Conditions And Diseases Flashcards
Asthma summary
Eval:
Physical exam and history
Txt:
nebulizer
Allergy summary
SS: reaction within 3-4 hours rhinitis asthma atopic dermatitis
Txt: Diet Diphenhydramine, 4 mg/kg/a6hr Epi Pen child education
FTT summary
Def: kid not growing like you expect to
Cause: multifactoral
SS: dysmorphic teeth stigmata of abuse lack development temperment affect
Eval: cbc ferritin BMP Vit D
Txt: feeding therapy (sos) dietary management medication g-tubes
Blunt abdominal trauma
Causes: falls, bike accidents, seatbelt injury, kick to abdomen
S/s: diffuse abd pain, vomiting, distensiton, sudden collapse if splenic injury
Dgx:Serial CTs
Tx conservatively
Infantile Acne
Who:2-4 weeks of life
S/s: pink, small papules
Tx: time/reassurance
Miliaria Rubra ( Heat Rash)
Who:Infants and adults
S/s: covered areas, flexural areas; clear vesicles on an erythematous base
Tx: symptomatic, avoid over heating
Milia
Who: neonates
S/s: little white bumps on forehead, cheeks, nose
Tx: reassurance
Erythema Toxicum
who: *neonates in the first 24-48 hours of life
S/S: 1-4mm central vesicle or pustule over large, blotchy erythematous base
Tx: reassurance
Measles (Rubeola)
Who: rare with adequate vaccination
S/s: *High fever, *cough, coryza, conjunctivitis, prodromal symptoms that *persist during the rash; *RASH that starts on face and spreads out *but still remains on face
Tx: close monitoring, symptomatic
Rubella (German Measles)
Who: rare with adequate vaccination
S/s: *rash that starts on face and spreads to trunk and extremities but the *face clears up; mild viral illness with tender lymphadenopathy
TX: symptomatic
Roseola
Who: children under 2
S/s: predominately on the trunk; after prodrome with a *High fever, children develop faint *blanchable pink maculopapules which *coalesce but the *fever disappears once rash appears
Erythema Infectiosum (Fifth’s disease)
Who: school aged children
S/s: after prodrome, child feels better but rash erupts on face (slapped cheek) and extremities (SPARES hands and feet) that is *lacy and caolesces
Tx: reassurance, symptomatic
Coxsackievirus (hand, foot, and mouth)
Who: children under 10
S/s: *rash or spots appear on hands and feet, parent complains child doesn’t want to eat and just doesn’t feel well
Tx: symptomatic
Scarlet Fever
Who: anyone
S/s: sunburn like rash that feels like sandpaper
Tx: oral abx
Dystocia
- brachial plexus injury (waiter’s tip hand)
- clavicle fracture (can’t move one arm)
Jaundice
high hemoglobin at birth because liver is immature and can’t get rid of broken down RBC’s
Dgx: coomb’s test
Tx: phototherapy
Kernicterus
Higher amounts of bilirubin in the brain
Bilirubin induced neurologic dysfunction-baby isn’t sleeping or eating well which leads to less pooping and peeing to get the bilirubin out
Leads to chronic bilirubin encephalopathy and hypotonia
Necrotizing Enterocolitis
most common in premature babies
GI signs
Respiratory Distress Syndrome
premature babies
tachypnea, retractions, nasal flaring
Trisomy 21
Down Syndrome
hypotonia, hyperflexibility, excess skin on back of neck, flat facies, simian crease, cardiac abnormalities
low IQ
Fragile X syndrome
repeat of trinucleotide in the FMR1
S/s:MC inherited cause of mental retardation, hand flapping and biting, poor eye contact, autism, macrocephaly, prognathia after puberty, large ears, thickening of nasal bridge
Full life expectancy
Meconium Aspiration Syndrome
when meconium is the first intestinal discharge from newborns
need to get it out to prevent bacterial infections
Spina Bifida/Neural tube defect
Etiology: congenital deformities involving coverings of the nervous system
S/s:myelomeningoceles-spinal cord and nerve roots herniate into a sac comprising the meninges
meningocele-herniation of the eninges through the bony defects
Encephalocele-herniation of meninges and neural tissue
Prevent: folic acid supplementation-occurs between days 17-30 of gestation
Tx: surgery, therapies, medications for complications
Muscular Dystrophy
MC hereditary neuromuscular disorder
inherited x linked recessive trait
defect is dystrophin protein
S/s: Gower’s sign, wheelchair bound by age 12, cardiomyopathy, resp complications
Dgx: elevated CK, muscle biopsy
tx: no medical cure or method to slow progression
death by age 22
Cerebral palsy
motor or postural abnormalities noted during development
assoc with prenatal, perinatal, or postnatal etiologies
many children and adults function at a high educational and vocational level
s/s: spastic diplegia, spastic quadriplegia, hemiplegia, extrapyramidal
Urinary Tract Infection
Etiology: E. coli, enterococcus (always get a culture even if UA looks clean)
Risk Factors: F:39, fever>2d; M: white, temp>39, fever>1d
Pathogenesis: Renal scarring from retrograde flow of urine (preventing kidney disease, HTN)
S/s:Neonate=sepsis, hypothermia, cholestatic jaundice; infant=F,V,D,irritable, FTT, malodorous urine; Preschool=change in voiding patterns,GI sx, fever; adolescent=dysuria, frequency, urgency, abd pain
Dgx: UA/UC
Tx:abx
F/U: within 48 hours of onset of any subsequent febrile illness
Vesicoureteral Reflux
regurgitation of urine from the bladder up to the kidney
incidence: higher in white and siblings
etiology: congenital or bladder outlet obstruction
classified by grades 1-5
Dgx: RUS, *VCUG, *RNC (identifies reflux), DMSA
tx: prophylactic abx, bladder training, antihcolinergics
STING-subureteric transurethral injection
Voiding dysfunction summary
Enuresis - refers to a repeated inability to control urination
- Primary : never achieved control
- Secondary : control for at least 6 months
Mild - pollakiura - giggle incontinence - vaginal reflux Moderate - lazy bladder - unstable bladder Severe - hinman syndrome
Eval:
UA/UC
RUS
cystogram
Txt: motivation DDVAP Tofranil time voiding conditioned response therapy
SIDS summary
Def: sudden death of infant 5
Txt:
help family cope with loss
Hemolytic Uremic Syndrome summary
Def: MC renal failure
Cause: infectious (ecoli), endothelial cell injury
SS:
age
Kawasaki disease summary
Def: mucocutaneous lymph node syndrome or infantile polyarteritis
SS: microvasculitis fever > 5 days and - peripheral extremity changes - polymorphous rash - oropharyngeal changes - bilateral, nonexudative painless conjunctival infection - acute lymphadenopathy
4 stages: - acute high fever and main symptoms - subacute desquamation of fingers and toes greatest risk of coronary aortic aneurysm - convalescent - chronic
Eval: elevated ESR/CRP 2 urine proteins Platlets > 450,000 pyuria ALT > 50 albumin
henoch schonlein purpura summary
Def: immune-mediated vasculitis
SS: purpura (lower extremities) ab pain joint pain and swelling N/V D, bloody stools scrotal edema
Eval:
UA
ab US
Txt:
self limiting
supportive
Leukemia summary
Acute lymphoblastic Leukemia MC
SS: fever bleeding bone pain lymphadenopathy
Eval: CBC diff clotting tests metabolic panel Uric acid LP bone marrow biopsy US
Txt:
meds
Seizures summary
Def: provoked (infections, etc.) and febrile
Generalized: engage both hemispheres
- absence
- grand mal
Focal: originate in 1 hemisphere
- simple (aware still)
- complex
Epilepsy summar
Def: chronic seizures
Benign focal - generalized occur during sleep; occasional occur when awake
Petit mal - 4-8 yr loss of consciousness that lasts seconds
juvenile myoclonic - 13 - 19 yr frequent morning within first hour due to sleep deprivation
grand mal - any age
Infantile seizures - sudden flexion or extension of trunk or both
Lennox-Gastaut Syndrome - intractable seizures (no good txt)
Status Epilepticus summary
Def: 5 min sustained convulsions
Eval: MRI CT CBC LFT blood glucose EEG
Txt:
Benzo
Phenytoin
Scoliosis summary
def: lateral curvature of spine
cause: idiopathic
SS: illiac wings and shoulder not level
Eval:
PA/lateral xray
MRI
Txt:
close follow up
braces
surgery
Genu Varum/valgum summary
Def: abnormal alignment of femur and tibia
SS:
vause or valgus
Txt:
Observation
Osgood Schlatter summary
Def: knee pain over tibial tubercle
SS:
pain with running and jumping
Eval:
pain over tibial
Txt:
NSAIDs, Ice, rest
Juvenile Idiopathic Arthritis summary
Def: MC chronic arthritis in kids
SS: morning stiffness joint swelling redness warmth high fever rheumatoid rash
Eval: CRP/ESR Hgb WBC tap joint
Txt:
NSAIDs
DMARDs
steroids
Developmental Dysplasia of Hip summary
Def: disorders of sublet, dislocation
SS:
painless limp
short leg
Eval:
Barlow/Orotoni exam
Txt:
Observe
harness or casting
Salter-Harris Fractures summary
1 - growth plate
- growth and metaphysics
- growth and epiphysis
- all elements
- crush
Legg-Calve Perthes summary
Def: avascular necrosis of femoral head
SS: pain in hip with limp painless limp externally rotated leg mild atrophy of thigh
Eval: CBC ESR AP/frog-leg lateral X-rays pelvis MRI
Txt:
bed rest
bracing or surgery
Slipped Capital Femoral Epiphysis summary
Def: MC hip disorder in adolescent
SS: obesity limp no known trauma externally rotated leg flexed leg will externally rotate
Eval:
AP/frog-leg lateral x-rays
Txt:
hospitalization
surgery
Nursemaid elbow summary
Def: sublet of radial head from capitellum due to immature annular ligament
cause:
axial pull on arm
Eval:
xray
Txt:
external rotate with flexion
Inguinal hernia
Hx: asymptomatic groin or scrotal swelling, most prominent with crying/straining/active, rarely painful, unless incarcerated
Exam: reducible inguinal/scrotal mass; thickening of spermatic cord/inguinal content; ovary frequently out into hernia sac in girls
Hydrocele
discreet sac of fluid (intrascrotal)
Dgx: spermatic cord proximal to an isolated hydrocele will be normal
Tx: infant: await spontaneous resolution
>1y: surgery for a persisting hydrocele as a hernia is likely also present
ADHD
def: combo of hyperactivity, impulsivity, and inattention that affects functioning in cognitive, academic, behavioral, emotional, and social
Cause: atypical frontal-striatal activation causing impaired function, imbalance of catecholamine metabolism in the cerebral cortex, high genetic component, environment and society
Dgx: look at criteria
Tx: combo of meds, behavioral, and educational
- make goals, special services at school
- Methylphenidate (Ritalin, Concerta, Metadate, Daytrana patch)
- Amphetamine (Dexedrine tabs, Vyvanse, Adderall)
- Nonstimulant: Strattera-norepi reuptake inhibitor; Buproprion, SSRI, Clonidine, TCA
umbilical hernia
persisting defect in the abd wall fascia at the site of umbilical cord attachment
tx: spontaneous closure is frequent without requiring surgical repair
Belly button anomalies
Umbilical polyp-moist, red umbilical nodule; tx with cauterization
Patent omphalomesenteric duct- embryologic connection to intestine (ileum), substantial drainage, requires surgery
Patent urachus- embryologic connection to urinary bladder, substantial drainage, urinary content flows into umbilical cord, requires surgery
Urachal cyst
urachus-connection to urinary bladder
s/s: umbilicus usually normal with lower midline abdominal wall mass; often infected with abd pain, fever, infraumbilical mass, erythema
Dgx: hx, exam, US
Tx: antibiotics to treat infection, surgical excision
Meckel’s Diverticulum
remnant of intestinal end of omphalomesenteric duct
Rule of 2s: 2% of pop, 2 years old, 2 feet from ileocecal valve, 2 inches long
S/s: bleeding per rectum, inflamm/meckel’s diverticulitis, small bowel obstruction, or asx
Tx: surgical excision of diverticulum
Autism
Cognitive differences: theory of mind, implicit learning and nonverbal sensitivity
S/s: poor social skills, rigid and inflexible adherence to routines, preoccupation with parts of an object or particular subject, sensory issues (can’t block out stimuli, hypersensitivity, fine motor problems, gross motor problems)
Dgx: interview, medical workup, psych assessment
Tx: social skills training, peer training, communication and conversational training, behavioral management, academic and educational support, tx of comorbid issues
No meds tx autism
Intussusception
form of bowl obstruction, intestine telescopes into itself
mainly idiopathic
S/s: cramping, bloody mucoid stools (currant jelly); sausage shaped abd. mass
Dgx: confirmed by radiology but only when it’s late, US, CT scan
Tx: hydrostatic/pneumotic reduction by the radiologist; if unsuccessful proceed to immediate surgery
Pyloric stenosis
concentric hypertrophy of pyloric muscle
S/s: 3-6 weeks old, progressive projectile, non bilious vomiting eventually with every feeding, dehydration, palpable epigastric abd mass “olive”
Dgx: “string sign” on Upper GI; US
Tx: NPO, Iv hydration, Pyloromyotomy
Thyroglossal duct cyst
thyroglossal duct originates from foramen cecum of the tongue
s/s: midline neck mass at hyoid cartilage level, infection can occur
Dgx: midline mass that moves during swallowing, no labs necessary
Tx: abx, surgical incision
Dermoid cyst
more superficial and mobile than TDC, still midline
Tx: surgical excision
Branchial cleft cyst/sinus
derived from branchial structures present at 4-8 weeks gestation
S/s: anterior border of SCM muscle and mucoid drainage
Tx: abx, surgical excision
