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Flashcards in Peds Deck (60)
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1
Q

abx for OM (decreasing order)

A
amoxicillin
augmentin
cefdinir (PCN allergic)
azithromycin (last resort)
r/o mastoiditis, tx with surgical decompression
2
Q

OE tx

A

abx drops: cipro
steroid drops
r/o mastoiditis, tx with surgical decompression

3
Q

sinusitis tx

A

typically VIRAL
if clearly bacterial: give augmentin
consider foreign body

4
Q

pharyngitis tx

A

augmentin

5
Q

what to do if bug in ear

A

Lidocaine to paralyze, don’t shine light! bug will go deeper

6
Q

blue with feeding, pink with crying + childhood snore

A

choanal atresia

dx: catheter fails to pass, or fiber-optic
tx: surgical

7
Q

if see croup that does not improve with racemic epi, think?

A
bacterial tracheitis
may be toxic appearing
dx: tracheal culture
tx: IV abx
f/u: ENT scope
8
Q

epiglottitis vs retropharyngeal abscess

A

both extend necks, will see tender u/l neck mass with abscess and LAD

dx: CT scan
tx: I/D or aspiration + IV abx

9
Q

how is peritonsillar abscess different

A

older kids (10+)
see uvular deviation
dx: clinical
tx: drain + abx

10
Q

extrathoracic vs intrathoracic FB

A

intrathoracic: expiratory wheeze
extrathoracic: inspiratory stridor

11
Q

FB XR

A

look for “coin sign”
if in trachea, will be A-P oriented, so see face of coin on lateral
if esophagus will be lateral

12
Q

bronchiolitis tx

A

O2, IVF
peaks 3-4
may not be able to eat so keep in hospital
f/u: hypoxemic resp. failure, ARDS

13
Q

seizure tx

A

levetiracitam (keppra)
phenytoin
valproate
lamotrigine

14
Q

simple febrile seizure
3/3 of the following
tx?

A
1x in 24 hrs
less than 15 minutes
generalized
tx: benzos, acetaminophen
if less than 3/3 it's complex, w/u with EEG, LP or MRI and tx: AEDs
15
Q

infantile spasms

A
less than 1 yr, not generalized, no fever, symmetric jerking
dx: EEG shows hypsarrhythmia
tx: ACTH
f/u: MR
associated with tuberous sclerosis
16
Q

tuberous sclerosis

A

angiofibromas, ash-leaf, afebrile seizures

dx: neuroimaging

17
Q

intussusception dx

A

KUB: will see perf or obstruction
U/S next: sn, track resolution, “target sign”
dx/tx: air enema, need surgery if fails or peritonitis or perforation

18
Q

“colon cancer” presentation in adult, think?

A
Meckel's
i.e. painless hematochezia or FOBT+ or iron-def. anemia
dx: technicium-99 scan
tx: resection
f/u: teenager: CT scan is better
19
Q

GI bleed distractors

A

babies swallow moms blood (Apt test)
epistaxis
iron pills, beets, medications
give reassurance

20
Q

other GIB stuff

A
IBD (UC more bloody)
infectious colitis (stool cx)
milk-protein allergy (change to hydrolyzed formula)
21
Q

dev. dysplasia of hip

A

dx: U/S after no resolution for 4 wks

22
Q

LCP (avascular necrosis)

A

6 yo

dx: XR, tx: cast

23
Q

SCFE

A

13 yo

frog-leg XR tx: surgery

24
Q

transient synovitis

A

hip pain after viral illness
+/- inability to bear weight
tx: supportive, ddx from septic joint with Kocher criteria (fever, ^WBC, ^ESR, (^CRP), non-weight bearing)

25
Q

bone cancer

Ewing vs Osteosarcoma

A

Ewing: mid-shaft
Osteosarcoma: distal femur (Rb association)
dx: XR then MRI and biopsy to confirm

26
Q

take peds fractures to OR for ORIF if ?

A

open, commuted, or involves growth plate

27
Q

strabismus tx

A

congenital: surgery before 6 mo
acquired: patch good eye, give glasses

28
Q

congenital cataracts

A

at birth: TORCH

after birth: galactosemia

29
Q

diseases of prematurity (if you see one look for the others)

A

retinopathy of prematurity
bronchopulmonary dysplasia
intracranial hemorrhage
NEC

30
Q

conjunctivitis

A

chemical: <24 hrs
gonorrhea: day 2-7, tx: ceftriaxone
chlamydia: days 5-14, u/l becomes b/l, mucopurulent, PO erythromycin
others: HSV, bacterial (d 5-14)

31
Q

w/u for macroscopic non-glomerular (no RBC casts) hematuria

A
U/S: shows +/- hydro
VCUG: shows +/- reflux
CT: trauma (use contrast) or stone (non contrast)
cystoscopy: intraluminal lesions
IVP, renal bx (not usually)
32
Q

Posterior urethra valves

A

“kid with BPH”
No UOP + distended bladder +/- oligohydramnios, ^CR
dx: U/S (hydro), VCUG (r/o reflux)
tx: catheter, sx

33
Q

hypo/epispadias

A

do NOT do circumcision, need that tissue for reconstruction

34
Q

Uteropelvic Junction Obstruction

A

presents with colicky abdominal pain with ^urinary flow (i.e. binge drinking)

dx: U/S: hydro, (NO hydro in ureter) VCUG: r/o reflux
tx: sx +/- stent

35
Q

ectopic ureter

A

girl with “fistula”

boys: asymptomatic (above urinary sphincter)
girls: constant leak (below urinary sphincter)
dx: U/S: no hydro, VCUG: r/o reflux, radionucleotide (renal function)
tx: reimplant

36
Q

vesiculouretural reflux

A
retrograde flow
usually found on antenatal U/S + hydro
may present with recurrent UTIs +/- pyelo
dx: U/S: hydro, VCUG: +reflux
tx: abx, surgery
37
Q

labs in HgbSS

A

Hgb: 7-9, ^Bili, ^retic
may need transfusion which may result in iron overload (tx: deferoxamine)
may need folate supplementation

38
Q

SCD osteomyelitis org

A

still most likely S. aureus!

Salmonella is commen in SCD

39
Q

avascular necrosis tx

A

initially conservative, may need sx

40
Q

SCD acute problems

A

stroke: FND, AMS
ACS: CP, SOB
tx: exchange transfusion (CVC)
priaprism: drainage before exchange transfusion

41
Q

vasoocclusive crisis tx

A

IVF, O2, IV opiates
compare to baseline Hgb, retic, bili
+/- abx
f/u: psychosocial stressors if no ^labs

42
Q

vasooclusive ppx

A

hydroxyurea, ^HbF
reduce # of crises
BM transplant not yet an option

43
Q

HgbSC

A

low Hgb (around 11)
hematuria
usually do not get crises
others: SB+, SBo

44
Q

recurrent sinopulmonary infections at 6 mos, low B-cells, NO IgG, IgA, IgM

A

X-linked Bruton’s agammaglobulinemia
confirm with RTK gene
tx: IVIG (scheduled), +/- BM transplant

45
Q

recurrent sinopulmonary infections in teenager, low B-cells, low of 2/3: IgG, IgA, IgM

A

CVID (“mild Bruton’s”)

tx: IVIG

46
Q

sinopulmonary or GI infections AND/OR anaphylaxis after blood transfusion

A

IgA deficiency
^IgG, ^IgM
tx: none
f/u: take IgA out of donor blood, EPI for anaphylaxis

47
Q

non specific immune deficiency, low B cells, low IgG, low IgA, ^IgM

A

hyper IgM

tx: none

48
Q

fungi and PCP infections, low absolute lymphocytes

A

DiGeorge
22q11.2 deletion, 3rd pharyngeal pouch
wide eyes, low ears, small face, no thymus
tx: TMP-SMX, IVIG bridge to thymic transplant
f/u: hypocalcemia (absent PTH)

49
Q

eczema, low platelets, low WBC, normal infections, ^IgM, ^IgG (trying to compensate)

A

Wiskott-Aldrich (X-linked)

tx: BM transplant

50
Q

Ataxia telangectasia associations

A

low Igs

DNA repair, leukemia, lymphoma

51
Q

immediate immunodeficiency, NO B/T cells, low WBCs, NO IgG/M/A, adenosine deaminase deficiency

A

SCID
“mega-AIDS”
tx: isolate, TMP-SMX, BM transplant

52
Q

S. aureus abscesses, ^WBC, ^IgG/M think?

A

Chronic granulomatous disease
catalase + infections
immune system trying to “ramp up”
tx: BM transplant

53
Q

^fever, ^WBC, NO pus, delayed cord seperation

A

LAD: WBC can’t leave blood
tx: BM transplant

54
Q

giant granules in PMNs, +partial albinism, neuropathy, neutropenia

A

Chediak Hegashi

55
Q

if has C1 esterase deficiency and get angioedema give ?

A

FFP

56
Q

who should not get egg containing vaccines

A

yellow fever
MMRV IS SAFE TO GIVE
influenza may/may not contain eggs

57
Q

Treatment for tetanus

A

Intubate, sedate, muscle relaxers, metronidazole IV

58
Q

Wound management if less than 3 lifetime doses of Tdap

A

If clean, just give Tdap

If dirty, Tdap + TIG

59
Q

Wound management if more than 3 lifetime doses of Tdap

A

Clean wound: if more than 10 years since Tdap, give Tdap
If less than 10 years, no treatment
Dirty wound: if more than 5 years since Tdap, give Tdap
If less than 5 years, no treatment

60
Q

Diphtheria treatment

A

Antitoxin, erythromycin or penicillin G, possible intubation, droplet precautions