adenopat

Diagnosis chy

15 yo
with
recurrent
URI, strep,
or
staph_x00
0D_
_x000D_
Pt has
high
fever,
toxic
appearan
ce,
sometime
s cellulitis
or
Who to susp
fluctuance

Often
appear
well_x000
D_
_x000D_
Nodes can
rupture
through
skin
though
> tx with
surgical
Appearance
excision
Asthma_x
000D_
Coughs that
Sinusitis
ental
irritant_x0
00D_
Fungal
infection_
x000D_
Dry coughsAsthma
00D_
Subglottic
disease_x
000D_
Foreign
Barking co body

Pertussis_
x000D_
Chlamydi
a_x000D_
Mycoplas
ma_x000
D_
Foreign
Paroxysmalbody
Habitual
cough_x0
00D_
Brassy/honTracheitis
Change in v
Laryngeal irritation (can be from rhinitis, GERD, etc)

Primary
complex
(large
hilar
adenopat
hy with
initial lung
focus)_x0
00D_
Focal
hyperinfla
tion_x000
D_
Atelectasi
s_x000D_
Small
local
pleural
Radiology feffusions
All pts
with
persistent
asthma_x
000D_
_x000D_
Need to
monitor
BP,
glucose,
growth
delay,
Who uses in
cataracts
Who gets me
When asthma is suspected but spirometry is normal

Cefuroxim
e_x000D_
Amoxicilli
n
clavulanat
Abx to treate
Ethmoid
and
maxillary
at
birth_x00
0D_
Frontal
start
around 6
Timing of 8 yr
Orbital
sinusitis_x
000D_
Cavernou
s sinus
thrombosi
s_x000D_
Meningitis
_x000D_
Epidural
Complicatioabscess
Mucus/sec
retions in
airways_x
000D_
_x000D_
Continuou
s, low
pitched,
polyphoni
Cause of rhc

Lymphoid
hyperplasi
a_x000D_
from
chronic
post nasal
drip and
with
chronic
nasal
Cause of coallergies

reaction:
1 hr,
PGs/LTs,
permeabil
ity,
hypersecr
etion,
bronchoco
nstriction_
x000D_
_x000D_
Late: 23
hrs later,
epithelial
destructio
n, fibrotic
remodelin
g,
hyperplasi
a of
bronchial
smooth
muscle_x
000D_
_x000D_
Airway
hyperresp
onsivenes
s can
persist for
days to
Stages of weeks

Hemisphe
ric: limb
abnormali
ties,
nystagmu
s, tremor,
dysmetria
(spares
speech)_x
000D_
_x000D_
Deep
nuclei:
resting
tremor,
myoclonu
s,
opsoclonu
s
(neurobla
Cerebellar stoma)
Medullobl
astoma
(20%)_x0
00D_
_x000D_
Juvenile
pilocytic
astrocyto
Most commo
ma (20%)
Classic
has
aura_x000
D_
_x000D_
Common:
no aura,
more
Classic vs common
HTN_x000
D_
Bradycard
ia_x000D_
Irregular
respiratio
Triad of ICPn
Complicati Blindness from elevated pressure around optic nerve sheath

Obesity_x
000D_
Meds (Vit
A,
tetracycli
ne, OCPs,
steroids)_
x000D_
Metabolic
disorders
(galactose
mia,
hypo
PTH)_x00
0D_
Infection
(sinusitis,
Causes of OM)
Location ofPineal gland or suprasellar region

Infratento
rial:
cerebellar
signs,
signs of
raised
ICP_x000
D_
_x000D_
Supratent
orial: focal
motor and
sensory
abnl on
opposite
side of
Presentatiolesion
Medullobl
astoma_x
000D_
Ependym
Male predooma
First
decade_x
000D_
8th
Two peaks decade
o

Supra <
2yo_x000
D_
Infa in
kids_x000
D_
Supra in
adolescen
Ages wherets/adults
13
yo_x000D
_
Several
wks after
viral
infection
(varicella,
coxsackie)
_x000D_
CSF w/
pleocytosi
s, high
Who does po
prot
Mumps_x
000D_
Enteroviru
s_x000D_
EBV_x000
D_
Bacterial
meningitis
pathogen
Infectious s
Alcohol_x
000D_
Anti
convulsan
ts_x000D_
_x000D_
Often get
dysmetria
and
nystagmu
Examples of
s also
Age of neu6mo to 3yo
D_
EKG_x000
D_
(save
echo for
Initial wor later)

stenosis_x
000D_
Coarctatio
n_x000D_
PDA_x000
D_
Murmurs asVSD

Days to
weeks of
age_x000
D_
occurs
as
pulmonar
y
resistance
When is a Vdecreases
Large:
RVH and
upright T
wave in
V1_x000D
_
Moderate:
LVH_x000
D_
EKG change
Small: nl
When are APreschool age
Innocent
murmur_x
000D_
Most commo
37 yo
Musical/vi
bratory_x
000D_
Best
heard
LLSB,
supine_x0
00D_
What does 37
S yo
Symptom
s of
CHF_x000
D_
_x000D_
Digoxin:
not good
Digoxin and
for VSD

SCFE_x00
0D_
_x000D_

posterior
displacem
ent of
capital
femoral
epiphysis
from
femoral
neck
through
cartilage
growth
Most commo
plate

Femoral
head
deformity
_x000D_
Degenera
tive
arthritis_x
000D_
_x000D_
often in
boys 410
Complicati yo
How long af24 wks after GI or GU infection
What action
Internal rotation
How is painBy opening the hip capsule (hold hip in flexion and external rotation)
Key way toElevated ESR, CRP in septic arthritis (can wait for lab values before doing joint tap if low

Weight
bearing_x
000D_
_x000D_
Pain is
NOT
position
dependen
t (like in
septic
arthritis or
transient
What worsesynovitis)

ESR:
remains
elevated
for weeks
after
improvem
ent_x000
D_
_x000D_
CRP:
elevated
46 hrs
after
initial
insult,
peaks at
3650 hrs,
and
returns to
normal
after 37
Time of ESR
days
1. Higher
SA to
body
mass
ratio_x00
0D_
2. Higher
basal
metabolic
rate_x000
D_
3. Higher
percentag
e of body
weight
that's
3 reasons kwater

1.
Random
BS >
200_x000
D_
2. pH <
7.3 or
HCO3 <
15_x000D
_
3. Modlg
ketonuria
or
ketonemi
Diagnosis a
glucose >
200_x000
D_
2. Fasting
>
126_x000
D_
3. 2hr
GTT >
200_x000
D_
4. HbA1c
Dx of diabe> 6.5
Most commo
Cerebral edema
Hyponatre
mia:
replacem
ent can
cause
central
pontine
myelinoly
sis_x000D
_
_x000D_
Hypernatr
emia:
replacem
ent can
cause
cerebral
Replacemen
edema

Iso: AGE,
diarrhea_x
000D_
Hypo:
adrenal
insufficien
cy_x000D
_
Hyper:
breastfee
ding
failure, DI,
inappropri
ate
rehydratio
n
Cause of issolutions
High
BUN_x000
D_
Acidosis
with
hypocapni
a_x000D_
Attenuate
d rise in
Na+ with
treatment
_x000D_
Admin of
Risk factor bicarb

Anti
pancreatic
(Anti
insulin,
GAD,
IA2)_x000
D_
Autoimmu
ne
thyroiditis
and
celiac_x00
0D_
_x000D_
DON'T
check
TFTs (can
be
elevated
due to
non
thyroidal
Other Abs illness)
Sodium conc
4550 mEq/L
Where's the
Blood in stool but not in vomit
Intussusc
eption_x0
00D_
_x000D_
also
bilious
emesis,
crampy
abd pain,
and
sausage
mass on
Current jellexam
Electrolyte Hypochloremic, hypokalemic metabolic alkalosis
Time of pre312 weeks
obs_x000
D_
2.
Eyes_x00
0D_
3.
CV/Lungs/
Abd_x000
D_
4.
Ears/oral
Order of excavity

Mobility
and
Position_x
000D_
_x000D_
Also
color,
transluce
ncy, and
Most import
other
Appearance
Bulging, yellow, poorly mobile
1/2. S.
pneumo/N
on
typeable
H.
inf_x000D
_
3. M.
catarrhalis
_x000D_
4. S.
Bacterial c pyogenes
Who do weKid
t with fever > 39C or moderate to severe otalgia
cin_x000D
_
Erythromy
cin_x000D
_
Clindamyc
Alternativein

VRA: good
6 mo to
2.5 yo,
not ear
specific_x
000D_
_x000D_
Conventio
nal: >
4yo,
frequency
Use of convspecific

Otoacoust
ic
emissions
(OAE)_x00
0D_
_x000D_
measure
cochlear
fxn in
response
to
presentati
on of
Which hearstimulus

Bullous
myringitis
_x000D_
Radial
vascular
dilation
(bicycle
spoke
distributio
n)_x000D
_
Marked
erythema
with
cobblesto
ne"
appearan
Findings asce of TM"

Abx: <
6mo, 6mo
to 2 yr: if
certain dx
or severe
disease,
>2 yo
with
severe
illness_x0
00D_
_x000D_
No abx:
6mo to
2yr with
uncertain
dx, > 2yo
without
severe
Who to useillness
Effusion >
3mo_x000
D_
If nl,
follow q3
6mo_x000
D_
If not,
consider
bilateral
myringoto
my with
tube
placemen
Who shouldt
Test for 0 Denver II

Permanen
t sensory
neural
hearing
loss
(SNHL)_x0
00D_
Tympanos
clerosis_x
000D_
Adhesive
otitis
media_x0
00D_
Cholestea
toma_x00
0D_
TM
perforatio
n_x000D_
Mastoiditi
s,
Labyrinthi
tis,
Meningitis
_x000D_
Epidural/b
rain
Complicati abscess
Cause of RU
FitzHughCurtis
What should
Bear down as you enter the rectum to relax the external sphincter

<1 yo,
more
F_x000D_
Pain,
irritability,
vomiting,
abd
distention
(if
intestinal
obstructio
Presentation)
Use of CT fAbscesses and Appendicitis
Use of US iPID, tuboovarian abscess (TOA)

Chronic
abd pain
(IBD)_x00
0D_
Dx
intussusc
Use of bari eption
Ileus_x00
0D_
Fluid
levels_x00
0D_
Fecaliths
(appy)_x0
00D_
Free air
(perforate
d
viscus)_x0
00D_
Malrotatio
n_x000D_
Use of KUBGallstones
What causeBacteria
spills from uterus, tracks along paracolic gutter, and causes inflammation of th
NS
bolus_x00
0D_
D25
bolus_x00
0D_
Maintena
nce D10
Immediate drip
What can be
Octreotide
Wide
complex
tachycardi
a_x000D_
inc PR
interval_x
000D_
QRS
widening_
x000D_
QT
interval
prolongati
EKG findin on

Myocardia
l
depressio
n of Na+
channels_
x000D_
_x000D_
Alpha1
2 causes o block
Pallid
(acyanotic
):
associate
d with
fall_x000
D_
_x000D_
Cyanotic:
associate
d with
anger_x00
0D_
_x000D_
occurs
6mo to
2 types of 6yr
Several
hours > 5
nights/we
ek_x000D
_
_x000D_
Age: > 2
wks,
peaks at 6
wks,
lessens by
Time period34 mo
SIDS:
most are
midnight
to
6am_x000
D_
_x000D_
ALTE:
most are
Time of SID8am8pm

Congenita
l dermal
melanocyt
oses_x000
D_
_x000D_
Slate gray
Other name
patches
Fracture thToddler's fracture: fracture of tibia in walking children
Posterior r Squeezing baby's thorax (shaken baby syndrome)
What's the 4mo:
25% of weight is fat
9
weeks_x0
00D_
Hgb
11_x000D
_
Then
starts to
When is therise after
Adrenal
insufficien
cy_x000D
_
Hypothyro
What can ca
idism

Screening
(newborn)
: detects
immunore
active
trypsinog
en in
blood_x00
0D_
_x000D_
Confirmat
ory =
genotypin
g for
specific
Screening vmutations

85
90%_x000
D_
aka 10
15% don't
have it
(they
have
normal
weight
gain,
normal
What percen
stools)
FLACC
(face,
legs,
activity,
cry,
consolabil
ity) for
non
verbal
kids_x000
D_
_x000D_
FACES: for
38
yo_x000D
_
_x000D_
010
scale: > 8
Pain scalesyo
Most commo
Functional abdominal pain

Slowing of
weight
gain (or
especially
weight
loss)_x00
0D_
_x000D_
Change in
height
velocity
suggests
more long
standing
First signs illness
What percen
50% are guiac positive

1.
Contrast
delays
potential
colonosco
py_x000D
_
_x000D_
2.
Increased
risk of
toxic
megacolo
2 problemsn with UC
Are crypt UC
Upper GI
study_x00
0D_
Colonosco
2 studies t py
1.
Cobblesto
ning_x000
D_
2.
Separatio
n from
nearby
loops
(bowel
wall
thickening
2 character)
Does UC orCD

1st line:
aminosali
cylates
(mesalami
ne)_x000
D_
>
Corticoste
roids, abx
(cipro,
metro),
immunom
odulators
(6MP,
MTX),
TreatmentsantiTNF
age
2_x000D_
_x000D_
premature
infants
should
catch up
When do you
by then
Most varia Language
When does9, 18, and 30 months

Internal
tibial
torsion_x0
00D_
common
in
childhood,
resolves
with
What causegrowth
8
yrs_x000
D_
can
have flat
feet until
How long do
then
yo_x000D
_
heel
strike
When doespresent
c

When do yo
18 and 24 months

1. Social
interactio
n_x000D_
2.
Communi
cation_x0
00D_
3.
Restricted
repetitive
and
stereotyp
ed
3 realms ofpatterns
Neurodeg
enerative
disease_x
000D_
Psychosoc
Which types
ial
Heterogen
eous
group of
non
progressiv
e
disorders_
x000D_
motor
and
postural
dysfunctio
Descriptionn
asphyxia
(10%)_x0
00D_
Intrauteri
ne
infection
(28%)_x0
00D_
Prematurit
y
(78%)_x0
00D_
IUGR
Risk factor (34%)

Extraretin
al
fibrovascu
lar
proliferati
on_x000D
_
Detachme
nt_x000D
_
Blindness/
visual
impairme
nt_x000D
_
_x000D_
risk: BW
Sequence of
< 1500g

Periventri
cular
Leukomal
acia
(PVL)_x00
0D_
damage
from
hypoxia,
ischemia,
inflammat
Complicatioion
Abnl
motor
developm
ent
(choreoat
hetoid
cerebral
palsy)_x0
00D_
Sensorine
ural
hearing
Complicatioloss
Tonsillecto
my_x000
D_
Cholecyst
2 surgeriesectomy
Cause of gal
Hemolytic anemia > bilirubin gallstones > cholelithiasis > cholecystitis

Age 2 mo
to 56
yrs_x000
D_
oral
penicillin
Which sicklBID
Pts with
sickle cell
get
PCV23_x0
00D_
_x000D_
2yo and
then
repeat 3
5 yr
later_x00
0D_
same
schedule
for
meningoc
PCV23 is g occal

1.
Myelosup
pression
by viruses
(parvoviru
s)_x000D_
2.
Hypersple
nism
(spleen
enlarges
and traps
2 things th RBCs)
Sickle cell
pts
between
215
yo_x000D
_

determine
risk of
stroke
(10% risk
Who gets t by 15 yo)

Chronic
anemia_x
000D_
Poor
nutrition_
x000D_
Painful
crises_x00
0D_
Endocrine
dysfunctio
n_x000D_
Poor
pulmonar
Causes of iy function

Becomes
progressiv
ely
fibrotic
and no
longer
palpable
by age 4
6_x000D_
_x000D_
Hgb SC or
Sbeta
thal can
have
splenic
enlargem
ent into
adolescen
What happen
ce
Baseline Hg69
Treatment of
IVF and IV narcotics
Age 46
yo_x000D
_
tonsils
can be
mildly
enlarged
during
Peak time othis time

Spontane
ous
peritonitis
_x000D_
often S.
pneumo
Most common
or GNRs
1.
Albumin
infusion_x
000D_
2. IV
furosemid
e_x000D_
3.
Corticoste
roids
(taper
over
wks)_x00
0D_
4. Sodium
restriction
(1500
2000
Management
mg/d)

Venous
thrombosi
s_x000D_
urinary
loss of
anti
coagulant
s, lipids
destabiliz
e
platelets,
inc
fibrinogen
, inc blood
viscosity
What are p(high Hct)

Steroid
responsiv
e_x000D_
Relapsing
_x000D_
Steroid
dependen
t_x000D_
Resistant
4 categori (> bx)
PID and TOA
Ultrasound
Chronic abd
Barium study
Who needsKids younger than 68 wks

Cold
extremitie
s_x000D_
(pt can be
cold with
adequate
circulation
What is the)

D:
disability
(quick
neuro
assessme
nt ICP,
toxidrome
s, etc)
and
dextrose
(check for
hypoglyce
mia)_x000
D_
_x000D_
E:
exposure/
environm
ent
(expose
all parts
of pt,
keep pt
What do thwarm)

What's a prVasoconstriction can make it difficult to get a good pulse ox measurement

Intraosseu
s
line_x000
D_
if
peripheral
IV can't
be placed
in 90
seconds_x
000D_
central
line also
acceptabl
e in older
kid or
Next line o adult
Prophylaxi Rifampin, cipro, or ceftriaxone
1119%
get
complicati
ons:_x000
D_
hearing
loss_x000
D_
neuro
disability_
x000D_

digit/limb
amputatio
ns_x000D
_
Complicati skin scar

Doesn't
eliminate
carrier
state._x00
0D_
Need
rifampin
(kids,
young
adults) or
cipro
(adults) or
57 d
ceftriaxon
e to
eliminate
carrier
Problem witstate
esis
imperfect
a_x000D_
Fracture_x
000D_
Recently
used
site_x000
D_
ContraindicInfection

Fracture_x
000D_
Fluid into
subQ (>
compartm
ent
syndrome
)_x000D_
Osteomye
litis_x000
D_
Microscopi
c fat, BM
Complicatioemboli

Inhibit
reuptake
of
NE_x000D
_
Antagoniz
e ACh (
>
hypotensi
on), Na+
channels
(>
dysrhyth
mias),
and GABA
(>
Actions of seizure)
Mydriasis_
x000D_
Fever_x00
0D_
Diaphores
is_x000D_
Tachycard
ia_x000D_
Agitation_
x000D_
Sympathomi
SZ
00D_
Resp
depressio
n_x000D_
Hypotensi
on_x000D
_
Bradycard
ia_x000D_
Hypother
mia_x000
D_
Opioid tox AMS
Miosis OR
mydriasis
_x000D_
Hypotensi
on_x000D
_
Bradycard
ia_x000D_
Hypother
mia_x000
D_
SedativehSedation

Dry
skin_x000
D_
Flushing_
x000D_
Tachycard
ia_x000D_
Ileus_x00
0D_
Urinary
retention_
x000D_
Fever_x00
0D_
Delirium,
AnticholineSZ
0D_
Sweating_
x000D_
Urinating_
x000D_
Bronchorr
hea_x000
D_
Bronchosp
asm_x000
D_
Muscle
twitch_x0
00D_
Bradycard
ia_x000D_
CholinergicSZ, coma

Cathartics
_x000D_
charcoal
helps
absorb
the toxins
and
cathartics
accelerate
defecatio
What is givn

Amenorrh
ea_x000D
_
Bradycard
ia_x000D_
Postural
hypotensi
on_x000D
_
Electrolyt
e
abnormali
ties_x000
D_
Continued
deficiency
of Ca,
Mg_x000D
_
Neuro
changes,
increased
reflex
tone,
compromi
sed
cardiac
Series of e function
Platelet
function
tests_x00
0D_
Factor VIII
activity_x
000D_
vWf
antigen
and
activity
(Ristoceti
n)_x000D
_
aPTT (but
can be
normal,
other
tests are
Best tests better)

Autosoma
l
dominant
with
variable
penetranc
e: Type 1
and
2_x000D_
_x000D_
Autosoma
l
recessive:
Genetics o Type 3
Intranasal
or IV
desmopre
ssin_x000
D_
vWF_x000
D_
OCPs/levo
norgestrel
IUD (for
menorrha
Meds to tr gia)
von
Willebran
d's
disease_x
000D_
1% of
populatio
Most commo
n

Usually
2472
hours
after_x00
0D_
_x000D_
MMR and
Varicella:
can be 7
When does10d
f after

1.
Kernig's:
resist
knee
extension
_x000D_
2.
Brudzinski
's: flex
hip/knee
in
response
to neck
flexion_x0
00D_
3.
Opisthoto
nos:
hyperexte
nsion of
neck and
spine_x00
0D_
_x000D_
often
NOT
positive in
infants
3 clinical t <12mo
Most commo
S. pneumo
How common
present in 35% of 336mo with fever
<3 or <12
mo
(depends
on
clinician)_
x000D_
toxic
appearing
_x000D_
WBC >
15,000
with left
shift_x000
D_
IndicationsT > 40

Kids
<2yo_x00
0D_
Strep
throat
uncommo
n in
young
kids and
ARF very
rare in
kids <
Who doesn't
3yo
Ampicillin
(E coli
often
resistant)_
x000D_
Ceftriaxon
e (careful
of ppts
with
Ca)_x000
D_
Piperacilli
n/tazobac
tam
(expensiv
e)_x000D
_
Ciprofloxa
cin (kids
>1
yo)_x000
D_
TMPSMX:
Treatment o
good
Who shouldAfter second febrile UTI or with concerning findings on renal/bladder ultrasound
Who shouldPts who don't respond to tx
How prevalPresent in 2550% of infants following first UTI

Most
common
type_x000
D_
most
often
resolves
spontaneo
usly in 2
5
yrs_x000
D_
PCP can
follow
(whereas
grade 35
needs to
be
referred
to
Management
urology)

Exposes
pt to
smaller
doses of
radiation
than
VCUG_x00
0D_

preferred
imaging
study to
follow pts
Benefit of with VUR
Only 10
30%_x000
D_
some
just have
fever and
irritability
_x000D_
most
common
in 10 mo
What percen
3 yr

Increased
caloric
requireme
nt_x000D
_
Illness_x0
00D_
Neuro
Sequelae odisease
Respirator
y
distress_x
000D_
closure
of glottis
with
What is gruexpiration

Chest
drawn in
with
inspiratio
n, abd
rises_x00
0D_
Force of
contractio
n from
diaphrag
m >>
ability of
chest wall
muscles
Signs and cto expand
Above:
stridor_x0
00D_
_x000D_
Below:
Sounds with
wheezing
Sounds fro Rhonchi

Coarse:
purulent
secretions
in
alveoli_x0
00D_
_x000D_
Fine:
pulmonar
y edema,
interstitial
Cause of fi disease
What shoulObtain imaging (xray or fluoroscopy) first
Dynamic eva
Chest fluoroscopy

Partial
obstructio
n: get air
trapping/h
yperinflati
on_x000D
_
_x000D_
Complete
obstructio
n: get
atelectasi
s, signs of
volume
loss of x
ray
(mediasti
Two manifes
nal shift)
#1 finding
=
Hypotonia
_x000D_
small
ears are
also
Most consi common

Nuchal
skin
thickness_
x000D_
Nasal
bone
ossificatio
n_x000D_
Growth
parameter
Findings o s

Lymphocy
te
karyotype
_x000D_
easier
than skin
Standard ka
fibroblasts

Infancy:
leukemoid
rxn,
transient
myeloproli
ferative
disorders
(TMD)_x0
00D_
_x000D_
> 1 yo:
iron
deficiency
Purpose of anemia
Tdap_x00
0D_
Meningoc
Which vacci
occal

Total body
water_x00
0D_
Total body
potassium
_x000D_
Bioelectric
al
impedanc
e_x000D_
Dual
energy x
ray
absorptio
Methods ofmetry
sporadic
onset,
sharp_x00
0D_
Location:
LSB_x000
D_
Exacerbat
ed by
deep
inspiratio
n_x000D_
Lasts sec
to
min_x000
D_
Resolves
spontaneo
Characterizusly
Tanner stagStage 4
Tanner stagStage 2
Tanner stagStage 3
Differentia Costochondritis: lasts hrs to days (compared to seconds to minutes)
is_x000D_
Anxiety_x
000D_
Tremulous
ness_x00
0D_
Symptoms Hunger
o

Dusky red
macules
>
wheals
> target
lesions
> fixed
for 13
wks_x000
D_
_x000D_
Most
common
with HSV,
Erythema m
meds

Diaper
dermatitis
, 710 mo
(can also
have
satellite
lesions)_x
000D_
_x000D_
Tx:
nystatin
or
imidazole
antifungal
Common tim
s
Selenium su
Tinea versicolor
Treatment o
PO griseofulvin, 68 wks
Irritant
dermatitis
_x000D_
_x000D_
spares
intertrigin
ous
Zinc oxide creases
Strength ofClobetasol > Betamethasone > triamcinolone > hydrocortisone
Location ofFolliculitis often below waste/groin

Papules
NOT
pustules_
x000D_

distinguis
h from
acne by
presence
of
inflammat
Pseudofolli ion
RadiographMass with central ring of hypoattenuation (mesenteric fat in intussusceptum)
000D_
65%
colicky
abd
pain_x000
D_
25%
renal
involveme
nt_x000D
_
510%
intussusc
Most commo
eption
What is sma
Constitutional factors maternal ethnicity, parity, weight, height
mia_x000
D_
Hypother
mia_x000
D_
Polycythe
3 risks for mia
PresentatioRuddy"/red color to skin
Respiratory distress
Poor feeding
Hypoglycemia
Sluggish blood flow"

Symmetri
c: both
head and
abd
circumfer
ence
decreased
proportion
ately_x00
0D_
_x000D_
Asymmetr
ic: greater
decrease
in abd
than head
(head
sparing
phenome
Symmetric non")"
D_
Warm
(large
SA/V)_x00
0D_
Position_x
000D_
Suction_x
000D_
Stimulate
(vigorous
5 basics of cry)
30% of
newborns
_x000D_
10% of 12
mo_x000
D_
_x000D_
Often
palpable
12cm
below L
costal
What percemargin

> 90%
have no
clinical
evidence
of disease
as
newborns
_x000D_
_x000D_
But 40%
are SGA,
30%
preterm,
25% of
males
have
inguinal
Most commo
hernias
Lubricatio
n_x000D_
Anti
inflammat
ories_x00
0D_
Topical
hydrocorti
sone_x00
0D_
Antihista
mines
(sedating
and
non)_x000
D_
Calcineuri
n
5 types of inhibitors

Stop
bottle
feeding
by 1215
mo_x000
D_
_x000D_
Fluoride
(promotes
re
mineraliza
tion of Ca
into
2 things to enamel)
Galactose
mia_x000
D_
_x000D_
Hypothyro
2 metabolicidism
Lose suck
reflex_x00
0D_
Lethargy_
x000D_
Irritability
_x000D_
Seizures_
x000D_
Severe mani
Death
Signs of keOpisthotonus,
rigidity, oculomotor paralysis, tremor, hearing loss, ataxia
wks_x000
D_
Direct
hyperbili
(progressi
ve)_x000
D_
Acholic
When and ho
stools

Cephaloca
udal
direction_
x000D_
45 at
face, 10
15 below
knees_x0
00D_
dermal
zones
often
underesti
mate true
level
How does jthough

>/= 24
hrs after
birth_x00
0D_
earlier:
might
miss PKU
and other
metabolic
disorders
that
require
accumulat
Optimal ti ion

Breast
feeding:
early 1st
week_x00
0D_
_x000D_
Breast
milk: first
47d,
peaks 10
14d, can
last up to
Time of bre12 wks
Is PE commNO. Often only occurs with underlying clotting disorder or placement of central venous c

NO_x000
D_
_x000D_
TTN: more
common
in term
babies_x0
00D_
risks:
mother
with DM,
C/S
Is prematurdelivery
NO_x000
D_
_x000D_

Document
ed
asphyxia
is
correlated
with
neuro
outcome.
Check
cord
arterial
blood gas
for
Are APGARacidosis.
s
SGA: <
10th
%_x000D_
AGA: 10
90th
%_x000D_
LGA: >
Small, appr90th %

clavicle_x
000D_
Brachial
plexus
injury_x00
0D_
Facial
nerve
palsy_x00
0D_
Complicat
ions of
C/S,
forceps,
and
vacuum_x
000D_
Hypoglyce
Complicati mia

Delayed
absorptio
n of
pulmonar
y
fluid_x000
D_
aka
persistent
postnatal
pulmonar
What is Tray edema.
Meconium
aspiration
syndrome
_x000D_
Diaphrag
matic
hernia_x0
00D_
Hypoplast
ic
lungs_x00
0D_
In utero
Causes of asphyxia
Which cardiTransposition of the great arteries (TGA)

Major
malformat
ions are
directly
related to
the First
Trimester
HbA1C
level_x00
0D_
HbA1C
levels
>12: 12x
Best indicarisk
RelationshiBabies with RR > 80 often can't tolerate oral or NG feeds and need IV nutrition
< 35 if
asympto
matic_x00
0D_
_x000D_
< 45 if
symptom
Hypoglycemi
atic
What can ha
Rebound hypoglycemia 12 hrs after
After 12
24
hours_x00
0D_
_x000D_
sooner:
indicative
of
mother's
status and
any
medicatio
ns
administe
When are el
red

 Breech
position:
3050%
of DDH
cases
occur in
infants
born in
the
breech
position._
x000D_
Gender:
9:1
female
predomin
ance._x00
0D_
Family
What are thhistory.

Myelopath
ic signs/sx
for
atlantoaxi
al
instability
_x000D_

importanc
e of
cervical
spine
positionin
g during
procedure
What is an s
DistinguishJitteriness: stimulussensitive movements, generalized symmetric

Neonatal
tetanus_x
000D_
Omphaliti
s_x000D_
Hemorrha
gic
disease of
the
newborn
(with no
Risks of hoVitamin K)
Definition > 65%
12
days_x00
0D_
sx due
to protein
in breast
milk or
formula
> poor
feeding,
lethargy,
and
When doesvomiting

Skeletal
disorders
(rickets,
osteogene
sis
imperfect
a)_x000D_
Chromoso
mal abnl
(Down)_x
000D_
Hypothyro
id_x000D_
Malnutriti
on_x000D
_
Causes of lICP

Microceph
aly_x000D
_
Craniosyn
ostosis_x0
00D_
Hyperthyr
oidism_x0
00D_
Causes of pNl
variant
Large
tongue_x0
00D_
Hoarse
cry_x000
D_
Puffy
myxedem
atous
Later sympfacies
mo_x000
D_
poor suck
and weak
Most commo
cry
20% of
obese 4
yo_x000D
_
80% of
obese
adolescen
Risk of aduts
PsychiatricODD/CD
Vision:
start 3
yr_x000D_
_x000D_
Hearing:
newborns,
then
resume at
When to sta
4 mo

Sleep
apnea
(7% of
overweigh
t)_x000D_
Dyslipide
mia_x000
D_
HTN (33%
of
obese)_x0
00D_
Nonalcoh
olic fatty
Sequelae ofliver
In young
kids_x000
D_
_x000D_
> 6 yo:
most is
When to suprimary

> 10 yo
or puberty
onset_x00
0D_
q2 yr with
fasting
serum
glucose_x
000D_
_x000D_

overweigh
t, FH,
race/ethni
city,
insulin
resistance
(AN,
PCOS,
HTN,
Who and ho
dyslipid)

< 2 yo:
rear
facing car
seat_x000
D_
24 yo:
forward
facing car
seat_x000
D_
48 yo:
belt
booster
Car seat ruseat
Cataracts
_x000D_
Glaucoma
_x000D_
Retinoblas
toma_x00
0D_
Chorioreti
Causes of anitis
0, 1, 6
mo_x000
D_
_x000D_
Times of ad3 times
2, 4, 6
mo_x000
D_
_x000D_
Times of ad3 times
Times of ad12 mo, second dose 6 months after and before 2nd birthday
yr_x000D_
_x000D_
2
times_x00
0D_
same as
Times of adMMR
1 yr and
46
yr_x000D_
_x000D_
2
times_x00
0D_
same as
Times of a Varicella
2, 4, 6
mo, 46
yr_x000D_
_x000D_
Times of ad4 times

D_
_x000D_
4
times_x00
0D_
same as
Times of adHib
D_
_x000D_
4
times_x00
0D_
same as
Times of adPCV
2, 4, 6,
15mo, 46
yr_x000D_
_x000D_
5
times_x00
0D_
start
getting
Tdap 11
Times of ad12 yo

e doing joint tap if low suspicion)

es inflammation of the hepatic capsule and diaphragm

holecystitis

er ultrasound

usceptum)

nt of central venous catheter

d IV nutrition