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Pead 6 Flashcards

1
Q

Biopsy cxs of biliary atresia?

A

Portal tract edema and fibrosis

Intrahepatic biliary duct proliferation

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2
Q

pathogenesis?

A

Progressive extrahepatic bile duct fibrosis and obstruction

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3
Q

Varicella zoster(chiken Pox) CM?

A 
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
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4
Q

Antiviral indication?

A

Immunocompromised and have complications (Pn.,CA)

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5
Q

Prevention?

A

Vaccine at age of 1 and 4

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6
Q

Gross motor change in infancy?

A 
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
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7
Q

Fine mtor change in infacy?

A

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

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8
Q

Language change in infancy?

A 
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
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9
Q

Social/cognitive?

A 
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
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10
Q

When babianski disaper?

A

12-24 month

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11
Q

Does tongue protrusion disappear in?

A

4-6 months: allow coordinated swallowing

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12
Q

Leg-Calve-Perthes disease pathophysiology?

A

Common in 5-7 year but occur (3-12)
Due to femoral head avascular necrosis
Due to vascular malformation

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13
Q

CM?

A

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

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14
Q

X-ray?

A

lucent and hyperdense bone lesion for replacement

flattening/fragmenting of the femoral head)

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15
Q

Managment?

A

Surgery if unable to femoral head inside the acetabulum

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16
Q

BPD(bronchopulmonary dysplasia) feature?

A 
CLD of neonate
Persistent 02 requirement
Tachypnea
Rhonchi
Bilateral lung haziness and reduced lung volume
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17
Q

Pathophysiology?

A

Prolonged 02 therapy
Mechanical ventilation
Inflammation

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18
Q

Progress?

A

Usually, resolve within2-4 a month

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19
Q

Risk factor?

A

Prematurity
LBW
MV
NRDS

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20
Q

what to do inpatient with overlapping symptoms of TS and S.artheritis(mild Esr elevation and low-grade fever)

A

Hp joint u/s then do Joint fluid analysis

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21
Q

What D/T septic arthritis from transient synovitis?

A 
IN SA
High fever
Mainly unilateral
Significant leukocytosis, ESR, and CRP elevation
Unable to bear wight on affected joint
22
Q

Cat scratch disease cxs sx?

A

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)

23
Q

Diagnosis and managment?

A

D-Usually clinical but can serology be done

M-usually self-limited but azithromycin can be given

24
Q

Mild PDA sign?

A

Continuous flow murmur

Accentuation pheripherial pulse

25
Precocious puberty?
Cystic acne Pubic hair development Accelerated growth In girl <8 and boys <9
26
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)
27
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
28
Another cause of Precocious puberty?
Maccune Albright syndrome(GND independent PP) Caffe-laid spot Fibrous bone dysplasia
29
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)
30
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.) ```
31
Patu syndrome?
``` IUGR Microcephaly Microphthalmia Cleft lip/palate/Umbilical hernia/ omphalocele/ holoprosencephaly(midline defect) Pollyductaly Cutis aplasia CHD Renal defect Rocker bottom defect ```
32
Urinalysis feature of renal papillary necrosis?
Hematuria No RBC casts Echogenic renal medulla on U/S
33
What makes symptomatic in SCT?
Hypoxia(high altitude) Dehydration Acidosis
34
manifestation in SCT?
``` RPN exertional Rhabdomyolysis Splenic infarction VTE Priapism ```
35
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.
36
cause of anemia of prematurity?
Impaired erythropoiesis Short RBC life span Repeated blood sampling
37
CM?
Usually asymptomatic | But may have apnea, tachycardia, and growth restriction
38
LAb?
low Hct and Hg Low reticulocyte Normocytic, normochromic Normal platelet and WBC
39
Test to do inpatient with isolated mild hypospadias?
``` Urologic study(helps for surgery consideration) leave foreskin (it may help in repair)--uncircumcised ```
40
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) ```
41
Medulloblastoma?
MC malignant pediatric bT | Originate in the cerebellum and usually compress 4th vent.
42
CM?
``` Cerebellar symptoms(compression) ICP sx(4th ventricle obstruction) ```
43
Tx?
Resection craniospinal radiation Chemotherapy
44
Niacin deficiency =(pallegra)sx?
Photosensitive Dermatitis(sun-exposed, thickened with clear demarcation) Depression, Distraction or dementia Diarrhea May have atrophic glossitis
45
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! ```
46
Prenatal opiate (heroin, methadone(given for heroin-addicted px women) complication?
IUGR SIDS Neonatal abstinence syndrome
47
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 ```
48
managment?
supporting(frequent small diet, keep in a quiet environment, and help to sleep) Pharmacologic(morphine, methadone, and buprenorphine)--if supportive treatment fails
49
Vesicourethral reflex pathogenesis?
retrograde flow of urine
50
Presentation?
Febrile UTI
51
Diagnosis?
U/S: Hydronephrosis/focal wedge-shaped fibrosis in kidney | Voiding Cystourethrogram: Urethral filling and dilated collecting system!
52
complication?
recurrent UTI | renal fibrosis--RF/HTN

Pediatrics (15 decks)

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