COMQUEST Wrongs 3 Flashcards
signs of hereditary spherocytosis in a baby
jaundice, anemia, splenomegaly
what labs should you order to dx hereditary spherocytosis?
CBC (MCHC) and reticulocyte count
what differentiates Carotenemia from jaundice?
the sclera are normal colored in carotenemia
failure to pass meconium <24 hrs and bilious vomiting after 12 hours?
meconium ileus
failure to pass meconium <24 hours and early onset bilious vomiting<12 hours?
duodenal atresia
signs and sx of meningitis in younger children?
can be subtle; poor feeding, lethargy, irritability, fever, bulging fontanelle( increased intracranial pressure), high-pitched cry, nuchal rigidity, and seizure; basically: febrile seizures with meningeal signs
suspect meningitis. next step?
in child without increased ICP: lumbar puncture–-> CSF and blood cultures–> abx if FAILS negative (no bulging fontanelle/increased ICP)
in a child with increased ICP (bulging fontanelle): blood culture—> abx—. CT scna—> LP if FAILS negative (bulging fontanelle/increased ICP)
itching, tearing, redness of sclera and conjunctiva, slight crusting is indicative of what?
viral conjunctivitis
most common cause of viral conjunctivitis?
adenovirus
treatment of viral conjunctivitis?
supportive care
conjunctival hyperemia, edema, mucopurulent exudate, eyes glued together in the morning, ocular pain is indicative of what?
bacterial conjunctivitis; H.flu, pneumococci, staph, strep
treatment of bacterial conjunctivitis?
topical abx
newborn presents with pallor, tachycardia, tachypnea. What is this?
acute blood loss
if cause of acute blood loss in a newborn is not determined, what test should be done?
Kleihauer-Betke test to confirm feto-maternal transfusion
Imaging and testing for osteomyelitis?
MRI and blood culture and bone or joint fluid, or even bone biopsy for gram stain and culture
How do you diagnose osteogenesis imperfecta?
biochemical studie or DNA sequencing from a skin biopsy
signs and sx of aspirin/salicylate toxicity?
difficulty hearing/tinnitus Respiratory alkalosis and metabolic acidosis.
Signs of iron toxicity
acute: bloody emesis, cv problems, death Later: coagulopathy, scarring of GI tract with obstruction
newborn with bloody emesis with no other signs of distress. Test?
Apt-downey test determines whether blood is baby’s or mom’s
new asx kid comes in for well child from guatemala/central america. what test do they need?
lead up to 16 yrs old ; also consider hypothyroidism, PKU
newborn with profound cyanosis, respiratory distress, minimal heart murmur with S3 gallop, diminished pulses, and liver enlargement. Enlarged heart with RVH.
total anomalous pulmonary venous return
signs and sx of MI in newborn
aberrant origin of coronary artery
sx of heart failure with diminished pulses in the lower extremities, and systolic murmur under left clavicle in newborn. no cyanosis.
coarctation of aorta
harsh, holosystolic murmur loudest at the lower left sternal border . no cyanosis
VSD
newborn presenting with signs and sx of heart failure (fatigue, poor feeding, failure to thrive, sweating). no cyanosis. continuous crescendo/decrescendo machine like murmur over left upper chest with an aortic ejection murmur heard at the right sternal border, second intercostal space.
PDA
