peds step 3

Card Set Information

Author:
pszurnicki
ID:
275483
Filename:
peds step 3
Updated:
2014-05-28 12:54:00
Tags:
peds
Folders:

Description:
peds
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user pszurnicki on FreezingBlue Flashcards. What would you like to do?


  1. what is given to newborn at birth
    • silver nitrate or erythromycin drops
    • vit k im
  2. What 4 tests are done before discharge
    • pku
    • hypothyroid
    • galactosemia
    • sensorineural hearing loss test
  3. 1 rx for mongolian spots
    2erythema toxicum
    3 port wine stain
    4 hemangioma
    5 preauricular tags/pits
    6 defect of iris(coloboma)
    7 aniridia
    8 branchial cleft cyst
    9 thyroglossosal duct
    10 omphalocele
    11 gastroschisis
    12 umbilical hernia
    13 undescended testis
    14 hydrocele
    15 hypospadias
    16 epispadias
    17 inguinal hernia
    • 1- rule out abuse
    • 2-- resolves on own
    • 3-- evaluate for glaucoma/anticonvulsants give laser therapy
    • 4- observe bc regresses on own by 5 yo, if large or interferes with organs, give steroids/laser therapy
    • 5-preauricular tags- evaluate for deathness/ultrasound of kidney for renal abnormalities
    • 6-coloboma evaluate for charge syndrome
    • 7-aniridia--screen for wilms tumor q3 untill 8
    • 8-infected cyst- abx if large--surgery
    • 9-thyroid scan and remove
    • 10- screen for trisomies
    • 11- surgical repair
    • 12- screen- down syndrome dont close till 2
    • 13- no rx untill 1 yo. bhcg, test or surgery
    • 14-diff from inguinal hernia
    • 15- look for other gu-hernia/undescended tes
    • 16-evaluate for bladder exstrophy
    • 17- surgery
  4. infants of diabetic mothers will have what kind of lab abnormalities
    • hypoglycemia
    • hypocalcemia
    • hypomagnesemia
    • hyperbili
    • polycythemia
  5. what structural defects do iodm have
    • cardiac- asd, vsd, truncus arteriosus
    • small left colon
  6. newborn has respiratory distress and hypoxia does not resolve with 100% oxygen, next step
    evaluate for cardiac causes
  7. what studies are ordered with cases of respiratory distress
    • cxr
    • abg
    • blood culture
    • cbc
    • cranial ultrasound
    • blood glucose
  8. best initial rx for rds
    • oxygen
    • nasal cpap
    • empiric abx
  9. best predictive tests for rds
    L/S of amniotic fluid prior to delivery
  10. best initial rx for rds
    most effective therapy
    • oxygen via nasal cpap
    • surfactant
  11. how to prevent rds
    steroids >24 hrs <34 weeks gestation
  12. 3 complications of rds
    • retinopathy of prematurity
    • intracranial hemorrhage
    • bronchopulmonary dysplasia
  13. Transient tachypnea of newborn vs rds
    • ttn--after term delivery--order CXR
    • rds---preterm
  14. presentation of meconium aspiration
    severe rds in a term infant with distress or hypoxia of infant in utero
  15. best intitial test for meconium aspiration
    cxr
  16. how to prevent meconium aspiration
    suction and intubate
  17. rx for meconium aspiration
    • cpap
    • intubate
    • extracorporeal memebrane
    • nitic oxide therapy
  18. complications of meconium aspiration
    • asporation pneumonitis
    • p. artery htn
    • air leak--pneumothorax, pneumomediastinum
  19. dx of diaphragmatic henria
    rx
    • cxr with ng tube coiling up in chest
    • intubate and surgical correction
  20. where do meconium plugs appear in gi tract vs ileus
    • plug--lower colon
    • ileus-- lower ileum
    • causes of plug--iodm
    • cystic fibrosis
    • hirshsprung
    • maternal drug abuse
  21. when is high bilirubi pathological
    • on first day
    • after 2 weeks
    • rise of 5mg/day
    • more than 12mg/on delivery
    • direct bili >2mg
  22. what tests are ordered when there is jaundice on first day
    • direct and indirect
    • cbc, retic, smear
    • coombs
    • mother and baby type
    • urinalysis and urine culture
  23. jaundice after 2 weeks and unconjugatd
    • uti or infections
    • hemolysis
    • rbc membrane or enzyme defects
    • problem conjugating bili
  24. jaundice after 2 weeks and high direct bili
    • best initial test--lft
    • sono and biopsy
  25. when do you do phototherapy
    when do you do exchange transfusion
    when bili is >12 mg

    photo doesnt work or bili encephalopathy is present
  26. most common cause of sepsis in first 24hrs
    after 24 hrs
    and rx for each
    • pneumonia--amp and gent
    • meningitis--amp and third gen cephalosporin but not ceftriaxone
  27. when do you suspect meningitis as cause of sepsis
    if there is lethargy and somnolence, otherwise it is not worked up for
  28. what is the organism causing the following torch infection
    1hydrocephalus, cranial calcifications, chorioretinitis
    2- intracranial calcifications, low platelets, hearing loss
    3- cataracts, deafness, blueberry muffin
    4-osterochondritis, periostitis--hutchinson teeth, bowed bones, sniffles, desquamating rash
    5- pneumonia, vesicles, keratoconjunctivitis, meningoencephalitis
    6- pneumonia, mental retardation
    • toxo
    • 2cmv
    • 3-rubella
    • 4-syphilis
    • 5- herpes
    • 6- varicella
  29. best initial test for torch infections
    most accurate
    • igm
    • pcr
  30. which torch infections presents with intrauterine growth retardation, mental retardation, seizures, hepatosplenomegaly, jaundice
    all of them
  31. screening test for torch infection
    total cord blood IgM
  32. 5 tests for seizures in a newborn
    • eeg
    • organic acids and amino acid essays--pyridone, pku
    • blood cultures
    • torch
    • ultrasound of head in premature for ICH
    • sodium, ca, mg, phosphorus, glucose
  33. rx for seizures in infants
    • phenobarbital
    • phenytoin if not controlled
    • correct electrolytes
  34. mnx of an infant born to a heroin using mother
    give opiods, dont give naloxone
  35. the following have what effect on sulfonamidesphenobarbitalnsaidsaceinhibitosisotretinoinphenytoindestetracyclinelithiumwarfarinvalproatecarbamezapine
    • sulfonamides-displaces bili from albumin
    • phenobarbital- vit k def
    • nsaids- closes pda
    • aceinhibitos- cranio facial abno
    • isotretinoin--facial and ear abnormalit
    • phenytoin--hypoplastic nails, abnoral facies
    • des- vaginal adenocarcionoma
    • tetracycline- discoloration of teeth
    • lithium-ebstein abnormality
    • warfarin-facial dysmorphysm and chondroplasia
    • valproate-nt defect
    • carbamezapine-nt defect
  36. fever without a focus vs fever of unknown origin <1 week in kids <3 yo
  37. when do you give empiric antibiotics for fever without a focus
    • if febrile
    • wbc >15,000
  38. culture first for fever and then give abx
  39. what bacteria should be covered for in neonate
    infant
    • group B
    • e.coli
    • listeria

    • infant--strep. pneumo--well apearing--single im ceftriaxone
    • toxic--iv ceftriaxone
  40. empiric rx for meningitis
    • iv vanco and ceftiraxone
    • for hib---ampicillin
    • e.coli--- ceftriaxone
    • n.meningitis--penicillin
    • strep .pneumo--peniciilin or 3rd gen cephalosporin
  41. complicatons of meningitis
    • throbosis
    • seizures
    • neurological defects
    • hearing loss
  42. definition of epilepsy
    2 unprovoked siezures 24 hours apart
  43. mnx of febrile seizure
    • reassure partents
    • control fever
    • r/o meningitis
  44. when are meds stopped for epilepsy
    after 2 years free of seizures
  45. rx for absence seizures
    ethosuxamide

    2nd line--valproic acid
  46. how does juvenile myoclonic epilepsy present
    rx
    • seizures in the am
    • rx valproic acid
  47. most common neurological disorder with west syndrome
    down syndrome
  48. rx for infantile spasms
    • acth
    • prednisone
  49. next step when suspecting ITP
    order peripheral smear to rule out TTP and HUS
  50. rx for hemophilia B
    factor 9 concentrates
  51. rx for hemophilia a
    • minor-ddavp
    • major--factor 8 concentrate
  52. rx for von willebrand disease
    • ddavp for minor
    • for major, concentrates of vwd with factor 8
  53. best initial and accurate tests for beta thalassemia
    hgb electrophoresis
  54. rx for beta thalassemia major
    • transfusion
    • splenectomy
    • prophylactic vaccinations
    • folate
  55. best diagnostic test for sickle cell
    hb electrophoresis
  56. chorionic villus sampling and amniocenteiss are done at how many weeks
    • cvs-10 weeks
    • amniocentesis -15 weeks
  57. when do you transfuse in sickle cell
    in symptomatic anemia
  58. when do you exchange transfuse  in sickle cell
    • priapism
    • stroke
    • acute chest syndome
    • avascular necrosis
    • before high risk surgery
  59. when do you give hydroxyurea for sickle cells
    • >3 episodes/year
    • symptomatic anemia
    • life threatening complications
  60. at discharge instructions for sickle cell pts
    • penicillin prophylaxis
    • immunizations-pneumovax
    • folate
    • hydroxyurea
  61. blood lead testing is done when in high risk pts
    at 12 and 24 months
  62. mnx of lead poisoning
    • refer to department of health >15
    • chelate at >45
  63. when do you start cows milk
    at 1 yo
  64. when do infants get physiological anemia
    at 12 weeks, nothing should be done
  65. when do you warfarin for kawasakis
    if there is thrombosis in the coronaries
  66. best initial test for cah 21 hydroxylase deficiency
    most accurate
    increased 17 oh progesterone

    17 oh progesterone after acth stimulation
  67. how does cah 21 hydroxylase def present
    • ambigous genitalia in girls
    • with hyponatremia
    • hyperkalemia
    • hypoglycemia
    • hypotension
  68. rx for mild cases of minimal change disease
    refractory to initial rx
    • steroids
    • cyclophosphamide
    • azathioprine
    • cyclosporine
  69. rx for autosomal recessive polycystic kidneys
    • dialysis
    • transplant
  70. most specific test for acute post streptococcal gn
    anti-dnase
  71. rx for apsgn
    penicillin, salt and fluid restriction
  72. most important management in apsgn vs iga nephropathy
    apsgn---penicillin

    IgA nephropathy---BP controle
  73. best initial tests for obstructive uropathy
    voiding cystaurethrogram and renal ultrasound
  74. rx for vesicourethral reflux
    abx untill it resolves
  75. best initial test for uti
    most accurate
    • urinalysis
    • urine culture
  76. rx for cystitis
    amoxacillin, tmp smx

    pyelonephritis--iv ceftriaxone, amp and gent
  77. which antibiotics should you not give to kids and teenagers
    • kids <7 tetracycline
    • adolescents <16 fq
  78. mnx of uti in kids
    • treat and obtain urine culture a weak later to confirm sterile urine
    • do ultrasound and voiding cystaurethragram if 2 episodes of febrile uti or family history of urological dz or organism other than uti, poor growth
    • htn
  79. best initial therapy for gerd in kids
    h2 blockers not ppi
  80. test for carbohydrate malabsorption
    clinitest but most accurate is breath hydrogen
  81. test for pancreatic enzymes
    serum trypsinogen
  82. what needs to be ruled out in pancreatic insufficiency?
    cystic fibrosis
  83. dx of giardiasis
    duodenal aspirate/biopsy
  84. best initial test for protein malabsorption
    spot stool alpha 1 antitrypsin level
  85. best initial tests for diarrha
    • stool blood, culture, leukocyts
    • ova and parasite
    • enzyme virus immunoassay
    • c diff toxin
  86. studies for kids with downs
    • tsh
    • hearing studies
    • echo for cardiac
    • ALL
    • Alzehiermiesr
    • duoednal atresia
  87. trisomy 18 associations
    • cardiac
    • renal
    • rocker bottom feet
  88. malformations of patau
    • everything midline
    • micrognathia
    • cleft lift/palate
    • holoprosencephaly
  89. when do you replace test for klinefelters
    at 11-12
  90. associations with turners
    • kidney
    • coarctation, bicuspid heart valve
    • hypothyroid
  91. association with fragile x syndrome
    adhd
  92. classic Beckwith -wiedman syndrome
    • enlarged everythinga
    • associated with wilms and hepatoblastoma
  93. robin sequence
    mandibular hypoplasia, cleft palate
  94. skeletal maturity is related wot what
    sexual maturity
  95. when do you work up kids for small size
    when they have crossed 2 major percentiles
  96. next step when you have normal weight gain but decreased height
    • assess gh
    • tsh
    • cortisol
    • xray of hand and wrist
  97. decreased weight gain is equal to decreased height
    systemic illness or genetic short stature or constitutional delayed short stature
  98. decreased weight gain more then decreased height
    • undernutirion
    • do stool fat
    • sweat test
    • assess calories
  99. contraindications to breast feeding
    • hiv
    • cmv
    • active herpes
    • breast ca
    • hbv untill immunized
    • tb, sepsis
  100. bedwetting before what age is normal
    before 5
  101. best initil test for enuresis
    • urinalysis
    • urine culture
    • vcug
  102. drug therapy for enuresis
    • tca
    • desmopressin
  103. best initial test for encopresis
    abd xray
  104. rx for retentive encopresis
    stool softeners
  105. mnx of someone who was exposed to hep b or a or varicella
    ivig and vaccine
  106. mnx of somone 6-12mo and >12 mo who was exposed to measles
    • 6-12--ivig and vaccine
    • >12mo--vaccine
  107. mnx of someone who was expose to rubella or mumps
    nothing
  108. mnx of a baby whose mother has no hep b antigen
    has hep b antigen
    • regular 3 immunizations
    • vaccine and ivig at 2 diff sites at birth and 3 doses by 6mo
  109. the only vaccine with a total of 5 doses
    DTAP
  110. HIB vaccine is given when
    <5yo
  111. mnx of child abuse
    • cbc, pt, ptt platelts, bleeding time
    • skeletal surgey
    • ct/mri
    • stool for blood
    • liver enzymes
  112. rx for croup
    nebulized epi
  113. rx for epiglotitis
    intubate give abx
  114. bacterial tracheitis is susually caused by what organism and it occurs when
    rx
    • s. auerus
    • after a viral infection

    abx and may need to intubate
  115. best initial and accurate for bronchiolitis
    • cxr
    • eliza
  116. rx for bronchiolitis
    • not ribavirin
    • supportive- oxygen
  117. prevention of bronchiolitis
    • palizumab
    • or ivig
  118. what bacteria cause of pneumonia gives staccato cough and peripheral eosinophilia
    chlamydia trachomatis
  119. what to order on ccs for pneumonia in kids
    not sputum cultures
  120. best initial and specific tests for cf
    sweat chloride conc on two separate days
  121. medication for cf
    ivacaftor
  122. mild respiratory 
    moderate 
    severe
    • tmp smx, cipro
    • zosyn
    • inhaled tobramycin
  123. when evaluating for chd, should you add abx
    yes
  124. what gives increased pulmonary markings
    • tgv
    • truncus arterirosusu
    • hypoplastic left heart syndrome
  125. rx for severe htn in adolsecents
    • aci
    • ccb

What would you like to do?

Home > Flashcards > Print Preview