clipp cases 2 Flashcards
What is transient synovitis?
Inflammation of the synovial lining of the hip usually occuring during or after a URI. Self limiting
What is the treatment for transient synovitis?
Rest and ibuprofen
What heart defects can present with a murmur and CHF in infancy?
VSD, PDA, aortic stenosis and coarctation of aorta
How do infants with CHF present?
- Tachypnea
- feeding difficulty
- Sweatin while feeding
- Longer feeding time
What is the treatment of CHF in infants?
Furosemide and digoxin
What kind of seizure has a postictal state?
Complex partial seizure
What kind of seizure can you induce and how?
Absence seizure and by hyperventilation
What is the EEG finding for a complex partial seizure?
Normal
What is the EEG finding for absence seizure?
spike and wave 3HZ
What kind of symptoms do you get with infratentorial tumors?
Cerebellar signs and increased intracranial pressure
What kind of symptoms do you get with cerebellar hemispheric tumors?
Hypotonia and hyporeflexia
What kind of symptoms do you get with supratentorial tumors?
Focal motor deficits and sensory deficits contralateral to the lesion
What kind of symptoms do you get with brain stem lesions?
Cranial nerve and gaze palsies
What is the most common pediatric brain tumor?
Medulloblastoma
What is the best pediatric brain tumor to get?
Astrocytoma
What is cushing triad?
Hypertension bradycardia and irregular respirations
What would a brain tumor in the cerebellar vermis cause?
Dysarthria, truncal ataxia, and gait abnormalities
What would a brain tumor in the cerebellar hemispheres cause?
Hypotonia, hyporeflexia, ipsilateral limb abnormalities, nystagmus, tremor/dysmetria
What would a brain tumor deep in cerebellar nuclei cause?
Resting tremor, myoclonus and opsoclonus
What are dennie’s lines?
These are transverse creases under the infraorbital that is a sign of chronic conjunctival inflammation
What is Henoch-Schnlein Purpura?
This is a IgA mediated vasculitis that affects skin, joints, GI, and kidneys
What are the typical signs and symptoms of HSP?
petechiae and purpura, arthritis of kness and ankles, hematuria and colicky abdominal pain
What is a common complication of HSP?
Intersucception (ileoileal)
What are some complications of PID?
Fits-Hugh-Curtis syndrome, tubo-ovarian abscess, infertility
What is the treatment for meningococcemia?
Penicillin G
What is the prophylactic treatment for meningococcemia?
Adults- Ciprofloxacin
Children- Rifampin
When would you use urinary alkalinization?
Salicylate intoxication
What kind of cardiac effects does TCA toxcitity have?
Hypotension, dysrhythmias, conduction delays
What is the treatment for TCA toxicity?
Sodium bicarbonate
What are retinal hemorrhages pathognomonic for?
shaken baby syndrome
When should you be worried about failure to thrive?
Weight
What is the difference between organic FTT and non organic FTT?
Organic FTT is based upon an underlying disease while non organic FTT is social factors
What is the mode of inheritance for cystic fibrosis?
Autosomal recessive
Are crypt abscessess common in ulcerative colitis or crohns disease?
Ulcerative colitis
Which inflammatory bowel disease involves mucosa, submucosa,muscularis and serosa?
Crohns disease
Which inflammatory bowel disease has fistula formation?
Crohns disease
What are the treatment options for crohns disease?
- mesalamine
- steroids
- antibiotics
- methotrexate
- Remicade
What rash is associated with crohns disease?
Erythema nodosum
What are some conditions you worry about with prematurity?
- RDS
- Bronchopulmonary dysplasia
- Periventricular leukomalacia
- Hyperbilirubinemia
- Retinopathy of prematurity
What brain finding is highly correlated with cerebral palsy?
Periventricular leukomalacia and cysts
Increased muscle tone and hyperreflexia in a premature baby should alert you to what condition?
Cerebral palsy
When is it recommended for physcians to use a screening tool to assess development in a child?
9,18,30 months
What are the clinical features of down syndrome?
Mental retardation, epicanthal folds, flat facial profile, single palmar crease, hypothyroidism, hypotonia, intestinal obstructions, cardiac defects, redundant neck skin, umbilical hernia, short stature, predisposition to leukemia
What is the abnormality of fragile X syndrome?
Inheritance of anormal number of trinucleotide repeats (CGG)
What is the labatory test for down syndrome?
Lymphocyte karyotype
Whats the pathophys for sickle cell disease?
There is a substitution of valine for glutamic acid at the 6th position of hemoglobin which leads to polymerization when deoxygenated
What is the mode of inheritance for sickle cell disease?
autosomal recessive
What organisms are sickle cell patient at increased risk for?
Strep pneumoniae, H. Flu, and N. meningitidis
What is the predominant hemoglobin at birth?
Hemoglobin F
What is the normal hemoglobin for adults?
Hemoglobin A
What are the vaccines given to kids with sickle cell disease?
- H. flu and pneumococcus 13 at 2,4,6 months
- pneumococcus 23 and meningococcus at 2,5yrs
- influenza annually
What is the management for acute chest syndrome?
Narcotics, hydration and incentive spirometry
What is the most common surgeries in sickle cell patients?
Tonsillectomy and cholecystectomy
What are some things that can cause nephrotic syndrome?
minimal change disease, membranoproliferative glomerulonephritis, IgA nephropathy, lupus, post step glomerulonephritis, hepatitis B, HIV, HSP
What is the most common cause of nephrotic syndrom in children?
Minimal change disease
What is the treatment for minimal change disease?
steroids, albumin infusion followed by furosemide and sodium restriction
What is pediculosis capitis?
Lice
Intense itching at night on the wrists, elbows, fingers and toes. What is this?
scabies
What is tinea corporis?
ring worm
What causes warts?
HPV
What kind of hypersensitivity do you get with acute uticaria?
Type 1 hypersensitivity
What causes a erythematous plaque with fine to thick greasy yellow scale typically seen on the scalp?
seborrheic dermatitis
What type of hypersensitivity causes contact dermatitis?
delayed type 4 hypersensitvity
What causes impetigo?
Staph aureus and strep pyogenes
What is the treatment for impetigo?
topical mupirocin
Patches of hypopigmentation on the face, neck, upper trunk and extremeties?
Pityriasis alba
Christmas tree distribution and herald patch is associated with what?
Pityriasis rosea
How would you treat mild acne?
BPO, retinoid, and topical antibiotics like erythromycin and clindamycin
How would you treat moderate acne?
Add oral antibiotic like tetracycline
How would you treat severe acne?
oral isotretinoin
What is the treatment for tinea capitis?
Griseofulvin
When do you need hepatitis B?
Birth, 2mo, 6mo
When do you need rotavirus?
2,4,6 months
When do you need DTap?
2, 4, 6, 15months, 4-6yrs
When do you need Tdap?
11-12yrs and then every 10yrs
When do you need H. flu?
2,4,6
When do you need pneumococcus vaccine?
2,4,6,12mo
When do you need inactivated polio vaccine?
2,4,6mo, 4-6yrs
When do you need MMR vaccine?
12months and 4-6yrs
When do you need hepatitis A vaccine?
12months and 6months after
When do you need varicella vaccine?
12months and 4-6yrs
When do you need HPV vaccine?
11-12yrs
When do you need meningococcal vaccine?
11-12yrs and then 16yrs
What vaccines are contraindicated in pregnancy?
MMR, Polio, Varicella and HPV
