Pead 6 Flashcards
Biopsy cxs of biliary atresia?
Portal tract edema and fibrosis
Intrahepatic biliary duct proliferation
pathogenesis?
Progressive extrahepatic bile duct fibrosis and obstruction
Varicella zoster(chiken Pox) CM?
Transmit by air Predorm(fever and mailase) Maculopapular rash(involve, trunk, face, and extremity, Highley pruritic with different stage of vesicle) Breakthrough varicella: mild varicella in a patient with taking only one vaccine) In rare case can cause pneumonia and ataxia
Antiviral indication?
Immunocompromised and have complications (Pn.,CA)
Prevention?
Vaccine at age of 1 and 4
Gross motor change in infancy?
2m--Head lift in pron position 4m--Role/sit with trunk support 6m--Site momentarily and propped on hand 7m--Sits independently 9m--Pulled to stand/cruise 12--Stand well/throw a ball and walk first steep
Fine mtor change in infacy?
2m–Unfisted in 50 % and track midline
4m–Hand will open mostly/reach the midline
6m–Transfer object from one hand to other/raking grasp
9m—3 fingr pincer grasop/hold cub/bottele
12–2 finger pincer grasp
Language change in infancy?
2m--Coos/alert to voice 4m---Smile/turn to voice 6m--Turn to his name,, Bublees 9m: Say mama or dada 12m-- Say one word other than mama/dada
Social/cognitive?
2m--social smile/recognize parent 4m--Enjoy looking around 6m--Stranger anxiety 9m--wave bye, play pat in Kake 12m--separation anxiety/Commes when called
When babianski disaper?
12-24 month
Does tongue protrusion disappear in?
4-6 months: allow coordinated swallowing
Leg-Calve-Perthes disease pathophysiology?
Common in 5-7 year but occur (3-12)
Due to femoral head avascular necrosis
Due to vascular malformation
CM?
Chronic progressive leg/hip pain with limping
Resistance to internal rotation and abduction
Tigh muscle atrophy
Not able to carry weight in the lesion site
X-ray?
lucent and hyperdense bone lesion for replacement
flattening/fragmenting of the femoral head)
Managment?
Surgery if unable to femoral head inside the acetabulum
BPD(bronchopulmonary dysplasia) feature?
CLD of neonate Persistent 02 requirement Tachypnea Rhonchi Bilateral lung haziness and reduced lung volume
Pathophysiology?
Prolonged 02 therapy
Mechanical ventilation
Inflammation
Progress?
Usually, resolve within2-4 a month
Risk factor?
Prematurity
LBW
MV
NRDS
what to do inpatient with overlapping symptoms of TS and S.artheritis(mild Esr elevation and low-grade fever)
Hp joint u/s then do Joint fluid analysis
What D/T septic arthritis from transient synovitis?
IN SA High fever Mainly unilateral Significant leukocytosis, ESR, and CRP elevation Unable to bear wight on affected joint
Cat scratch disease cxs sx?
caused by Bartonella hassle
papular/nodular skin lesion at bite/scratch site(may unnoticed)
Reginal painful, tender, large LDP with overlying skin erythema
+/- fever of known origin(>14 day)
Diagnosis and managment?
D-Usually clinical but can serology be done
M-usually self-limited but azithromycin can be given
Mild PDA sign?
Continuous flow murmur
Accentuation pheripherial pulse
Precocious puberty?
Cystic acne
Pubic hair development
Accelerated growth
In girl <8 and boys <9
How to approach?
Assess bone growth first
High(>2SD)bone growth–thru PP
Normal bone growth–Premature adrenarche(isolated Pubic hair devt) and Premature thelarche(Isolated breast devt)
Low bone growth–Hypothyroidism(can cause GND dependent PA/T)
High(>2SD)bone growth?
measure LH
High LH–Central(pituitary/hypothalamus dependent)
Low LH–Do GnRH stimulation
If low after LH–peripheral cause(tests/adrenal)
If LH is high after stimulation–Still consider the central cause
Another cause of Precocious puberty?
Maccune Albright syndrome(GND independent PP)
Caffe-laid spot
Fibrous bone dysplasia
why GDM is not associated with 1st TM hyperglycemia complication?
GDM occurs after 2nd TM(organogenesis complete .I.e risk of CHD, SLCS and NTD is low)
sign of Edward (trisomy 18) disorder?
Advanced maternal age(high meiosis ND) IUGR Microcephaly Prominent occiput Micrognotia Low set ears A clenched fist with overlapping fingers CHD Renal defect Hip abduction defect rocker bottom feet(talus bone has formed in the wrong position and other foot bones have shifted on top of it.)
Patu syndrome?
IUGR Microcephaly Microphthalmia Cleft lip/palate/Umbilical hernia/ omphalocele/ holoprosencephaly(midline defect) Pollyductaly Cutis aplasia CHD Renal defect Rocker bottom defect
Urinalysis feature of renal papillary necrosis?
Hematuria
No RBC casts
Echogenic renal medulla on U/S
What makes symptomatic in SCT?
Hypoxia(high altitude)
Dehydration
Acidosis
manifestation in SCT?
RPN exertional Rhabdomyolysis Splenic infarction VTE Priapism
Bloody diarrhea managment?
In the case of E.C o;157:H:7 only supportive(AB and loperamide increase risk of HUS) but in the case of Sh,Ca, and Sal we can give Ab if severe.
cause of anemia of prematurity?
Impaired erythropoiesis
Short RBC life span
Repeated blood sampling
CM?
Usually asymptomatic
But may have apnea, tachycardia, and growth restriction
LAb?
low Hct and Hg
Low reticulocyte
Normocytic, normochromic
Normal platelet and WBC
Test to do inpatient with isolated mild hypospadias?
Urologic study(helps for surgery consideration) leave foreskin (it may help in repair)--uncircumcised
Hypertrophic pyloric stenosis CM?
Firstborn boy Non-bilious projectile vomiting Gae 3-5 week HHMalkalosis with compensatory Respiratory Acidosis Olive mass(may not be palpable)
Medulloblastoma?
MC malignant pediatric bT
Originate in the cerebellum and usually compress 4th vent.
CM?
Cerebellar symptoms(compression) ICP sx(4th ventricle obstruction)
Tx?
Resection
craniospinal radiation
Chemotherapy
Niacin deficiency =(pallegra)sx?
Photosensitive Dermatitis(sun-exposed, thickened with clear demarcation)
Depression, Distraction or dementia
Diarrhea
May have atrophic glossitis
MMR vaccine S/E?
the measles may cause a reaction in 3-5 % within 1-3 weeks of vaccination Mild fever and rash less contagious Resolve by itself Normally given at 1 and 4 years!
Prenatal opiate (heroin, methadone(given for heroin-addicted px women) complication?
IUGR
SIDS
Neonatal abstinence syndrome
Neonatal abstinence syndrome CM?
48-72 hr delayed upto 4 week High pitched cry Sleeping and feeding difficulty Tremor Seizure Autonomic dysfunction(seating,sneezing) Tachypnea Vomiting Diarrhoa
managment?
supporting(frequent small diet, keep in a quiet environment, and help to sleep)
Pharmacologic(morphine, methadone, and buprenorphine)–if supportive treatment fails
Vesicourethral reflex pathogenesis?
retrograde flow of urine
Presentation?
Febrile UTI
Diagnosis?
U/S: Hydronephrosis/focal wedge-shaped fibrosis in kidney
Voiding Cystourethrogram: Urethral filling and dilated collecting system!
complication?
recurrent UTI
renal fibrosis–RF/HTN
