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Pediatrics: Case Files > MedU Clipp 21 > Flashcards

MedU Clipp 21 Flashcards

1
Q

(5) Signs and Symptoms that Indicate Urgent Stabilization?

A
  • 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
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2
Q

What causes Petechiae and Purpura?

A
  • 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
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3
Q

(10) DDx for Bruising and Leg Pain?

A
  • 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)
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4
Q

Causes of Hepatomegaly?

A
  • Inflammation (Viral Hepatitis)
  • Infiltration (Leukemia / Lumphoma)
  • Accumulation of Storage Products (Glycogen Storage)
  • Congestion (CHF)
  • Obstruction (Biliary Atresia)
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5
Q

Causes of Arthritis in Children?

A
  • Trauma
  • Septic Arthritis
  • Transient Synovitis
  • Reactive Arthritis
  • Lyme Disease
  • Rheumatic Fever
  • Juvenile Idiopathic Arthritis
  • Systemic Lupus Erythematososu
  • Henoch-Schonlein Purpura
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6
Q

(3) DDx for Rash and Leg Pain?

A
  • 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
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7
Q

Infections that Cause Splenomegaly?

A
  • Epstein-Barr virus
  • Cytomegalovirus
  • Bacterial Sepsis
  • Endocarditis
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8
Q

Hemolysis that causes Splenomegaly?

A

Sickle Cell Disease

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9
Q

Malignancy that causes Splenomegaly?

A
  • Leukemia
  • Lymphoma
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10
Q

Storage Diseases that cause Splenomegaly?

A
  • Gaucher Disease
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11
Q

Systemic Inflammatory Diseases that cause Splenomegaly?

A
  • Systemic Lupus Erythematosus
  • Juvenile Idiopathic Arthritis
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12
Q

Congestion that causes Splenomegaly?

A
  • A complication of Portal Hypertension
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13
Q

Laboratory Evaluation of Henloch-Scholen Purpura (HSP)?

A
  • Platelet Count
  • Urinalysis
  • BUN and Creatine
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14
Q

What is Henoch-Schonlein Purpura (HSP)?

A
  • a.k.a. Anaphylactoid purpura
  • Self-limited
  • IgA-mediated
  • Small-vessel Vasculitis
  • Typically involves the Skin, GI tract, Joints, Kidney’s
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15
Q

Signs and Symptoms of HSP?

A
  • Hallmark of HSP is non-Thrombocytopenic purpua
  • Renal involvement (33%)
  • Hematuria
  • Arthritis (knees and ankles)
  • Colicky Abdominal Pain (65%)
  • Upper Respiratory Tract Infection (66%)
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16
Q

What is Idiopathic Thombocytopenic Purpura (ITP)?

A
  • 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
17
Q

What is Intussusception?

A
  • A Proximal Segment of Bowel invaginates or Telescopes into the Distal segment adjacent
  • Mesentery becomes entrapped
  • Vascular compression
  • Ischemia
  • ‘Currant-jelly’ stool
18
Q

What is the Classic Presentation of Intussusception?

A
  • 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
19
Q

Treatment of Intussusception?

A
  • Air Enema
  • Barium Enema
  • Reduction by Hydrostatic pressure
  • HSP-intussusception is usually ileo-ileal and will not be reduced by Air or Barium Enema
20
Q

Complications of HSP?

A
  • Intestinal Bleeding - Stool Guaiac test
  • Kidney Involvement - Hematuria
21
Q

How do you tell the difference between HSP and ITP?

A
  • Thrombocytopenia is not a characteristic of HSP
  • Low Platelets is commonly seen in ITP
  • Often the delineating finding

Pediatrics: Case Files (16 decks)

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