Pediatric

Respiratory Disorders in Children

• Respiratory syncytial virus (RSV) is the most common cause of Bronchiolitis.
• Bronchiolitis typically affects children under 1 year old.
• Mycobacterium tuberculosis has not disappeared, despite regular vaccination, and there are sporadic cases.
• Upper respiratory tract infections typically present with a painful throat, cough, fever, and nasal blockage.
• Upper respiratory tract infections are significant in babies under 1 year old due to feeding difficulties caused by nasal blockage.
• Perennial Rhinitis, occurring year-round, is commonly caused by dust and pet dander.
• Barking cough is a typical symptom of Laryngitis.
• Initial advice for a child experiencing Laryngitis is exposure to mist or cold outdoor air.
• In a hospital setting, the first treatment for Laryngitis is nebulized epinephrine.
• Group B-hemolytic streptococcus is the most common cause of pneumonia in newborns via vaginal birth.

Parapneumonic Effusion and Asthma

• Giardia lambia does not cause Para pneumonic effusion
• In the early stages of Para pneumonic effusion, the pleural effusion is usually sterile with a low leukocyte count.
• Host resistance, bacterial virulence, and timely medical intervention determine the risk of developing a true empyema.
• Vaccination against Pneumococcus and Hemophilus influenzae has reduced parapneumonic effusion cases.
• Clinical presentations of Para pneumonic effusion include chest pain, dyspnea, tachycardia, and persistent fever.
• Hypoalbuminemia is a typical laboratory finding in Para pneumonic effusion.
• Typical clinical elements of asthma are cough and wheezing.
• Low BMI is not considered a risk factor for asthma.
• Common triggers for asthma include animal epithelia, tobacco smoke, perfumes, and seasonal pollen; but not food.
• A wet cough is not typical for asthma.
• Spirometry is the medical test that confirms asthma.

Cardio

• The umbilical cord typically has 2 arteries and 1 vein.
• Foramen ovale and ductus arteriosus are normal in a fetal heart but not in a child's heart.
• Patent ductus arteriosus (PDA) is NOT a cyanotic heart defect.
• Coarctation of the aorta, Atrial Septal Defect (ASD), and Ventricular Septal Defect (VSD) do not usually cause cyanosis.
• Atrial septal defect (ASD) involves an abnormal opening in the atrial septum.
• 20% of atrial septal defects close spontaneously in the first year of life, and most infants/children are asymptomatic initially.
• It is false that if spontaneous closure of an Atrial Septal Defect does not occur it is OK until school age where medical therapy continues.
• During auscultation of a heart with a ventricular septum defect (VSD), a pansistolic murmur is heard which is louder if the defect is a small defect
• Patent ductus arteriosus (PDA) is most commonly found in premature infants.
• Non-cyanotic heart defects typically present with shortness of breath and poor weight gain.
• Tetralogy of Fallot includes four heart defects.
• Laryngitis is not be caused by Streptococcus group A

Seizure/Epilepsy

• Epilepsy defined as predisposition to recurrent epileptic seizures.
• Focal seizures originate within networks limited to one hemisphere and may or may not impair awareness.
• Motor manifestations of generalized seizures are not unilateral.
• Malnutrition is not a probable etiology for seizures
• A total blood count is not helpful to diagnose epilepsy
• Walking is not a trigger for seizure
• Treatment for epilepsy is usually started after the second unprovoked seizure.
• Medical withdrawal from epilepsy treatment should be considered after 18-24 months without a seizure.

Meningitis

• Meningitis is best defined as inflammation of the meninges, manifested by cerebrospinal fluid (CSF) pleocytosis.
• Conjunctivitis is not a major factor for developing meningitis.
• H. influenzae is not a typical pathogen that causes meningitis in infants under 3 months.
• Typical presentations of Meningitis: fever ,Nuchal rigidity, and Brudzinski sign, but not Purpura
• Grey-marble skin is an alarming sign suggesting meningococcemia.
• Brudzinski sign is a typical sign of meningitis.
• High fever is not part of "Cushing triad" which includes Systemic hypertension, Bradycardia and Respiratory depression.
• Neisseria meningitides is a Gram-negative diplococcal with vaccines available against serogroups A, C, W, Y, and B.
• Treatment against meningococcemia should include antibiotics as soon as meningococcemia is suspected and finding of two veins cannulas, starts vasal filling with liquids
• Prophylaxis for meningococcemia involves one dose of Ceftriaxone for children or ciprofloxacin for adults for persons with close contact with the patient.
• Psychiatric symptoms are a typical sign of encephalitis.

Anemia

• Anemia in a 4-year-old is defined as a hemoglobin value under 11 g/dl.
• Nutritional iron deficiency is not a typical cause of anemia in the neonatal period.
• Chronic infection anemia is not an inherited causes of anemias
• Evaluation for anemia: RBC, Hemoglobin, hematocrit, MCV, MCH.
• Ferritin is an iron storage protein of the body.
• Perinatal factors in developing anemia in neonates include fetal-maternal hemorrhage, twin-twin transfusion syndrome, and prematurity.
• Introduction of unmodified cow's milk before 12 months of age is a typical diet factor causing iron deficiency anemia.
• Dark urine is not a symptom of iron deficiency anemia.
• Milk or dairy products should be avoided for approximately one hour before and two hours after taking iron supplements.
• Pica is not a sign of hemolytic which include Jaundice, Dark urine or Splenomegaly

Hemorrhagic Disease/Thrombocytopenia

• After endothelial injury which includes after a platelet plug formation: Adhesion, Aggregation, Secretion and Procoagulant activity
• Thrombocytopenia is defined as a platelet count under 150,000/microL.
• Gingival bleeding, epistaxis, and petechiae are typically presented with Trombocitopenia
• Joint hemorrhage and swelling are typically presented with Hemophylia
• Deficiency of Factor VIII causes hemophilia A.
• Desmopressin is used as a therapy to treat mild hemophilia A.