Peds

1. Legg-Calve-Perthes; XR = wide articular space + necrosis femoral head; self-

limited; tx by maintaining joint mobility (use brace to keep hip in
acetabulum) or surgical tx w/ osteotomies; exam = limited abduction and
internal rotation
2. CP = nonprogressive motor impairment; cog disability, MR, vision problem,
skeletal, seizures, poor PO, poor growth/development; most likely to have
problems w/ constipation
3. DTaP given @ 2, 4, between 15 18mo, final = between 4-6years;

4. Roseola HHV6-7: high F defervesce rose-pink macular rash (trunk-
>extreme)
a. Measles = rare because of universal vaccination; morbiliform w/
koplik
b. Rubella = head to toe rash; prodromal lymphadenopathy and
lowgrade fever
5. Recurrent UTI anatomic US (look for urinary tract abnormality and
hydronephrosis) and VCUG (dx and evaluate severity of reflux)
a. DMSA scan looks for renal scarring
6. Infantile Hemangiomas = most common benign tumor (can be on skin or on
organs e.g. liver) in kids, resolves/involutes by 18mo; usually asymptomatic
but large ones assoc. w/ high output cardiac failure (bc of incr vascular
flow to hemangioma); tx = steroids interferon
7. RMSF = ha, fever, rose-colored blanching maculopapular rash (starts in
extremities central); see petechiae, low platelets, low leuks, low serum
Na+; tx w/ Doxy if unable chloramphenicol (side effects = BMS, aplastic
anemia, leukemia, gray baby)
8. +string sign = Crohn


9. suspect nephritic/nephrotic syndrome => 24hr urine + tx w/ pred
10. ITP = dx of exclusion; usually presents after viral infection; low plt and incr-
to-normal megakaryocytes; resolves (in kids) <2mo
a. HUS and TTP would see F, MAHA, renal failure, thrombocytopenia
11. MCC meningitis infants = GBS, Listeria, E. coli; MCC brain abscess in
meningitis = Citrobacter koseri (vertical transmission) tx w/ 3
rd
gen/4
th
gen
ceph + aminolglycoside x4wk; CSF = nphil predom, high pro, low gluc;
12. Chlaymdia PNA = staccato cough, low-grade F or no F; CXR =
hyperinflation or ground glass appearance; can have normal leuk w/
eosinophilia
13. MVP = apical click followed by systolic murmur (can be source of CP in
kids); MVP vs MR/TR = holosytolic murmur
14. AOM = high dose amox x 10 days; 2
nd
line = augmentin, ceftriaxone or
cefuroxime; after initiating abx = recheck in 2-3 days to make sure working
(clinical improvement)
Set 2
1. Cat bites = P. Multocida + S. Aureus; 1
st
line = Amoxicillin-Clavulanate
2. Kawasaki = F>5days, rash, mouth stuff, lymphadenopathy, nonpurulent
conjunct, desquamation coronary artery dilation/aneurysm; IVIG + ASA;
get echo
3. Mild-mod dehydration = okay w/ PO hydration at home normal diet
4. Septic arthritis suspicion = first line: get arthtrocentesis; leuk > 50k w/
predom neutrophils
5. Turners = short, gonadal dysgen, shield chest, wide nips, thick neck, no
2ndary sex characteristics; labs = high FSH and LH, low estrogen; buccal
swab = normal epithelial cells w/ no Barr bodies; Tx = estrogen
replacement therapy
6. Lesch nyhan = self harm, choreoathetosis, MR, hyperuricemia; get HPRT
7. SLE = malar/discoid rash, arthritis, photosens, seizure/psychosis, mucocut
ulcers, renal d/o (proteinuria, casts), serositis, heme d/o (anemia,
leukopenia, etc), +ana titer
8. Wilms Tumor = del chr 11; p/w htn and abd mass in kid; can be part of
WAGR = Wilms, Aniridia, GU abnormalities (cryptorchidism, ambiguous
genitalia), Retardation (mental)
9. 1
st
step w/ severe dehydration = correct shock state w/ boluses of LR or NS;
then correct based on dehydration state (hypernatremic = >150, isonatremic
130-150, hyponatremic <130); for hypernatremic = maintenance and solute
deficit over first 24hrs w/ half free water deficit w/ maintenance and 2
nd
half
of free water deficit over 2
nd
24hrs
10. perinatal asphyxia => hypoxic-ischemic encephalopathy
11. MCC VP shunt infection = Staph epi followed by S. Aureus
12. Myoglobinuria suspect if see +blood in dip stickcan occur after exercise
13. infant w/ new hydrocele, recently fell 2 days ago, +tive transillumination
test = should still r/o acute scrotal conditions w/ Doppler to assess perfusion
(bowel in hernia or hematocele can give +tive transillumination test);
14. RUS = good for eval hydronephrosis, renal abscess, calculi, anatomic
abnormlaties; VCUG = renal scarring or VUR
a. routine imaging needed for: girls <3yo, boys of any age w/ first UTI,
children of any age w/ febrile UTI, children w/ recurrent UTI (if not
imaged previously), first UTI in child of any age w/ family h/o renal
dz, abnormal voiding pattern, poor growth, urinary tract abnormal.
15. suspect HIV in FTT, developmental delay, fever, thrush, recurrent ear
infections, generalized lymphadenopathy
Set 3