Pead 4 Flashcards
Patient, who has anovulatory AUB and has C/I for OCP what to give?
Progesterone
What should be done for patients with septic arthritis not respond to vancomycin?
add ceftriaxone(cover G -ve and some anaerobes)
when considering tx in infectious mono.?
Corticosteroid if the patient has respiratory difficulty
fetal hydantoin sydrome?
Due to inutro phenytoin exposure microcephaly wide fontanel Cleft lip and plate Distal phalange hypoplasia cardiac(AS, PS)
Prevention?
reduce phenytoin
increase the folic acid dose
peritonsillar abscess?
fever
sore throat
uvula deviation
muffled noise
Pediatric constipation risk factor?
Initiation of solid food and cow milk prior to 12 months
Entry to school
Toilet training
CM?
Painful hard bowel movement
Stool witholding
Fecal incontinence
complication?
anal fissure
hemorrhoid
enuresis/UTI
Managment?
1st-lower milk(<24 oz) and inc fiber diet and water intake
2nd –laxatives
3rd–suppositories/enema
DiGeorge syndrome?
Craniofacial anomaly(CP) Abnormal facies Hypoparathyroidism Cardiac defect(conotruncal anomaly) Thymic hypoplasia
bee sting allergy respond but recur after IM epinephrine what should you do?
Repeat IM epinephrine
Venom immunotherapy after stabilization
what to do inpatient with bac. meningitis?
First, do LP
If critical start Ab before LP
x-linked agamaglobulinimia CM?
X-linked recessive
Recurent SP and GI infec
>3-6 month
absent/decrease lymphoid tissue
Managment?
Immunoglobulin therapy
Prophylactic Ab
Selective mutism dxs?
Selective silence in some situations.
For more than one month
R/O other causes like autism
Considered as part of SAD
Managment?
CBT
SSRI
HPV vaccination?
2 dose 6 months apart in age <15
3 dose in age > 15
If sexually active?
annual chlamydia infection screening in age <25
Routinely done in adolescence health visit?
Contraceptive and safe sexual practice
CM of posterior uretral valve in neonate?
Bladder distension
Low urine output
Gaining weight in early neonatal days
RD due to lung hypoplasia
What to do?
Abdominopelvic U/S
Cystourethrogram if U/S abnormal(pos.urethral dilation)
Cystoscopy for confirmation and abalation
Tx for otitis externa?
Topical flouroquinolol(cover Psudomonas(MCC) and s.aures(2ndc)).
Fetal alcohol syndrome 3 pathognomic feature sign?
Smooth filtrum
Thin upper vermilion border
Small palpebral fisure
Other sign?
Microcephaly groweth < 10 % Intellectual disability ADHD Social withdrawal Delay in motor and language development
Chylothorax cxs?
Exudative
High TG
Lymphocyte predominant
Milky
Risk?
thoracic duct injury 2ndary to
Trauma/surgery
Cong .mal(down,nannon)
Malignancy
Managment?
CT/thoracentesis
Limit fat diet
TD ligation
Cerebral palsy sign?
1-2 year
UMNL sign
Predominantly involve the lower extremity
Downward and inward feet(equinovarus deformity)
Motor development affected
Non-progressive
Basal ganglia atrophy and periventricular lukomalasia
Risk factor?
Prematurity
Low birth weight
perinatal hypoxic encephalopathy
Managment?
physical, occupational and nutritional therapy
antispasmodic therapy
speech therapy
Cause of Iron deficiency anemia in children?
Start cow milk before 12
maternal IDA
Prematurity
what about vit D?
all infants should be given daily Vit D
B-12?
in strict vegetarians
VIT C?
Breast milk contains an adequate amount
Ductad dependent CHD menifestation?
fine at delivery
begat to be symptomatic after PDA starts to close in the first 24 hr.
what are this CHD?
TAVR T.atresia Truncus arteriosus TGA Hypoplastic LV
Managment?
Give PGE1 unless concomitant PDA
Bacterial AGE symptom?
fever
abdominal pain
bloody diharroa
Shigella compl?
seizure
Bacteremia(fatal)
Low Hus risk
Rectal prolapse
managment?
supportive
Ab in severe case(not inc. risk of HUS unlike H15:7 e.coli)
HL histopathology?
Reed Sternberg cells
in cat scratch lymphoid hyperplasia with necrosis
Sx?
B-Symptoms
cervical/mediastinal LDP
Dyspnea and cough in Mediastinal involvement
managment?
chemotherapy > 85% cure
DMD feature?
Groos motor devt affected Gower sign Inability to stand alone in 18 month Calf psudohyperthrophy inability to run,go stairs and Wealcher dependent on adolescence due to contracture Normal fine motor and other function
Workup?
CK level–screening
Dystrophin gene defect –diagnostic
Mild DHN?
loss of 3-5 % fluid
Asymptomatic
Moderate DHN?
6-9 % loss Decrease skin turgor Decrease urine OP Tachycardia Capillary refill 2-3 % Dry mucous membrane
Sever DHN?
10-15 % Cool clumpy skin capillary refill > 3 min sunken eyeball sunken fontanelle lethargy Minimal/ no u/o hypotension and shock
managment?
Isotonic crystalloid IV in moderate to sever
oral hydration in mild and moderate
TOF CVS finding?
Crescendo/decrescendo murmur at LUSB Single s1(aorta closure-A1,pulmonary stenosis--absent P1)
acute managment?
Knee chest position-In.PVR
also inc.o2 delivery — pul. vasodilation
those both effect lead to inc.RV outflow
