Term
| 7 yo male presents complaining of a 1 month hx of red, well-demarcated plaques covered with dry, thick, silvery scales located on the extensor surfaces of extremities, scalp, and buttocks with large lesions located over pressure points of knees and elbows. Dx? |
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Definition
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Term
|
Definition
|
|
Term
| Pt education for psoriasis |
|
Definition
| daily exposures to small amounts of sunlight may improve psoriasis, but intense sun exposure can worsen symptoms and cause skin damage. |
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Term
| 12 yo male presents with what was thought to be a recalcitrant case of eczema, presents complaining of "dirty brown" scales that have migrated to his thighs, trunk, and buttocks. As a newborn, he had a collodion membrane at birth. Biopsy = increased granular layer and stratum corneum. Dx? |
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Definition
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|
Term
| what future disease can develop in a pt who had a collodion membrane at birth? |
|
Definition
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|
Term
| This condition has thick warty scales with occasional blistering. The skin lesion are more prominent on the flexural surfaces. Dx, Tx? |
|
Definition
Epidermolytic Hyperkeratosis.
Use fo keratolytics, lubricants, oral retinoids, antibiotics for secondary infection (staph aureus) |
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|
Term
| Pt is highly involved in sports. He complains of itchiness and scaling of his feet. Dx? |
|
Definition
| juveinle plantar dermatosis - "sweaty sock syndrome" |
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Term
| tx fo juvenile plantar dematosis |
|
Definition
| lubrication of feet, covering them at night and topical steroids in severe cases. Use of charcoal-impregnant foam insoles is helpful |
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|
Term
| pt complains of dryness lips during the winter season. Dx? |
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Definition
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|
Term
| tx of lip licking eczema? |
|
Definition
| elidel and protopipc ointment (t-cell supprsesor). Try to avoid steroids on facial skin because it will cause hyper-vascularization, striae, and discoloration |
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Term
| child complains of redness and itching around his waist in the distribution of his belt. dx? |
|
Definition
| irritant contact dermatitis. |
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|
Term
| tx of irritant contact dermatitis? |
|
Definition
| topical steroids, avoid irritant |
|
|
Term
| what lesions are associated with recalcitrant atopic dermatitis? |
|
Definition
|
|
Term
| how do you treat recalcitrant atopic dermatitis with lichenification? |
|
Definition
| 1 week tapering couring of systemic corticosteroids beginning at 0.5 to 1.0 mg/kg/day. May add a hydrating agent like LacHydrin or an oral antihistamine for severe itching. Avoid irritant |
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Term
| Condition caused by excessive sweating |
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Definition
|
|
Term
|
Definition
| topical antifungal or oral ketoconazole (1 time dose) |
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|
Term
| infant patient presents with redness around the genitals, dx, tx? |
|
Definition
candidal diaper dermatitis.
nystatin cream |
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|
Term
| flat top violaceous papules along the shins... |
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Definition
|
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Term
| phenomenon of linaer lesions |
|
Definition
| koebner phenomenon at sites of previous trauma |
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Term
| lesions developed after receiving an immunization |
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Definition
|
|
Term
| MCC of erythma multiforme in children? |
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Definition
|
|
Term
| MCC of recurrent erythema multiforme |
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Definition
|
|
Term
| tx for brown recluse spider bites |
|
Definition
| dapsone, it decreases the degree of tissue damage |
|
|
Term
| This child complains of itchiness that worsens at night. The lesions are located in the intertriginous regions of the hands and feet. Dx, tx? |
|
Definition
scabies.
Permethrin cream - oral antipruritic lesions and topical steroids may be required. Never treat an infant with Lindane (KWell) due to neurotoxicity |
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|
Term
| Child presents with complaints of an itchy scalp and nits. Other children in the classroom have the same complaints. Dx, tx? |
|
Definition
head lice.
pediculicide - permethric 1% or 5% or ovide |
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|
Term
| small round lesions that are dome shaped and appear on the child without any accompanyng sxs. dx? |
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Definition
|
|
Term
| tx for molluscum contagiosum? |
|
Definition
| observation or aldara cream 5% |
|
|
Term
| child's lesions occurred about 6 months ago, now they are enlarged and contracted. tx? |
|
Definition
| intralesional steroid injections alone or in combo with surgical excision. May give mederma to decrease scar. |
|
|
Term
| a patient with juvenile xanthogranuloma may have manifestations in what other organ? |
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Definition
|
|
Term
| who should a child diagnosed with juvenile xanthogranuloma be referred to? why? |
|
Definition
| ophthomologist, risk of hyphema |
|
|
Term
| pt with a hx of heavy sun exposure presents with a lesion which is increasing in size and varying in color. dx? |
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Definition
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|
Term
|
Definition
| STAT referral to dermatologist or oncology specialist. |
|
|
Term
| lesions consist of a flat topped papule, appear fairly aburptly, usually in a linear or sometimes swirled distribution along the lines of Blaschko. Can occur anywhere. Will resolve in 1-2 years. |
|
Definition
|
|
Term
|
Definition
| antihistamines, block H1 receptors 1st line. ex. = diphenhydramine, hydroxyzine |
|
|
Term
| what is the causative agent for hand, foot, and mouth disease? |
|
Definition
|
|
Term
|
Definition
| calamine lotion, oatmeal bath, atarac at bedtime. To prevent superinfection apply bacitracin to denuded lesions until scab forms. |
|
|
Term
| child has a fine pink-red maculopapular rash, you also note post-auricular LAD and Forchheimer spots on teh soft palate on the 1st day the rash appeared. Dx? |
|
Definition
| rubella caused by rubella virus (contagious 1 week before rash and 1 week after) |
|
|
Term
| normal appearance of rubella? |
|
Definition
| exanthem on the face which spreads to the trunk and limbs and usually fades after three days |
|
|
Term
| child has a lacy reticular rash that started on his tunk and then spread to his extremities. He also has reddened cheeks. A fever preceeded the rash by 2-3 days. |
|
Definition
|
|
Term
| when is erythema infectiosum most contagious? |
|
Definition
| incubation period of 4-14 days |
|
|
Term
| what is the causative agent of erythema infectiousum? |
|
Definition
|
|
Term
| discrete rose colored macules that start centrally on the trunk and spread to the face, scalp and extremities. Mom admits to an abrupt high fever 2 days prior to the rash. dx? |
|
Definition
|
|
Term
| causative agent of roseola? |
|
Definition
|
|
Term
| Pt presents with a rash, cough, low-grade fever, and conjunctivitis. Rash is erythematous, and confluent starting at the head and moving caudally. Hands and soles are involved. Dx? |
|
Definition
| Rubeola - Nine-Day/ Red Measles/ "Ordinary Measles" |
|
|
Term
|
Definition
|
|
Term
| what congenital heart diseases require subacute bacterial endocarditis prophylaxis? |
|
Definition
| congenital/rheumatic heart disease (MCC of aortic stenosis), mitral valve prolapse, cyanotic congenital heart disease |
|
|
Term
| for what cardiac conditions is bacterial endocarditis prophylaxis recommended? |
|
Definition
| prosthetic valve/conduit, obstructive/regurgitant lesions, all dental procedures, GI/GU procedures, surgeries |
|
|
Term
| what congential heart conditions DO NOT require bacterial endocarditis prophylaxis? |
|
Definition
| isolated secundum ASD, surgical repair of ASD, VSD, or PDA (w/o residual and beyond 6 months of age), previous CABG, MVP without regurg, physiologic/ functional/ innocent heart murmurs, previous Kawasaki without valvular dysfunction, cardiac pacemakers and implanted defibrillators |
|
|
Term
| what vessels are involved in TOGA? |
|
Definition
| aorta, pulmonary artery, coronary arteries |
|
|
Term
| what is the MAJOR manifestations of Jones criteria? |
|
Definition
| polyarteritis, carditis, chorea, erythema marginatum, subcutaneous nodules |
|
|
Term
| what are the minor manifestations of Jones Criteria? |
|
Definition
| fever, arthralgia, previous rheumatic fever, elevated acute phase reactants, increasd ESR/CRP, leukocytosis, prolonged P-R interval |
|
|
Term
| what is the diagnosis of acute rheumatic fever based on? what are the rules? |
|
Definition
| Jones Criteria. Evidence of pervious strep pharyngitis infection + 2 major, or 1 major and 2 minor. |
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|
Term
|
Definition
|
|
Term
| what condition is rarely seen in children? |
|
Definition
| restrictive cardiomyopathy |
|
|
Term
| 4 lesions in Tetrology of Fallot |
|
Definition
| pulmonary stenosis, over-riding aorta, VSD, RVH |
|
|
Term
| DOC for bacterial endocarditis prophylaxis prior to dental procedure. Dose? |
|
Definition
|
|
Term
|
Definition
All the T's + hypoplastic left heart syndrome.
Tetrology of Fallot
Tricuspid Atresia
Transposition of the Great Arteries
Truncus Arteriosus
Total Anomalous Pulm. Venous Connection |
|
|
Term
|
Definition
| ASD, PDA, VSD, Pulmonary Stenosis, Aortic Stenosis, Coarctation of the Aorta |
|
|
Term
| list the acquired heart diseases (8) |
|
Definition
| Kawasaki, Rheumatic heart disease, congestive/ restrictive/ hypertrophic cardiomyopathy, myocarditis, pericarditis, infective endocarditis |
|
|
Term
| Pt allergic to PCN, what is the DOC for bacterial endocarditis prophylaxis prior to dental procedure? dose? |
|
Definition
|
|
Term
| diagnostic criteria for Kawasaki disease... |
|
Definition
fever > 5 days, plus 4 of 5 with other illness w/ similar signs being excluded.
1. polymorphous rash
2. bilateral conjunctival injection
3. mucuous memrane changes (diffuse injection, erythema/fissuring or lips, strawberry tongue)
4. acute, non purulent cervical LAD
5. extremity changes (erythema of palms/soles, indurative edema of hands/feet, membranous desquamation of the fingertip) |
|
|
Term
|
Definition
main goal is to prevent coronary artery disease and to relieve symptoms.
Mainstay of tx = IV gamma-globulin (IVIG) at 2g/kg |
|
|
Term
| physical activity for a child at cardiac risk level 3 |
|
Definition
1st decade = no restriction beyond initial 6-8 weeks.
2nd decade = physical activity guided by stress testing every other year.
Competative contact athletics with endurance training is discouraged |
|
|
Term
| tx for rheumatic heart disease |
|
Definition
bed rest.
abx = PCN to eradicate B-hemolytic strep
ASA for arthritic pain.
daily exam for development of carditis.
anti-inflammatory meds - corticosteroids.
symptomatic treatment. |
|
|
Term
| tx for hypertrophic cardiomyopathy |
|
Definition
moderate restriction of activity negative inotropes (BB, CCB)
SBE prophylaxis
Defibrillator if at risk of sudden death
sx w/ subaortic obstruction = myectomy |
|
|
Term
| tx of dilated cardiomyopathy |
|
Definition
management for CHF = digoxin, diuretics, rest.
anticoagulants to decrease the risk for thrombus formation |
|
|
Term
| tx of restrictive cardiomyopathy |
|
Definition
| bed rest, diuretics, inotropes (dopamine, dobutamine), digoxin, gamma globulin (2g/kg in 24 hrs), steroids, heart transplantation if not better. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what are the systolic heart murmurs? |
|
Definition
| AS, PS, TR, MR, systolic clicks, ASD, VSD, ejection sounds |
|
|
Term
| what are the diastolic heart murmurs? |
|
Definition
| TS, MS, AR, PR, opening snap, S3, S4 |
|
|
Term
| what murmurs are both systolic and diastolic? |
|
Definition
|
|
Term
|
Definition
| rare but could occur in children with anomalous origin of LCA, Kawasaki disease, congenital haert disease (presurgical/postsurgical), and dilated cardiomyopathy. MC the children have HTN, lupus, myocarditis, cocaine ingestion, and use of adrenergic drugs (Beta agonists for asthma, etc) |
|
|
Term
| what children should have lipid monitoring according to the AAP? |
|
Definition
parents/grandparents with coronary atherosclerosis < 55 yo.
parents/grandparents with MI, angina, PVD, CVD, or sudden cardiac death < 55yo.
parent with elevated blood cholesterol level > 240 mg/dL.
unattainable parental hx with other risk factors such as smoking, diet high in saturated fats and cholesterol, or obesity. |
|
|
Term
| management for normal/borderline LDL |
|
Definition
| education and risk factor intervention including diet, smoking cessation, and exercise. Borderline - re-eval in 1 year. |
|
|
Term
|
Definition
| examine for secondary causes (liver, thyroid, renal disorders), and familial disorders. Then initiate low fat, low cholesterol diet, and re-eval in 3 months. |
|
|
Term
| when should drug therapy be considered in children with dyslipidemia |
|
Definition
| children > 10yo after failure of adequate trial of diet therapy (6-12 months). |
|
|
Term
| DOC for children with high LDL |
|
Definition
|
|
Term
| what are the 5 innocent murmurs? |
|
Definition
| Stills murmure, Pulmonary ejection murmur, pulmonary flow murmur, venous hum, carotid bruit |
|
|
Term
| common age for Stills murmur |
|
Definition
| 3-6 yo, occasionally in infants |
|
|
Term
| common age for a pulmonary ejection murmur? |
|
Definition
|
|
Term
| common age for pulmonary flow murmur? |
|
Definition
| premature and full term infants. Disappears by 3-6 months of age. |
|
|
Term
| common age for venous hum |
|
Definition
|
|
Term
| common age for carotid bruit? |
|
Definition
|
|
Term
| what is the phsyiologic factor that causes development of Eisenmenger syndrome? |
|
Definition
| complication of uncorrected congenital heart anomalies that produce L to R shunting. Increased pulmonaryr resistance develops over time reversing the L to R shunt to a R to L shunt = cyanotic. |
|
|
Term
| causative agent of EBV/Mono |
|
Definition
|
|
Term
| causative agent of erythema infectiosum? |
|
Definition
|
|
Term
| causative agent of roseola |
|
Definition
|
|
Term
| causative agent of rubella? |
|
Definition
|
|
Term
| causative agent of hand-foot-mouth disease? |
|
Definition
|
|
Term
| causative agent of Kawasaki disease? |
|
Definition
| febrile illness of unknown etiology |
|
|
Term
| causative agent of Scarlet Fever |
|
Definition
|
|
Term
fever, mild malaise, adenopathy, DA, sore throat, coryza.
discrete, pink-red, fine, maculopapular eruption begins on face and spreads cephalocaudally to a generalized rash in 24 hrs then fades and clears completely in 72 hrs. Forchheimer spots. |
|
Definition
|
|
Term
| peak incidence of rubella |
|
Definition
| late winter and early spring |
|
|
Term
| can rublla cross the placenta? |
|
Definition
|
|
Term
| affects children 6-36 months. Sxs = abrupt rise in temperature, anorexia, irritability. rash = erythematous, maculopapular exanthem after fever subsides, rose-pink macules that begin on the trunk and spread rapidly to the extremities, face, neck, and scalp. |
|
Definition
| roseola (exanthem subitum) |
|
|
Term
| highly contagious. fever, malaise, dry cough, coryza, conjunctivitis. Koplik spots appear on buccal mucosa (bluish white dots surrounded by red halos) |
|
Definition
|
|
Term
| communicable disease characterized by abrupt onset of fever and posterior pharyngeal ulcers |
|
Definition
|
|
Term
| most common viral cause of pharyngitis |
|
Definition
|
|
Term
| secondary infections acquired by varicella patients |
|
Definition
pneumonia, secondary bacterial infection (superinfection)
cellulitis, osteomyelitis, septic arthritis, encephalitis, acute cerebellar ataxia (clears in 24-72 hr), Reye's syndrome, hepatic failure, progressive varicella, DIC |
|
|
Term
| diseases with fever prodrome that develop a rash (8) |
|
Definition
| rubella, rubeola, varicella, scarlet fever, lyme disase, RMSF, Kawasaki, Gianotti Crosti Syndrome |
|
|
Term
| Know vaccine schedule and when it it no longer necessary to give certain vaccines |
|
Definition
|
|
Term
| irreversible focal bronchial dilation, usually accompanised by chronic infection and associated with diverse conditions, some congential or hereditary |
|
Definition
|
|
Term
| most common cause of bronchiolitis |
|
Definition
|
|
Term
| what treatments should be avoided in bronchiolitis patients? |
|
Definition
corticosteroids, sedatives.
Antibiotics should only be used if there is an underlying bacterial infection. |
|
|
Term
| when is a PPD considered positive without risk factors? for members of high-incidence populations? for HIV+ or other immunocompromised patients? |
|
Definition
no risk = 15mm
high risk = 10 mm
immunocompromised = 5 mm |
|
|
Term
|
Definition
|
|
Term
|
Definition
asx pt with +PPD = INH, consider pyridoxine (Vit B6).
isoniazid may cause liver toxicity, monitor LFT's monthly |
|
|
Term
|
Definition
| short term hopsitalization wiht INH + rifampin, consider pyrazinamide. |
|
|
Term
| first line tx for child in respiratory distress (tachypnea, rales, crackles, nasal flaring) |
|
Definition
| admit! commonly placed in atmosphere of cool, humidified oxygen to relieve hypoxemia, and reduce insensible water loss from tachypnea |
|
|
Term
| most common cause of pneumonia in the first several years of life |
|
Definition
|
|
Term
| definitive diagnosis of viral pneumonia |
|
Definition
|
|
Term
|
Definition
| minimal supportive treatment required. |
|
|
Term
| tx for bacterial pneumonia |
|
Definition
| DOC = azithromycin, amoxicillin, augmentin, doxycycline, clarithromycin |
|
|
Term
| in hospital tx of bacterial pneumonia |
|
Definition
| 3rd generation cephalosporin, vancyomycin |
|
|
Term
| CXR findings in tuberculosis |
|
Definition
cavitation, apical or subapical cavitary infiltrates.
MC findings in children are isolated hilar or mediastinal adenopathy, segmental hyperinflation or atelectasis, alveolar consolidation, interstitial densities, pleural effusion or cavitation. |
|
|
Term
| future complications for a 5 yo with cystic fibrosis? |
|
Definition
| life threatening lung infections (pseudomonas), obstruction of the pancreas (malabsorption), 95% of men are sterile, |
|
|
Term
| acute inflammation of the tracheobronchial tree, generally self limited, and with eventual complete healting and return of function |
|
Definition
|
|
Term
| best tx for bronchogenic cysts |
|
Definition
|
|
Term
| best test for child presenting with abdominal distention, emesis, and failure to pass meconium |
|
Definition
sweat chloride test, > 60mEq = positive.
normal = 10-35 mEq |
|
|
Term
| MC presenting symptom of cystic fibrosis |
|
Definition
| acute or persistent respiratory symptoms |
|
|
Term
| most obvious difference between viral and bacterial pneumonia |
|
Definition
|
|
Term
| confirmatory dx of a child with allergies |
|
Definition
| percutaneous skin test, AKA scratch/prick test |
|
|
Term
| causative factors for IgE response (4) |
|
Definition
| oral allergy syndrome, GI anaphylaxis, acute urticaria/angioedema, anaphylaxis |
|
|
Term
| correct non-pharmacological management of avoiding food allergies in children |
|
Definition
| avoidance of allergens, delay introduction of foods, elimination diet |
|
|
Term
| child with coughing, SOB, and wheezing. Wheezes daily at school and PEF 75%. Tx? |
|
Definition
| moderate asthma = B2 agonist, inhaled corticosteroid |
|
|
Term
| pt with asthma presents with chronic wheezing x 1 week. Pt has daily maintenance with inhaled albuterol. Which is the first line med to control the wheezing episode once albuterol has been tried? |
|
Definition
| long acting beta agonist with combo inhaled steroid (advair) |
|
|
Term
| what's the safest approach for managing a child who complains of itchy eyes and watery nose with sneezing? |
|
Definition
| avoid offending agents, antihistamines |
|
|
Term
| when should an inhaled steroid be added to the asthma regimen? |
|
Definition
| moderate persistent asthmatics |
|
|
Term
| technique of running the thumb down the medial surface of the tibia - gives a more interpretable response in infants and toddlers because it avoid stimulation of a plantar flexion or withdrawal response |
|
Definition
|
|
Term
| MCC of tuberous sclerosis |
|
Definition
|
|
Term
| what skin lesions are seen with tuberous sclerosis? |
|
Definition
cutaneou lesions in all ages -
ash-leaf macule, facial angiofibroma, sebaceous adenoma, subungual/periungual fibromas, shargeen patch |
|
|
Term
| astrocytoma of the retina on or about the optic nerve head. Refractile, yellowish, mulinodular cystic lesions |
|
Definition
|
|
Term
| round or oval gray-yellow glial flat patches found centrally or peripherally. Unless near the macula they are not of clinical significance. |
|
Definition
|
|
Term
| 2 retinal lesions associated with tuberous sclerosis |
|
Definition
| mulberry tumor nodular, hamartomas (phakomas) |
|
|
Term
| 3 cardinal manifestations of Sturge-Weber Syndrome |
|
Definition
vascular malformation/port wine stain,
ipsilateral leptomeningeal angiomatosis with associated intracranial calcifications,
mental retardation and ipsilateral ocular complications. |
|
|
Term
| cerebral disturbances caused by abnormal electrical discharges that may be manifested as an impairment or loss of consciousness, abnormal motor activity, behavioral abnormalities, sensory disturbance, or autonomic dysfunction |
|
Definition
|
|
Term
| characterized by 2 or more reccurent seizures that are not provoked by a metabolic or toxic disturbance or by an acute insult. |
|
Definition
|
|
Term
| type of seizure that affects one area in one hemisphere of the brain |
|
Definition
| partial seizure (focial) or Jacksonian seizure |
|
|
Term
| types of simple partial seizures (4) |
|
Definition
| motor, sensory, autonomic, and psychic |
|
|
Term
| difference between simple and complex seizures |
|
Definition
| complex seizures = impaired consciousness |
|
|
Term
| seizure that affects both sides of the brain |
|
Definition
|
|
Term
| most common seizure disorder in childhood |
|
Definition
febrile seizures.
MCC = URI from viral infection |
|
|
Term
| minimum workup for febrile seizure |
|
Definition
| fasting glucose, calcium, magnesium, serum electrolyte levels |
|
|
Term
|
Definition
| control fever, reassurance, they will resolve on their own. |
|
|
Term
| seizures occuring without identifiable cause in a patient with cognitive impairment or with neurological deficits |
|
Definition
|
|
Term
| examples of cryptogenic seizures |
|
Definition
| West's syndrome, Lennox-Gastaut syndrome, Mesial-temporal lobe epilepsy, neocortical focal epilepsy |
|
|
Term
| examples of idiopathic seizures |
|
Definition
| childhood absence epilepsy, juvenile absence epilepsy, juvenile myoclonic epilepsy, epilepsy with grand mal, benign focal epilepsy of childhood, autosomal dominant frontal lobe epilepsy, primary reading epilepsy |
|
|
Term
| seizures occuring without an identifiable cause in a patient with entirely normal findings on neurologic exam and of normal intelligence. Benign partial epilepsy of childhood and juvenile myoclonic epilepsy |
|
Definition
| idiopathic (genetic) epilepsy |
|
|
Term
| defintive diagnosis of cerebral palsy |
|
Definition
not made until a child is 1 year old (or 15-18 months if premie). POSTER
Posturing and abnl movement patterns.
Oropharyngeal problems
Strabismus
Tone (increased or decreased)
Evolutional responses (persistent reflexes)
Reflexes - increased DTR's |
|
|
Term
| subtypes of cerebral palsy |
|
Definition
| hemiparesis, spastic diplegia and quadriplegia, athetoid or ataxic cerebral palsy, hypotonic cerebral palsy |
|
|
Term
| MC hereditary neuromuscular disorder |
|
Definition
| Duchenne Muscular Dystrophy |
|
|
Term
| which types of MD follows a milder and more protracted course? |
|
Definition
| Becker Muscular Dystrophy |
|
|
Term
| symptoms of both types of muscular dystrophy |
|
Definition
| Gowers sign, trendelenburg gait, respiratory muscle involvement, scoliosis, pseudohypertrophy, cadriomyopathy, intellectual impairment, epilepsy, myalgias and muscle spasms. |
|
|
Term
| labs/tests used to dx muscular dystrophy |
|
Definition
| serum CK, muscle biopsy = diagnostic, specific molecular genetic dx is possible. |
|
|
Term
| medical sign that indicates weakness of proximal muscles, namely those of the lower limg. Describes a pt that has to use his hands and arms to "walk" up his own body from a squatting position due to lack of hip and thigh muscle strength |
|
Definition
|
|
Term
| an abnormal gait associated with a weakness of the gluteus medius. It is characterized by the dropping of the pelvis on the unaffected side of the body at the movement of heelstrike on the affected side. |
|
Definition
|
|
Term
| second most common muscular dystrophy in the US, epilepsy is not common. |
|
Definition
| myotonic muscular dystrophy (Steinhart disease) |
|
|
Term
| birth defect in which one or more of the vertebrae fail to form properly in the fetus during the first trimester of pregnancy. No sac or protrusion of the spinal cord |
|
Definition
|
|
Term
| imaging studies for spina bifida occulta |
|
Definition
| Xray, US (before age 3), CT, MRI, myelography, spinal tap to r/o meningitis in children with sinuses. |
|
|
Term
| spinal cord stays within spinal canal, but meningeal sac protrudes through the opening in the vertebrae but are nevertheless well covered by skin |
|
Definition
|
|
Term
| sac or cyst includes not just the coverings of the spinal cord but also the cord's nerve roots and often the cord itself, bulging out and often not covered by skin |
|
Definition
|
|
Term
| which is more common, meningocele or myelomeningocele? |
|
Definition
|
|
Term
| 12 month old presents for WCC. He was given MMR at 9 months, do you repeat it at 12? |
|
Definition
| the MMR given before 12 months does not count, repeat at 12 months |
|
|
Term
| 4 yo presents for WCC, allergic to eggs. Can they get MMR? flu vaccine? |
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Definition
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Term
| Pt is due for 12 month vaccines (MMR/VZV/Hib/HepA) you decide to give a PPD due to high risk. How should this be done? |
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Definition
| MMR and PPD are either given simultaneously or 1 month apart to prevent false positive |
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Term
| 6 yo presents for WCC and has only had 3 Hib vaccines, do you complete the series? |
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Definition
| no, catch up is only done through 59 months of age. |
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Term
| 15 month old was exposed to measles yesturday, what do you do? |
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Definition
if previously vaccinated they should be immunized.
if no vaccines given, you should vaccinate within 72 hrs of exposure. Immunoglobulin may be given within 6 days of exposure |
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Term
| do parents have the right to refuse immunizations? can you dismiss them from the practice? |
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Definition
| yes they have the right to refuse, as far as dismissal....follow your clinics protocol |
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Term
| 12 month old due for immunizations, your clinic is out of VZV, what do you do? |
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Definition
| defer the vaccine for this visit and administer on a future visit up to 15 months or catch up from 18-23 months |
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Term
| 4 yo pt, you can't read the dates on his previous 2 Hep B shots, what do you do? |
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Definition
| attempt to find the actual medical record, if you can't, go ahead and give the third, the series is not re-started due to delay. |
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Term
| who has priority for flu vaccines? |
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Definition
| pts with asthma and sickle cell disease |
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Term
| can you give a 4 month old the RV series? |
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Definition
| no, the maximum age to start the series is 14 weeks, 6 days |
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Term
| 2 yo vomits most of his RV dose, what do you do? |
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Definition
| do not order another dose, count the dose as #1, continue the series as usual. |
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Term
| 15 month old chlid presents for WCC, DTaP was given at 2, 4, 6, 12 months. Do you need to repeat dose #4? |
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Definition
| no dose #4 can be given as early as 12 months as long as it's 6 months after dose #3. |
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Term
| 5 yo child presents for WCC, IPV dose #3 was given at 4 yo WCC. Should you order a 4th dose at this visit? |
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Definition
| no, the child does not get a 4th IPV after the age of 4 |
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Term
| child presents for shots, had a low grade fever yesturday. Pt is feeling well today, is well hydrated, and is responding well to her surroundings. Can you give the shots? |
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Definition
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Term
| 15 yo presents and wants to know if she is a candidate for teh HPV vaccine? |
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Definition
| yes, boys and girls age 9-26 are cadidates. No evidence of protection against previous infection. |
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Term
| 20 mo presents for shots and has a rash all over her trunk and the extensor surfaces of her extremities, can you give the shots? |
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Definition
| no, child is considered "ill" |
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Term
| 21 yo presents before attending college. Never had chicken pox nor been vaccinated. What do you do? |
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Definition
| give 2 VZV shots separated by 4 weeks. |
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Term
| 10 yo asthma patient needs flu vaccine for this season. He has never been vaccinated in the past. Do you give 2 or 1 dose? |
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Definition
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Term
| who gets 2 doses of the flu vaccine? |
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Definition
| first time vacinees from 6 months - 8 yo |
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Term
| 16 yo who recieved Td before entering 7th grade would like the Tdap vaccine, can you give it? |
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Definition
| yes, Tdap can be given regardless of the interval since the last Td |
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Term
| child age 7-10 yo hasn't recieve DTaP immunizations, can a dose of Tdap be given as part of the primary series? |
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Definition
| yes, Tdap can be substituted for any dose in the series, preferably dose #1 |
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Term
| 18 yo needs to be UTD on her immunizations before attending college, what immunizations are recommended? |
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Definition
| menactra, varicella, HPV, MMR, PPV, Hep A, Tdap, IPV, influenza |
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Term
| what immunizations CANNOT be given to a 16 yo pregnant patient? |
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Definition
| live virus vaccinations: LAIV, MMR, VZV, BCG, Vaccinia, Zoster |
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Term
| 12 yo male traveling to India for the summer to visit family. How would you handle this patient? what shots must he have? |
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Definition
| make sure his immunizations are UTD. You may need to send him to the Health Department Epidemiology Clinic so they can determine exact vaccine needs for endemic diseases in the area he will be visiting. |
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Term
| 3 day old pt presents to the clinic having recieved Hep B #1 at birth in a remote hospital. Mom's Hep B status is unknown. How would you handle this patient? |
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Definition
| Determine Mom's HBsAg status ASAP, if +, administer HBIg no later than 1 week after birth |
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Term
| 12 yo has not received the chicken pox vaccine, 3 yo sibling developed the varicella rash 2 days ago. What do you do for the 12 yo? |
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Definition
| apply VZV #1 toda and in 3 months repeat the series |
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Term
| what lab tests are ordered to determine if a pt has receieved the Hep B series? |
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Definition
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Term
| what population groups CANNOT get the LAIV? |
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Definition
| pregnant, asthmatic/RAD, CV, and pulmonary disease patients |
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Term
| 60 yo male with PMHx of herpes zoster. Is he a candidate for the Zoster vaccine?? |
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Definition
| yes, he may receive 1 dose of Zostavax. |
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