Primary Care Exam 2 condensed

Amniotic Band/Constriction Syndrome

Fibrous stands that encircle fetal parts causing deformity, refer to plastics

Branchial Cleft & thyroglossal cysts and sinuses

Neck region, drains into the pharynx, surgical consultation is required

Developmental Dysplasia of the hip risk factors

female, high birth weight, breech

Treatment for DDH

Pavlik harness 23 hours a day

Transient tachypnea of the newborn

incomplete evacuation of fetal lung fluid

Symptoms of TTN

tachypnea, minimal oxygen, resolves in 24-48 hours

Neonatal Respiratory Distress Syndrome

Surfactant deficiency disorder, rapid and progressive respiratory distress, tachypnea, cyanosis

Meconium Aspiration Syndrome symptoms

tachypnea, grunting, cyanosis within hours of delivery

Meconium Aspiration Syndrome treatment

if good tone, heart rate above 100, supportive cares

Umbilical Hernia

Weakness of the umbilical ring, soft reducible swelling in umbilical area, no surgery unless older than 5 years

Hypoglycemia risk factors

steroid exposure, SGA, LGA, diabetic mothers, asphyxia, sepsis

Vitamin K deficiency bleeding/Hemorrhagic disease of the newborn risk factors

prematurity, antiepileptic medications by mother, no Vit K after birth

How to treat toxoplasmosis

Pyrimethamine + Sulfadiazine

How to treat gonorrhea

IV ceftriaxone

How to treat Chlamydia

PO erythromycin/azithromycin

How to treat syphillis

crystalline penicillin G for 10 days

How to treat HSV

Acyclovir for 14-21 days

Talipes Equinovarus (club foot)

ankle is in equinus- pointed down, sole of foot is inverted, refer to ortho, casts, bracing program

What is craniosyntosis

premature closure of suture lines, refer to neurosurgery

What is reticulocytes

immature red blood cells

What should a blood sugar be after 48 hours of life

above 60

AAP state hypoglycemia for an infant starts at what

45 and below

Congenital rubella

blueberry muffin skin lesions, no treatment

How to treat Group B

Penicillin G

How to treat Listeriosis

IV ampicillin/gentamicin

When to RTS after tinea corporis

72 hours after azole cream

when to RTS after tinea capitis

2 weeks after Griseofulvin

When to RTS after HSV

when no new lesions at least 72 hours

Define sudden cardiac death

death within 6 hours of previously normal state of health

4 priority screening questions for SCD

fainting, unexplained seizure, chest pain/SOB, family hx of cardiac conditions

What is apophysitis

inflammation/trauma to the growth plate

What is neurapraxia

nerve root/brachial compression, traction injuries

Female athlete triad

bone mineral density, menstrual function, energy availability

Osgood Schlatter

knee pain @ patellar tendon, pain increased during and immediately after exercise, bony prominence over tibial tuberosity

Osgood Schlatter treatment

Avoid activity that causes pain, ice, patellar tendon strap

How fast can you get heat stroke

15-20 minutes

Oestochondritis Dessicans

tenderness of femoral condyle, 4-6 weeks immobilization

Legg Calve Perthes Disease

insufficient blood supply to femoral head causing necrosis

sx of legg calve perthes disease

limp, pain, antalgic gait, positive trendelenburg, decrease ROM

treatment of legg calve perthes disease

surgical osteotomy, core decompression

Slipped capital femoral epiphysis

proximal femoral epiphysis slips

sx of slipped capital femoral epiphysis

groin pain, obesity, antalgic gait, external rotation of toes, unable to bear weight, positive hip stress test

tx of slipped capital femoral epiphysis

immediate intervention to not bear weight, referral

Sever Disease/ Calcaneal apophysitis

pain with forced dorsiflexion of the ankle, use heel cushions

Laryngotracheobronchitis

barky cough, stridor, URI prodrome, human parainfluenza virus, decadron/racemic epi, steeple sign

Epiglottitis

fever, muffled voice, dysphagia, drooling, child looks toxic, hyperextension of the neck, give broad spectrum abx, thumbprint sign in XR

3 D’s

dysphagia, drooling, distress

Bronchitis

URI prodrome, congestion, rhinitis, cough, coryza, otitis media, supportive cares

Pneumonia

tachypnea, cough, fever, resp distress

how to treat pneumonia

amox 90 mg/kg/day in 2 doses or cefdinir 14 mg/kg/day in 2 doses

how to treat CAP

azithromycin 10 mg/kg/day

Parainfluenza virus

cause of croup, URI sx, croup sx, supportive cares

Pertussis treatment

Azithroymcin 10 mg/kg/day x 5 days, prophy treat close contacts

Rhinosinusitis treatment

under 2yrs Augmentin 90 mg/kg/day in 2 doses

older 2 yrs Amoxicillin 45-90 mg/kg/day in 2 doses

Adenovirus sx

tonsillitis, adenopathy, conjunctivitis

What is a PDA

provides a connection between the pulmonary artery and the aorta which has blood go to the heart bypassing the lungs

Circulation of blood flow of the heart

right atrium, tricuspid valve, right ventricle, pulmonary artery, goes to lungs, left atrium, mitral valve, left ventricle, aorta

What heart defect is common in preemies

PDA

What heart defects are common in birth-1 weeks olds

coarctation of the aorta, cardiomyopathy

heart defects common in 1-3 weeks olds

VSD, AV canal, aortic stenosis, PDA

heart defects common in 1-year olds

myocarditis, rheumatic fever

Defects causing left to right shunting (acyanotic)

AV canal, PDA, ASD, CHF

causes increased pulmonary blood flow

defects causing right to left shunting (cyanotic)

tetralogy of fallot, pulmonary stenosis, VSD

causes decrease in pulmonary blood flow

How to treat PDA

indomethacin/ ibuprofen

how to treat TET

knee to chest position (boot shaped heart)

how to treat Transposition of the great arteries

IV prostaglandin E (egg shaped heart)

Note about pulmonary stenosis and rapid growth

rapid growth can cause pulmonary stenosis to worsen

Innocent murmur sx

grade 1-4, changes with position, varies in loudness, heard in LLSB, ECG normal

Examples of innocent murmurs

stills murmur, venous hum, pulmonary flow mumur

7 S’s

systolic, small, soft, short, single, sweet, sensitive

pathologic murmur symptoms

systolic clicks, diastole murmur, fixed split, S4 gallops, not positional, Grade 4+, harsh, murmur with syndrome associated with CHD

Examples of pathologic murmurs

aortic stenosis, pulmonary stenosis, coarctation

SAFER

syndrome, age, family hx, eval feeding, rheumatic fever