Term
Childhood growth:
Newborns may lose ___% of their birth weight in the first week. they should be back to birthweight by ___ weeks
At ___ months, they should double their birth weight
At ____ months, they should triple their birth weight.
The average 30 month only weighs ___ lbs and is ____ inches tall
The average 4 year old is ____ lbs and is ___ inches tall |
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Definition
10%
2 weeks
6 months
12 months
30 lbs/30 in
40 lbs/40 in |
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Term
Failure to thrive:
Weight for age falls below the ___ percentile or cross 2 major percentile lines (75th to 50th to 25th) |
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Definition
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Term
Childhood growth definitions:
1) Short stature: >/= ___ standard deviations below the mean
2) Obesity: >__-% for weight
3) Overweight: >___% for weight |
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Definition
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Term
Childhood vaccines:
At birth (1)
2-6 months (6)
12 months (5) |
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Definition
Birth: hep B
2-6 months: Hep B, rotavirus, DTAP, Hib, Pneumococcal, Polio (IPV)
12 months: MMR, varicella, hep A, HIB, Pneumococcal |
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Term
Pertussis:
3 clinical stages
Dx via?
Tx? |
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Definition
Stages: catarrhal (cough, runny nose), paroxysmal (paroxysms of cough, worse at night, increasing in severity for weeks), convalescent
Dx via nasopharyngeal swab
Tx:
Z pack Or clarithromycin bid x7 days |
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Term
| A 4 year old child presents with clustered white lesions on the buccal mucosa, cough, fever, redness of the eyes, and runny nose. They also have an erythematous, maculopapular rash that began on the face but has progressed to the trunk and extremities. d and treatment? |
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Definition
Measles (rubeola)
Tx: supportive
Key notes: 3 c's: cough, coryza, conjunctivitis + koplik's spots |
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Term
| ____ is a morbilivirisu in the paramyxovirus family |
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Definition
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Term
| Vaccines (4) for 7-18 year olds |
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Definition
TDAP
HPV
meningicoccal
23 valent penumovax (in high risk populations) |
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Term
| Leading cause of mortality in newborns. can cause sepsis, pneumonia, meningitis |
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Definition
Group B strep
TX: IV penicillin G or V
Moms who test positive should get abx 4 hours prior to delivery |
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Term
Benign childhood illness caused by HHV-6
presents in 6 mos-3 years with abrupt onset high fever (>103.5) for 4 days. then fever breaks and pt develops a blanching, maculopapular rash starting on the neck and trunk and spreading to the face adn extremities. |
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Definition
Roseola
Tx: supportive
Roseola: high fever, rash that starts on extremities trunk and spreads to extremities and face
Rubeola (measles): fever, 3 c's, rash that starts on face and spreads to trunk and extremities |
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Term
| School-aged child presents with low grade fever, HA, URI symptoms and facial flushing. within a few days, the have a lacy, pink macular rash on their torso and extermities. Dx and Treatment? |
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Definition
| Erythema Infectiosum "Fifth's Disease" Parvovirus B19 Tx: supportive |
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Term
| Always rule out _____ in a child with strabismus |
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Definition
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Term
Acute otitis media:
1) Most common bacterial causes
2) Treatment |
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Definition
Strep pneumo (most common)
H flu
Strep pyogenes
Moraxella catarrhalis
<2 y/o: treat w/ ab
>2 y/o: watchful waiting x48 hrs and then abx
Amoxicillin 80-90mg/kg/d for 7-10 d
Cefalosporoin if pcn allergy |
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Term
Acute pharyngitis:
most common causes |
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Definition
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Term
| Child presents with beefy red throat, tonsillar exudate, petechiae on soft palate, cervical LAd. dx and treamtnet? |
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Definition
GABHS - culture is gold standard rather than rapid strep
Tx: Penicillin V/Amoxicillin x 10 days
Cephalopsporin, clinda, clarithromycin, or z pack if PCN allergy |
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Term
| 2 year old child presents with beefy red tonsils, fever, and rough, sandpaper rash over groin and torso. dx? |
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Definition
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Term
Complications of pharyngitis:
1) common in kids >10 y/o. presents with high fever, muffled voice, drooling, dyspnea. PE shows assympetric tonsillar bulge w/ displacced uvula
2) More common in kids <4 y/o. high fever, inability to extend neck, muffled voice, drooling, toxic appearnace. caused by infeection of retropharyngeal lymph nodes |
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Definition
1) PTA
2) retropharyngeal abscess
tx both with I*D and abx |
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Term
A child somewhat suddenly develops high fever adn sore throat. within a matter of hours, they appear toxic, have muffled voice and difficulty swallowing w/ drooling. On exam, the child is sitting upright and leaning forward with their chin up and mouth open in a "sniffing position". lateral neck xray shows a thumbprint sign
dx, tx, and most common pathogen? |
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Definition
Epiglottitis
DO NOT examine oropharynx
intubate immediately
3rd generation cephalosporin (ceftriaxone IV)
Cause: H flu |
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Term
2 y/o presents with barking cough, inspiratory stridor, and URI symptoms. anterior neck xray shows steeple sign.
dx, pathogen, and treatment? |
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Definition
croup (laryngotracheobronchitis)
parainfluenza virus
Tx: hydration, humidity, DEXAMETHASONE, nebulized epi if severe
all kids with croup get dexamethasone |
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Term
A 9 month old baby presents with URI smptoms, low grade fever, paroxysmal wheezy cough, and poor feeding. Exam reveals crackles, wheezes, nasal flaring and retractions.
Dx, pathogen, and treatment? |
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Definition
Bronchiolitis
RSV
Tx: supportive, nebulized albuterol if allergic/asthma type pt
**in infant <1 y/o w/ wheeze - answer bronchiolitis |
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Term
child presents with sudden onset coughing, choking, wheezing. XR reveals hyperinflation of the lungs.
dx? |
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Definition
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Term
| 6 year old child presents with grade II/VI musical/vibratory SHORT EARLY systolic ejection murmur heard best at left lower sternal border that diminishes with valsalva |
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Definition
| Still's murmur - most common innnocent murmur of childhood |
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Term
| 6 year old child presents with grade II/VI CONTINUOUS musical humming systolic murmur heard best at the upper sternal borders and radiates to the neck. it goes away when the jugular vein is compresseed |
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Definition
| Venous hum - 2nd most common, also innocent |
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Term
| What childhhood heart problem presents wtih a widely split/fixed S2? generally asymptomatic. |
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Definition
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Term
Most common childhood heart disease
generally asymptomatic
presents with loud, harsh, blowing, holosystolic murmur heard best of lower left sternal border
If severe, can present with CHF in infancy |
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Definition
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Term
| Common childhood cardiac abnormality. presents wtih bounding peripheral pulses and continous "machinery" murmur heard best at 2nd L ICS. increased risk if maternal rubella infx in pregnancy. |
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Definition
PDA
ductus arteriosus allwos blood from pulmonary artery to flow to the aorta, bypassing the nonaerated fetal lungs in a fetus. should close by 4 days of age
premies get indomethacin to try to close it |
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Term
| 10 year old child presents with high blood pressure in the upper extremities compared to LE. Pulses also seem greater in the UE. he has a blowing systolic murmur in the left axilla and xray shows a notching of the ribs. dx and tx? |
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Definition
coarctation of aorta
surgical repair |
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Term
| an infant presents with sudden cyanosis and hypoxemia when he becomes upset. a rough systolic ejection murmur is heard in the 3rd ICS. xray reveals a boot shaped heart. dx and tx? |
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Definition
tetralogy of fallot --> this is the answer in any cyanotic baby
tx: surgical repair by 18 mos |
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Term
| 4 components of tetralogy? |
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Definition
VSD
pulmonary stenosis
overriding aorta
RVH |
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Term
Jones criteria for rheumatic fever
need 2 major OR 1 major and 2 minor PLUS evidence of strep infection for dx
Major criteria (5)
Minor criteria (4) |
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Definition
Major:
carditis, polyarthritis, chorea, erythema marginatum, subcu nodules
Minor: fever, arthralgia, elevated ESR/CRP, prolonged PR on eKG |
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Term
a healthy-appearing 3 week old infant presents with projectile non-bilious vomiting after feeding. exam reveals an olive-shaped mass in the abdomen
dx and tx? |
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Definition
pyloric stenosis. dx via US
tx: surgical repair |
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Term
a 12 month old infant present wtih paroxysmal abdominal pain associated with screenign and drawing up of the knees. parents report bloody, mucosy, currant jelly stools. exam reveals a sausage shaped mass in the abdomen. abd US shows a target sign"
dx and tx? |
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Definition
intussusception
tx: hydrostatic or pneumatic enema. surgery if unsuccessful
can be seen in Meckel's diverticulum, CF, or idiopathic |
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Term
| an infant presents in their first month of life with bilious vomiting and abdominal distention. xray shows a double bubble sign. dx and treatment? |
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Definition
volvulus - when the bowel twists aroudn the SMA and kinks the duodenum. leads to ischemia
tx: surgery |
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Term
a male infant presents with painless rectal bleeding and recurrent cases of intussusception. due to remnants of embryonic vitellointestinal duct.
dx and treatment? |
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Definition
meckel's diverticulum
dx via technitium scan
tx: surgery |
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Term
What condition:
-due to decreased enzyme activity
-associated wtih intellectual disability, hyperactivity, seizures, light complexion, and musty odor of sweat and urine.
-now screened for in all infants |
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Definition
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Term
caused by enterobius vermicularis. presents with intense nocturnal perianal pruritis in 5-10 year olds
dx and tx? |
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Definition
pinworms
tx: albendazole or pyrantel pamoate - single dose, repeated 2 weeks later |
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Term
UTI in kids
1) infants usually present with ____
2) Toddlers usually present with ____
3) Most common pathogen?
4) Tx |
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Definition
1) fever
2) previously potty trained kid starts having accidents
3) E. coli
4) cefixime or cefdinir (3rd gen ceph) |
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Term
Childhood UTIs
1) when to do renal US
2) when to do VCUG (voiding cystourethrogram) |
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Definition
When to do renal US:
-child <2 w/ first febrile UTI
-child of any age with recurrent febrile UTI
-children with UTI who have family hx of renal/uro dz, poor growth, or HTN
-children who do not respond to abx
VCUG:
-children with two or more febrile UTIs
-children wtih first febrile UTI AND: abnormal renal US, temp > 102.2 and pathogen other than E. coli OR poor growth/HTN |
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Term
Penis problems:
1) undescended testes. affects 3% of full term babies and 30% of premies. can lead to infertility adn malignancy. Tx?
2) Normal variant due to active cremasteric reflex.
3) Abnormal ventral placement of urethral meatus. affects 1/250 males. tx?
4) bulge that appears int he groin and increases w/ crying or straining. more common in premies. tx? |
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Definition
1) cryptorchidism. tx: surgery ASAP after 4 months. MUST be done before 2 years
2) retractile testes - can be coaxed back into scrotum
3) hypospadius - do not circumcise. surgery between 6-12 months (refer to uro)
4) inguinal hernia- MUST be surgically repaired d/t risk of incarceration |
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Term
Developmental dyspalsia of the hip:
1) 9:1 _____ (gender) predominance
2) _____ test: hips are flexed and thihgh is adducted while pusshing posteriorly to dislocate the hip.
3) ____ test: hips are flexed and abducted to reduce a dislocation
4) If either of those tests are positive, do what next?
5) treatment? |
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Definition
1) Female
2) barlow
3) ortolani
4) US
5) pavlik harness |
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Term
a male child presents with painless limp that starts after activity. progresses to mild pain n the anterior thigh/knee. xray reveals flattening of the femoral head.
dx? cause? tx? |
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Definition
Legg Calve Perthes
due to AVN of the femoral head
tx: refer to ortho for splinting but is typically self-limited w/ rest. |
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Term
a healthy but tall or fat child presents with limp and pain in the thigh and knee. PE reveals limited internal rotation of the hip. xray looks like "ice cream falling off the cone."
dx and tx? |
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Definition
Slipped capital femoral epiphysis
tx: immediate surgical fixation |
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Term
a 14 year old athlete presents wtih anterior knee pain and tenderness over the tibial tubercle. xrays are normal.
dx and tx? |
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Definition
Osgood Schlatters
tx: rest, NSAIDs, infrapatellar band |
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Term
SALTER HARRIS fracture classifications
1) most common type. fracture passes across the growth plate and through the the metaphysis.
2) The end of the bone is crushed and the growth plate is compressed. poor prognosis.
3) Fracture runs through the epiphysis, through the growth plate, and into the metaphysis. surgery is necessary
4) Present w/ pain directly over growth plate. xray is normal. caused by epiphysis separating from the metaphysis. requires casting.
5) uncommon. fracture runs through the epiphysis and separates part of the growth plate from the metaphsis. surgery is necessary. |
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Definition
1) II- "above"
2) V - "everything's ruined"
3) IV: "through"
4) I- "separation"
5) III - "lower"
SALTER:
Separation
Above
Lower
Through
Everything's Ruined |
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Term
Common childhood injuries:
1) stable fracture that causes one cortex of the forearm bone to buckle while the other remains unchanged. tx?
2) fx of one cortex while the other bends but remains intact. tx?
3) subluxation of the radial head caused by pulling on the arm. child presents w/ arm flexed, pronated at their side and doesn't want to move it. |
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Definition
1) torus or buckle fx - tx with short arm cast for 3-4 weeks
2) greenstick fx - usually needs to be reduced then casted for 6 weeks in long-arm cast
3) nursemaid's elbow - reduce, splint only if recurrent |
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Term
| 17 year old male presents with gradually worsening localized pain over a long bone. there is a palpable mass on exam. xray shows a lytic lesion with a sunburst pattern. on labs, alk phos is elevated. dx? |
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Definition
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Term
febrile seizures:
1) by definition, must be caused by a ______ infection
2) workup?
3) tx?
4) increased risk for epilepsy? |
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Definition
1) non-CNS
2) r/o meningitis. look for underlying cause (otitis media, roseola, etc)
3) tx: antipyretics, treat underlying infection
4) NO increased risk for epilepsy |
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Term
a 4 week old male infacnt presents with vomiting after meals. parents state it "shoots across the room." He was full term, otherwise appears healthy but has not gained weight since birth. what is the most appropriate treatment?
1) switching to a soy-based formula
2) Surgery
3) educating the parents about appropriate feeding techniques
4) 10 day course of abx |
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Definition
| surgery - pyloric stenosis |
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Term
2 y/o is brought to the ED by his mother with sudden osnet choking, gagging, coughing. vitals show tachycardia and increased resp rate. PE shows decreased breath sounds over RLL with inspiratory rhonchi and localized exp wheezes. CXR shows hyperinflation and mediastinal shift to the left on expiration. dx?
1) asthma
2) Epiglottitis
3) foreign body aspiration
4) PE
5) pneumonia |
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Definition
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