in life subsequent telangectasia then Ig def |
Ataxia-telangectasia
|
|
|
Gait ataxia
sensory deficits scoliosis cardiomyopathy |
Friedrich's ataxia
|
|
|
X-ray findings in sickler: 5
|
Dactylitis
Compression fractures Areas of avasc necrosis Codfish vertebrae Occult osteomyelitis |
|
|
Dz characterized by:
Eczema Immunodef Thrombocytopenia |
Wiskott-Aldrich (X-linked)
|
|
|
Immunodef of Wiskott-Aldrich is special how?
|
High IgA levels but everything else low
|
|
|
Strabismus is?
|
Misalignment of eyes
|
|
|
How detect strabismus
|
cover test, alternate cover test
|
|
|
Prolonged strabismus can lead to?
|
ambylopia -> disfunctional pathway of visual cortex
|
|
|
Neurodegenerative d/o of infants
slow dz hypotonia tongue fasiculations muscle wasting rapidly progressive -> death in 1st 2 YOL |
Spinal muscular atrophy type 1 -> wiernick hoffman dz
|
|
|
Dx suggested by:
encephalopathy anemia abd pain gum & teeth discoloration |
Pb tox
|
|
|
Tx for Pb tox 2
|
EDTA
Penicillamine |
|
|
2nd most common primary malig of children
|
CNS malig
|
|
|
Is CP progressive?
|
no
|
|
|
how Tx spasticity in CP?
|
baclofen
benzo |
|
|
most common congenital tumor
consists of all 3 germ cell layers arises in sacro-coccygeal region |
teratoma
|
|
|
air in bowel wall suggests what in premie?
|
NEC
|
|
|
Temp Tx for gastroschisis
|
cover extruding bowel in sterile bowel
|
|
|
2 most common upper airway manifestations of CF
|
b/l nasal polyposis
recurrent sinusitis |
