The Tall Man Shadow > Pediatric > Flashcards

Pediatric Flashcards

(147 cards)

Study These Flashcards
1
Q

What is a common mechanism for a scaphoid fracture?

A

FOOSH; snuffbox tenderness, axial thumb load.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What imaging findings are associated with a scaphoid fracture?

A

X-ray can be negative x2; thumb spica and re-xray.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the casting durations for scaphoid fractures?

A

Distal (SA 6 w), middle (LA 6 w → SA 2–4 w), proximal (LA 8–12 w).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What complications can arise from a scaphoid fracture?

A

Non-union, AVN; refer if proximal/displaced/angulated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the findings for lateral epicondylitis?

A

Pain with resisted wrist extension/supination; long-finger extension pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the treatment for lateral epicondylitis?

A

RICE, NSAIDs, brace, stretch/strengthen; steroid injection; casting PRN.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the mechanism for posterior elbow dislocation in kids?

A

Fall/twist; obvious deformity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What complications can occur with posterior elbow dislocation?

A

Ulnar/median nerve; brachial artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the treatment for posterior elbow dislocation?

A

Reduction with anesthesia; short immobilization then early ROM.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the characteristics of olecranon bursitis?

A

Boggy swelling; protect/compress/ice/NSAIDs; aspirate if infected; bursectomy if chronic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the treatment for triceps tendinopathy/rupture?

A

Rest/NSAIDs; partial → splint; complete → surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common ankle sprain?

A

ATFL (inversion); Ottawa rules for x-ray.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment for ankle sprains?

A

RICE, NSAIDs, rehab.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What stability test is used for ankle injuries?

A

Anterior drawer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What should be suspected with talar dome pain?

A

Osteochondral fx; X-ray (AP/lat/mortise ± stress).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What imaging is used for tibial stress fractures?

A

Cone-down x-ray; bone scan/MRI (CT gold); graded return (10%/wk); air cast if high-risk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the red flags for low back pain?

A

Cancer, age>50, wt loss, fever, night/rest pain, neuro deficits, IVDU, immunocomp, UTI, osteoporosis, bladder dysfunction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What syndromes are associated with low back pain?

A

Sciatica (disk), cauda equina (saddle anesthesia, retention, bilat deficits), stenosis (neurogenic claudication).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the neuro levels for low back pain?

A

L4 (squat/rise, med foot, knee reflex), L5 (dorsiflex big toe, med web), S1 (plantarflex, lat foot, ankle reflex).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When should imaging be done for low back pain?

A

After 4–6 w unless red flags; MRI by 12 w if persistent.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the treatment for low back pain?

A

NSAIDs/acetaminophen, short-course muscle relaxant/opioid PRN, PT, early activity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the urgent treatment for cauda equina syndrome?

A

MRI → urgent decompression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the rotator cuff muscles?

A

Supraspinatus, infraspinatus, teres minor, subscapularis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What tests are positive for rotator cuff injuries?

A

Painful arc, drop-arm; imaging MRI if tear suspected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the treatment for Achilles tendinopathy?
NSAIDs (GI/renal/TE risks), rest/ice/heel lift; rupture → US; ortho.
26
What is Osgood–Schlatter disease?
Tibial tubercle apophysitis; benign/self-limited; x-ray optional.
27
What are the signs of an ACL tear?
Pivot, pop, immediate swell, cannot WB; Lachman/pivot shift; PT vs surgery; prevention with neuromuscular training.
28
What are the symptoms of patellofemoral pain?
Anterior knee pain, stairs, theater sign; exam tilt/glide/grind; imaging not required.
29
What are the symptoms of carpal tunnel syndrome?
Paresthesias/weakness; Tinel/Phalen; RF pregnancy/DM/obesity/RA/SLE/hypothyroid; NCV to confirm; splint/activity mods/NSAIDs.
30
What is a Colles’ fracture?
Distal radius (FOOSH); also check scaphoid/ulna.
31
What is the casting protocol for a Colles’ fracture?
Long arm → then short arm; frequent follow-up.
32
What is a red flag for Colles’ fracture?
Pain/numbness → consider compartment syndrome → remove cast.
33
Neonatal fever workup
CBC, lytes, blood Cx, urine Cx (cath), LP, CXR.
34
Likely bugs in neonatal fever
E. coli, GBS, Enterococcus.
35
Empiric treatment for neonatal fever
Ampicillin + Gentamicin.
36
Bugs causing neonatal meningitis
GBS, E. coli, Strep pneumo, Listeria, Staph.
37
Diagnosis for neonatal meningitis
LP.
38
Treatment for neonatal meningitis
Ampicillin 200–300 mg/kg/day q6h IV + Cefotaxime 200 mg/kg/day q6–8h IV.
39
Contraindications for LP in neonatal meningitis
Overlying skin infection; ↑ICP (mass/lesion, papilledema); bleeding diathesis/thrombocytopenia.
40
Chemoprophylaxis for contacts of meningococcus
Rifampin 600 mg q12h x2 d (children 10 mg/kg; infants 5 mg/kg) or ciprofloxacin.
41
Who to prophylax for meningococcus
Household, daycare, intimate contacts from 7 d before sx to 24 h after treatment start.
42
Signs of meningitis in a 4-year-old
↓LOC, nuchal rigidity, Kernig/Brudzinski, bulging fontanelle, HA, emesis, tachy, hypotension, petechiae/purpura, focal deficits.
43
Bugs causing child meningitis
S. pneumo, N. meningitidis, H. influenzae.
44
Treatment for child meningitis
Ceftriaxone or Cefotaxime ± Vancomycin (if pneumococcus suspected).
45
Treatment for definite N. meningitidis
Pen G 250,000 U/kg/day QID.
46
History for abdominal pain in an 11-year-old
Onset, severity, radiation, wt loss, constipation, gas, N/V.
47
Physical exam findings for abdominal pain
Rebound, focal TTP, guarding, BS changes, psoas/obturator signs.
48
Differential diagnosis for abdominal pain
Appendicitis, constipation, hernia, testicular torsion.
49
Investigations for abdominal pain
CBC, UA & C/S, abdo U/S, stool C/S if indicated.
50
Criteria for acute rheumatic fever (ARF)
Jones: 2 major or 1 major + 2 minor + strep evidence.
51
Major criteria for ARF
Carditis, polyarthritis, chorea, erythema marginatum, subcut nodules.
52
Minor criteria for ARF
Fever, arthralgia, prior ARF/RHD, ↑ESR/CRP/WBC, prolonged PR.
53
Strep evidence for ARF
Throat Cx, RADT+, ↑ASO, scarlet fever.
54
Treatment for ARF
Bedrest (carditis), ASA, antibiotics.
55
Secondary prophylaxis for ARF
IM benzathine penicillin monthly x 5 yrs.
56
Complication of ARF
Chorea (can treat with prednisone).
57
Signs of Kawasaki disease
Fever; conjunctivitis; mucositis (cracked lips, strawberry tongue); rash → desquamation; extremity changes; LAD.
58
Treatment for Kawasaki disease
IVIG + aspirin.
59
Differential diagnosis for Kawasaki disease
Measles, scarlet fever.
60
Pathologic jaundice in neonates
<24 h = pathologic.
61
Risk factors for kernicterus
<37 wks, <2500 g, hemolysis (isoimmunization/G6PD/spherocytosis), sepsis, jaundice <24 h, resuscitation at birth.
62
Risk factors for jaundice
FHx jaundice/anemia/liver dz/IEM; polycythemia/bruising/cephalohematoma; poor feeding, delayed meconium, wt loss; sepsis, asphyxia; SGA/late preterm; endocrine; East Asian/Native American; IDM; maternal sulfas/antimalarials.
63
Investigations for neonatal jaundice
CBC/diff, group & screen, DAT, total & indirect bili, LFTs, G6PD.
64
Treatment for neonatal jaundice
Phototherapy + hydration.
65
Side effects of phototherapy
Dehydration, loose stools, bronze baby, rash, hypernatremia, retinal injury (shield), masks other etiologies.
66
Features of febrile seizures
Temp-related; age 6 mo–6 y; no CNS infection/metabolic cause; generalized tonic-clonic; simple if <15 min, non-focal, single (or <30 min total if series); no post-ictal neuro deficit.
67
Non-benign features of seizures
Residual neuro deficit.
68
Recurrence risk for febrile seizures
30–50% (younger age ↑). Epilepsy risk ~2%.
69
Prevention medications for febrile seizures
Benzodiazepines; anticonvulsants (phenytoin/phenobarb).
70
Outpatient test for febrile seizures
EEG (select cases).
71
Consideration for retinal hemorrhages
Consider abuse.
72
Acute management of febrile seizures
ABC, lateral, suction, O₂, IV NS; check glucose → give D25 1 g/kg if low; home PR diazepam 0.5 mg/kg; hospital phenytoin 20 mg/kg (1 mg/kg/min), then phenobarb 20 mg/kg if needed; >45 min → ICU; antipyretics.
73
Diagnosis of asthma in kids (<6 y)
Clinical index.
74
Stringent criteria for asthma diagnosis
≥3 wheeze episodes <3 y + (≥1 major: parental eczema/asthma) or (≥2 minor: eosinophilia, wheeze without colds, allergic rhinitis).
75
Supporting criteria for asthma diagnosis
Severe episode; ≥3 episodes; after age 1; nocturnal/exercise cough; response to meds.
76
Diagnosis of asthma in kids (≥6 y)
FEV₁ +12% post-BD or PEF +20%.
77
Risk factors for asthma
FH atopy/asthma, smoke, dust mites, carpets, pets, RSV bronchiolitis, ASA/NSAID sensitivity.
78
Prevention for asthma
Avoid cats/dogs if bi-parental atopy; BF has many benefits.
79
Step-up treatment for asthma
SABA → ICS → LTRA → LABA → oral steroids.
80
Acute management for asthma
O₂, neb salbutamol, SC epi, IV steroids, fluids, ± IV salbutamol, ± intubation.
81
Control targets for asthma
<4 daytime sx/wk; <1 night/wk; normal activity; <4 PRN uses; mild/infrequent exacerbations; FEV₁/PEF >90% PB; diurnal var <10–15%.
82
Office monitor for asthma
Peak flow.
83
Croup in an 18-month-old
Parainfluenza/RSV/adenovirus/influenza/measles/mycoplasma; late fall/winter; barking cough, hoarseness, stridor, URI prodrome; usually non-toxic.
84
Signs of epiglottitis
Toxic, drooling, tripod, rapid.
85
Worsening signs in croup
Drooling, dysphagia, indrawing, tracheal tug, cyanosis, ↓air entry.
86
Home management for croup
Cool air, humidifier, reassurance.
87
Severe croup management in ED
Racemic epinephrine + dexamethasone 0.6 mg/kg; O₂.
88
Emergency management for epiglottitis
IV cefuroxime 150–200 mg/kg/day TID; airway.
89
Symptoms of pediatric UTI
Fever, abdo/flank pain, incontinence, dysuria, hematuria, urgency, N/V, nocturia.
90
Admission criteria for pediatric UTI
IV if toxic, dehydrated, or cannot take PO.
91
Risk factors for pediatric UTI
Female; uncirc male; VUR; toilet training/voiding dysfunction; BOO; instrumentation; improper wiping; pinworms; sexually active; PUV; neurogenic bladder.
92
Diagnosis for pediatric UTI (2–24 mo)
SPA; >2 y MSU.
93
Treatment for pediatric UTI (PO 7–10 d)
TMP-SMX 5–10 mg/kg/d q12h, nitrofurantoin 5–7 mg/kg/d q6h, amoxicillin 40 mg/kg/d q8h, cefixime; IV amp+gent if needed.
94
Prophylaxis for pediatric UTI (till imaging)
TMP-SMX 0.5–1 mg/kg HS; nitrofurantoin 1–2 mg/kg HS; amox 5 mg/kg HS.
95
Imaging for pediatric UTI
Renal U/S ± VCUG (per local guidance; <5 y often imaged).
96
Risks of untreated VUR
Scarring, HTN, recurrent pyelo, poor growth, ESRD.
97
Differential diagnosis for hematuria in a 4-year-old
Pseudo (beets, dyes), meds (rifampin, nitrofurantoin), urates; myoglobin/hemoglobin; GN (IgA, post-strep, lupus, MPGN, HSP), HUS (E. coli O157:H7), structural (trauma, tumor, stone, obstruction), UTI, coagulopathy.
98
Investigations for hematuria
UA, C/S, CBC, PT/INR, PTT, lytes, renal U/S, blood Cx, stool C/S, Cr/BUN, phosphate, albumin, sickle screen, ANA, C3.
99
Triad of Henoch–Schönlein purpura (IgA vasculitis)
Palpable purpura (LE/buttocks), arthralgia (large joints), GI pain/bleed ± intussusception; renal IgA nephropathy (hematuria/proteinuria).
100
Investigations for Henoch–Schönlein purpura
CBC, ESR/CRP, lytes, Cr/BUN, IgA, ± skin biopsy.
101
Treatment for Henoch–Schönlein purpura
Analgesia; steroids if severe pain/renal/GI.
102
Airway assessment for pediatric procedural sedation
Mallampati, mouth opening, teeth, tongue size, tonsils, neck length/mobility, chin size, obstruction.
103
Side effects of ketamine in sedation
Laryngospasm → jaw thrust, suction, PPV, succinylcholine if needed.
104
Contraindications for pediatric procedural sedation
<3 months, known psychosis.
105
Osgood–Schlatter condition
Tibial tubercle apophysitis; active adolescents; worse with running/jumping.
106
Differential diagnosis for Osgood–Schlatter
Patellar tendinitis, PFS, patellar sublux, SCFE, osteochondritis, patellar dislocation, septic joint, Legg–Calvé–Perthes.
107
Imaging for Osgood–Schlatter
X-ray (optional).
108
Quick note on PFS
Overuse/maltracking; ant knee pain with stairs/sitting; “giving out.”
109
Screening for developmental dysplasia of the hip (DDH)
Serial newborn hip exams (Grade A) until walking.
110
Maneuvers for DDH screening
Ortolani, Barlow, Galeazzi.
111
Risk factors for DDH
Female, breech, FHx, primip, oligohydramnios, foot deformity.
112
Consider DDH with
Limp/toe-walking.
113
Imaging for DDH
<5 mo hip U/S; >4–6 mo X-ray.
114
Treatment for DDH
Pavlik harness (<6 mo, stable); >6 mo consider closed/open reduction.
115
Approach to limp in a child
Labs: CBC, ESR, blood Cx, RF, ANA, PTT, sickle screen, UA.
116
Imaging for limp in a child
X-ray; bone/gallium scan PRN.
117
If septic arthritis suspected in limp
Arthrocentesis (Dx & decompress).
118
Common bugs for limp in children
Staph aureus (child); GBS (infant).
119
Differential diagnosis for limp in <3 y
Trauma, osteomyelitis, septic arthritis, transient synovitis, JRA, leukemia, neuroblastoma, hemophilia, sickle cell.
120
Differential diagnosis for limp in 3–10 y
Above + HSP, Legg–Calvé–Perthes, bone tumors, growing pains.
121
Differential diagnosis for limp in >10 y
Above + SLE, seronegative spondyloarthropathy, dermatomyositis, SCFE, Osgood–Schlatter, fibromyalgia, CRPS.
122
Normal dysfluency in stuttering
Brief sound reps up to ~1/10 sentences (18 mo–3 y), ↑ when tired/excited.
123
Concerning features of stuttering
Frequent syllable reps, consistent dysfluency, embarrassment/avoidance, 1–7 y, >6 mo.
124
Treatment for stuttering
Parent-focused: slow modeled speech, time to talk, non-judgmental acknowledgment, praise fluent speech.
125
Risk factors for fetal alcohol spectrum
Alcohol use, low SES/education, no prenatal care.
126
Facial features of fetal alcohol spectrum
Thin upper lip, smooth philtrum, small palpebral fissures.
127
Other diagnostic features of fetal alcohol spectrum
Developmental/learning problems, poor judgment/behavior, organ dysfunction.
128
Physical exam findings in Down syndrome
Hypotonia, flattened face, epicanthal folds/upslant, small ears/mouth, low-set ears, single palmar crease, wide 1–2 toe gap.
129
Medical issues associated with Down syndrome
CHD (ASD/VSD), TE fistula, recurrent OM, dysplastic hips, thyroid dz, leukemia, early dementia, seizures, depression.
130
Screens for Down syndrome
↓AFP/estriol, ↑β-hCG, ↑NT, PAPP-A.
131
Incidence of Down syndrome
~1/800–1/1000. Most common = trisomy 21.
132
Recurrence risk for Down syndrome
~1/100 up to age 35.
133
Features of congenital rubella syndrome
Neuro: microcephaly, MR; Eyes: glaucoma, cataracts, micro-ophthalmia; Ears: SNHL; Heart: PDA, ASD/VSD; GI: HSM; Heme: thrombocytopenia; Skin: “blueberry muffin,” jaundice.
134
Pregnancy risk with Fifth disease (Parvovirus B19)
Hydrops fetalis (esp. 1st–2nd tri).
135
Testing for Fifth disease
IgM/IgG (IgM = recent; IgG = immune).
136
Typical presentation of Fifth disease in children
Slapped cheeks → lacy maculopapular rash spreading down; well-appearing.
137
Differential diagnosis for Fifth disease
Measles, rubella, roseola, enterovirus, Kawasaki, scarlet fever.
138
Contagious period for Fifth disease
Before rash.
139
What is tested for in suspected cases?
IgM/IgG (IgM = recent; IgG = immune).
140
What is a typical presentation of the child?
Slapped cheeks → lacy maculopapular rash spreading down; well-appearing.
141
What are the differential diagnoses (DDx)?
Measles, rubella, roseola, enterovirus, Kawasaki, scarlet fever.
142
What indicates it is not measles?
Rash pattern/sequence, lack of cough/coryza/conjunctivitis prodrome, pruritic lacy rash.
143
When is the condition contagious?
Before rash; once rash appears, not infectious (safe for cousin/school).
144
What is the duration of the rash?
Up to 5 weeks.
145
What are potential complications?
Aplastic crisis (esp. hemoglobinopathies), pneumonia, encephalitis, secondary bacterial infection.
146
What is the treatment?
Supportive; transfuse if aplastic crisis.
147
What should pregnant contacts do?
Avoid exposure <20 wks; test IgG/IgM.
The Tall Man Shadow
flashcards
Decks in class (38)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions