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63 Cards in this Set
- Front
- Back
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-when can healthy adults and kids exposed to VZV receive the vaccine (ie post exposure prophylaxis)?
-when is post exposure prophylaxis recommended with the VZV immune globulin product? |
-w/in 3-5 days of exposure
-VZV Ig is indicated for high-risk persons w/in 96 hours (4 days) of exposure |
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vaccines at birth?
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hep B
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Vaccines at 2 months?
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heb B, rota, dtap, Hib, PCV, IPV
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Vacines at 4 mo/s?
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Rota, DTaP, Hib, PCV, IPV
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Vaccines at 6mo.s?
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Rota, DTaP, Hib, PCV, IPV
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Vaccines at 15 mo.s:
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Hep B, DTap, Hib, PCV, MMR, VZV, Hep A (12-18 x2)
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Vaccines at 4 yrs.
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DTap, IPV, MMR, VZV, MCV (if asplenic)
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Vaccines at age 12?
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Td, MCV, HPV (x3)
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Vaccines at 16?
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MCV
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Vaccines at 6
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Influ and annually
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which vaccines can't egg allergic patients receive?
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Influ and MMR
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contraindication to VZV vaccine
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allergy to neomycin
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Jaundice type on 2nd or 3rd day of life?
Physiologic cause? |
Physiologic jaundice that will resolve w/in the first several weeks after birth.
>ed bili prdxn from shorter life span and >er turnover of neonatal RBC <ed bil clearance due to deficiency of UGT |
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breastfeeding jaundice
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-exaggeration for physiologic jaundice seen in exclusively breastfed infants who aren't getting enough breast milk. will see elevated unconjugated bili.
-Effective breastfeeding isn't established in the first few days of life -> inadequate enteral intake prolonging intestinal transit time and resulting in an increased enterohepatic circulation. Also baby loses a little weight from dehydration from inadequate fluid intake. |
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SCID
-presents with -dx confirmed by: |
-recurrent sinopulmonary infxns, oral candidiasis, persistent diarrhea.
-absent lymph nodes and tonsils, lymphopenia, absent thymic shadow on CSR, abonormal T and B and natural killer cells |
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EBV:
presentation |
presents with bilateral subacute-chronic lymphadenopathy and systemic symptoms like fever, pharyngitis, and hepatosplenomegaly
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Acute unilateral lymphadenitis in kid
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usually caused by bacterial infection
MC pathogen is S. Aureus, followed by group A streptococcus |
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congenital syphilis presentation in infant
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hepatosplenomegaly, cutaneous lesions, jaundice, anemia, rinorrhea. Metaphyseal dystrophy and periostitis can be seen on XR
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Conginital toxoplasmosis presentation
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hepatosple, hydrocephalus, chorioretinitis, and intracranial Calcifications
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congenital rubella presentation
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sensorineural hearing loss, cataracts, heard defects, hepatosplenomegally, microcephaly, throbocytopenic purpura (ie blueberry muffin rash)
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congenital CMV presentation
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IUGR, hepatosplenomeg, petechiae or purpura, microceph, chorioretinitis, sensorineural hearing loss, periventricular calcifications
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congenital HIV presentation
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typically asymptomatic at birth
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Wiskott Aldrich syn
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X-linked disorder
WITE= (bacterial) Infxn thrombocytopenia eczema thrombocytopenia is caused by <ed platelet prdxn and the few platelets that exist are typically quite small |
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bordatella pertussis
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whooping cough
-tx : macrolide (azithro clarithro erythro) -1st stage, catarrhal phase= flu like -2nd stage is paroxysmal phase = whooping -leukocytosis -hospitalization when <3 mo.s old , and those 3-6 mo.s with severe paroxysms |
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Homocystinuria
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- = marfan's features+mental retardation+thromboembolic events+downward dislocaton of lens
-Auto Rec -caused by cystathinone synthase deficiency -Tx: high doses of Vit B6 |
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Vit D def
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-rickets
-craniotabes, rachitic rosary, large ant. fontanelle, thickening of lower end of long bones |
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Neonatal necrotizing enterocolitis (NEC):
-when does it happen -signs - abdo XR will show |
-first 2 weeks of life to 3 mo.s of age
- abdo distention, nausea, vomiting -pnematosis intestinalis |
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Bruton's
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X linked
- recurrent pneumonia and otitis media after 6-9 mo's of age all leves of immunoglobulins (IgM, IgG, IgA, etc) and circulating B-cells are decreased |
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Internal carotid artery dissection
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potential cause of stroke in children that is usually associated with history of trauma to the soft palate with foreign body (ex.kid falls with pencil in mouth)
-caused by thrombosis that embolizes to brain due to compression of int. carotid A. or caused by dissection of int. carotid A. leading to ischemic stroke -stroke symptoms can be delayed up to 24 hours -Dx can be confirmed with MRI/MRA |
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Pyloric stenosis
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-presents 2-4 weeks of life
-nonbilious, projectile vomiting -visible gastric peristaltic waves -palpable mass in epigastric area |
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Hirschsprung dz
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-failure to pass meconium after 48 hrs
-abdo distention |
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intestinal atresia
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-can happen anywhere from duodenom to colon
-bilious vomiting, abdo distention -XR shows: triple bubble=jejunal atresia; double bubble=duodenal atresia and gasless lower abdo |
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milestone drawing:
-3 yr old can copy: -4 yr old can copy: -5 yr. old can copy -6 yr. old can copy: |
-3 - cross and circle
-4 - square, rectangle -5 - triangle -6 - diamond |
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Hyper-IgM syndrome (ie HIM synd)
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- high levels of IgM with deficiency of IgG, IgA and poor Ab responses to immunizations
-presents with recurrent sinopulmonary infxns and pneumocystis jiroveci pneumonia - Differentiated from X-linked agammaglobunlinemias and other hypogammagobulinemias bc of high IgM levels and |
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Young child with recurrent URTIs and bilateral nasal polyps
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must r/o Cystic fibrosis
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MCC of acute diarrhea in kids 6 mos - 2yrs
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rotavirus
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DiGeorge Syndrom
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CATCH22
-Cardiac defect (tetrology of fallot) -Abnormal facies -Thymic aplasia -Cleft palate -HypOcalcemia (tetany) problem with 3rd and 4th pharyngeal pouches |
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Language development:
2 months: 6 months: 1 year: 2 years: |
2 mos = social smile
6 mos = babbles 1 yr = 2 words, obeys 1-step command 2 yr = 2-3 word phrases, obeys 2-step command |
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Gross motor development:
3 mos 4 mos 6 mos 12 mos 24 mos |
3 mos = holds head
4 mos = rolls back to front and front to back 6 mos = sits unsupported 12 mos = walks alone 24 mos = walks up and down stairs w/o help |
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fine motor development
6 mos 12 mos 15 mos 24 mos |
6 mos = raking grasp
12 mos = throws object 15 mos = builds 2 block tower 24 mos = builds 6 block tower and turns pages of books |
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social development:
2 mos 6 mos 12 mos 18 mos 24 mos |
2 mos = recognizes parents
6 mos= recognizes strangers (stranger anxiety) 12 mos = imitates action / comes when called 18 mos = plays with other kids 24 mos = parallel play |
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SCD
when pt presents with acute severe anemia there may be what types of crisis? |
-aplastic crisis: will see absent reticulocytes in peripheral blood smear
-splenic sequestration crisis: will see in pt.s who havent developed auto-splenectomy. there is vaso-occlusion and pooling of RBCs in spleen. Fall in [Hgb] and persistent reticulocytosis. Pt may develop hypotensive shock. splenectomy is recommended -hemolytic crisis |
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Down's synd GI malformations
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-Duodenal atresia (double bubble)
- Hirschsprung's dz - Esophageal atreasi - Pyloric stenosis - Malrotation of bower |
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Baby presents with meconium ileus, and ground glass appearance on abdo XR
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CF
meconium ileus - bilious vomiting and failure to pass meconium at birth |
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iron def reticulocyte level
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iron def is a type of microcytic anemia. low retics due to <ed erythropoiesis
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how to differentiate btwn thalassemia and iron def in microcytic anemia
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thalassemia has elevated RDW (red cell distribution width)
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features of benign murmur
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-asymptomatic pt.
-murmur intensity grade 2 or less -normal S2 -no audible clicks -normal pulses -no other abnormlaties |
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pthological murmur
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-SOB, CP, dizzy, etc
-intesity >or=3 -abnormal S2 -murmur loudest at upper left sternal border -absent/diminished femoral pulses -murmur's quality is unchanged with position |
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Klumpke's paralysis is
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-brachial palsy in neborns after excessive traaction on arm.
-paralysis of hand, and ipsilateral Horner's syndrome (ptosis and miosis), and is secondary to injury of 7th, 8th CMs and 1st thoracic nerve |
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painless melena in 2-3 yo kid most likely cause?
-etiology: -Dx? |
-most likely Meckel's diverticulum
-failed obliteration of vitelline duct during fetal development -technetium-99m pertechnetate scanning |
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leukoria in kid
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= retinoblastoma
-refer kid to opthalmologist |
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MC predisposing factor for acute bacterial sinusitis is
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viral upper resp infxn
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pt.s with down synd are prone to endocardial cushion defects which can rapidly cause
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pulmonary HTN
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Tx of choice for local impetigo
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topical mupirocin
or oral erythromycin |
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kid with symtpoms of subarachnoid hemorrhage - headache vomiting, AMS, nuchal regidity. and its confirmed by CT.
what's the most likely cause? Most probable additional finding? |
In kid it is : AVM (arteriovenous malformation) with rupture into subarachnoid space
-Hx of seizures and migrain like headaches |
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Infant shows mild atrophy of left calf, left calcaneum and talus are in equinus and varus positions, midfoot is in varus position, and forefoot is in adduction.
Dx Next step in mngmt. |
talipes equinovarus = clubfoot
-must be managed immediately; stretching and manipulation of foot followed by serial plaster casts, malleable spleints, or taping - if the above doesn't help then , Qx betwn 3 and 6 months of age |
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TORCH infxns - what are they?
how are they physically characterized in neonate? |
toxoplasmosis, rubella, CMV, HSV, syphillis
- microcephally, hepatosplenomegaly, deafness, chorioretinitis, and thrombocytopenia |
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MC fractures in pediatric pop?
-what secondary injury is most commonly assoc.d with this patient's fracture? |
supracondylar fractures
brachial artery injury -> compartment syndrome and volkman's contracture |
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measles treatment
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Vit A
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Kid misdiagosed with reactive airway dz. doesn't respond to inhaled bronchodilators and corticosteroids but is relieved with neck extension
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vascular rings can compress the trachea and lead to stridor, wheezing, and SOB shortly after birth.
Tx is Qx |
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beckwith-wiedmemann syndrome:
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macrosomia, macroglossia, visceromegaly, omphalocele, hypoglycemia, hyperinsulinemia, pancreatic hyperplasia
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rubella how it presents
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low grade fever, lymphadenopathy (sub-occipital and posterior auricular) rash. rash starts on face and spreads down body.
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adverse rxn to DTaP. what do you do?
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diphteria and tetanus toxoids, and avoid the pertussis component
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