childhood/dolescent infections Flashcards
red flags for childhood infx: persistent pain swelling/redness in 1 joint fever unusual rash 6 more
loss of appetite fever limp weakness unexplained weight loss tired
5 MC ped cancers
- leukemia
- cns tumor
- lymphoma (hodgkins, non >15y)
- bone cancer
- neuroblastoma (infants)
2 MC childhood bone cancers
ewing’s sarcoma
osteogenic sarcoma
MC solid tumor besides CNS tumor, 50% dx’d in first 2 years
neuroblastoma
- abx resistant infx if in marrow, stiff neck, HA, vomit, bone pn
- if hypothalamus destroying, inc appetite and weight
leukemia
cancer in 5-10yo, often mis dx’d dt rapid growth and mimic of other dx
CNS/brain tumor
B and T cell, burkett’s lymphoma
painless swelling, often liver and spleen
non-hodgekin’s lymphoma
rare cancer male 2:1 involving the long bones around the knee
bone cancer
osteosarc >ewings
cancer usually in adrenal glands, abd, neck, pelvic or chest sympathetic ganglia
neuroblastoma
s/s: swollen gums, fever, pallor, bleeding, bone pain, fatigue
leukemia
s/s: HA worse in AM, n/v, seizure, personality change, ataxia, hemiplegia, blurry vision, CN palsies
CNS/brain tumor
s/s cells spreadin lymph glands of neck, chest, abd
fatigue, fever, cough, chills, night sweats, pruritis, HA, weight loss, facial edema, abd pn, SOB
lymphoma
non and hodgkins
s/s pain and swelling at site of tumor, pain progresses to severe, limp, wakes at night with fever and sweating, systemic signs of infx
bone cancer
s/s: fever, abd pn, weight loss, FTT, irritability, abd or c/s mass, chronic/watery diarrhea, ptosis, pallor, croup, bowel/bladder dysfx
neuroblastoma
CHILDCANCER acronym
Continued, unexplained weight loss HA, with early AM vomiting Inc swelling/bone pn Lump/mass Dev of bruising/bleeding/rash Constant infx A whitish color behind eye Nausea or vomiting Constant tireness/pallor Eye/vision changes Recurrent fever of unknown origin
hard, non-mobile/non-tender lymph nodes unexplained weight loss abd mass (+ blood) recurrent HAs cervical lymphadenopathy unexplained weight loss occult blood in stool/urine bone pain (esp w fever)
childhood cancer red flags
MC malignancy in children
ALL
leukemia with lower cure rate, 15%
AML
HA, visual disturbances, general discomfort in extremities could indicate a ____ tumor
pituitary
16x22mm (acrossxdeep) on xray taken at 40” FFD is indicative of
enlarged sella turcica
pituitary adenoma secreting growth hormone
acromegaly
gigantism
onset of growth hormone oversecretion of this disorder occurs prior to skeletal maturation (open physis)
gigantism
3 malignant tumors
osteosarcoma
chondrosarcoma
fibrosarcoma
bone island, osteoid osteoma, enchondroma, osteochondroma, fibrous displasia are all ____ tumors
benign
on xray, ___ appears as a solid radiodensity, _____ as stippled, and ___ will appear hazy
bone
cartilage
fibrous
benign tumors are MC bt the ages of
10-30 yo
with malignant tumors, if the pt is <10yo, suspect _____ or _____. If the pt is over 40, suspect ___, _____ or _____
ewings and osteosarcoma
mets, myeloma, chondrosarcoma
4th mc primary bone malig that sits in the long bones, s/s are weight loss, fever, fatigue, painful tumor - mimics infx and is a permative lesion with cortical saucerization
ewing’s sarcoma
lymphoma, leukemia, neuroblastoma, ewing’s, EG, MM, and osteomyelitis are all ______
round cell lesions
cancer known as the great masquerader, MC <2 yo, my be comorbid with horner’s, immature nerve cell found in an embryo/fetus
neuroblastoma
MC benign tumor of the hand is ____. if there are multiple, it is called _____. multiple + soft tissue hemangioma’s is known as _____
enchondroma
ollier’s
maffucci’s
clinically silent tumor usually in humerus and prox femur, appears with fallen fragment sign, centrally located
simple bone cyst (SBC)
quasimalignant tumor, subarticular and eccentric, expansile, no sclerosis, distal femur and radius, prox tib and humerus, 20-40yo
giant cell tumor (GCT)
very painful and aggressive tumor, looks like blister on the bone, proliferation of vascular component of marry, MC in femur
aneurysmal bone cyst (ABC)
2 ddx for bone island
mets, blastic mets
rare, benign bone lesion with nidus of <2 cm that causes severe pain that is worse at night, MC in 20s, and it’s ddx
osteoid osteoma
ddx: brodie’s abcess
multiple osteochondromas that cause painless, lumpy joints, MC in hands and pelvis
HME (herditary multiple exostosis)
fibrous tissue replacing bone that causes a ground glass appearance or smoking matrix
fibrous dysplasia
polyostotic FD, precocious puberty and skin spots when combined are known as
mccune-albright syndrome
fibrous cortical defect (smaller) and a non ossifying fibroma (larger) are both types of
fibrous xanthomas
solitary benign bone-forming tumor in spine and long bones that is MC in the dorsal aspect of the vertebrae
osteoblastoma
2nd MC primary malignant tumor of bone, usually in the KNEE, causes painful swelling in the limb
osteosarcoma
pustules on face, neck, axilla, arms, hands that can occur after getting chicken pox shot
molluscum contagiosum
polio virus
poliomyelitis
bark of a seal, MC in boys 1.5-3yo
croup
measles caused by the ____ show up with koplik spots, tx with vit a
paramyxovirus
mumps is caused by the
paramyxovirus
____ aka german measles, caused by togavirus
rubella
_____ will occur often if the pt is exposed to rubella within 4w of birth - cardiac, cerebral, ophthalmic and auditory defects
congenital rubella syndrome (CRS)
gray pseudomembrane, very rare, irreversible bacteria, req antitoxin + abx
diptheria
organism that causes tetanus
clostridium tetani
whooping cough or 100 days cough, tx with vit C and vit D
pertussis
-bordatella pertussis
slapped cheek syndrome, human parvovirus B19, with 3 stages
fifth dz
exanthem subitum or roseola infantum, type of HHV affecting the salivary glands in kids with a non itchy red rash
sixth dz
enterovirus 71, coxsackie A - thru direct contact with mucus causing painful lesions in mouth followed by a specific rash
hand foot mouth dz
fever, sore throat, swollen lymph nodes/liver/spleen, inc WBC
mono
MC STD
chlamydia
