Ophtho_Derm_Respiratory_UW_pretest Flashcards
Most common predisposing factor to orbital cellulitis
Bacterial sinuisitis
Gonococcal conjunctivitis aka
ophthalmia neonatorum
3 most common causes of conjunctivitis in neonates
Chemical, gonoccocal conjunctivitis, chlamydial
What day does chlaymdial conjunctivitis present and gonococcal conjnctivitivs
5-14 days; 2-5 days
Gonoccocal conjunctivitis can be prevented with?
Erythomycin ointment within 1 hour of birth.
Trachoma presentation
Follicular conjunctivitis and pannus (neovascularization) in the cornea
Ophtho exam for infants
Fixation and tracking
Ophtho exam for older infants and children
Strabismus
Viscual acuity testing for kids older than 3
Snellen letter chart
What is strabismus
Ocular misalignment
treatment of strabismus
Forced used of eye with defect. Cover normal eye, or put cyclopegic drops in normal eye (make it blurry)
Abnormal findings for strabismus
constant stabismus at any age, eye deviation after 4 months of age, asymmetry of corneal light reflexes, asymmetry intensity of red reflexes, deviation on cover test, torticollis or head lift
Erythema multiforme usually follows what kind of infection?
“Target” lesions. Follows herpes simplex infection.
Measles rash compared to rubella rash.
Measles tend to be more severe than rubella. Also a/w high fever (up to 104), coryza, and malaise.
Scarlet fever rash has what kind of texture
Sandpaper due to numerous tiny papules
Congenital rubella ppt?
sensorineural hearing loss, intellectual disability, cardiac anomalies, cataracts, glaucoma
Presentation of rubella in children?
low grade fever, cephalocaudal rash, blanching, maculopapular; conjunctivitis, coryza, cervical lypahdenopathy, Florscheimer spots
Dx of rubella
PCR, and acute serology of IgM and IgG
What is eczema herpeticum and presentation?
Form of primary herpes simplex virus infection a/w atopic dermatitis. Numerous vesicles over area of atopic dermatitis is typical.
How should eczema herpeticum in infants be treated?
Can be life threatening in infants. Treat with acyclovir.
Some infantile hemangiomas can be treated with?
beta blockers
Preferred initital treatment for tinea capitis
Oral griseofulvin
Tinea capitis is?
Superficial dermatophytosis that occurs commonly in children, especially african american.
What is erythema toxicum neonatorum (ETN)
asymptomatic, blotchy, erythematous papules and pustules. Can change appearance. Occurs in first 2 weeks of life.
Allergic contact dermatitis is an example of what kind of hypersensitivity
Type IV which is aka cell-mediated, delayed-type
type 1 hypersensitivity
aka immediate hypersensitivity. IgE mediated. Allergen binds and cross-reacts with 2 IgE molecules attached to mast cell. Atopy, urticaria, anaphyslaxis
Type 2 hypersensitivity.
aka antibody mediated hypersensitvity. Cytotoxic reactions involve specific reactions of IgG or IgM to cell-bound antigens. The antibodies then activiate complement resulting in cell damage. Example hemolytic anemia
Type 3 hypersensitvity
aka immune complex mediated hypersensitivity. Antibodies of IgM or IgG form complexes with antigens and nonspecifically activate the complement cascade and other inflammatory processes. Examples include serum sickness.
HSV infection on face is usually where?
Orolabial region
What are the most common causes of impetigo?
Staph aureus and streptococcus pyogenes
Children with HSP have what kind of platelet count?
Normal
SSSS caused by? Presentation?
Exfoliative toxin producing Staph aureus. Prodrome of fever, irritability, skin tenderness, followed by generalized erythema and superficial flaccid blisters with positive nikolsky sign. Scaling and desquamation follow. Before resolution of disease.
What is torticollis
Twisting of the neck due to asymmetric muscle activity
Most common cause of acquired torticollis
Upper respiratory infections, minor trauma, cervical lymphadenitis and retropharyngeal abscess.
For kids presenting with torticollis what should be done?
Obtain cervical spine radiographs to rule out cervical spine fracture or dislocation
Hereditary angioedema presentation
Rapid onset edema of face, acral extremities, genitals, trachea, and abdominal organs without urticaria.
Hereditary angioedema is due to
Deficiency/dysfunction in C1 inhibitor which results in elevated levels of edema producing factors of C2b and bradykinin
What is the most common cause of acquired angioedema
ACE inhibitor use which leads to elevated levels of bradykinin
Steeple sign on xray
Croup
Thumbprint sign and loss of varucellular space
Epligotittis
1st priority in epligotittis
Secure the airway by endotracheal intubation in operating room. Keep child comfortable and calm.
What is bronchiolitis
first episode of wheezing a/w URTI and signs of respiratory distress
How does bronctiolitis present?
URTI sx, wheezing, coughing, fever, respiratory distress
Neonates are vulnerable to what complications of bronchiolitis
Apnea and respiratory failure
Chest x-ray findings for RDS?
Characteristic fine reticular granularity of the lungs.
Treatment for RDS?
Assisted ventilaton - CPAP. In more severe cases, intubation and mechanical ventilation.
CD19+ cells are?
B lymphocytes
CD3+ cells are
T lymphocytes
Risk factors for RDS
1) prematurity the most important. 2) male sex, perinatal asphyxia, maternal diabetes, C section without labor
Laryngomalacia presentation
Inspiratory stridor, worse in supine position and with crying. Peaks at 4-8 months
Laryngomalacia prognosis
Most resolve by 18 months.
Dx of laryngomalacia
Clinical but direct visualizatin of laryngoscopy shows collapse of supraglottic structures during inspiration.
Erb duchenne / phrenic nerve paralysis during delivery results in what kind of chest finding on what imaging
Fluorscopy or U/S. shows asymmetric diaphragmatic motion of the chest in a seesaw manner. Chest xray can be normal or show elevated hemidiaphragm.
What is diagnostic for CF?
Sweat chloride concentration of greather than 60mEq/L. Less than 40 are normal.
Bronchiolitis commonly caused by
RSV, and also parainfluenza virus and adenovirus. Tx is generally supportive and condition is generally self limited.
Lung empyema is characterized by what on x-ray
Nearly complete white out by pleural or extrapleural fluid collection. Pus in anatomical cavity is an empyema.
Lung abscesses are generallyc aused by
Staph aureus, Strep pyogenes, strep pneumo
How many weeks required before hypersensitivty to tuberculin develops?
3-8 weeks required. Therefore you TB test should be repeated in exposed persons if there is a negative reaction at the time the contact with source of infection is broen.
Are small children with TB infectious?
Not usualy because TB is transferred by gram negative bacilli laden droplets are dispersed through the air. Small infants aren’t capable of coughin up and producing sputum. If produced, they swallow it back
Standard treatment for TB?
Isoniazid and rifampin for 6 months, ethambutol and pyrazinamide for first 2 months.
Idiopathic pulmonary hemosiderosis ppt/findings? Test?
may have findings that point to pneumonia like fever, respiratory distress, localized chest fidings. But hemoptysis can suggest pulmonary hemorrhage. Can find microcytic and hypochromic anemia, low serum iron levels, occult blood in stools from swalling pulmonary secretion. bronchoalveolar lavage will reveal hemosiderin laden macrophages.
What is an uncommon but potentially life threatening sequale of viral croup?
Bacterial tracheitis.
Bacterial tracheitis signs?
Biphasic stridor and high fever, after several days of viral URI symptos. Patients can also present acutely without the initial viral sx.
Bacterial tracheitis management?
Endotracheal intubation and IV antibiotics.
Failure to rinse mouth after inhaled steroids can lead to?
Thrush which is a localized candida infection
Kartagener Syndrome
Triad of situs inversus, chronic otitis media and sinuisits, and airway disease
What is congenital cystic adenomatoid malformation and what are the radiographic findings
Thought to arise from embryonic disruption that causes improper development of bronchioles. Large lesions may compress the affected lungs and cause pulmonary hypoplasia and cause midline shift away from lesion. Tx is surgical excision of the affected lobe.
Retropharyngeal abscess clinical ppt
Hx of pharyngitis, sore throat, refusal of food, drooling, abrupt fever, buldge in posterior pharyngeal wall is diagnostic as are lateral radiographs of the neck. Palpation reveals fluctuant mass
Where is the retropharyngeal abscess located
Behind the posterior pharyngeal wall and in front of the prevertebral fascia
