1. What is the schedule for Hep B?
    • Birth
    • 1-2 month
    • 6 months
  2. DTap or Tdap age >7?
    Tdap >7 years
  3. When does a patient recieve a Tdap?
    11-12 years old (tetanus & pertussis)

    Third trimester of pregnancy
  4. How often is Td booster given?
    Every 10 yrs
  5. PCV (pneumococcal vaccine) is given to who?
    Vulnerable Populations
  6. Polio vaccine is contraindicated in what allergies?
    Neomycin streptomycin polymixin B
  7. What are 2 examples of live/attenuated vaccines?
    • MMR (attenuated)
    • Varicella (live)
  8. Why is oral polio no longer given?
    It was a live vaccine, now the polio vaccine is not and can be given to anyone
  9. MMR & Varicella should not be given to who?
    <1 yo; immunocompromised; Pregnant pts
  10. A live/attenuated vaccine is supposed to produce what type of reaction in patients who develop immunity?
    Fever & non-puritic Rash
  11. Influenza vaccine is recommended annually in ages >____.
    >6 months
  12. Children receiving the flu vaccine for the first time need ____ doses separated by ____ weeks.
    Need 2 doses separated by 4 weeks
  13. What type of rash is concerning after a vaccine?
    Pruritic Rash
  14. What is the CDCs recommendation for length of time to monitor a child after receiving a vaccine?
    15 minutes
  15. A vaccine given ___ days prior to the scheduled time to receive it is considered a valid dose
    4 (anything given 5 days or more is considered invalid and must repeat)
  16. How far apart must live vaccines be given?
    4 weeks
  17. Any neonates with acute conjunctivitis within 30 days of birth should be tested for what?
    STDs (Chlamydia, Gonorrhea, herpes)
  18. Weight loss in a newborn infant greater than what % is abnormal? How soon should it be regained?
    >7% is abnormal - weight should be regained in 10-14 days
  19. A newborn has >6 Cafe au Lait Spots, what should be ruled out?
    Neurofibromatosis & Von Recklinghausen’s Disease
  20. What should be given to breastfeeding babies in their first few days of life because the breast milk doesn’t contain enough?
    Vitamin D drops (atleast 200 IU of Vit D)
  21. Cows Milk should be avoided until what age? Drinking it too soon is a major cause of what?
    Should be avoided until 12 months old - too soon can cause Iron Deficiency Anemia
  22. Head circumference is measured at every child visit until what age?
    3 years
  23. How much should head circumference increase in first year of life for a newborn?
  24. The urethral opening is located on the central aspect of the glans of the penis. What is this called & what should be done?
    Hypospadias (refer to urology)
  25. Fluid collection inside the scrotum
  26. Transillumination is used to assess what?
    • Hydrocele
    • Scrotal Mass
    • (sinusitis)
  27. What finding in newborns increases risk of testicular cancer?
    Cryptoorchidism (refer)
  28. Birth weight should _______ at 6 months & ______ at one year.
    Double then triple
  29. Caput succedaneum is diffused edema of the scalp that does or does not cross midline?
    Does cross midline a trauma due to prolonged vaginal labor
  30. Sweeping that does not cross midline or suture is called what? What needs to be ruled out?
    Cephalohematoma (traumatic subperiosteal hemorrhage)

    Rule out skull fracture
  31. When is a strong Moro (startle) reflex considered abnormal? What is it indicative of?
    6 months and older is indicative of brain damage
  32. What are white papules found on the gum line that resembles erupting tooth?
    Epstein’s Pearls
  33. Urethral opening on top of the penis gland/shaft?
    Episoadias (refer)
  34. Asymmetry of the thigh/gluteal folds should make you rule out what?
    Rule out congenital Hip dysphasia or hip fracture
  35. If mother is HBsAG positive what should you give the neonate?
    HBIG (Hep B immunoglobulin) & Hep B Vaccine
  36. DTap is given to what ages?
    < 7
  37. Name that test: Hold each knee and place your middle finger over the greater trochanter and rotate hips in frog leg position. A click/clunk indicates a positive test.
    Ortolani Maneuver
  38. Name that test: Place index & middle finger over the greater trochanter and push both knees midline. Positive finding will produce a clunk and suggests developmental dysphasia of the hip.
    Barlow Maneuver
  39. If the infant is making clicking noises while breastfeeding what does it mean and what should you do?
    Poor latch, more of the areola needs to go in mouth
  40. A pediatric patient has a hyperextended neck and is mouth breathing, what should you suspect?
    Epiglottitis (Haemophilus is main cause prior to Hib vaccine)
  41. Asymptomatic Abdominal mass that rarely crosses to midline in patients 2-3 years old is known as what?
    Wilm’s Tumor (Congenital Kidney Tumor)
  42. At what age should a child roll both directions, play peak-a-boo & pat-a-cake?
    9 months
  43. At what age should speech be understood by most family members?
  44. At what age should speech be understood by strangers?
  45. What age can a child ride a tricycle?
  46. What age should a child be able to copy a circle?
  47. What is the age & the name of the stage where the child expresses the desire to marry the opposite sex?
    Oedipal Stage, occurs between 3-6 years old
  48. What age should a child be able to ride a bicycle?
    6-7 years
  49. ADHD is accompanied by what 3 symptoms?
    • Hyperactivity
    • Impulsivity
    • Inattention
  50. ADHD DSM-5 Diagnostic Criteria
    • Symptoms present before age 12
    • Symptoms > 6 months
    • Symptoms evident in 2 different settings
  51. At what age can you prescribe meds for ADD?

    What schedule drugs do you prescribe?

    Schedule 2
  52. Initial daily Med management for persistent asthma in a 4 year old?
    Inhaled Steroid
  53. What is the one major difference in asthma management in pediatrics?
    Oral Leukotryine Agonist (singular) because 1/3rd of Peds have LTR driven asthma
  54. Inhaled steroids in children can affect their height, therefore what is the tolerance level of asthma attacks in one year before placing a child on steroids every day?
  55. Most common bacteria causing pneumonia?

    Streptococcus Pneumonia

    90mg/kg per day of Amoxicillin
  56. Most sensitive symptom of confirmed pneumonia?
    Increased RR
  57. Most common cause of bronchiolitis?
  58. When do you use albuterol/steroids in bronchiolitis?
    Only in severe bronchiolitis because it can be treated symptomatically with Tylenol & it is viral so ABX are not indicated
  59. What is the most common symptom in patients with cystic fibrosis?

    (Often diagnosed at birth through screening)
  60. Most common form of cancer in Peds?
    Leukemia (ALL)
  61. Most evident sign on a CBC that signifies Leukemia?
    Thrombocytopenia accompanied by a Low platelet count - <100,000

    (Bleeding!!! -bruising, gums bleeding)
  62. Any node > ____ mm is considered enlarged (except Epitrochlesr node)
  63. Red Flag Headache symptoms in child?
    • -Night time awakening from head ache
    • -Thunderclap HA
    • -N/V
    • -Age <3
    • -absent family history
  64. What is a classic finding in a patient with pyloric Stenosis?
    4-6 week old baby with an OLIVE SHAPED mass

    Work Up - Ultrasound

    More common in first born male
  65. GERD management in Peds?
    • -avoid Smoke
    • -Breastfeed
    • -small frequent thickened feeds

    Do not start H2 Blockers/PPI if possible
  66. Intermittent colicky abdominal pain, that’s accompanied by blood mucous current jelly stools is caused by?
  67. Preferred means of rehydration in someone with viral gastroenteritis?
    Commercially Prepared Electrolyte Solution
  68. When should the male testicles be descended that warrants referral if they haven’t?
    6 months
  69. At what age is hydrocele expected to resolve?
    By 12 months
  70. What is often associated with hydrocele?
    Inguinal Hernia
  71. Bilateral conjunctivitis without exudate, and the patient presents with raised red papillae on tongue (strawberry tongue). Swollen hands/feet. What is this presentation found in?
    Kawasaki Disease

    (Follow-up with Ped Cardiologist)
  72. A pull or twist of the arm may cause what?
    Nursemaid’s Elbow (annular ligament slips over radial head)
  73. What does Oshood Schlatter Disease usually correspond with?
    Growth spurt (9-14 yo) because the soft and hard tissue haven’t grown at equal rates
  74. Pain over the tibial tubercle/knee in adolescents is associated with what?
    Osgood Schlatter Disease
  75. Positive Trendelengberg’s sign? Indicative of what?
    Ask child to stand on affected side causes pelvic tilt (unaffected side lower) -A DIP IN THE HIP!

    Leg Calve-Perthes Disease & Slipped Capital Fenoral Epiphysis
  76. Osteonecrosis of the capital femoral epiphysis, more common in boys, walk with a limp.
    Legg-Calve-Perthes Disease
  77. Patient has history of febrile illness and aspirin/salicylate inake is at risk for what?
  78. Child sensitive to noises, touch, smells, and/or textures. Poor eye contact. Does not interact with others. Slow to poor language development. Repeated body movements such as flapping arms. May show normal development but regress by age 1-2. What is this disease known as?
  79. Acute onset of fever, sore throat, headache, and anorexia. Multiples blisters on hands/feed/diaper area. Ulcers inside mouth and throat. What disease is this known as?
    Hand Foot Mouth

    • Self-limited Disease recovery will occur 5-7 days
    • Ibuprofen/Tylenol
    • Salt Water gargle & drink cold fluids
  80. Koplik’s spots are small white papules insides the cheeks by the rear molars. What are common in?
  81. Smooth wax-like round (dome shaped) papules 5 mm in size. Central umbilication with white plug. Name that rash?
    Molluscum Contagiosum
  82. Name that rash: generalized rash in different stages where new lesions appear daily in form of papules, vesicles, pustules, & crusts. Purification & highly contagious.
  83. Name that rash: Located in the interdigital webs of hands, waist, axilla, penis. Very puritic, especially at night.
  84. Name that rash: Homey colored crusted lesions. Fragile bullae. Pruritic.
  85. Patient is mentally retarded with large head circumference. Patient has a long face with prominent forehead, jaw, & large ears. Large body with flat feet. What is the name of the disease?
    Fragile X Syndrome
  86. What causes Molluscum Contagiousum?
  87. At what age do children develop early abstract thinking (Piaget)?
  88. What age can the first HPV (Gardasil) vaccine be given?
  89. All college freshman living in dorms are at high risk for what? What is indicated?
    High Risk of meningocccal infection - MCV4 is recommended by CDC
  90. Live attenuated influenza virus nasal only is indicated for what age groups?
    Healthy people aged 2-49 years of age
  91. Vaccine Adverse Event Reporting System is responsible for what?
    Governmental program to report clinically adverse events
  92. What laboratory test may be elevated in teens going through growth spurts?
    Alkaline Phosphate
  93. No parental/guardian consent is necessary for what?
    • Contraception
    • Treatment of STDs
    • Diagnosis/Management of Pregnancy
  94. Name that Tanner Stage: Breast Bud Development
  95. Name that Tanner Stage: Breast/Aerola are in one Mound
  96. Name that Tanner Stage: Aerola/Breast separate to form secondary mound
  97. Name that Tanner Stage: testes enlarge - Increased scrotum Rugae
  98. Name that Tanner Stage: Penis Lengthens
  99. Name that Tanner Stage: Penis Widens
  100. Name that Tanner Stage: Adult like
  101. What are 2 examples of an emancipated minor?
    -Legally Married or Active Duty Military

    (Give full consent as an adult w/o parental involvement)
  102. What type of birth control should be avoided in anorexic patients?
    Depo-Provera & other progesterone only contraceptives since they can cause bone loss
  103. Adam’s Forward Bend Test helps diagnose what?
    Scoliosis - refer to pediatric orthopedic specialist
  104. What degree curve in scoliosis diagnoses does not need to be referred and can be observed?
    10 degree curve and less
  105. Primary/Secondary Amenorrhea: absence of menarche by age 15
  106. Primary/Secondary Amenorrhea: Absence of menses for 3 cycles last 6 months and previously had menses. Can be caused from pregnancy, stress, exercise, or PCOS.
  107. More common in obese males where bilateral breast are enlarged due to fatty tissue. Soft to touch & non tender. What is this caused by?
  108. Occurs in pubertal males who having the onset of enlarged breast/assymetrical breast tissue. Breast are tender to palpitation. What is this caused by?
  109. True/False: Any treatment not related to sexual activity requires parental consent.
  110. A child has an enterobiasis infection, what is this and what should you do?
    Pinworms - scotch tape test
  111. Orchitis (swelling of testicles) is caused by what virus?
    Mumps Virus
  112. Precocious puberty is defined as puberty before the start of what age in boys/girls?
    • Girls 8
    • Boys 9
  113. A lacy, slapped cheeked appearing rash that appears in 3 stages is caused by what condition?
    Erythema Infectiosum (Fifth Disease)
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