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Infants and Elders > I&E Week 2 > Flashcards

I&E Week 2 Flashcards

1
Q

Most common age of presentation of celiac dz:

A

6 - 24 months although may present in adulthood

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2
Q

A child presents with recurrent abdominal pain and forceful, bilious vomiting. What are you worried about?

A

Intestinal malrotation

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3
Q

Most common etiology of recurrent abdominal pain (RAP):

A

Functional (non-organic): no discernible biochemical or structural explanation (90%)

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4
Q

What distinguishes a cyanotic CHD from pneumonia in terms of clinical presentation?

A
  • Fever with pneumonia
  • Murmur with CHD
  • Poor feeding, cyanosis, low O2 sat, chest pain, fatigue, cough (with large VSD) are common in both
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5
Q

What else should you examine when examining a patient with metatarsus adductus (metatarsus varus)?

A

Hip dysplasia, present in 10-15% of patients with metatarsus adductus

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6
Q

What is one important difference in clinical presentation between Legg Calve Perthes disease and a SCFE?

A

Painful limp with SCFE, painless with LCP.

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7
Q

Usually bilateral condition caused by repeated stress on the tibial tubercle, occurring more often in males, and which results in swelling in the region of tibial tuberosity and pain worsened with activity:

A

Osgood Schlatter

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8
Q

SSx of patella femoral syndrome:

A
  • Pain going up and down stairs
  • Worse with activity or after sitting
  • Knee feels unstable
  • Tender to lateral/medial palpation
  • Compression of patella causes pain
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9
Q

What type of x-ray should you order to evaluate someone for patella femoral syndrome?

A

Sunrise view

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10
Q

Most common cause of intra-cranial injury in children less than a year old:

A

Child abuse

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11
Q

Some of the reasons pediatric dosing is different than adults:

A
  • Poor renal elimination: GFR can take months to develop and won’t reach capacity until sometime in childhood
  • Metabolism: usually lower in infants and may be higher in children compared with adults
  • Higher SA/V the smaller you are, plus thinner strateum corneum and increased hydration
  • Plasma proteins develop over 1st year
  • Increased total body water in kids affects volume of distribution
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12
Q

Criteria for febrile seizures:

A
  • Age 3 months to 6 years
  • Temp > 38.8
  • No CNS infection
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13
Q

Define “parasomnia”:

A

Disorders of arousal, partial arousal, and transitions between stages of sleep. Mostly occur early in the night during deep NREM sleep.

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14
Q

What’s the most common age group for night terrors?

A

3 - 8 years old

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15
Q

Peak age group for nightmares:

A

3 - 5 years old. 25 - 50% of kids have them.

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16
Q

What’s the most common sleep disorder in kids, and what developmental stage does it sometimes correspond with?

A
  • Insomnia

- Often begins around 9 months as separation anxiety is beginning

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17
Q

Most common class of psychiatric disorders in kids:

A

Anxiety disorders

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18
Q

Mgmt of anxiety disorders in kids:

A
  • CBT, therapy and family interventions
  • SSRIs (combination CBT and SSRI is more effective than either alone)
  • Short term benzos (clonidine or other alpha agonist can be used instead)
19
Q

Typical age for anxiety disorders:

A

Average age of onset is 5 years

20
Q

Common somatic complaints seen with depression:

A
  • Insomnia or other sleep issues
  • HA, stomach ache
  • Low concentration
  • Low energy
  • Appetite changes
21
Q

How depressed should a child be before antidepressants should be started?

A
  • Should be considered for moderate depression.

- Strongly recommended for severe depression

22
Q

SSx of diphtheria:

A
  • Tenacious gray pharyngeal membrane
  • Bull neck (brawny edema)
  • (Posterior) cervical lymphadenopathy
  • Rapid pulse
  • Stridor (also occurs with croup)
23
Q

Management of diphtheria:

A
  • IV penicillin G for 14 days

- Bed rest and isolation for 1 - 7 days

24
Q

Metatarsus adductus (varus):

A
  • Flexible: 2-ary to intrauterine positioning, resolves spontaneously
  • Rigid: Unknown etiology, serial casting required.
  • Associated hip dysplasia
25
Q

Diagnosis of club foot:

A
  • Plantar flexion
  • Inversion
  • Adduction
26
Q

Etiology of club foot:

A
  • Idiopathic (may be hereditary)
  • Neurogenic (look for spinal anomalies)
  • Associated syndromes such as arthrogryposis
27
Q

Treatment for club foot:

A
  • Serial casting every week for 6-8 weeks

- Surgery to lengthen contractures in severe cases

28
Q

Risk factors for congenital hip dysplasia:

A
  • Family Hx
  • Breech birth
  • Female (2-3 x more likely)
29
Q

Treatment for congenital hip dysplasia:

A
  • If 18 months
30
Q

Treatment for torticollis:

A
  • Passive stretching
  • Surgical release of muscle origin/insertion if stretching doesn’t work
  • DON’T excise muscle “tumor”
31
Q

Scoliosis:

A
  • Adolescent idiopathic scoliosis the most common type
  • Cobb angle > 10
  • Adams forward bend test in school
  • Bracing if Cobb angle > 20
  • Surgery if Cobb angle > 40
32
Q

Treatment for SCFE:

A

Surgical fixation of femoral head

33
Q

Treatment for Legg Calves Perthes disease:

A

None. Usually self-limiting.

34
Q

Femoral anteversion vs tibial torsion:

A
  • Tibial torsion benign cause of pigeon toe in infants
  • Femoral anteversion responsible for most pigeon toe after age 2
  • Both usually resolve spontaneously
35
Q

Treatment for Osgood Schlatter:

A

None usually. Rest. Can do NSAIDS for pain.

36
Q

True or false: Osgood Schlatter is more common in males than females.

A

True

37
Q

Typical SCFE patient:

A

Overweight adolescent male

38
Q

Treatment for patella femoral syndrome:

A
  • NSAIDS
  • Knee support
  • Physical therapy
  • Surgery to release lateral retinaculum
39
Q

Most common bacteria seen in septic joint:

A
  • Staph

- Neisseria (most common hematogenous spread in adolescents)

40
Q

Treatment for ALL:

A
  • 4 stages
  • 24 months duration
  • chemo, chemo + radiation, intense chemo, maintenance chemo
41
Q

Lab findings in Hodgkins lymphoma:

A
  • Normal CBC

- ESR may be elevated

42
Q

Treatment for Hodgkins lymphoma:

A
  • Chemo (radiation usually unnecessary)

- HSCT for refractory dz

43
Q

What cells seen on microscopy are pathognomonic for Hodgkins lymphoma?

A

Reed Sternberg cells

Infants and Elders (3 decks)

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