Iran Specialty Board - Pediatrics flashcards

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

Apgar score

A 0–2 score for heart rate, respiratory effort, muscle tone, reflex irritability, and color at 1 and 5 minutes; it guides resuscitation but does not diagnose asphyxia.

Surfactant therapy

Endotracheal administration of natural surfactant (poractant alfa or beractant) for respiratory distress syndrome; early rescue within 2 hours reduces pneumothorax and mortality.

Physiologic jaundice

Unconjugated hyperbilirubinemia appearing after the first 24 hours of life from immature hepatic conjugation; jaundice within the first 24 hours is always pathologic.

Mid-parental height

Boys: (father + mother + 13 cm)/2; girls: (father + mother − 13 cm)/2. The target range is ±8.5 cm around this value.

Autism screening

M-CHAT-R/F is administered at 18 and 24 months. Diagnosis requires deficits in social communication plus restricted or repetitive behaviors across multiple settings.

Failure to thrive

Weight below the 3rd percentile or crossing two major percentile lines; evaluation addresses caloric intake, malabsorption, and endocrine or renal causes.

Phenylketonuria

Phenylalanine hydroxylase deficiency detected by newborn screening; a low-phenylalanine diet and sapropterin for responsive patients prevent intellectual disability.

Galactosemia

Classic form presents with jaundice, hepatomegaly, cataracts, and E. coli sepsis in the neonate; treatment is strict avoidance of galactose and lactose.

MCAD deficiency

Medium-chain acyl-CoA dehydrogenase deficiency causing hypoketotic hypoglycemia triggered by fasting or illness; avoid prolonged fasting and give IV dextrose during illness.

Hepatitis B birth dose

All infants receive the vaccine within 24 hours of birth; infants of HBsAg-positive mothers also receive HBIG within 12 hours.

Kawasaki disease

Fever for at least 5 days plus 4 of conjunctivitis, oral changes, rash, extremity changes, and cervical lymphadenopathy; treat with IVIG 2 g/kg and aspirin.

Anaphylaxis treatment

Epinephrine 0.01 mg/kg IM (max 0.5 mg) into the anterolateral thigh, repeated every 5–15 minutes; adjuncts include fluids, oxygen, and antihistamines.

Cow milk protein allergy

Extensively hydrolyzed formula is first line; amino acid formula for severe or refractory cases; soy formula is not recommended before 6 months of age.

SCID

Severe combined immunodeficiency presents with failure to thrive, chronic diarrhea, and opportunistic infections; live vaccines are contraindicated and HSCT is curative.

Prostaglandin E1

Maintains ductal patency in ductal-dependent congenital heart lesions such as transposition, pulmonary atresia, and critical coarctation until surgical or catheter intervention.

Infective endocarditis prophylaxis

Amoxicillin 50 mg/kg (max 2 g) 30–60 minutes before dental procedures, only for high-risk lesions such as prosthetic valves or prior endocarditis.

Cystic fibrosis diagnosis

Autosomal recessive CFTR mutation; newborn screening uses immunoreactive trypsinogen; a sweat chloride of 60 mmol/L or greater is diagnostic.

Croup treatment

Dexamethasone 0.15–0.6 mg/kg as a single dose; nebulized epinephrine is added for moderate-to-severe inspiratory stridor and retractions.

Celiac disease

Tissue transglutaminase IgA plus total IgA; duodenal biopsy showing villous atrophy confirms; lifelong gluten-free diet is the treatment.

Pyloric stenosis

Nonbilious projectile vomiting at 3–6 weeks; ultrasound shows pyloric thickness over 3 mm and length over 15 mm; correct hypochloremic alkalosis before surgery.

Nephrotic syndrome

Edema, proteinuria with urine protein/creatinine ratio above 2, hypoalbuminemia, and hyperlipidemia; minimal change disease is the most common childhood cause.

Hemolytic uremic syndrome

Microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury, usually after Shiga toxin-producing E. coli; avoid antibiotics and antimotility agents.

Diabetic ketoacidosis

pH below 7.3, bicarbonate below 15 mEq/L, and ketonemia; fluid resuscitation over 48 hours and insulin infusion 0.05–0.1 U/kg/h; watch for cerebral edema.

Congenital hypothyroidism

Elevated TSH on newborn screening; levothyroxine 10–15 mcg/kg/day started within 2 weeks prevents intellectual disability and supports normal growth.

Congenital adrenal hyperplasia

21-hydroxylase deficiency causes virilization in girls and salt wasting; elevated 17-hydroxyprogesterone; treat with hydrocortisone and fludrocortisone.

Sickle cell disease

Hydroxyurea reduces vaso-occlusive crises; penicillin prophylaxis until age 5; acute chest syndrome is treated with oxygen, antibiotics, and transfusion.

Immune thrombocytopenia

Isolated thrombocytopenia with petechiae and bruising; IVIG or corticosteroids for significant bleeding; avoid platelet transfusion unless bleeding is life-threatening.

Status epilepticus

A seizure lasting more than 5 minutes; first-line treatment is a benzodiazepine, then fosphenytoin 20 mg/kg IV or levetiracetam 60 mg/kg IV.

Duchenne muscular dystrophy

X-linked dystrophin deficiency with Gowers sign, calf pseudohypertrophy, and elevated CK; treat with corticosteroids and exon-skipping agents.

PALS epinephrine dose

Epinephrine 0.01 mg/kg IV/IO (0.1 mL/kg of 1:10,000) every 3–5 minutes; defibrillate at 2 J/kg, then 4 J/kg for shockable rhythms.

Activated charcoal

Given at 1 g/kg within 1 hour of ingestion when the airway is protected; it binds many toxins but is ineffective for iron, lithium, and alcohols.

DKA cerebral edema

Suspect with headache, bradycardia, hypertension, and altered mental status during treatment; give hypertonic saline or mannitol and slow the fluid rate.