Created by Jaimie Shah
almost 11 years ago
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management of the newborn
blue/gray macules on presacral back/posterior thigh; usually fade in first few years
firm, yellow, white papules/pustules with ery base which peak on the second day of life
Permanent unilateral vascular malformation
Red, sharply demarcated, raised lesions appearing in first 2 mos, rapidly expand and involute in 5-9years
preauricular tags/pits; assoc with hearing loss and GU abn
defect in iris
change syndrome
absence of iris
mass lateral to midline
Mass in midline that moves with swallowing and tongue protrusion
GI tract protrusion through umbillicus with sac
abdominal defect lateral to midline w/o sac
congenital weakness where vessels of the fetal and infant umbilical cord exitited through rectus abd muscle
scrotal swelling with translumination
Unilateral absence of testes in scrotal sac
urethral opening on ventral surface
urethral opening on dorsal surface
inguinal buldge or reducible scrotal swelling
lab abn in the infant of a diabetic mother
assoc abn in the infant of a diabetic mother
test for a neonate in RDS
complications of neonatal RDS
term newborn delivered by C-sec or rapid second phase labor with tachypnea, usu resolves in 24-48hrs
CXR after meconium aspiration shows?
tx of meconium aspiration
complications of meconium aspiration
pt with respiratory distress and scaphoid abdomen
associated with meconium plugs
Meconium ileus assoc with
VACTERL abn
ddx of double bubble on xr
premature infant with low apgar and blood stools, apnea, lethargy; abd wall erythema and distention
NEC dx and tx
xr finding of NEC
pathologic jaundice
Physiologic Jaundice
when is hyperbili pathologic
jaundice in first 24 hours, what is the workup?
if jaundice>2wks and no elevation in conjugated bili what to consider?
prolonged jaundice and elevation of conjugated bili
feared complication of jaundice
tx jaundice
early onset sepsis (first 24hrs)
late onset sepsis (after first 24hrs)
emperic sepsis abx
general features of TORCH infections
toxoplasmosis in newborn
rubella in newborn
CMV in newborn
herpes in newborn
syphilis in newborn
varicella in newborn
dx work up of seizures in a newborn
tx of seizures in newborn
WD of from drugs in first 48hours
WD in newborn seen in first 96hrs up to 2 wks
infants of addicted mothers are higher risk of what
tx of oppiod WD in infant
anesthetics effect on neonate
barbiturate effect on neonate
mag sulfate effect on neonate
phenobarb effect on neonate
sulfonamides effect on neonate
NSAIDs effect on neonate
ACE I effects on neonates
isotretinoin effect on neonate
phenytoin effects on neonate
DES effect on neonate
tetracycline effect on neonate
Lithium effect on neonate
Warfarin effect on neonate
valproate and carbamazepine
patient with upward slanting palpebral fissures, speckling of iris, inner epicanthal folds, small stature, late fontanel closure, MR
dx work up/ assoc with trisomy 21
low set, malformed ears, microcephaly, micrognathia, clenched hand, rocker bottom feet, hammer toe, omphalocele
dx workup of trisomy 18
defect of midface, eye, forebrain development, holoprosencephaly, microcephaly, micropthalmia, cleft lip/palate
dx workup of trisomy 13
WAGR syndrome
low IQ, behavioral problems, slim with long limbs, gynocomastia
dx workup of klinefelter syndrome
Small stature female, gonadal dysgenisis, low IQ, congenital lymphadema, webbed posterior neck, broad chest, wide spaced nipples
dx workup with turner's
macrocephaly in early age, large ears, large testes, most common cause of MR in boys
multiorgan enlargement, macrosomia, macroglossia, pancreatic beta cell hyperplasia so hypoglycemia, large kidneys with neonatal polycythemia
dx workup of beckwith-wiedemann
obesity, MR, binge eating, small genitalia; decreased life expectancy due to obesity
MR, inappropriate laughter, absent speech of <6 words, ataxia, and jerky arm movements resemble puppet gait and recurrent seizures
mandibular hypoplasia, cleft palate; obs possible over first four weeks of life
birth weight doubles by 6 mos and triples by first year
height percentile at 2 years correlates with final adult height
indicator of acute malnutrition
best indicator of under or over weight
skeletal maturity is related to sexual maturity
most common cause of failure to thrive
when do you work up growth in child
ddx of growth pattern with dec weight and dec lenght/height
normal weight gain, but decrease in height
ddx of growth pattern with dec weight gain equal to dec length
advantages to breastfeeding
contraindications to breastfeeding
drugs that make breastfeeding contraindicated
infant reflexes that appear at birth and diappear at 4-6mos
infant reflexs present at 6-8mos and persist
present at 9 mo
present at 12mos of age
present at 15mos of age
present at 18mos of age
present at 2 years of age
present at 3 years of age
present at 4 years of age
invol voiding urine at least twice a week for at least 3mos in childern over 5 yo
dx testing of enuresis
tx of enuresis
unintentional passge of feces in clothes etc in children > 4
dx testing for Encopresis
tx encopresis
are immunizations altered for LBW or premature infants
dont give live vaccines to immunocompromised pts
following are not contraindications to immunizations
egg allergy not contraindication for MMR, yellow fever, and flu vaccine
MMR does not cause autism or IBD
hep b vaccine does not cause demyelinating neuro disorders
Meningiococcal vaccine not related to development of GBS
review vaccine schedule chart
immunization ppx after exp to measles
ppx immunization after exp to varicella
Hep exposure ppx
mumps and rubella post exp
Hep B vaccine schedule
DTaP vaccine schedule
HiB vaccine
has been associated with herpes zoster development after immunization
dx tests for child abuse
tx steps of child abuse
child age 3mo-5yr with URTI, rhionrheaa, sore throat, hoarse, deep bark cough, insp stridor, tachypnea, worse a night
management for croup
sudden onsent muffled voice, drooling, dyphagia, high fever and stridor; pts sits tripod and toxic appears
mgmt of epiglotitis
what abx is needed as PPX for family contacts to epigolotits pt
Brassy cough, high fever, respiratory distress, but no drooling or dysphagia; child<3yrs usually occurs after viral URTI
gray white pharyengeal membrane, may cover soft palate and bleeds easily
sudden coughing of choking w/o warning
patient drooling and difficult swallowing
patient has continued symptoms with treatment
sudden allergic reaction with swelling, needs steroids and epi or intubation
severe cough develops after 1-2wks with whoop and spells, look for child with incomplete immunization history
what do you r/o if recurrent respiratory infections in a child
bronchiolitis basics
best prevention against bronchiolitis
child<2 with mild URI, fever, Parosyxmal wheezy cough, dyspnea, tachypnea, Apnea; wheezing prolonged expirations
dx, tx, and prevention of bronchiolitis
URI symps, low grade fever, tachypnea
acute onset, sudden, shaking chills, high fever, prominent cough, Pleuritic CP, diminished breath sounds, dullness to percussion
infants 1-3mos of age with insidious onset, no fever or wheeze, staccato cough and peripheral eosinophillia, maybe conjunctivitis at birth
CXR viral PNA
CXR of Pneumococcal PNA
CXR of mycoplasma/Chlamydia
Dx of PNA in children
tx PNA in child
infant with meconium ileus, FTT, malabs, steatorrhea, vit ADEK def, rectal prolapse, persistent cough. Assoc with undescended testes, infertility (no vas deferns), ABPA
dx tests of CF
tx of CF
acyanotic congenital HD
cyanotic defects
what causes delayed presentation of CHD
presentation of CHD
abn of exam of CHD
murmur heard with fever, infection or anxiety; only systolic; grade<2/6
Dx testing of CHD
Harsh holosystolic murmur over L sternal border, loud pulmonic S2; half close spont in first 6mos; surgical repair if FTT, pulm HTN, or R to L shunt
Loud S1, wide fix split S2, systolic ejection murmur along left upper sternal border, most ASx and close by 4 (secundum type) if primary they need surgery; PFO needs closure if embolic occur
Combo of primum ASD, VSD adn common AV valve; presents like VSD; surgery in infancy before pulm htn develops
can be asx or result CHD, give PGE1 at birth, attempt balloon valvuloplasty
wide pulse pressure, bounding arterial pulses, machine gun murmur; use intomethacin in preme's to close it; term infants need surgery closure
early systolic ejection click at apex of left sternal border, replace valve and anticoagulate
BP higher in arms than legs, PDA dependent so give PGE1 to maintain; repair after stabalize
VSD + RVH + Routflow obs + overidding aorta; RV impulse, thrill along L sternal border; hyperpnea, irritability, cyanosis
more common in IODM, S2 single and loud, murmur absent, ductus dependent; Sx needed
abx ppx for endocarditis
blood pressure >95% on nomogram
Secondary causes HTN in newborn
early childhood causes of secondary HTN
adolescent causes of HTN
causes of Renal vascular HTN in children
Dx testing for secondary HTN
causes of acute diarrhea
dx testing for acute diarrhea
initial tx for acute diarrhea
tx of shigella diarrhea
tx of campylobacter diarrhea
salmonella diarrhea tx
Tx C. Diff diarrhea
tx of E. histolytica or Giardia
tx Cryptosporidium
young child 5-10d after infection with pallor, weakness, oliguria, and acute renal failure
fat malabs testing
Carbohydrate malabs
protein malabs
with malabs test for vit def
child with chronic diarrhea, FTT, GR, anorexia
Celiac patients have increased risk of what
tx of GERD in infant
first 6wks of life, vomit after feeds, hypoCl and met alkalosis and firm abd mass
painless rectal bleed in an infant
tx of cystits and pyelo in kids
do not give the follow abx in kids
further mgmt of UTI in kids
if VCUG shows reflux
most common causes of obs uropathy
presents in children 5-12yo, 1-2wks after strep or 3-6wks after impetigo; see edema, HTN, and hematuria
Dx test for APGN
tx APGN
has a normal C3 presents after URI, in 20-30yo and need BP control
b/l flank masses and hypoplasia, HTN, oliguria, ARF
MCD tx
complications of nephrotic syndrome
most common cause of CAH (aut recessive)
infant with vomitting, dehydrated, hyponatremia, hypoglycemia, hyperkalemia, ambiguous genitalia at birth
labs for CAH
tx CAH
patient with fever for 5days has b/l conjuctivits w/o exudate, strawberry tongue, dry cracked lips, erythema and swelling of hands and desquemation of fingertips, nonvesicular rash, cervical LAD
dx testing for Kawasaki dz
tx of kawasaki dz
2-8 yo child with Maculopapular rash (purpura), fever, abd pain, hx of URI
HSP assoc with what
dx test for HSP
tx HSP
anemia is common in the term and exagerated in the preterm infant?
when do you seen anemia from decreased iron intake in infants
tx iron def anemia in infants
child with hyperactivity, aggression, learning disability, impaired growth, constipation and mental lethargy
screening for lead poisoning
tx of lead poisoning in kids
most common causes of mortality in pediatric SCD
Dx testing of SCD
transfusion in SCD
when do we give hydroxyurea
routine care for SCD
Defenitive tx of SCD
2nd month of life, prog anemia, hypersplenism, and cardiac decompensation, expanded medulary space with inc expansion of face and skull, extramedullary hematopoesis; hepatosplenomegaly
dx test for Beta thal
tx of beta thal
what is increased in coags for Hemophelia A and B
what coags are off in VWD
clotting factor assay show decreased levels of factor 8 or 9
quantitative assay for vWF ag, vWF activity
mixing study results
tx of hemophillia A
tx of hemophillia B
tx VWF disease
if hemophelliac prior controlled now not what do you do
ITP basics
tx of ITP
PE in ITP
febrile seizure has increased risk of epilepsy based on what factors
define epilepsy
when to stop seizure medications
EEG and tx of Absence Sz
jerky movements in the morning at the onset of adolescence
JME EEG and tx
infantile spasms for first year of life, 75% have underlying CNS problem (usu Downs)
West syndrome EEG and tx
simple partial sz description
tx of simple or complex partial sz
generalized sz description
generalized sz EEG and tx
fever of unk focus is <1 week but FUO is >3 wk duration
fever of unknown focus get empiric abx if....
fever of unknown focus in neonate
fever of unknown focus in infant
complications of menegitis
complication of S. pneumo menegitis
complication of HiB menegitis
complication of meningococcus
ppx abx for n. menegitis and Hib only?