Deck 3 Flashcards
how do you dx esophageal atresia
you do an xray to show the nasogastric tube coiled up in the blind ending pouch
what murmurs do you hear at the left sternal border
HOCM and aortic/pulmonic regurg
where is ASD heard
at the left 2nd intercostal space (pulmonic area)
where is VSD heard
in the tricuspid area (slightly to the left of sternum)
what is associated with the VACTERL anomalies
Vertebral abnormality, Anal imperforation, Cardiac abnormalities, TracheoEsophageal fistula, Radial, Renal and Limb anomalies
diagnostic tests for growth hormone deficiency
after ruling out malnuritional causes, you can get ILP-1 levels (end product of GH axis) and bone age scan
is bone age delayed in constitutional growth delay
yes
what is pustular melanosis
this is where the newborn has a pustular rash that can erupt and then have a macuole underneath. its benign
pustule vs. vesicle
pustule has pus in it and vesicle is just fluid
macule vs. papule
macule is flat and papule is raised
what is milia
this is a benign rash of childhood in which the epidermal pores get filled with keratin
what is congenital dermal melanocytosis
these are areas concentrated with melanocytes and look like a bruise, must be documented so child abuse is not suspected later
what is milaria
this is like milia but instead is obstruction of sweat glands, fix by removing insult and cooling infant
signs of congenital dacryostenosis in a neonate
increased tearing, eyelash crusting, clear conjunctivae
signs of a peritonsillar abcess
severe sore throat, fever, muffled voice, dysphagia, drooling
diagnostic criteria of peritonsillar abcess
trismus (lock jaw), unilateral swelling, ulvula deviation, fluctuant bulging of soft palate
do you need any imaging for peritonsilar abcess dx
nope!
signs of GAD in children
excessive worry + >1 of : restlessness, fatigue, difficulty concentrating, irritability, sleep disturbance
treatment of GAD in children
SSRIs (sertraline)
what do tet spells do for children (physiology)
they increase systemic vascular resistance which decreases the right to left shunt (decreasing cyanosis)
tetrology of fallot anomalies
P: pulmonary stenosis // R: RV hypertrophy // O: overriding aorta // V: VSD
can HIV present as meningitis
yes!
can anabolic steroid use cause gynecomasstia
yes
can gynecomastia be physiologic in boys?
yes! especially as they go through puberty (tanner stages 3/4)
what is WAGR syndrome
11p deletion: W: wilms tumor // A: aniridia (no iris) // G:genitourinary abnormalities // R: mental retardation (intellectual disability)
can kids have PTSD
yes
signs of prader willi
hyperphagia/obesity, intellectual disablity, hypotonia, weak suck, hypogonadism, dysmorphic features
most common bacteria that causes bacterial sinusitis
nontypable H flu, strep pneumo, moraxella
treatment of clavicle fracture in a neonate
reassurance and gentle handling
location of oral lesions in herpangina
gray vesicles –> ulcers along the solft palate, palatine pillars, tonsils and uvula
what causes herpangina
coxsackie A
signs of herpetic gingivostomatitis
clusters of vesicles in the anterior oral cavity (buccal mucosa, tongue, gingiva, hard palate)
what bug causes herpetic gingivostomatitis
herpes simplex
what tests to order in a chlid with obesity
lipid panel, HbA1c, liver enzymes (fatty liver), sleep study (polysomnogram)
what is GBS
strep agalactiae
signs of GBS in a 5 week old
bacterimia, meningitis, bacterimia
gram stain and shape of GBS
gram positive cocci in chains/pairs
what shoudl be suspected if a child has encopresis
this is fecal incontinence in the sleep, fix their constipation
what diagnositc test should be done if a child has gross bleeding per rectum
meckel scan!
acute unilateral cervical lymphadenitis bug
staph aureus or strep pyogenes
murmur characteristics of a physiologic curvature of the jugular or subclavian veins
continuous, heard on right infraclavicular space, decreases in intensity turning head to ipsilateral side
peutz jeghers syndrome findings
brown macules on lips and buccal mucosa, colonic hamartomas in GI tract
signs of occult blood loss
fatigue, anemia
signs of bronchopulmonary dysplasia in neonate
continued requirement of supplemental oxygen >28 days
pathogenesis of bronchopulmonary dysplasia
reduced septation of the alveoli due to arrest of pulmonary development from being on a vent
what is laryngomalacia
this is intermittent collapse of the arytenoid cartiliage on inspiration
signs of laryngomalacia in infants
noisy breathing, GERD
when do you hear the stridor in laryngomalacia (inspiratory or expiratory)
inspiratory stridor
can the infant have HSV even if mom had no signs
definitely, often times transmission is from asymptomatic mothers
signs of congenital HSV infection
chorioretinitis, skin vesicles or scars, microcephaly
three presentations of HSV in a neonate
1) skin, eye, mouth 2) meningoencephalitis 3) disseminated disease
big differences between crohns and UC
crohns: skip lesions (granulomas), transmural, mostly small intestine, perianal disease // UC: mainly epithelial lesions, continuous, starts in rectum
presentation of IBD in a child
dramatic weight loss, bloody stool, diarrhea, early satiety, etc
UC enema exam finding
lead pipe - loss of haustra
complications of crohns
strictures; fibrosis; fistulas
treatment of crohns
azothioprine, 6-mercaptopurine, methotrexate
treatment of UC
sulfasalazine, olsalazine, or balsalazide
what is required for dx of celiac disease
biopsy of the duodenum
what is a BRUE
this is when the infant has a brief resolved unexplained event that means the infant has normal vitals and appearance, is growing normally and is not otherwise ill
how do infants present with volvulus
Abdominal distention, bilious vomiting, and blood per rectum; usually presents in infancy
pathophysiology of volvulus
incomplete intestinal rotation during fetal development
imaging findings in volvulus
birds beak or corkscrew sign
difference between heat exhaustion and heat stroke
heat exhaustion maintains their mental status, heat stroke loses mental abilities and is >104F
treatment of OCD in a child
SSRI
signs of neonatal abstinence
irritablity, hypertonia, tremor, sneezing, yawning, diaphoresis, diarrhea, etc
two causes of late passing of meconium
hirschsprungs or meconium ileus
pathophys of meconium ileus
inspissated stool due to cystic fibrosis
xray description of meconium ileus
dilated loops of bowel proximal to the lesion
what is Legg-Calvé-Perthes disease
this is just idiopathic avascular necrosis of the femoral head
what does avascular necrosis of the femoral head look like on xray
fragmentation of the femoral head
complications of mono
splenic rupture, acute airway closure due to tonsillitis, autoimmune hemolytic anemia
how do you evaluate gross hematuria of a child
kidney and bladder US
what is the main cause of a metaphyseal corner fracture
child abuse
what type of hypersensitivity is poison ivy
type 4
signs of osteoid osteoma
pain worse at night, progressive worseness, relieved by NSAIDS
signs of turners in a newborn
lymphedema (horseshoe kidney), loose skin around neck, dysplastic nails
description of webbed neck
short with loose skin
pathophys of hypoplastic left heart
non-functional LV due to mitral atresia, aortic valve etc.
what do hypoplastic left heart babies need to survive
maintence of the PDA and ASD
signs of hypoplastic left heart
postnatal cyanosis once PDA closes, no correction of cyanosis with O2, no murmur
what is TAPVR
this is when all the pulmonary veins (oxygen blood) return to the SVC/RA/IVC etc instead of the LA
when does TAPVR present
cyanosis at birth
what is APVR
this is when > or equal to 1 pulmonary vein returns to the SVC/RA/IVC etc instead of LA
when does APVR present
adolescence
signs of APVR in an adolescent (xray)
enlarged R sided heart markings due to chronic volume overload and pulmonary overcirculation
clinical signs of APVR in an adolescent
signs of pulmonary hypertension= exertional dyspnea, fatigue
what do you see on cardiac cath O2 levels of a APVR adolescent
increased spO2 in the RA and RV compared to the IVC
what is post transplant lymphoproliferative disorder
this is when a child with an organ transplant develops lymphadenopathy, fever and a leukopenia
what is the pathophys of post transplant lymphoproliferative disorder
this is when you are taking immunosuppressents and this causes T cells to have limited surveilance viral oncogenic pathogens which leads to abnormal B cell hyperproliferation due to EBV
what imaging do you do for a suspected volvulus
you do an upper GI series
urine findings in kawasakis
sterile pyuria (WBCs)
clinical signs of evlevated lead levels in children
developmental regression (especially speech), constipation, anemia, fatigue, irritability, emotional lability
treatment of lead poisonin
chelation with succimer, EDTA
