MedU Clipp 21 Flashcards
(5) Signs and Symptoms that Indicate Urgent Stabilization?
- Altered Mental Status
- Cerebral Perfusion, Airway, Circulation
- Mottled Skin
- Respiratory Distress
- Tachypnea, Grunting, Increased work of Breathing
- Respiratory Depression
- Slow, Shallow, Oxygenation and Ventilation
- Cyanosis
What causes Petechiae and Purpura?
- Trauma
- Platelet Deficiency or Dysfunction
- Immune-mediated Thrombocytopenia
- Bone marrow Infiltration / suppression
- Malignancy
- Coagulation abnormalities (hereditary, clotting-factor)
- Vascular fragility (immune-mediated vasculitis)
- Combos
- Coag Abnormalities, Vascular fragility, platelet consumption
(10) DDx for Bruising and Leg Pain?
- Coagulation Disorder
- Henoch-Schonlein purpura (HSP)
- Idiopathic Thrombocytopenic Purpura (ITP)
- Leukemia
- Viral Infection
- Bacterial Endocarditis
- Drug Reaction
- Meningococcal Septiciemia
- Rocky Mountain Spotted Fever
- Systemic Lupus Erythematosus (SLE)
Causes of Hepatomegaly?
- Inflammation (Viral Hepatitis)
- Infiltration (Leukemia / Lumphoma)
- Accumulation of Storage Products (Glycogen Storage)
- Congestion (CHF)
- Obstruction (Biliary Atresia)
Causes of Arthritis in Children?
- Trauma
- Septic Arthritis
- Transient Synovitis
- Reactive Arthritis
- Lyme Disease
- Rheumatic Fever
- Juvenile Idiopathic Arthritis
- Systemic Lupus Erythematososu
- Henoch-Schonlein Purpura
(3) DDx for Rash and Leg Pain?
- Henoch-Schonlein Purpura
- primarily the lower extremities
- periarticular vasculitis (arthritis or arthralgia)
- Idiopathic Thrombocytopenic Purpura
- NOT a/w splenomegaly
- Leukemia
- Pain secondary to bone marrow expansion
- Splenomegaly
- Lymphadenopahty
Infections that Cause Splenomegaly?
- Epstein-Barr virus
- Cytomegalovirus
- Bacterial Sepsis
- Endocarditis
Hemolysis that causes Splenomegaly?
Sickle Cell Disease
Malignancy that causes Splenomegaly?
- Leukemia
- Lymphoma
Storage Diseases that cause Splenomegaly?
- Gaucher Disease
Systemic Inflammatory Diseases that cause Splenomegaly?
- Systemic Lupus Erythematosus
- Juvenile Idiopathic Arthritis
Congestion that causes Splenomegaly?
- A complication of Portal Hypertension
Laboratory Evaluation of Henloch-Scholen Purpura (HSP)?
- Platelet Count
- Urinalysis
- BUN and Creatine
What is Henoch-Schonlein Purpura (HSP)?
- a.k.a. Anaphylactoid purpura
- Self-limited
- IgA-mediated
- Small-vessel Vasculitis
- Typically involves the Skin, GI tract, Joints, Kidney’s
Signs and Symptoms of HSP?
- Hallmark of HSP is non-Thrombocytopenic purpua
- Renal involvement (33%)
- Hematuria
- Arthritis (knees and ankles)
- Colicky Abdominal Pain (65%)
- Upper Respiratory Tract Infection (66%)
What is Idiopathic Thombocytopenic Purpura (ITP)?
- ITP is caused by the binding of an anti-platelet antibody to the platelet surface
- -> Leading to the Removal and Destruction of Platelets in the Spleen and Liver
- -> Isolated Thrombocytopenia in Healthy Children
What is Intussusception?
- A Proximal Segment of Bowel invaginates or Telescopes into the Distal segment adjacent
- Mesentery becomes entrapped
- Vascular compression
- Ischemia
- ‘Currant-jelly’ stool
What is the Classic Presentation of Intussusception?
- Paroxysms of Severe Abdominal Pain w/ Inconsolable crying
- Passage of “Currant Jelly’ Stool w/ Blood and Mucus
- Palpation of a “Sausage-shaped” mass in the Right Abdomen
Treatment of Intussusception?
- Air Enema
- Barium Enema
- Reduction by Hydrostatic pressure
- HSP-intussusception is usually ileo-ileal and will not be reduced by Air or Barium Enema
Complications of HSP?
- Intestinal Bleeding - Stool Guaiac test
- Kidney Involvement - Hematuria
How do you tell the difference between HSP and ITP?
- Thrombocytopenia is not a characteristic of HSP
- Low Platelets is commonly seen in ITP
- Often the delineating finding
