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163 Cards in this Set
- Front
- Back
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Bacterial eye discharge management |
Erythromycin Tetracycline Polymyxin B eye solution |
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Gonococcal treatment |
Emergency!!! Treat with PCN or ceftriaxone |
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Chlamydia |
Erythromycin ointment Oral tetracycline |
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Viral eye infections treatment |
Watery eyes Cooled saline drops Antihistamines Sulfa eye solution |
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Bright red irritated eyes cause |
Possible herpes |
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What kids are more at risk for cataracts? |
Downs, diabetics, Marfan abd atopic dermatitis. |
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Symptoms of cataracts |
Painless, decrease |
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Bacterial ear drops for kids |
Ciprofloxacin and dexamethasone |
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Antifungal ear drops |
Clotrimazole |
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What accounts for 30% of ear infections |
Strep |
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What accounts for 20% of ear infections? |
Haemophilus influenza |
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Tympanic membrane with ear infection |
Swollen and red. Rarely bulges |
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Med for ear infection |
Amox 80-90mg/kg/day |
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Vaccines to prevent ear infection |
Hib pcv14 and flu Smoking |
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Are antihistamines effective for fluid on the ear? |
No |
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Reevaluate ome when? |
3-6mth |
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Sensorineural hearing loss |
Anything effects neuro system. Tumor, syohilis, med toxication |
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Webber test lateralizes to what ear? |
Affected ear |
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Sensorineural hearing loss results |
Weber- uneffected Rinne- abnormal in affected ear |
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Antitussive for what age |
6 and > |
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Pressure on the kiesselbach plexus helps with what? |
Nosebleeds |
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What diagnosis has a sandpaper like rash? |
Scarlet fever |
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Group A strep symptoms |
F- fever L- lack of cough E- exudate A- adenopathy |
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Antibiotic for strep infection |
PCN 250mg tid for 10 days If allergy to PCN, erythromycin 250mg 4x a day for 10 days |
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Epiglottis |
Age 6-10 Strep, pneumococci and H. Influ |
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What diagnosis has the thumb sign? |
Epiglottis |
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What virus is the causative agent of croup? |
Parainfluenza |
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What age for croup? |
3mth to 6yrs |
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Croup on X-ray |
Steeple sign |
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Lab tests for mono |
Neutropenia Positive heterophil and monospot Rise in IGM and IGG on EBV |
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Contact sports after mono diagnosis? |
Wait at least 3 weeks due to risk or spleen rupture |
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What age for sinusitis |
9 or over Maxillary or ethmoid sinuses most affected Same pathogens as ear infection |
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Halitosis is what? |
Discolored nasal discharge |
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Front |
Back |
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Bronchicholitis age and findings |
Under 3yr CXR- hyperinflated lungs, areas of consolidation POS RSV
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Obstructive airway disease |
Reduced airflow rates, lung volume normal or larger Trouble exhaling- air trapping results in decreased FEV1 (asthma, chronic bronchiolitis, cf) |
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Restrictive airway |
Reduced volumes and expiratory flow rates Trouble inhaling air (pneumonia) |
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High risk respiratory infants can receive what and how often |
Synagis IM every month during RSV season High risk: less than 2yr ans treated for lung disease in last 6 months <32 wk at birth and under 1yr 32-35wk can be treated if: day care, school aged siblings, pollution, abnormal airway, neuromuscular problems |
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Pulse paradoxus happens with what?? |
Asthma- ominous sign! Increase in pulse pressure between inspiration and expiration |
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Hospitalize if peak flow reading is less than what? |
60 liter/min |
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Asthma classification for 2days a week symptoms, doesn’t interfere with activity, peak flow 80 or greater, rescue inhaler 2 days a week |
Intermittent |
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If asthma symptoms are daily, waken up once a week at night, use rescue daily, cab interfere with normal activity and peak flow 60-80 |
Moderate persistent |
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CXR findings with pneumonia |
Consolidation Patchy infiltrates |
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CF |
Autosomal recessive Chromosome 7 |
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Cf labs |
Pilocarpine (sweat test) Pulomonary function test Hyponatremic and hypochloremic Cystic lesions and atelectasis |
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CF |
Autosomal recessive Chromosome 7 |
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Cf labs |
Pilocarpine (sweat test) Pulomonary function test Hyponatremic and hypochloremic Cystic lesions and atelectasis |
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Internal hip rotation causes spasm in what diagnosis? |
Toxic synovitis |
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Can toxic synovitis have normal X-ray? |
Yes and normal fluid aspiration |
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Hospitalize with toxic synovitis if what?? |
High fever or septic arthritis |
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Hospitalize with toxic synovitis if what?? |
High fever or septic arthritis |
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What common musculoskeletal disorder can occur more often in girls with periods or a trauma? |
Slipped capital femoral head |
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Genu VARUM |
Bowleg (very bow leg) |
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Genu VARUM |
Bowleg (very bow leg) |
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Genu VALGUM |
Val has knock knees and needs them evaluated because he’s over 7yrs old |
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Refer to ortho is curve of spine is greater than what percentage? |
25% |
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Muscular Dystrophy starts in what part of the body?? |
Lower extremities and works it’s way up |
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Muscular Dystrophy starts in what part of the body?? |
Lower extremities and works it’s way up |
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What is the most common inherited neuromuscular disease in children? |
MD |
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Grower sign |
Walks hands up to legs to get up |
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Grower sign |
Walks hands up to legs to get up |
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Lab findings for MD?? |
Increased creatine kinase Myopathy Abnormal EKG Necrotic degenerating nerve fibers DNA analysis |
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Grower sign |
Walks hands up to legs to get up |
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Lab findings for MD?? |
Increased creatine kinase Myopathy Abnormal EKG Necrotic degenerating nerve fibers DNA analysis |
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Done |
Done |
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Grade 1,2,3 sprains |
Grade 1: Stretching but no tear. Can bear weight Grade 2: can bear minimal weight, some limited rom and pain Grade 3: no weight bearing and profound swelling and bruising |
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Ottawa rule Is used when? |
To assess if further management is needed for ankle injury or it can be observed |
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Ottawa rule Is used when? |
To assess if further management is needed for ankle injury or it can be observed |
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Girl or boys more likely to have salter fracture? |
Boys twice as likely |
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What diagnostic testing is done for infants with suspected fracture |
Ultrasound |
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Salter 1-5 |
1. Break in physis (1 layer) 2. Most common!! Physis and meta 3. Three layers: physis, meta and epiphysis 4. Through all three totally 5. Rare!! Crushed bone or compression across whole bone |
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Treatment of salter 1 and 2 |
Closed reduction or casting |
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Treatment of salter 1 and 2 |
Closed reduction or casting |
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Salter 3 -5 |
Open reduction internal fixation |
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Treatment of salter 1 and 2 |
Closed reduction or casting |
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Salter 3 -5 |
Open reduction internal fixation |
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If fracture not visible on X-ray for the elbow then look at what other sign?? |
Fat pad on elbow and the alignment |
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What arm injury is worse with supination? |
Nursemaid elbow |
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Management of nurse maid elbow? |
Motrin at home |
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What does OLD CART stand for dealing with headaches? |
Onset, location, duration, characteristics, aggravating factors, remedial (what makes it better), treatment |
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Viral meningitis most common in what age group? |
1mth- 5yr Infants between 6-12mth high risk |
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Symptoms of meningitis in infants mimic what? |
Sepsis |
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Protein and glucose issues in meningitis patients |
They like their proteins and are conscious about sugar intake |
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Patient comes in with increased HC, bulging fontanel, head tilt, irritability, loss of milestones what should you assess for? |
Brain tumor |
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Common sign of brain tumors in older children |
Headache first thing in am followed by vomiting and increases in frequency |
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What reflex is positive with brain tumor |
Babinski sign |
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Confusional migraine happens most often with what age group? |
Younger children. Some don’t even have headache. Just confusion, NV and awake next day fine |
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Partial sezuires |
One hemisphere No loss in consciousness |
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Febrile sezuires |
Most common in 1-3y 5% of kids get them |
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Most common type of neurofibromatosis |
NF 1- recklinghausen disease |
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Symptoms of neurofibromatosis |
Sezuires, mult cafe spots (6 or more over 5mm), freakles in arm pits and inguinal, iris lisch nodules, family hx |
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Symptoms of neurofibromatosis |
Sezuires, mult cafe spots (6 or more over 5mm), freakles in arm pits and inguinal, iris lisch nodules, family hx |
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Onset of tic disorders at what age? |
6-12yrs |
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Symptoms of neurofibromatosis |
Sezuires, mult cafe spots (6 or more over 5mm), freakles in arm pits and inguinal, iris lisch nodules, family hx |
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Onset of tic disorders at what age? |
6-12yrs |
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What meds can make tics worse?? |
Methylphenidate, pemoline, amphetamines |
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Symptoms of neurofibromatosis |
Sezuires, mult cafe spots (6 or more over 5mm), freakles in arm pits and inguinal, iris lisch nodules, family hx |
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Onset of tic disorders at what age? |
6-12yrs |
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What meds can make tics worse?? |
Methylphenidate, pemoline, amphetamines |
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Normal MCV |
80-100 |
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Symptoms of neurofibromatosis |
Sezuires, mult cafe spots (6 or more over 5mm), freakles in arm pits and inguinal, iris lisch nodules, family hx |
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Onset of tic disorders at what age? |
6-12yrs |
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What meds can make tics worse?? |
Methylphenidate, pemoline, amphetamines |
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Normal MCV |
80-100 |
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Mchc normal percentage (HgB and RBC) |
32-36% |
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MCH (weight) |
26-34pg |
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MCH (weight) |
26-34pg |
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Red cell distribution |
Iron deficiency- increased Thalassemia- normal or slightly larger ACD- normal |
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MCH (weight) |
26-34pg |
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Red cell distribution |
Iron deficiency- increased Thalassemia- normal or slightly larger ACD- normal |
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Normal retic |
1-2% |
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What’s the most common cause of microcytic anemia??? |
Thalassemia |
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Symptoms of thalassemia |
Bronze skin Large spleen Frontal bossing Genetic!!! |
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Labs for thalassemia |
< hgb < MCV Retic > > ferritin > Bili |
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Sickle cell trait |
HgB AS- no symptoms |
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Sickle cell trait |
HgB AS- no symptoms |
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Sickle cell anemia |
HgB SS- bad pain, vasoncrisis |
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Sickle cell trait |
HgB AS- no symptoms |
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Sickle cell anemia |
HgB SS- bad pain, vasoncrisis |
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Symptoms of sickle cell |
Jaundice, delayed puberty, large spleen, enlarged heart, systolic murmur, fatigue. |
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Labs for sickle cell |
Hematocrit 20-30% Elevated WBC (12,000-15,000) Platlets high (over 400,000) Blood in urine |
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What meds can be used to help sickle cell patients? |
Folic acid Hydroxyurea 35mg/kg/day (stimulates Hgb F) |
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What vaccine should be give. To those with sickle cell?? |
Pnumovax |
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What diagnosis shows gross hemiaturia? |
Sickle cell |
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What diagnosis is deficient in factor 8?? |
Hemophilia a |
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Female factor 8 patients have a what risk factor of kid having diagnosis? |
25% |
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Are hemophilia patients phenotypically normal? |
Yes |
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Lead poisoning from? |
Paint/ old house Soil Gasoline Good/ drinking water |
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Signs of lead poisoning |
Fatigue Gi Headache Ataxia Papilledema |
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What do burtonian lines indicate?? (Bluish gingiva) |
Lead poisoning |
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Normal lead level? |
<10 |
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What lead level do you refer to hematologist? |
10-14 |
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What lead level do you start chelation therapy? |
45-69 |
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What lead level do you start chelation therapy? |
45-69 |
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What level lead hospitalize |
Over 70 |
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In what condition is bone marrow replaced by blast cells |
Leukemia |
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All common in what ages? |
4yr most common with boys |
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Leukemia symptoms |
Fatigue, nose bleeds, infection, bruising, pale, bone pain and enlarged spleen |
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What lab is most common with leukemia?? |
Thrombocytopenia 85% of cases |
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What type of diabetes produces ketosis? |
Type 1 |
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Diagnosis diabetes with a serum blood sugar of what? |
>126 x2 |
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Diagnosis diabetes with a serum blood sugar of what? |
>126 x2 |
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If random BS >200 and polydipsa. Polyurea, weight loss what is next step?? |
Fasting study |
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Whats elevated in diabetes labs? |
Ketones Blood urea Nitrogen Creatine |
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Is A1C elevated in type 1 diabetes?? |
Normal 4-6% |
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Fasting BS in type of type 1 |
100-125 |
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How many carbs for diabetes |
50%-60% |
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How many carbs for diabetes |
50%-60% |
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Total fat and protein in diabetic diet? |
25-30% fat 10-20% proteins |
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How many carbs for diabetes |
50%-60% |
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Total fat and protein in diabetic diet? |
25-30% fat 10-20% proteins |
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What causes the somogyi effect? |
Nocturnal hypoglycemia at 3a and rebounds with high sugar by 7a |
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How many carbs for diabetes |
50%-60% |
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Total fat and protein in diabetic diet? |
25-30% fat 10-20% proteins |
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What causes the somogyi effect? |
Nocturnal hypoglycemia at 3a and rebounds with high sugar by 7a |
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Dawn phenomenon |
Becomes desensitized to insulin causing to rise over the night.. add bedtime insulin to fix this problem |
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Type 2 Diabetes link or not to HLA (antibodies)? |
No |
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Common first symptom of diabetes in women?? |
Vaginitis?? |
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Labs for type 2 diabetes |
Ketones in blood and urine |
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Screening for type 2 Diabetes |
10yrs old or onset of puberty |
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If surgery what should the type 2 diabetes do with metformin? |
Discontinue 48hr before procedure |
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Ear infection therapy |
1. Amoxicillin 80-90mg/kg/day 2. Augmention 3. Ceftriaxion |
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Cholesteatoma |
Cyst in ear usually seen with recurrent ear infections |
