Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MOD 1 Exam 2 and 3 > Ch 10: Diseases of Childhood/infancy > Flashcards

Ch 10: Diseases of Childhood/infancy Flashcards

1
Q

What happens with exposure to cyclopamine?

A

Inhibits Hedgehog signaling

Leads to:
Holoproencephaly
Cyclopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What happens with exposure to Valproic acid?

A

Reduced expression of HOX proteins, which are important for patterning of limbs, vertebrae, and craniofacial structures

Leads to:
Limb mutations (similar to thalidomide)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What happens with exposure to Vitamin A deficiency?

A

All-trans retinoic acid is key for normal development

Leads to:
Eyes, GU, CV, diaphragm, lung probs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What happens with exposure to Vitamin A toxicity?

A

Too much inhibits TGF-B, important for palatogenesis

Leads to:
CNS and cardiac defects
Craniofacial defects = cleft lip/palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How would you classify preterm?

A

Anytime before 37 weeks of gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the risk factors associated with preterm premature rupture of membranes?

A

Prior history of PPROM
Vaginal bleeding
Maternal smoking
Low SE status and poor maternal nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the MOD behind PPROM?

A

Infectious agents activated TLR –> deregulate prostaglandin expression –> uterine smooth muscle contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some common infections seen with PPROM?

A 
Ureaplasma urealyticum
mycoplasma hominis
Gardnerella vaginalis 
Trichomonas 
Gonorrhea
Chlamydia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can result with PPROM?

A

Gives rise to RDS, necrotizing enterocolitis, sepsis, intraventricular and germinal matrix hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What gives rise to fetal infections and what sx do you see?

A 
TRCH: 
Toxoplasmosis 
Rubella 
Cytomegalovirus 
Herpes virus

SX:
fever, encephalitis, chorioretinitis, hepatosplenomegaly, pneumonitis, myocarditis, hemolytic anemia, vesicular or hemorrhagic skin lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is neonatal RDS? What is the mechanism behind it?

A

It is a hyaline membrane disease
Commonly associated with preterm males, maternal diabetes, and C-section delivery

There is a lack of surfactant (SP-B and SP-C) production from type 2 pneumocytes, which is accelerated at week 35 of gestation

Lungs will collapse with each successive breath. compounded by soft thoracic wall that get pulled in as diaphragm recedes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What would you see in imaging with RDS?

A

CXR shows ground-glass infiltrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What would you see on physical examination of lungs with RDS?

A

Collapsed alveoli

Necrotic cellular debris on autopsy that is incorporated with eosinophilic hyaline membranes lining bronchioles and alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some immediate complications with RDS? What is the mechanism behind them?

A

Retrolental fibroplasia = retinopathy of maturity, VEGF level low then increase, which causes retinal vessel proliferation –> lesions

Bronchopulmonary dysplasia = inflammatory cytokines IL-1, TNF, IL-6, IL-8 may play a role

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some long term complications with RDS?

A

Patent ductus arterioles
Intraventricular hemorrhage
Necrotizing enterocolitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In who do you see necrotizing enterocolitis most commonly?

A

Pre mature infants (1 in 10 for very low birth weight)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is necrotizing enterocolitis triggered?

A

It is multifactorial
Likely triggered by eating
No single bacterial pathogen has been linked

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the mechanism behind necrotizing enterocolitis?

A

PAF (platelet activating factor) –> increases mucosal permeability by promoting enterocyte apoptosis and reducing intercellular tight junctions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What problems does necrotizing enterocolitis lead to in the GI tract?

A

Target terminal ileum, cecum, and right colon

Leads to distention

Mucosal or transmural coagulative necrosis, ulceration, bacterial colonization and submucosal gas bubbles

Often leas to strictures from fibrosis involved in healing process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is necrotizing enterocolitis managed?

A

Most managed conservatively, some need bowel resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What happens with exposure to Parovirus B19?

A

Common cause of transplacental infections
Commonly targets erythroid cells

Leads to: 
erythema infectious (face-slap rash)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What happens with exposure to Group B streptococcus?

A

Most common cause of early-onset perinatal sepsis and meningitis (within first 7 days of life)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What happens with exposure to Listeria and candida?

A

Most common cause of late-onset sepsis (7 days to 3 month)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is immune hydros caused by?

A

Caused by blood cell antigen incompatibility b/w mother and fetus

B/w Rh- and Rh+ father –> first pregnancy leads to IgM antibodies against Rh+ –> repeat exposure leads to IgG ab that can cross placenta and attach fetus

25
Q

What are Sx of immune hydrops?

A

Hemolysis –> anemia –> hypoxic injury to liver –> reduced plasma oncotic pressure –> generalized edema and anasarca (generalized body swelling)

26
Q

What are the major causes of non-immune hydrops?

A

1) Cardiovascular
2) Chromosomal anomalies = most common is Turner syndrome (cystic hygroma)
3) Fetal anemia (not Rh- or ABO associated) = usually caused by Parovirus B19, which targets erythroid precursors and causes apoptosis of RBC

27
Q

What are Sx of non-immune hydrops?

A

Fetal anemia –> fetal and placenta pale

Liver and spleen enlarged from cardiac failure

Bone marrow = compensatory hyperplasia –> increase hematopoietic activity causes large amounts of immature cells in circulation (erythroblastosis fetalis)

28
Q

What is PKU? Who is it seen in? What is it caused by?

A

Common PKU = seen in Scandinavian patients

Caused by autosomal recessive defect in phenylalanine hydroxylase –> unable to convert Phe to Tyr

Try gets shunted into minor pathways (metabolites = toxic) –> abnormal smell

29
Q

What Sx do you see with PKU and how do you treat it?

A

Musty odor to body/urine
Severe mental retardation
Decreased pigmentation of hair and skin, eczema

TX = limit Phe in diet (non effective in its with BH4 deficiency)

30
Q

What is Galactosemia?

A

Most commonly occurs due to defect in galactose-1-phosphate uridyl transferase (GALT)

Galactose1P accumulates in liver, spleen, lens, kidney, heat, cerebral cortex, erythrocytes

Causes activation of separate pathways –> produces galactitol and galactonate

31
Q

What Sx do you see with galactosemia?

A

Jaundice, failure to thrive
Hepatomegaly, widespread scarring similar to cirrhosis
Opacification of lens = cataracts
Mental retardation, alteration in nerve cells (particularly in dentate nuclei of cerebellum)
Amino acuduria
Prone to Ecoli septicemia
Hemolysis and coagulopathy

32
Q

What is cystic fibrosis? What is its genetic association?

A

Abnormal Cl- channel, results in highly viscous secretions in lungs that can obstruct airway

1/2500 births - most commonly in caucasians

3 BP deletion, F508 on CTFR
Autosomal recessive
Found on 7q31.2

33
Q

What Sx do you see in cystic fibrosis?

A

Influenza
Pseudomonas aeruginosa infections (neutrophils!)
Bronchiectasis and atelectasis

Meconium ileus + rectal prolapse
Hepatic steatosis, focal biliary cirrhosis

Recurrent pancreatitis
Male infertility

34
Q

What is sudden infant death syndrome (SIDS)?

A

Sudden death of infant <1 yr old which remains unexplained after thorough investigation

Delayed development in arousal and cardiorespiratory control

Skin = petechiae

35
Q

What are the risk factors for SIDS?

A

Vulnerable infant –> maternal smoking, sleeping with parents, overly soft surfaces and thermal stress

Critical development period in homeostatic control

Exogenous stressor

36
Q

SIDS is a disease of exclusion. What do you need to rule out?

A

Trauma

37
Q

What is the most common tumor of infancy? What Sx do you see?

A

Hemangioma - resolves with age

Skin = flat, large lesions refereed to as port wine stains
Can be associated with von Hippel-Lindau disease

38
Q

What is a lymphangioma?

A

Hamartomatous or neoplastic

Usually in neck, axilla, mediastinum and retroperitoneal tissue

39
Q

What is lymphangiectasis?

A

Abnormal dilations of preexisting lymph channels

Usually present as diffuse swelling of part or all of extremity

40
Q

What is the MOD behind congenital infantile fibrosarcoma? What is the prognosis?

A

Commonly due to 12: 15 translocation
Forms ETV6-NTRK3 fusion –> constitutively active –> excess RAS and PI3K/AKt signaling

Good prognosis

41
Q

Describe immature vs. mature teratomas.

A

Immature = malignant teratoma mixed with another germ cell tumor; potential for malignancy depends of amount of immature tissue present

Mature = benign, well-differentiated cystic lesions

42
Q

What are sacrococcygeal teratomas?

A

Most common type of teratoma
More so in girl
Seen in coordination with other midline defects = meningocele, spina bifida

43
Q

What is a neuroblastoma?

A

Differentiation of primitive neuroblasts into mature elements. Can be small in situ lesions or overt tumors

44
Q

Describe the inheritance pattern of neuroblastomas.

A

Usually sporadic

1-2% are familial
Familial often include germline mutation in ALK gene

45
Q

What is the histology of a neuroblastoma?

A

Small cells with dark nuclei, cytoplasm and poorly difined borders

Homer-Wright pseudo rosettes = tumors with neutrophils around them

Can stain for enolase and catecholamine-containing granules

46
Q

What does the presence of Schwann cells indicate in a neuroblastoma?

A

It is more of a mature ganglioneuroma

Associated with more favorable outcome

47
Q

In who mostly are neuroblastoma present?

A

Children under the age of 2 with large and masses, fever, and weight loss

48
Q

How can you diagnose a neuroblastoma?

A

90% produce catecholamines –> elevated levels of catecholamines in the blood + VMA and HVA

49
Q

What skin sx do you see with a neuroblastoma?

A

Disseminated neuroblastomas with multiple mets can cause deep blue discoloration of skin = blueberry muffin babies

50
Q

What are the important prognosis factors of neuroblastomas?

A

1) Age + stage = above 10 mo. gives worse prognosis
2) Morphology
3) Amplification of MYCN = bad –> associated with deletion on chromosome 1
4) Ploidy = hyper diploid –> better prognosis
5) Expression of neurotrophin receptor

51
Q

What is a Wilms tumor?

A

Most common primary renal tumor and 4th most common pediatric malignancy in US

Can be bilateral (synchronous) or unilateral (metachronous)
B/l presents 10 mo earlier and usually has germline mutation

52
Q

What Sx are associated with Wilms tumor?

A

Will present with large abd masses, HTN, hematuria, fever

53
Q

What molecule plays are role in Wilms tumor production?

A

Beta cadherin

54
Q

Where is metastasis common with Wilms tumor?

A

Lung

55
Q

The risk of Wilms tumor is increased with a least 3 recognizable groups of congenital malformations associated with distinct chromosomal loci. What are then?

A

1) WAGR/WAGI syndrome
2) Denys-Drash syndrome
3) Bekwith-Wiedeman syndrome

56
Q

Describe WAGR/WAGI syndrome.

A

33% risk - Germline deletion of 11p13

WAGR = Wilms, Anirdia, Genital anomalies, mental retardation

Result in mutations in:
WT1 = Wilms tumor associated gene
PAX6 = provides instructions for making protein that is involved in early development of eyes, spinal cord, and pancreas

57
Q

Describe Denys-Drash syndrome.

A

90% risk

Gonadal dysgenesis (male pseudohermaphrodism) 
Early onset nephropathy --> renal failure 
Increase risk of gonadoblastoma
58
Q

Describe Beckwith-Weidemann syndrome.

A

Example of genomic imprinting - 11p15.5 (WT2-IGF2)

Some have CDKN1C mutation - cell cycle regulator that broadly inhibits multiple CDKs

Increased risk of heptoblastoma, pancreatoblastoma, adrenal cortical tumors, rhabdomyosarcoma

SX = Organomegaly, macroglossia, hemihypertropgym omphalocele, adrenal cytomegaly

MOD 1 Exam 2 and 3 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions