5: Pediatrics 2 Flashcards
The ______ is the most important part of the evaluation - even in children!
history
Describe Roseola
- High fever for a few days-> rapid defervescence (fever stops)-> then gets salmon colored rash after fever breaks. Child is no longer contagious when rash appears.
- Caused by HHV-6 (Human herpesvirus 6)
- No treatment needed
Describe Pyloric stenosis
- Projectile vomiting in an infant 2-8 weeks of age
- Hungry baby
• Electrolyte abnormalities (hypochloremic
metabolic acidosis from HCl loss)
- Ultrasound is diagnostic
- Treated with surgery
Describe Meningococcemia
- Starts with nonspecific prodrome, followed by worsening symptoms and rash (palpable purpura)
- Caused by Neisseria meningitidis which gives sepsis
- Shoot with antibiotics like penicillin first, ask questions later
Describe Group A Streptococcal Infections
Note inflammation of the oropharynx with petechiae on the soft palate, small red spots caused by group A streptococcal pharyngitis (red pharynx).
Group A streptococcal nasopharyngitis in a toddler is associated with tender anterior cervical lymphadenopathy.
Group A streptococcal scarlet fever with characteristic scarlet fever sandpaper-like rash with desquamation.
Group A streptococcal infections give scarlet (red) fever which can give rhinorrhea, and strawberry tongue (of scarlet fever).
Protracted nasopharyngitis is the most common presentation of group A streptococcal infection in toddlers.
Describe radial head subluxation (nursemaid’s elbow)
Called nursemaid’s elbow
Subluxation of the radial head typically results from a quick pull on a child’s arm. Often this occurs when a child is holding hands with a caregiver who lifts the child by the arm or tries to prevent a fall.
Subluxation occurs after longitudinal traction is placed on a pronated extended arm. In maturity, the annular ligament encircles and supplies stability to the radial head. In children, this ligament is not completely fused and is therefore generally weak. When longitudinal axial traction is placed on an extended pronated arm, the radial head may therefore slip or tear through the weak annular ligament into the radiocapitellar articulation. This results in entrapment of the annular ligament and a subluxation (or partial dislocation) of the radial head.
Describe teething
The process of teething involves baby teeth breaking through a child’s gums. This can cause red cheeks, fever, swelling, drooling, irritability, sleeplessness and a decrease in appetite.
The red cheecks or frozen teething rings can freeze the fat in the cheecks & can last a while.
Treat by not giving popsicle or freezing & give tylenol.
Describe a blinking tic
blinking eyes for no particular reason
very common & mistaken for seizures
most kids outgrow them by 18 years of age
tics can be cough, movement, etc.
If pediatric patient has symmetrical rashes or cuts on the tops of his feet & his parents do not know how it got there and that it just appeared suddenly. What could this be ____.
Cigarette burns from abuse
The lack of information of giving specific history, gives you an indication that there is abuse.
Pediatric Puzzler: describe Intasiseption.
He has intasiseption. An intussusception is an emergency medical condition in which a part of the intestine has invaginated into another section of intestine, similar to the way in which the parts of a collapsible telescope slide into one another. This can often result in an obstruction. Ileocecal = most common & age range of 3 - 12 months is most common. Diagnosis made by radiology. Due to hypertrophy of peyer’s patches.
17 mo old with intermittent stiffening episodes
Went to several medical professionals & no idea from anyone
Patient is in pain when he stiffens up
Elevated lactate level = intestinal mucosas
Triad = intermittent colicky abdominal pain/ stiffening, vomiting, bloody-jelly stool.
Radiographic sign = target or donut sign
Vomiting
Jelly stool & blood in stool
