Iraqi Board Pediatrics flashcards

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

Apgar score timing

Assigned at 1 and 5 minutes after birth; it never guides resuscitation decisions, which are made before delivery based on the clinical situation.

Physiologic jaundice timing

Jaundice that appears after 24 hours of life; jaundice within the first 24 hours is always pathologic and requires urgent bilirubin and Coombs testing.

Necrotizing enterocolitis hallmark

Feeding intolerance, abdominal distension, and bloody stools in a preterm infant; abdominal x-ray shows pneumatosis intestinalis. Treatment is bowel rest, decompression, and antibiotics.

Kawasaki disease criteria

Fever for at least 5 days plus 4 of 5 features: conjunctivitis, mucosal changes, rash, extremity changes, and cervical lymphadenopathy. Treat with IVIG and aspirin.

Febrile infant under 28 days

Any fever in an infant younger than 28 days warrants a full sepsis evaluation, admission, and empiric intravenous antibiotics regardless of appearance.

Primary immunodeficiency red flags

Two or more pneumonias, four or more ear infections per year, failure to thrive, family history, or need for intravenous antibiotics suggest immunodeficiency.

Tetralogy of Fallot spell

Hypercyanotic episode treated with knee-chest position, oxygen, morphine, intravenous fluids, and phenylephrine; avoid isoproterenol, which worsens obstruction.

Ductal-dependent lesions

Transposition of the great arteries, critical coarctation, and interrupted aortic arch depend on the ductus arteriosus; maintain patency with prostaglandin E1 infusion.

Innocent murmur features

Systolic, grade 2/6 or less, no thrill, normal S2, varies with position, no radiation, and an asymptomatic child.

Croup treatment

A single dose of dexamethasone 0.15-0.6 mg/kg; add nebulized epinephrine for moderate to severe stridor. Symptoms are barking cough and inspiratory stridor.

Bronchiolitis management

Supportive care with oxygen and hydration; respiratory syncytial virus is the most common cause; bronchodilators and corticosteroids are not routinely recommended.

Anaphylaxis epinephrine dose

Intramuscular epinephrine 0.01 mg/kg of 1:1000 concentration, maximum 0.5 mg, into the anterolateral thigh; repeat every 5-15 minutes as needed.

Pyloric stenosis findings

Nonbilious projectile vomiting at 3-6 weeks, visible peristalsis, olive-shaped mass, and hypochloremic hypokalemic metabolic alkalosis; treat with pyloromyotomy.

Bilious vomiting in neonate

A surgical emergency until malrotation with volvulus is excluded by an upper GI contrast study; do not delay surgical consultation.

Celiac disease diagnosis

Anti-tissue transglutaminase IgA with total IgA level; confirm with duodenal biopsy showing villous atrophy and crypt hyperplasia.

Simple febrile seizure

Generalized seizure lasting less than 15 minutes, occurring once in 24 hours, in a child 6 months to 5 years; no routine EEG or neuroimaging is indicated.

Status epilepticus first-line

A benzodiazepine such as lorazepam 0.1 mg/kg intravenously or midazolam 0.2 mg/kg intramuscularly; second-line is fosphenytoin or levetiracetam.

Duchenne muscular dystrophy signs

X-linked disorder with Gowers sign, calf pseudohypertrophy, and elevated creatine kinase; confirm with genetic testing; corticosteroids slow progression.

Diabetic ketoacidosis management

Isotonic fluid resuscitation, insulin infusion 0.05-0.1 units/kg/hour, and monitoring for cerebral edema; avoid rapid osmotic shifts in children.

Congenital hypothyroidism treatment

Levothyroxine 10-15 mcg/kg/day started within 2 weeks of life to prevent intellectual disability; newborn screening uses TSH.

Congenital adrenal hyperplasia

21-hydroxylase deficiency causes salt wasting, ambiguous genitalia in girls, and hyperkalemia with hyponatremia; treat with hydrocortisone and fludrocortisone.

Nephrotic syndrome treatment

Prednisone 60 mg/m²/day for 4-6 weeks then alternate-day therapy; findings are heavy proteinuria, hypoalbuminemia, edema, and hyperlipidemia.

Hemolytic uremic syndrome triad

Microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury, often after bloody diarrhea; management is supportive with dialysis as needed.

Hypospadias management

Do not circumcise; refer for surgical repair at 6-18 months of age because the foreskin may be needed for reconstruction.

Iron deficiency anemia treatment

Elemental iron 3-6 mg/kg/day for 3 months after hemoglobin normalizes; findings are microcytic hypochromic anemia with low ferritin and high TIBC.

Sickle cell prophylaxis

Penicillin prophylaxis from 2 months to 5 years, hydroxyurea for frequent crises, and pneumococcal vaccination.

Tumor lysis syndrome

Hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia; prevent with hydration and allopurinol or rasburicase.

Acetaminophen toxicity antidote

N-acetylcysteine, most effective within 8 hours of ingestion; use the Rumack-Matthew nomogram at 4 hours post-ingestion to guide therapy.

Organophosphate poisoning

SLUDGE syndrome with salivation, lacrimation, urination, diarrhea, GI upset, and emesis; treat with atropine and pralidoxime.

Systemic JIA features

Quotidian fever, evanescent rash, arthritis, hepatosplenomegaly, and serositis; risk of macrophage activation syndrome.

IgA vasculitis features

Palpable purpura on the lower extremities, arthritis, abdominal pain, and nephritis; management is supportive with urine monitoring.

Autism screening

Use the M-CHAT at 18 and 24 months; refer for behavioral therapy and audiology; no single diagnostic test exists.