Arab Board Pediatrics Final Written flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

APGAR score components

Appearance (color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration. Each scored 0–2, total 0–10, assessed at 1 and 5 minutes after birth.

Neonatal resuscitation compression ratio

For newborns requiring CPR, use a 3:1 compression-to-ventilation ratio (90 compressions and 30 breaths per minute) with 100% oxygen when the heart rate is below 60 after effective ventilation.

Kernicterus

Bilirubin-induced neurologic damage from severe neonatal hyperbilirubinemia, causing lethargy, hypotonia, seizures, and long-term choreoathetosis, hearing loss, and gaze palsy.

Innocent murmur features

Soft systolic murmur grade ≤2/6, no thrill, normal S2, best heard at left sternal border, decreases with standing or Valsalva; no symptoms or abnormal cardiac findings.

Tetralogy of Fallot spell

Hypercyanotic episode from increased right-to-left shunt; treat with knee-chest position, calm, oxygen, IV fluids, morphine, and propranolol; avoid isoproterenol.

Kawasaki disease criteria

Fever ≥5 days plus ≥4 of: rash, conjunctivitis, oral changes, extremity changes, cervical lymphadenopathy. Treat with IVIG 2 g/kg and aspirin to prevent coronary aneurysms.

Asthma severity classification

Mild intermittent: symptoms ≤2 days/week. Mild persistent: >2 days/week but not daily. Moderate persistent: daily. Severe persistent: throughout day, limiting activity and sleep.

Cystic fibrosis diagnosis

Sweat chloride ≥60 mmol/L on two occasions, or two CF-causing mutations, or abnormal nasal potential difference, plus compatible clinical features such as chronic lung disease or malabsorption.

Croup treatment

Dexamethasone 0.15–0.6 mg/kg orally or intramuscularly as a single dose; add nebulized epinephrine for moderate-to-severe stridor at rest or retractions.

Celiac disease serology

IgA tissue transglutaminase antibody ≥10 times upper limit of normal plus positive endomysial antibody; confirm with duodenal biopsy showing villous atrophy and crypt hyperplasia.

Biliary atresia

Progressive obliteration of extrahepatic bile ducts causing neonatal cholestasis; jaundice beyond 2 weeks with direct hyperbilirubinemia; Kasai portoenterostomy before 60 days improves outcome.

Pyloric stenosis

Hypertrophy of pyloric muscle in infants 3–6 weeks old causing projectile nonbilious vomiting, olive mass, and hypochloremic hypokalemic metabolic alkalosis; treat with pyloromyotomy.

Congenital hypothyroidism

Thyroid hormone deficiency detected by newborn screening with elevated TSH; treat with levothyroxine 10–15 µg/kg/day started within 2 weeks to prevent irreversible intellectual disability.

Diabetic ketoacidosis

Hyperglycemia, ketonemia, and metabolic acidosis (pH <7.3, bicarbonate <15) in type 1 diabetes; treat with isotonic fluids, insulin infusion, potassium replacement, and monitor for cerebral edema.

Nephrotic syndrome

Edema, proteinuria >3+ or >40 mg/m²/h, and hypoalbuminemia <2.5 g/dL; first-line treatment is prednisone 60 mg/m²/day for 6 weeks then alternate-day therapy.

Post-streptococcal glomerulonephritis

Cola-colored urine, hypertension, and edema 1–2 weeks after streptococcal pharyngitis; low C3, elevated ASO; supportive care, resolves spontaneously in most children.

Posterior urethral valves

Congenital obstruction in male infants causing poor urinary stream, palpable bladder, and bilateral hydronephrosis; diagnosed by voiding cystourethrogram; treat with catheterization and valve ablation.

Febrile seizure

Seizure in children 6 months–5 years with fever, no CNS infection; simple if generalized, <15 minutes, once in 24 hours; no routine EEG or neuroimaging needed.

Status epilepticus management

Seizure >5 minutes or repeated without recovery; give lorazepam 0.1 mg/kg IV, then fosphenytoin 20 mg/kg IV; if refractory, use levetiracetam or phenobarbital.

Infantile spasms

Flexor or extensor spasms in infants with hypsarrhythmia on EEG; treat with ACTH or vigabatrin; early treatment improves neurodevelopmental outcome.

Fever without source

Fever ≥38°C without identifiable cause in infant <3 months; requires full sepsis evaluation including blood, urine, and CSF cultures and empiric antibiotics.

Primary immunodeficiency red flags

≥2 pneumonias per year, recurrent deep abscesses, failure to thrive, family history of immunodeficiency, or need for intravenous antibiotics; prompt immunology referral.

Iron deficiency anemia

Microcytic anemia with low ferritin, low MCV, and high RDW; treat with elemental iron 3–6 mg/kg/day; reticulocytosis occurs within 1–2 weeks.

Sickle cell disease management

Hydroxyurea for frequent crises, penicillin prophylaxis until age 5, pneumococcal vaccination, and transcranial Doppler screening to prevent stroke.

Tumor lysis syndrome

Metabolic emergency with hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia after rapid tumor cell breakdown; prevent with hydration and allopurinol or rasburicase.

Anaphylaxis treatment

Epinephrine 0.01 mg/kg intramuscularly (max 0.5 mg) into the anterolateral thigh; repeat every 5–15 minutes; adjuncts include H1/H2 antihistamines and corticosteroids.

Acetaminophen overdose

N-acetylcysteine is the antidote; dose based on Rumack-Matthew nomogram; start within 8 hours of ingestion to prevent hepatotoxicity.

PALS compression ratio

For children with 2 rescuers, use 15 compressions to 2 breaths at 100–120 compressions/min; for 1 rescuer, 30:2; epinephrine 0.01 mg/kg every 3–5 minutes.

Autism spectrum disorder screening

Screen with M-CHAT at 18 and 24 months; refer for behavioral therapy if positive; core features are social communication deficits and restricted repetitive behaviors.

ADHD first-line treatment

For children under 6 years, behavioral therapy first; for 6 years and older, stimulant medication (methylphenidate) plus behavioral therapy.

Adolescent depression treatment

Screen with PHQ-A; first-line is cognitive behavioral therapy or SSRI (fluoxetine or escitalopram); monitor closely for suicidality.

Growth chart red flag

Crossing two major percentiles upward or downward on a growth chart warrants evaluation for endocrine, nutritional, or chronic disease causes.