MTB 6 (Pulm) Flashcards
Croup Presentation
Parainfluenza, RSV Triad: Barking cough Coryza Inspiratory stridor
CXR of Croup
Steeple sign - narrowing of air column into trachea
Tx of Croup
Severe - Racemic Epinephrine
Mild - steroids
Dx test for croup
Clinical dz
How to differentiate croup from epiglottitis?
Hypoxia on presentation in croup
Hypoxia imminent in epiglottitis
Differential Dx for Inspiratory stridor - Pediatric
Squeaky, whistle-like Croup Foreign body aspiration Anatomic - Laryngomalacia
Laryngomalacia Presentation
Inspiratory stridor worse in supine position, crying, feeding
Loudest at 4-8 mo’s
Dx test for Laryngomalacia
Laryngoscopy will show omega shaped epiglottis and collapse of supraglottic structures
Epiglottitis Presentation
Hib Hot potato voice Fever Drooling Tripodding Refusal to lay flat PE: hot cherry red epiglottis
Xray of Epiglottitis
Thumb print sign
Tx of Epiglottitis
Intubate in OR
Ceftriaxone for 7-10 days
Rifampin to all close contacts
Cause of whooping cough
Bronchitis by bordetella
Presentation of whooping cough
Catarrhal stage = severe congestion/rhinorrhea, D1-14
Paraxysmal = severe coughing w/extreme gasp for air (inspiratory whoop) -> vomiting, D14-30
COnvalescent = decreased frequency of cough, 14 days duration
Test for whooping cough
Clinical, whooping inspiration, voimting, burst blood vessels in eyes
CXR of whooping cough
butterfly pattern
Tx for whooping cough
Catarrhal - Erythromycin, azithromycin
Isolate child
Macrolides for all close contacts
Pharyngitis presentation
Cervical LA Petechiae Fever > 104 Other URI sxs Acute RF and GN
Dx for Pharyngitis
Rapid DNAase Ag test
Tx for Pharyngitis
Oral PCN 10 days
Macrolides if allergic
Diptheria Presentation
Gray vascular pseudomembranous plaques
DO NOT SCRAPE
Diptheria Dx and TX
Culture superficial membrane
Antitoxin
ABx do NOT work
Congenital hip dysplasia
Age group
Presentation
Infants
Screening during first few NB exams
Congenital hip dysplasia
DX and Tx
Ortolani and Barlow maneuver - click/clunk heard in hip
Tx: Pavlik harness
Legg-Calve-Perthes dz
Age group
Presentation
Ages 2-8
Avascular necrosis of femoral head
Presents w painful limp
XRay of Legg-Calve-Perthes dz
Joint effusions and widening
Tx of Legg-Calve-Perthes dz
Rest
NSAIDs
Surgery on both hips
Slipped Capital Femoral Epiphysis
Age group
Presentation
Ages 10-16 obese
Displacement of femoral epiphysis
Painful limp AND externally rotated leg
Slipped Capital Femoral Epiphysis XRay
Widening of joint space
Slipped Capital Femoral Epiphysis TX
Internal fixation with pinning
Duchenne muscular Dystrophy
Age
Presentation
Age 3-5
Progressive weakness, Gower maneuver, calf pseudohypertrophy, intellectual disability, cardiomyopathy
Duchenne muscular Dystrophy
Dx
Genetic for deletion of dystrophin chrom xp21
Confirm w/muscle Bx
Becker muscular dystrophy
Age
Presentation
Age 5-15
Milder weakness than DMD
Myotonic Muscular Dystrophy
Age 12-30
Facial weakness, hand grip, myotonia, dysphagia
Arrythmias, cataracts, balding, testicular atrophy, infertility
Osgood Schlatter
Age
Presentation
Traction of apophysitis
Knee pain in adolescent males - athletes
Edema/tenderness over tibial tubercle
Pain w/extension of knee against resistane
TX for Osgood Schlatter
Activity restriction
Stretching exercises
NSAIDs
