Lecture 47 - Pediatric Physical Diagnosis

Question 1

Pediatric BP is always taken in the RUE. Why?

If pediatric patients have a diagnosed HTN, the first thing you should think of is issues with the _____.

Answer 1

Aortic coartation will cause HTN ONLY in the RUE.

Kidneys

Question 2

Physical characteristics of Hypothyroidism include coarse _____ and _____ hernia.

In Fetal Alcohol Syndrome (FAS), look for wide spaced ____, absent or smooth _____, and thin upper lip.

Answer 2

Coarse Facies

Umbilical hernia

Eyes

Philtrum

Question 3

Cushing’s physical exam findings might reveal characteristic _____ hump (upper back) and _____ facies.

Answer 3

Buffalo hump

Moon facies

Question 4

Sickle cell can present with ______ hyperplasia (increased production of RBCs to compensate for hemolysis).

Answer 4

Maxillary hyperplasia (big overbite)

Question 5

Multiple Cafe au lait spots (at least 5 greater than ____cm) OR ______ freckling (Crowe’s sign) are indicative of _______.

Hypopigmented macule or freckling is indicative of ______ ______.

These are both autosomal _______, often with incomplete penetration.

Answer 5

0.5cm

Axillary freckling

Neurofibromatosis

Tuberous Sclerosis

Dominant

Question 6

Nevus Flammeus (Port wine stain) is indicative of ____-____ disease. These children have seizures bc they have the same vascular malformation in the brain as the one that causes the Nevus Flammeus.

Answer 6

Sturge-Weber

Question 7

Children presenting with Edema, especially diffuse or in multiple areas –> think kidneys, so they should be tested with a urinalysis bc ______ syndrome resulting from ____ _____ disease is the most common kidney issue.

Answer 7

Nephrotic syndrome

Minimal Change disease

Question 8

Mottling (Cutis Marmorata) is a blotchy appearance of the skin. It can be normal, but if the patient is ill appearing, it can be a sign of ______.

Answer 8

Sepsis

Question 9

Is central or peripheral Cyanosis in children normal?

Answer 9

Peripheral

Central will present with cyanosis of mucous membranes.

Question 10

Petechiae/Purpura rashes are of great concern if they are generalized. They can be a sign of Meningococcemia or Rocky Mountain Spotted fever. If it is non-infectious and there is Thrombocytopenia with Neutropenia and Anemia –> ______ until proven otherwise, and the child should be sent for bone marrow biopsy. If it’s just thrombocytopenia –> Immune Thrombocytopenic Purpura which is much less severe.

Answer 10

ALL (Acute Lymphocytic Leukemia)

Question 11

Children presenting with conjunctivitis that spares the area around iris and skin rashes, cracked red lips, or swollen hands may have ______ disease –> a vasculitis with multi-organ involvement that can cause fatal MI from aortic aneurysm).

Answer 11

Kawasaki disease

Question 12

Henoch-Schonlein syndrome is a vasculitis that presents with a characteristic purpura rash, but where specifically? It often follows _____ infection and can lead to GI, renal, or _____ issues.

Answer 12

Below the waist, so on the buttocks and legs.

Viral

Joint

Question 13

Leucocoria describes a white reflex in the eye when a light is shown on them. It can indicate _____ or Retinoblastoma.

Answer 13

Cataracts