What is hyaline membrane disease (respiratory distress syndrome) and what are 7 risk

factors? (race, gender, delivery method?)

In infants with HMD, hypoxemia is the result of 3 factors. . .

What are some other problems on the DDx for HMD?

Treatment of HMD?

What is the most common cause of respiratory distress in newborns?

What is TTN? _x000D_
How is it treated?_x000D_
What are some risk factors?

What are the four levels of cognitive development and the ages at which they occur?

What are the age ranges of the following in girls:_x000D_

Breast development begins_x000D_
Breast development complete_x000D_
Pubic hair appears_x000D_
Growth spurt begins_x000D_
Menarche
What are the age ranges of the following in boys:_x000D_
1) Testes growth begins_x000D_
2) Pubic hair appears_x000D_
3) Penis growth begins_x000D_
4) Genital growth complete_x000D_
5) Growth spurt starts_x000D_
6) Strength spurt
How long after the growth spurt does menarche happen? How long after thelarche?
How many years does puberty take to complete in girls?_x000D_
boys?
How does FSH and LH relate to pubarche?
What is responsible for pubic hair growth?
Average linear growth begins at what age for boys vs. girls?
what is the narrowest point in the pediatric airway?
Croup_x000D_
most common ages?_x000D_
When is the cough worse?_x000D_
Management?

At what ages should you:_x000D_

double birth weight_x000D_
triple birth weight_x000D_
quadruple birth weight?
How is mid parental height calculated?
What is the most sensitive test for primary hypothyroidism?
What is the most common thyroid disorder in kids?
What is the age cutoff where no permanent intellectual or neurological damage is done
during
What isacquired
the mosthypothyroidism
common cause of hyperthyroidism in kids?
What antibodies would be present in:_x000D_
Graves disease_x000D_
Hyper phase of hashimotos_x000D_
Hypo phase of hashimoto

What are 3 antithyroid drug treatments and their side effects (2)

What
What
What
What
What

age can children recieve radioactive ablation with no concerns for malignancy?
percent of patients remain hyperthyroid after initial ablation?
are the remission rates after 2 years of medication therapy for hyperthyroid?
is the most appropriate treatment of a 13 year old with Graves disease?
is the DDx for a congenital goiter?

Describe the course of Measles

Describe the course of Rubella

Roseola infantum

Erythema Infectiosum

How long are varicella patients contagious for? What test can be used to test for it?
Hand Foot Mouth disesase
What is the most common cause of hematogenously spread cellulitis?
Treatment of the following Tineas:_x000D_
Capitis_x000D_
Corporis/Cruris/Pedis
Describe the Dawn Phenomenon
Describe the somogyi phenomenon
Single most critical value in evaluating growth?

Average growth velocities for:_x000D_

012 months _x000D_
1224 mo _x000D_
2436 mo_x000D_
36 months puberty _x000D_
Puberty
What should be assumed about height deceleration between the ages of 3 and 12 years?
Definition of short stature
Delayed BA, subnormal growth rate, obesity (2 possibilities)
What would you order for lab evaluation of short stature?

Why can there be a false positive rate on TSH in newborns?

How is transient hyperthyroidism treated?

A baby is screened with a total T4 level which is decreased. The TSH is normal. What is the
next step?
When do kids adopt adult stooling patterns?
Osmotic Diarrhea. . _x000D_
stool sodium? _x000D_
Osmolarity?_x000D_
Exogenous vs. endogenous DDx?

Secretory Diarrhea_x000D_
Sodium?_x000D_
Osmolarity?_x000D_
DDx?
Treatments of the following:_x000D_
Giardiasis_x000D_
Cryptosporidium

VACTERL

CHARGE what each letter means

MURCS

Turner syndrome: heart defects (2), renal, appearance

Alagille Syndrome: _x000D_

heart defect, liver, eye, vertebral, appearance, cause

Prader Willi: _x000D_

Appearance in the infant. Appearance of older child.

Cornelia de Lange: appearance

Di George: heart, Endocrine, appearance, inheritance

Williams Syndrome: cardiac, endocrine, appearance, inheritance

Features of Trisomy 18

Trisomy 13
What vitamin deficiencies are associated with the following diets?_x000D_
Vegan?_x000D_
Goats Milk?
What anemias are the following ethnicities associated with?_x000D_
African American?_x000D_
Mediterranean?_x000D_
Southeast asian?_x000D_
Northern European?
What type of anemia is associated with nail spooning?
What are the two types of microcytic anemia?
What are the 4 types of macrocytic anemia?

What are the 7 types of normocytic anemia?

How is hemophilia inherited?
What lab abnormalities are seen with hemophilia?
Mild/Moderate Hemophilia A may respond to _____
1st line treatment for type I vWD?
What is the typical course for ITP?
At what age would the following actions be cause for concern?_x000D_
<15 words_x000D_
Unable to use 2 word phrases
How old is this kid. _x000D_
Draws primitive figures, assume others feel same way, ask why questions, uses imagination,
pretend
How old play
is this kid: past tense, sings songs, knows first/last name, counts to 4, knows colors.
How old is this kid: future tenst, counts to 10, knows telephone number, recognizes most
letters
Caloric requirement for birth to 6 months? 623 months?
Caloric content of human milk?
When is mom usually screened for GBBS?

What are the 3 things that are done prophylactically on a newborn?

Define the following and what to do with them:_x000D_

Cephalohematoma_x000D_
Caput Succedaneum

At what age do most umbilical hernias close?

In regards to DDH, what age is the Ortolani and Barlow signs no longer positive? What is a
diagnostic sign at this point?
What radiology is used for DDH?
At what age do the following reflexes disappear?_x000D_
Moro_x000D_
Stepping_x000D_
Suck and Root_x000D_
Palmer Grasp_x000D_
Plantar Grasp_x000D_
Fencer
What is the ounce requirement for nutrition per pound for an infant?
How long should a car seat face backwards for?
What are 4 uses for Cefipime?

What is the spectrum of activity of Carbapenems?

How do Meropenem and Imipenem differ?

What is the monobactam Aztreonam effective against?

Aminoglycosides:_x000D_
3 examples?_x000D_
spectrum of activity?Explain its synergism

Spectrum of activity for Vanco?

Macrolides:_x000D_
2 Examples_x000D_
7 bugs it can treat well

Lincosamides:_x000D_
1 Example_x000D_
Spectrum of activity
TMP/SMX:_x000D_
Mechanism of action?_x000D_
Spectrum of activity?
Tetracyclines:_x000D_
2 examples_x000D_
Spectrum of activity

Quinolones:_x000D_
Spectrum of activity_x000D_
1st, 2nd, 3rd, 4th generation?

Linezolid_x000D_
spectrum of activity?
Streptogramins:_x000D_
2 examples_x000D_
spectrum
Daptomycin_x000D_
spectrum
Telithromycin
Tigecycline

for the following fluids, state the amount of NaCl present:_x000D_

.9 NS_x000D_
1/2 NS_x000D_
1/4 NS_x000D_
LR_x000D_
D5W
For the following fluids, state the OSM of each:_x000D_
.9 NS_x000D_
1/2 NS_x000D_
1/4 NS_x000D_
LR_x000D_
D5W
What numbers are used to calculate maintenance fluids per kg?
How much Na, K, Cl, and Glucose are required for each 100 ml of water?

Calculate MIV req. per day for a 12 kg child.

Calculate MIV req. per day for a 70 kg child and convert to hourly rate

What is the max rate to correct serum sodium in hypo/hypernatremic dehydration?

What fluids would you order for a 15 month old girl (wt. 20kg)
describe the rapid rehydration method

Differentiate between simple and complex seizures

What meds are used in both generalized and partial seizures?

What med is used only in generalized seizures?

What meds are only used in partial seizures?

what is the age range for febrile seizures?

percent recurrence for febrile seizures in kids?
what is the most common physical disability in childhood?
What are the four main options to treat epilepsy?

What are the criteria for the asthma severities?

What are the treatments for:_x000D_

Mild intermittent_x000D_
Mild persistent_x000D_
Moderate persistent_x000D_
Severe persistent

what is the most common inherited lethal dz in caucasians? How is it inherited?

The first thing to come to mind with rectal prolapse?
Which onset type of JRA is most common?
Pericarditis is most likely to occur in which type of JRA?
Uveitis is most likely to occur in which of the following:_x000D_
little boys with pauci JRA_x000D_
little girls with pauci JRA
What is the most useful in early diagnosis of uveitis in JRA?
What is the best initial tx for JRA?
T/F:_x000D_
1In pauci and poly JRA, the ANA test is more likely to be positive than is the RF test_x000D_
2In systemic JRA, both the ANA and RF are expected to be negative_x000D_
3In pauci JRA, ANA positivity is associated with an increased risk of eventual uveitis_x000D_
4RF positivity is just as commin in JRA as it is in adult RA

When is a child most susceptible to infection?

Diagnostic criteria for Kawasaki

HMD is due to insufficient surfactant at the time of birth. This increases surface tension and
decreases lung compliance. _x000D_
_x000D_
Risk factors include:_x000D_
Male, Premature, Caucasian, Gest. Diabetes, Csection, 2nd born twin, FHx.
Right to left shunting via:_x000D_
_x000D_
shunt vessels in the lung_x000D_
past atelectatiic air spaces_x000D_
PDA, PFO
TTN CXR shows higher lung volumes_x000D_
_x000D_
Bacterial PNA difficult to distinguish from GBS. Routine to treat all HMD babies with ABX
until ()Cx are received_x000D_
_x000D_
Pulmonary Edema many causes_x000D_
_x000D_
Aspiration PNA meconium or amniotic fluid.
1) Prevent premature delivery. _x000D_
2)If preterm delivery is inevitable, then treat with steroids antenatally_x000D_
3)Surfactant replacement therapy
TTN
TTN is a delayed clearance of fetal lung fluid. _x000D_
_x000D_
Treatment:_x000D_
self limited with resolution within 4872 hours. Some treatment includes fluid restriction and
oxygen._x000D_
_x000D_
Risk factors include: _x000D_
Csection_x000D_
Premature_x000D_
Delayed clamping of the umbilical cord_x000D_
Maternal sedation_x000D_
Maternal diabetes_x000D_
Fetal distress
Sensorimotor 2 years_x000D_
Preoperational 27 y/o_x000D_
Operational 712 y/o_x000D_
Formal >12 y/o

1)
2)
3)
4)
5)

Breast dev. 813_x000D_

Breast dev. complete 1218_x000D_
Pubic hair appears 814_x000D_
Growth spurt 914_x000D_
Menarche 1016

1)
2)
3)
4)
5)
6)

Testes growth begins 913_x000D_

Pubic hair appears 1015_x000D_
Penis growth begins 1014_x000D_
Genital growth complete 1318_x000D_
Growth spurt starts 1016_x000D_
Strength spurt 1317

3 years after menarche_x000D_

2 years after thelarche
4 years_x000D_
3 years in boys
Unrelated
DHEA, DHEAS
10 years for girls_x000D_
11.5 for boys
subglottic trachea
6 months 5 years_x000D_
Worse at night_x000D_
humidification_x000D_
cold air_x000D_
steroids_x000D_
epinephrine aerosols_x000D_
heliox
Double: 5 months_x000D_
Triple: 12 months_x000D_
Quadruple 2 years
Boys: FH + (MH + 5)/2_x000D_
Girls: FH + (MH 5)/2
TSH
Hashimoto's thyroiditis
3 years old
Graves
Graves antiTSI_x000D_
Hashimotos, hyper phase antiTPO and anti thyroglobulin_x000D_
_x000D_
Hashimotos hypo phase same has hyper phase

PTU, Methimazole, Cabimazole_x000D_

_x000D_
Side Effects include: agranulocytosis, hepatitis
5
2540%
25%
Methimazole
Neonatal Graves_x000D_
Congenital Hypothyroidism
812 day incubation prodrome (conjunctivitis, coryza, fever, cough, malaise) koplik
spots maculopapular rash beginning on the head and spreading down. Paramyxovirus.
Major complication is subacute sclerosing panencephalitis
Caused by Rubellavirus (A Togavirus) When infected postnatally, it is often asx. Sx can
include, erythematous maculopap discrete rash, with generalized LAD and fever. Transient
polyarthralgias_x000D_
_x000D_
When infected prenatally, it is much more serious. Sx include, heart/eye/auditory defects,
neuro malformations, IUGR, blueberry muffin spots

Caused by HHV6, begins with abrupt fever (103106) for 15 days, child appears well during
the fever, after 34 febrile days a MP rash develops on trunk and spreads peripherally, fever
resolves as rash appears,
Parvovirus B19 Mild, self limiting, no prodrome, low grade fever (if any), Rash begins as
slapped cheek, erythematous, pruritic MP rash develops on arms and spreads to trunk/legs.
Associated with fetal hydrops during pregnancy.
24 hours before rash until all lesions are crusted (1 week)_x000D_
Tzank prep
Coxsackie A virus prodrome of anorexia, fever, oral pain followed by crops of ulcers on oral
mucosa
S. Pneumo
Oral griseofulvin for 46 weeks_x000D_
topical antifungals for 4 wks
Increasing insulin resistance from 3am8am. Nocturnal GH secretion. Sugar is normal at 3am
and high at 8am
Rebound hyperglycemia following hypoglycemia. Low sugar at 3am and high at 8am
Height velocity

012 25cm_x000D_
1224 12cm_x000D_
2436 8cm_x000D_
36mopuberty 47cm per year_x000D_
Puberty 814cm/year
Pathologic until proven otherwise
2 SD below mean (,3%ile)
Cortisol excess or Hypothyroidism
CBC w/diff, Complete metabolic panel, T4/TSH, IGF1/GFBP3, UA/ESR, Celiac panel (Serum
IgA, Antiendomysial Ab, Tissue transglutaminase), Bone age film
Because of the TSH surge that occurs in the first 24 hours of life.
Treat vigorously to prevent HF. Hospitalize to monitor HR and EKG_x000D_
Treat with:_x000D_
PTU rather than methimazole because PTU decreases conversion of T4 to T3._x000D_
Beta Blockers_x000D_
Lugols solution to block release of preformed thyroid hormone_x000D_
Pharmacological doses of glucocorticoids which block conversion of T4 to T3.

Free T4. . .if decreased along with normal TSH then you need to rule out central
hypothyroidism. If normal, then they have TBG deficiency
1 year old
Stool sodium < 70 meq/L _x000D_
OSM >2x(Na+K)_x000D_
Exogenous: laxatives, artificial sweeteners, antacids, excessive CHO, lactulose_x000D_
Endogenous: disaccharidase deficiency, pancreatic insufficiency, infectious diarrhea, loss of
surface area (short gut, IBD, Celiac, milk protein enteropathy, rota)

Stool sodium >70meq/L OSM=2x(Na+K)_x000D_

DDx: infection with toxigenic organism (Cholera, E. coli, salmonella, C. diff)_x000D_
Mucosal necrosis or atrophy, bile acid malabsorption, Hormone secreting tumors

Giardiasis:_x000D_
Metronidazole, nitazoxanide, furazolinide_x000D_
Cryptosporidium:_x000D_
Nitazoxanide, azithromycin

Verterbra (hemivertebrae)_x000D_
Anus (imperforate)_x000D_
Cardiac (VSD)_x000D_
TE fistula_x000D_
Renal (horseshoe)_x000D_
Limb (clubfoot)
Coloboma_x000D_
Heart (ASD)_x000D_
Atresia choanae_x000D_
Renal (fused kidneys)_x000D_
Ear (deafness)
Mullerian duct (absent prox 2/3 of vagina)_x000D_
Renal agenesis_x000D_
CSpine defects C5T1
Bicuspid aortic valve_x000D_
coarctation_x000D_
horseshoe kidney_x000D_
low set ears_x000D_
wide nipples
PPS_x000D_
Paucity of intrahepatic bile ducts_x000D_
Direct hyperbili_x000D_
Opaque margin of cornea_x000D_
Butterfly/hemivertebrae, Triangular face_x000D_
Deep set eyes. _x000D_
_x000D_
AD inheritance_x000D_
mutation of JAG1
Infant: hypotonia, poor feeding, small hands/feet, almond shaped eyes_x000D_
Older child: marked weight gain, MR, unusual eating behaviors, skin picking, rage

Growth retardation, long eyelashes, thick eyebrows, upturned nares, hirsutism, hypoplastic
nipples, short limbs, missing digits, genital abnormalities. No diagnostic test available
Left sided heart lesions, hypocalcemia, _x000D_
prominent nose, _x000D_
long fingers, _x000D_
high arched/cleft palate. _x000D_
_x000D_
Sporadic inheritance, _x000D_
AD for affected individual

Supravalvular aortic stenosis, _x000D_

Hypercalcemia, _x000D_
Full lips and lower face, Stellate pattern to iris, _x000D_
mild to moderate MR with cocktail party personality. _x000D_
_x000D_
AD inheritance for affected individual, _x000D_
sporadic inheritance.
Hypertonic_x000D_
Overlapping fingers_x000D_
Most miscarry_x000D_
90% die within a year
Midline abnormalities, most miscarry
Vegan B12 deficiency_x000D_
Goats milk folate deficiency
AA HbS, HbC, thalassemia, G6PD_x000D_
Mediterranean Thalassemia, G6PD_x000D_
Southeast asian Thalassemia, HbE_x000D_
Northern European_x000D_
Hereditary Spherocytosis
Iron Deficient
Iron Deficient_x000D_
Thalassemia
Aplastic anemia_x000D_
Diamondblackfan_x000D_
Liver disease_x000D_
Myelodysplastic syndrome
Sickle cell, HS, G6PD, AIHA, HUS, Infxn, Renal disease
AR
aPTT elevated, normal aPTT mix, decreased VIII or IX
DDAVP
DDAVP
50% resolve within 12 months_x000D_
80% resolve within 6 months
15 words at 18 months_x000D_
2 word phrases At 24 months
3 y/o
4 years
5 years
108kcal/kg/day and 98kcal/kg/day
20 kcal/oz
3537 weeks

Vit. K_x000D_
Eye infxn prophylaxis with erythromycin or tetracycline eye ointment_x000D_
HepB mom's status, HBIG vs. vaccine
Cephalohematoma _x000D_
Blood under periosteum_x000D_
Does not cross suture lines_x000D_
Leave alone, will go away_x000D_
Caput Succedaneum_x000D_
scalp edema from pressure_x000D_
Diffuse, crosses suture line_x000D_
Resolves in 12 days
34 years
after 812 weeks, the O/B sign isn't positive and limited abduction is a more reliable sign
Before 4 months U/S_x000D_
After 4 months plain hip xray
Moro 3 months_x000D_
Stepping 6 weeks_x000D_
Suck and Root 4 mo. awake 7 mo. asleep_x000D_
Palmer Grasp 4 months_x000D_
Plantar Grasp 10 months_x000D_
Fencer 6 months

23 oz./pound
until 20 lbs or 1 year
1)PNA_x000D_
2)UTI_x000D_
3)Skin/Skin structure infxns_x000D_
4)Empiric tx in febrile neutropenic patients
G+, G aerobes, G anaerobes
Meropenem is:_x000D_
232x more active against Enterobacter_x000D_
24x more active against pseudomonas_x000D_
less active against G+_x000D_
Equivalent activity agains anaerobes_x000D_
MRSA/Enterococcus resistance
G rods
Gentamicin, Tobramycin, Amikacin_x000D_
_x000D_
G enterics, MRSA_x000D_
_x000D_
Synergistic effect with Beta lactams against G+, G
G+

Erythromycin, Azithromycin_x000D_
_x000D_
L. Pneumophila_x000D_
M. Pneumoniae_x000D_
C. Pneumomoniae_x000D_
C. Trachomatis_x000D_
B. Pertussis_x000D_
M. Cattharalis_x000D_
Camphylobacter
Clinda_x000D_
_x000D_
G+ aerobes_x000D_
G+/G anaerobes
inhibition of folic acid pthwy_x000D_
_x000D_
G aerobes_x000D_
Staph aureus
Doxycycline, Minocycline_x000D_
_x000D_
Rickettsia_x000D_
M. Pneumo_x000D_
C. Pneumo_x000D_
C. Trachomatis_x000D_
S. aureus MRSA
1st gen: G rods_x000D_
2nd gen: G rods, pseudomonas, Staph aureus _x000D_
3rd gen: G rods, pseudomonas, Staph aureus, PCN resistant S. pneumo, Legoinella,
Chlamydia, Mycoplasma_x000D_
4th gen: everything above plus anaerobes
G+ (incl. beta lactam resistant and vanco resistant)
Dalfopristin, Quinupristin_x000D_
_x000D_
G+ (except enterococcus and those resistant to beta lactams and vancomycin)
skin infections due to strep spp. MRSA and E. Faecalis
effective against respiratory pathogens
G+/G aerobes/anaerobes_x000D_
_x000D_
Adult soft tissue and intraabdominal infections

.9 NS. . .154mEq NaCl_x000D_

1/2 NS. . 77mEq NaCl_x000D_
1/4 NS. . .38mEq NaCl_x000D_
LR . . . .147mEq NaCl_x000D_
D5W. . . .0mEq NaCl
.9 NS. . .308 mOsm/L_x000D_
1/2 NS. . 154 mOsm/L_x000D_
1/4 NS. . 77 mOsm/L_x000D_
LR. . . . 310 mOsm/L_x000D_
D5W. . . .250 mOsm/L
4 2 1_x000D_
100 50 20
3mEq Na_x000D_
2mEq K_x000D_
5mEq Cl_x000D_
5 grams glucose
1000+100 = 1100ml/day_x000D_
NaCl = (3mEq)(11) = 33mEq_x000D_
KCl = (2mEq)(11) = 22mEq
1000+500+1000 = 2500ml/day_x000D_
10kg 10kg 50kg_x000D_
_x000D_
(3mEq Na)(25) = 75mEq Na_x000D_
(2mEq K)(25) = 50mEq K_x000D_
_x000D_
2500ml/day = 2 and a half one liter bags of D5 .2NS each with ~20mEq K
5 mEq/L/hr
D5 .2NS at 60ml/hr with 20 mEq K
1) NS bolus at 20ml/kg over 3060 min. until UOP_x000D_
2) D5 1/2NS with 20mEq K at:_x000D_
1.5x MIV for mild dehyd._x000D_
2 times MIV for moderate dehyd_x000D_
2.5x MIV for severe dehyd.
Simple no change in consciousness_x000D_
Complex alteration of consciousness
Valproic Acid_x000D_
Phenobarbitaol_x000D_
Phenytoin_x000D_
Lamotrigine_x000D_
Topiramate
Benzos

carbamazepine_x000D_
oxcarbazepine_x000D_
felbamate_x000D_
gabapentin
6 months 6 years
33%
CP
AEDs_x000D_
Ketogenic Diet_x000D_
Surgery_x000D_
Vagus nerve stimulator
Mild Intermittent: Sx<1x per week, brief flares, nighttime sx<2x per month_x000D_
_x000D_
Mild persistant: Sx>2x per week but not daily. night sx 2 times per month_x000D_
_x000D_
Moderate persistant: daily sx, flares limit activity. night sx>1x per week_x000D_
_x000D_
Severe persistent: continual sx, limit activity, frequent night sx.

Mild intermittent: no daily meds, inhaled B2 agonist prn_x000D_

_x000D_
Mild persistent: one daily med like an inhaled corticosteroid plus a short acting
bronchodilator prn_x000D_
_x000D_
Moderate persistent: Daily med either inhaled steroid with or w/o long acting beta agonist
plus prn bronchodilator_x000D_
_x000D_
Severe persistent: high dose daily steroid and long acting beta agonist plus prn
bronchodilator
CF AR
CF
pauci
Systemic
little girls with pauci JRA

slit lamp
NSAID
1)T_x000D_
2)T_x000D_
3)F_x000D_
4)T

612 wks
Fever for 5 days plus 4 of the following:_x000D_
1)Rash_x000D_
2)Bilateral Conjunctivitis_x000D_
3)1.5 cm node_x000D_
4)changes of lips/oral cavity_x000D_
5)edema/erythema of extremities