Pediatrics Flashcards

A comprehensive set of 350 practice flashcards covering core pediatric topics from pneumonia, jaundice, immunodeficiencies, congenital heart disease, nephrology, endocrinology, and more as per the provided lecture notes. Created from "the pther pediatrics file"

Q1: What is pneumonia in infants and toddlers?

An infection of the lower respiratory tract involving the airways and parenchyma.

Q2: What are the three main classifications of pneumonia outlined?

Bronchopneumonia (patchy consolidation), lobar pneumonia (entire lobe), and interstitial pneumonia (interstitium).

Q3: List common risk factors for pediatric pneumonia.

Anatomical defects, aspirations, immunosuppression, asthma, cystic fibrosis (CF).

Q4: Name typical newborn pathogens for pneumonia.

GBS, Listeria, E. coli, HSV, CMV (gential tract organisms).

Q5: Name viral etiologies most common in infants/toddlers.

RSV, rhinovirus, parainfluenza, adenovirus.

Q6: Name bacterial etiologies common in children over 5 years.

Mycoplasma (most common atypical), Streptococcus pneumoniae.

Q7: What are characteristic presentations of bacterial pneumonia in children?

High-grade fever, fatigue, cough, dyspnea, tachypnea, use of accessory muscles, hypoxia, pleuritic chest pain, poor feeding.

Q8: What are characteristic viral pneumonia symptoms in children?

Low-grade fever, dyspnea, wheezing, stridor, poor feeding; onset typically insidious.

Q9: How might oxygen saturation help differentiate etiologies in pneumonia?

Low saturation suggests atypical or viral causes; normal saturation is more typical of lobar bacterial pneumonia.

Q10: What are classic CBC and CXR findings for pneumonia?

CBC: leukocytosis (strep), leukopenia or normal (staph/viral). CXR: lobar consolidation (bacterial), diffuse interstitial patterns (viral), patches for mycoplasma.

Q11: What are common radiographic findings associated with Streptococcus pneumoniae?

Cavities containing fluid and air.

Q12: What is the initial outpatient antibiotic for <2 months with pneumonia?

Ampicillin plus gentamicin (ampicillin/gentamicin).

Q13: What is the initial outpatient antibiotic strategy for >2 months with pneumonia?

High-dose amoxicillin (about 100 mg/kg/day).

Q14: Name second-line antibiotics for atypical organisms or penicillin allergy.

Cefuroxime/Augmentin; macrolides (e.g., azithromycin); fluoroquinolones (adolescents).

Q15: List criteria for hospitalization of a child with pneumonia.

Under 6 months; toxic appearance or dehydration; complications (e.g., empyema); hypoxemia (<92%); immunosuppression; poor response to antibiotics.

Q16: What is the recommended inpatient treatment for pneumonia in <1 month olds?

Ampicillin plus gentamicin.

Q17: What is recommended inpatient therapy for 2 months to 2 years old with pneumonia?

Augmentin or cefuroxime.

Q18: What is recommended inpatient therapy for >2 years with pneumonia?

Ampicillin or penicillin-G (2nd line: Augmentin, cefuroxime, ceftriaxone).

Q19: Name common pneumonia complications.

Exudates, empyema, necrotizing pneumonia, abscess, pneumatoceles, pneumothorax.

Q20: What might unilateral recurrence of pneumonia suggest?

Foreign body, congenital malformation, or airway obstruction.

Q21: What might bilateral recurrence of pneumonia suggest?

Asthma (most common), GERD/aspiration, immunosuppression, CF, left-to-right shunts.

Q22: What is the age-adjusted respiratory rate normal ranges given?

Newborn 30-60; Infant 20-40; Child

Q23: What family-of-drugs can be used for atypical pneumonia?

Azithromycin or erythromycin (clarithromycin generally avoided under 2 months due to pyloric stenosis risk).

Q24: In pneumonia management, what is the role of vaccination?

Immunization with MMR, DTP, S. pneumoniae can decrease risk.

Q25: What is a typical presentation that might suggest empyema?

Infected pleural effusion with blunting of costophrenic angles; might accompany bacterial pneumonia.

Q26: What is the difference between pediatric lobar and interstitial pneumonia in imaging?

Lobar pneumonia shows consolidation of an entire lobe; interstitial pneumonia shows diffuse interstitial markings.

Q27: What are the major diagnostic tools for pneumonia in kids?

CBC, electrolytes, chest radiograph, serology for viruses, and possibly serology for specific etiologies.

Q28: What is the general duration of pneumonia antibiotic therapy in children?

7–10 days.

Q29: What vaccination can help prevent bacterial pneumonia?

S. pneumoniae vaccination (PCV).

Q30: What is the term for patchy consolidation involving one or more lobes?

Bronchopneumonia.

Q31: What is the term for pneumonia that involves the entire lung lobe relatively homogeneously?

Lobar pneumonia.

Q32: Which group is most likely to have Mycoplasma pneumoniae as a cause?

Children over 5 years.

Q33: Name a potential complication of pneumonia with staphylococcal involvement.

Empyema or necrotizing pneumonia.

Q34: What drug is used for presumed bacterial pneumonia in hospital if <1 month?

Ampicillin and gentamicin.

Q35: What drug is often avoided in infants due to pyloric stenosis risk?

Clarithromycin (clarithromycin) in very young infants.

Q36: How is pneumonia severity risk assessed for hospitalization?

Age under 6 months; dehydration; hypoxemia; poor response to antibiotics; immunosuppression; complications.

Q37: What imaging finding suggests a viral etiology in pneumonia?

Perihilar infiltrates or diffuse interstitial markings.

Q38: Name the three age-based etiologies for pneumonia by age group.

Newborn: GBS, Listeria, E. coli, HSV, CMV; Infant/Toddler: viral most common (RSV, rhinovirus, etc.) and bacterial (S. pneumoniae, HiF, S. aureus, Mycoplasma, Chlamydia afebrile); >5y: Mycoplasma and S. pneumoniae.

Q39: What are the key signs of hypoxia in bacterial pneumonia?

Cyanosis, tachypnea, use of accessory muscles, and hypoxia.

Q40: What is the role of fever in distinguishing bacterial vs viral pneumonia?

Bacterial pneumonia typically presents with high-grade fever; viral often presents with lower fever.

Q41: What does a patchy peripheral consolidation on CXR typically indicate?

Viral pneumonia (or Mycoplasma in some contexts).

Q42: When is Augmentin preferred in pneumonia management?

As an alternative in <2 months? Actually, Augmentin is listed as an alternative; used when amoxicillin alone is insufficient or in beta-lactam allergy.

Q43: What are the key prerequisites for hospitalization for pneumonia in children?

Under 6 months, toxic appearance, dehydration, hypoxemia, complications, lack of response to outpatient antibiotics.

Q44: What is the typical hospital course duration for pediatric pneumonia?

7-10 days of antibiotic therapy; duration may vary by clinical course.

Q45: What is a pneumonitis vs pneumonia distinction relevant to kids?

Pneumonia refers to infection with consolidation; pneumonitis may refer to inflammatory process without consolidation.

Q46: What is the management approach for Mycoplasma pneumoniae in adolescents?

Macrolide antibiotics (e.g., azithromycin) or doxycycline in older children; avoid clarithro in under 2 months due to pyloric stenosis risk.

Q47: What complication does pneumonia predispose to with staph aureus?

Empyema or necrotizing pneumonia.

Q48: What is a key radiographic feature of Strep pneumoniae pneumonia?

Lobar consolidation.

Q49: How is hospital treatment different for

Q50: What defines interstitial pneumonia on imaging?

Inflammation of interstitium with diffuse markings rather than focal consolidation.

Q51: Name the five major complications listed for pneumonia in the notes.

Exudates/empyema, necrotizing pneumonia, abscess, pneumatocele, pneumothorax.

Q52: What is the significance of pleural effusion in pediatric pneumonia?

Pleural effusion indicates possible empyema or bacterial pneumonia with complications.

Q53: Which organism is associated with afebrile Chlamydia in pneumonia?

Chlamydia (afebrile) can be seen in some atypical presentations.

Q54: In adults vs children, which age group is most likely to have Mycoplasma pneumoniae as a cause?

Children over 5 years old.

Q55: How long should immunization reduce pneumonia risk?

Immunization reduces risk of specific pneumonias (pneumococcal) but does not eliminate risk entirely.

Q56: Which therapy is not routinely used for pneumonia <2 months?

Macrolide monotherapy is generally avoided due to resistance and age considerations.

Q57: What is the purpose of hospitalizing a febrile, dehydrated child with pneumonia?

To ensure adequate antibiotic therapy, IV hydration, and monitoring for complications.

Q58: What type of pneumonia is suggested by perihilar infiltrates?

Mycoplasma or viral infections, particularly atypical bacteria.

Q59: What is the role of serology in pneumonia diagnosis?

Used to identify specific viral etiologies (Influenza, RSV) and sometimes atypical bacteria.

Q60: Why is cefuroxime or Augmentin used as alternatives?

Used when there is penicillin allergy or suspected beta-lactamase producing organisms.

Q61: What is the clinical relevance of tachypnea thresholds in kids?

Age-specific limits help determine severity and need for hospitalization.

Q62: What are risk factors for acquiring pneumonia in a child with CF?

Anatomical/airway disease; CF predisposes to pneumonias including atypical organisms.

Q63: What is the typical initial step in evaluating pediatric pneumonia?

Clinical assessment with history and physical exam to determine severity and need for imaging.

Q64: How is the term 'empyema' defined in pneumonia context?

Empyema is pus accumulation in the pleural space, often a complication of pneumonia.

Q65: What is the typical age distribution of pneumonia etiologies?

Newborn: GBS, Listeria, E. coli; Infant/Toddler: viral most common; >5 years: Mycoplasma and S. pneumoniae.

Q66: What is the relation between vaccination and pneumonia risk?

Vaccines reduce risk of several bacterial pneumonias, notably pneumococcal and Hib.

Q67: Which organism is a common cause of pleural effusion in pneumonia?

Streptococcus pneumoniae can be associated with empyema and pleural effusion.

Q68: What is a key management step for suspected bacterial pneumonia in infants under 2 months?

Hospitalization for IV antibiotics (ampicillin/gentamicin) and monitoring.

Q69: When would a macrolide be chosen for pediatric pneumonia?

Atypical pneumonia or penicillin allergy; particularly in school-age children.

Q70: How is the duration of pneumonia treatment determined?

Typical duration is 7-10 days; shortened or extended based on clinical response.

Q71: Define lobar pneumonia.

Pneumonia affecting an entire lobe of the lung with relatively homogeneous involvement.

Q72: Define bronchopneumonia.

Patchy consolidation involving one or several lobes.

Q73: Define interstitial pneumonia.

Inflammation primarily affecting the interstitium and alveolar walls.

Q74: Which viruses are checked for specifically in pneumonia workup?

Influenza, RSV among others via serology or targeted testing.

Q75: What is the typical CXR finding for viral pneumonia?

Diffuse interstitial infiltrates or perihilar markings.

Q76: What is the management concern with empyema in children?

Requires prompt antibiotics and often drainage; may need chest tube.

Q77: What is the risk of using fluoroquinolones in adolescents with pneumonia?

Potential adverse effects including cartilage damage; used cautiously in adolescents.

Q78: What is the role of bacteremia in pneumonia diagnosis?

Blood cultures can help identify bacteremia but may not differentiate viral from bacterial infection.

Q79: Why are chest radiographs sometimes insufficient to distinguish viral vs bacterial pneumonia?

Radiographic findings overlap; clinical context and lab tests guide differentiation.

Q80: In pediatric pneumonia, which age group is at highest risk for complications like empyema?

Infants and young children with bacterial pneumonia, especially S. aureus and GAS.

Q81: What is the recommended management for empyema once diagnosed?

Antibiotics plus drainage (thoracentesis or chest tube); sometimes surgery.

Q82: What is the importance of hydration in pneumonia management?

Maintains perfusion, supports fever management, and assists with mucous clearance.

Q83: What supportive measures accompany antibiotic therapy in pneumonia?

Oxygen as needed, fluids, antipyretics, and respiratory support if needed.

Q84: What are atypical pathogens in pediatric pneumonia?

Mycoplasma pneumoniae and Chlamydia pneumoniae.

Q85: How is hypoxemia defined in the pneumonia context?

Oxygen saturation below 92% is concerning and may require supplemental oxygen.

Q86: Which bacterial pneumonia presents with high fever and productive cough in older children?

Streptococcus pneumoniae typically presents with high fever and productive cough; lobar pneumonia pattern on imaging.

Q87: What is the medical term for patchy lung infiltration seen on X-ray?

Patchy peripheral consolidation often seen with viral or atypical pneumonia.

Q88: What is the significance of the 'tripod position' in pneumonia?

Indicates use of accessory muscles for breathing, suggesting severe respiratory distress.

Q89: Which antibiotic is often used for outpatient therapy of atypical pneumonia in children older than 5?

Macrolides such as azithromycin or erythromycin.

Q90: What is the typical duration of antibiotic therapy for pneumonia in children?

7-10 days, depending on clinical response and etiology.

Q91: How does vaccination reduce pneumonia risk in children?

Prevents pneumococcal and Hib infections, reducing risk of bacterial pneumonia.

Q92: What is a common cause of pneumonia in neonates requiring NICU admission?

Group B Streptococcus, E. coli, Listeria, and Gram-negative organisms.

Q93: What is a key distinguishing factor for hospitalization in pneumonia due to dehydration?

Hydration status and ability to take oral intake; dehydration supports admission.

Q94: What organism is tied to afebrile pneumonia in Chlamydia infections?

Chlamydia pneumoniae; afebrile presentation more common in some viral-bacterial co-infections.

Q95: What is the mainstay of treatment for pediatric pneumonia with a penicillin allergy?

Macrolide antibiotics (e.g., azithromycin) or alternative beta-lactams based on allergy severity.

Q96: What is the role of radiography in diagnosing pneumonia in kids?

Chest X-ray helps categorize pneumonia type (lobar vs bronchopneumonia vs interstitial) and detect complications.

Q97: What management step is critical when a hospitalized child fails to improve after 48-72 hours of antibiotics?

Reassess diagnosis, consider complications, imaging for effusions or empyema, and consider alternative antibiotics.

Q98: Which feature on CXR indicates a potential empyema?

Pleural effusion with loculations or pleural line thickening.

Q99: What is the clinical sign of necrotizing pneumonia?

Necrosis with cavitation and possible multiple abscesses; often caused by Staph aureus.

Q100: Which vaccine schedule helps prevent pneumonia-causing pathogens in kids?

PCV (pneumococcal), Hib-containing vaccines, and measles-mumps-rubella vaccine among others.