Pediatrics EOR (135 Topic Quick Cram) (Smarty PANCE)

What is the first-line treatment for mild comedonal acne?

Topical Retinoids (e.g., Tretinoin, Adapalene)

What are comedonal vs inflammatory acne lesions?

Comedonal: open (blackheads) and closed (whiteheads) comedones; Inflammatory: papules, pustules, nodules, cysts

What is the classic distribution of Atopic Dermatitis in infants vs. older children?

Infants: Extensor surfaces (cheeks, elbows, knees); Older children: Flexural surfaces (antecubital/popliteal fossae)

What is the first-line treatment for Diaper Dermatitis (Irritant)?

Barrier creams (Zinc oxide) and frequent diaper changes

What distinguishes Candidal Diaper Dermatitis from Irritant Dermatitis?

Candida involves the skin folds and has "satellite lesions"; Irritant spares the folds

What is the drug of choice for a severe drug eruption (SJS/TEN)?

Immediate discontinuation of offending agent + supportive care (Burn unit admission for TEN)

What is the classic "Target Lesion" pathognomonic for?

Erythema Multiforme (often triggered by HSV in kids)

What is the "Honey-colored crust" lesion diagnostic for?

Impetigo (caused by Staph aureus or Group A Strep)

What is the treatment for Impetigo?

Topical Mupirocin (Bactroban) for localized; Oral Cephalexin for widespread

What is the treatment for Lice (Pediculosis Capitis)?

Permethrin 1% shampoo (repeat in 7-9 days to kill hatching nits)

What are the "5 P's" of Lichen Planus?

Purple, Polygonal, Planar, Pruritic, Papules (with Wickham Striae)

What is the "Herald Patch" associated with?

Pityriasis Rosea (followed by "Christmas Tree" rash on back)

What is the classic location for Scabies burrows in infants?

Web spaces of fingers/toes, palms, and soles (intensely pruritic at night)

What is the treatment of choice for Tinea Capitis (Ringworm of scalp)?

Oral Griseofulvin (Topicals do not penetrate hair shaft adequately)

What is the hallmark sign of Urticaria (Hives)?

Blanchable, edematous, pink papules/wheals (evanescent - move around/fade <24hrs)

What bacterial pathogen is the most common cause of Acute Otitis Media?

Streptococcus pneumoniae

What is the first-line antibiotic for Acute Otitis Media?

Amoxicillin (80-90 mg/kg/day)

What is the classic presentation of Epiglottitis?

Drooling, Dysphagia, Distress (Tripod position), High fever (caused by Hib, now rare)

What is the "Thumb Sign" on lateral neck X-ray diagnostic for?

Epiglottitis (swollen epiglottis)

What is the most common cause of Epistaxis in children?

Digital trauma (nose picking) to Kiesselbach's plexus

How is hearing impairment screened in newborns?

Otoacoustic Emissions (OAE) or Auditory Brainstem Response (ABR)

What is the most common cause of Mastoiditis?

Untreated Acute Otitis Media (presents with post-auricular pain/erythema)

What is the treatment for Oral Candidiasis (Thrush) in infants?

Oral Nystatin suspension (apply to cheeks/tongue)

What distinguishes Orbital Cellulitis from Periorbital (Preseptal) Cellulitis?

Orbital has Pain with Eye Movement, Proptosis, and Ophthalmoplegia (Preseptal does not)

What is the treatment for Otitis Externa (Swimmer's Ear)?

Ciprofloxacin/Dexamethasone otic drops

What is the classic "Hot Potato Voice" and uvular deviation sign of?

Peritonsillar Abscess

How do you distinguish Strabismus (misalignment) from Pseudostrabismus?

Corneal Light Reflex (Hirschberg Test) - light reflects centrally in both pupils in pseudostrabismus

What is the "Slapped Cheek" rash indicative of?

Erythema Infectiosum (Fifth Disease) - caused by Parvovirus B19

What is the risk of Parvovirus B19 in sickle cell patients?

Aplastic Crisis

What causes Hand-Foot-and-Mouth Disease?

Coxsackievirus A (Type A16 most common)

What is the classic presentation of Measles (Rubeola)?

Cough, Coryza, Conjunctivitis (3 C's) + Koplik spots -> Rash starts on face spreads down

What are Koplik Spots?

White/blue-grey spots on buccal mucosa (pathognomonic for Measles)

What is the classic presentation of Mumps?

Bilateral Parotitis (swollen salivary glands) and Orchitis in post-pubertal males

What are the three stages of Pertussis (Whooping Cough)?

Catarrhal (cold symptoms), Paroxysmal (whooping cough), Convalescent (recovery)

What is the treatment for Pertussis?

Azithromycin (Macrolide) - also treats exposed contacts

What is the "Scotch Tape Test" used for?

Diagnosing Pinworms (Enterobius vermicularis) - nocturnal anal itching

What is the classic presentation of Roseola (Exanthem Subitum)?

High fever for 3-5 days -> Fever breaks -> Maculopapular rash appears on TRUNK first (HHV-6)

What distinguishes Rubella (German Measles) from Rubeola (Measles)?

Rubella rash is milder, spreads faster (3 days), and has Posterior Auricular Lymphadenopathy

What is the "Dew drop on a rose petal" rash?

Varicella (Chickenpox) - vesicles in different stages of healing

What is the major complication of Atypical Mycobacterial Disease (Cervical Lymphadenitis) in kids?

Chronic draining sinus tract (fistula) from lymph node; requires surgical excision (not antibiotics)

What is the most common cause of Acute Bronchiolitis?

Respiratory Syncytial Virus (RSV)

What is the classic presentation of Acute Bronchiolitis?

Infant <2 years with viral prodrome, respiratory distress, wheezing, and crackles (winter months)

What is the only proven treatment for Bronchiolitis?

Supportive care (Oxygen/Hydration); Steroids and bronchodilators are NOT routinely recommended

What is the hallmark sound of Croup (Laryngotracheobronchitis)?

Barking "seal-like" cough and inspiratory stridor

What is the classic X-ray finding in Croup?

"Steeple Sign" (subglottic narrowing)

What is the treatment for moderate-to-severe Croup?

Dexamethasone + Nebulized Racemic Epinephrine

What is the gold standard diagnostic test for Cystic Fibrosis?

Sweat Chloride Test (>60 mmol/L is positive)

What is the most common organism causing pneumonia in Cystic Fibrosis patients?

Pseudomonas aeruginosa

What is the first sign of Cystic Fibrosis in a newborn?

Meconium Ileus (failure to pass stool)

Where is an aspirated Foreign Body most likely to lodge?

Right Main Bronchus (wider, shorter, more vertical)

What is the diagnostic and therapeutic procedure of choice for airway Foreign Body?

Rigid Bronchoscopy

What is the cause of Hyaline Membrane Disease (RDS) in newborns?

Surfactant deficiency (common in premature infants <30 weeks)

What is the classic Chest X-ray finding in Hyaline Membrane Disease?

Diffuse reticulogranular "ground-glass" appearance with air bronchograms

What is the most common cause of viral pneumonia in infants?

RSV

What are the Major Jones Criteria for Acute Rheumatic Fever?

Joints (Polyarthritis), Carditis, Nodules, Erythema Marginatum, Sydenham Chorea

What is the classic murmur of an Atrial Septal Defect (ASD)?

Systolic ejection murmur with a Fixed Split S2

What is the classic physical exam finding in Coarctation of the Aorta?

Higher BP in upper extremities vs. lower extremities (and delayed femoral pulses)

What genetic condition is Coarctation of the Aorta associated with?

Turner Syndrome (45,XO)

What is the murmur of Hypertrophic Cardiomyopathy (HOCM)?

Harsh systolic crescendo-decrescendo murmur that INCREASES with Valsalva/Standing

What are the diagnostic criteria for Kawasaki Disease?

Fever >5 days + 4 of 5 (CRASH): Conjunctivitis, Rash, Adenopathy (cervical), Strawberry tongue (mucocutaneous changes), Hand/Foot swelling

What is the major cardiac complication of Kawasaki Disease?

Coronary Artery Aneurysm

What is the treatment for Kawasaki Disease?

IVIG + High-dose Aspirin

What is the classic murmur of a Patent Ductus Arteriosus (PDA)?

Continuous "machine-like" murmur at the left upper sternal border

What medication is used to close a PDA in premature infants?

Indomethacin (NSAID)

What is the classic Chest X-ray finding in Tetralogy of Fallot?

"Boot-shaped heart" (due to RVH)

What are the four components of Tetralogy of Fallot?

PROVe: Pulmonary stenosis, RVH, Overriding aorta, VSD

What helps relieve a "Tet Spell" (cyanotic episode)?

Squatting or knees-to-chest (increases systemic vascular resistance, decreasing R->L shunt)

What is the most common congenital heart defect?

Ventricular Septal Defect (VSD)

What is the classic murmur of a VSD?

Harsh Holosystolic murmur at the Left Lower Sternal Border

What is the "Rule of 3s" for Colic?

Crying >3 hours/day, >3 days/week, for >3 weeks in a healthy infant

What is the classic X-ray finding in Duodenal Atresia?

"Double Bubble" sign (air in stomach and duodenum)

What genetic condition is Duodenal Atresia associated with?

Down Syndrome (Trisomy 21)

What is Encopresis?

Involuntary fecal soiling in a child >4 years old (usually due to severe constipation/impaction)

What is the most common cause of Gastroenteritis in children?

Rotavirus (though Norovirus is common in all ages)

What is the classic presentation of Hirschsprung Disease?

Failure to pass meconium within 48 hours, abdominal distention, explosive stool on rectal exam

What is the Gold Standard for diagnosing Hirschsprung Disease?

Rectal suction biopsy (shows absence of ganglion cells)

What is the difference between an Indirect and Direct Inguinal Hernia?

Indirect: Lateral to epigastric vessels, enters scrotum (patent processus vaginalis); Direct: Medial to vessels (weak fascia)

What is the classic triad of Intussusception?

Abdominal pain (colicky), Vomiting, "Currant jelly" stools

What is the diagnostic and therapeutic test for Intussusception?

Air or Barium Enema

What is the classic physical exam finding in Intussusception?

Sausage-shaped mass in the RUQ

What distinguishes Breast Milk Jaundice from Breastfeeding Jaundice?

Breastfeeding Jaundice: First week of life (dehydration/lack of milk); Breast Milk Jaundice: After first week (milk factor inhibits conjugation)

What defines Physiologic Jaundice?

Jaundice appearing Day 2-3, resolves by Day 7; Direct bilirubin is normal (unconjugated hyperbilirubinemia)

What causes Pellagra?

Niacin (Vitamin B3) deficiency - Dermatitis, Diarrhea, Dementia

What is the classic presentation of Pyloric Stenosis?

Projectile non-bilious vomiting in a 2-6 week old infant

What is the physical exam finding in Pyloric Stenosis?

"Olive-shaped" mass in the epigastrium

What is the diagnostic test of choice for Pyloric Stenosis?

Abdominal Ultrasound (thickened pylorus >4mm)

When does an Umbilical Hernia typically require surgical repair?

If it persists beyond age 5 years (most close spontaneously by age 2)

What are the symptoms of Vitamin A Deficiency?

Night blindness (nyctalopia) and dry skin/eyes (xerophthalmia)

What are the symptoms of Vitamin C Deficiency (Scurvy)?

Bleeding gums, petechiae, poor wound healing, corkscrew hairs

What is the classic presentation of Vitamin D Deficiency (Rickets)?

Bowing of legs (genu varum), rachitic rosary (costochondral thickening), soft skull (craniotabes)

What are the physical features of Down Syndrome (Trisomy 21)?

Epicanthal folds, flat nasal bridge, macroglossia, single palmar crease (Simian crease), up-slanting palpebral fissures

What is the most common cardiac defect in Down Syndrome?

Atrioventricular Septal Defect (AV Canal Defect)

What defines a Simple Febrile Seizure?

Generalized tonic-clonic, <15 mins, once in 24 hrs, fever present, child 6mo-5yrs

When is the MMR vaccine first administered?

12-15 months (2nd dose at 4-6 years)

Which vaccines are Live Attenuated?

MMR, Varicella, Rotavirus, Intranasal Influenza

When does an infant double and triple their birth weight?

Double: 4-6 months; Triple: 12 months

When should the Anterior Fontanelle close?

10-24 months

At what age does the Moro Reflex disappear?

3-6 months

At what age should a child walk alone?

12-15 months

At what age does a child have a 2-word vocabulary?

2 years (puts 2 words together)