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Pediatrics > Pead 6 > Flashcards

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
Q

Precocious puberty?

A

Cystic acne
Pubic hair development
Accelerated growth
In girl <8 and boys <9

26
Q

How to approach?

A

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
Q

High(>2SD)bone growth?

A

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
Q

Another cause of Precocious puberty?

A

Maccune Albright syndrome(GND independent PP)
Caffe-laid spot
Fibrous bone dysplasia

29
Q

why GDM is not associated with 1st TM hyperglycemia complication?

A

GDM occurs after 2nd TM(organogenesis complete .I.e risk of CHD, SLCS and NTD is low)

30
Q

sign of Edward (trisomy 18) disorder?

A 
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
Q

Patu syndrome?

A 
IUGR
Microcephaly
Microphthalmia
Cleft lip/palate/Umbilical hernia/ omphalocele/ holoprosencephaly(midline defect)
Pollyductaly
Cutis aplasia
CHD
Renal defect
Rocker bottom defect
32
Q

Urinalysis feature of renal papillary necrosis?

A

Hematuria
No RBC casts
Echogenic renal medulla on U/S

33
Q

What makes symptomatic in SCT?

A

Hypoxia(high altitude)
Dehydration
Acidosis

34
Q

manifestation in SCT?

A 
RPN
exertional Rhabdomyolysis
Splenic infarction
VTE
Priapism
35
Q

Bloody diarrhea managment?

A

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
Q

cause of anemia of prematurity?

A

Impaired erythropoiesis
Short RBC life span
Repeated blood sampling

37
Q

CM?

A

Usually asymptomatic

But may have apnea, tachycardia, and growth restriction

38
Q

LAb?

A

low Hct and Hg
Low reticulocyte
Normocytic, normochromic
Normal platelet and WBC

39
Q

Test to do inpatient with isolated mild hypospadias?

A 
Urologic study(helps for surgery consideration)
leave foreskin (it may help in repair)--uncircumcised
40
Q

Hypertrophic pyloric stenosis CM?

A 
Firstborn boy
Non-bilious projectile vomiting
Gae 3-5 week
HHMalkalosis with compensatory Respiratory Acidosis
Olive mass(may not be palpable)
41
Q

Medulloblastoma?

A

MC malignant pediatric bT

Originate in the cerebellum and usually compress 4th vent.

42
Q

CM?

A 
Cerebellar symptoms(compression)
ICP sx(4th ventricle obstruction)
43
Q

Tx?

A

Resection
craniospinal radiation
Chemotherapy

44
Q

Niacin deficiency =(pallegra)sx?

A

Photosensitive Dermatitis(sun-exposed, thickened with clear demarcation)
Depression, Distraction or dementia
Diarrhea
May have atrophic glossitis

45
Q

MMR vaccine S/E?

A 
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
Q

Prenatal opiate (heroin, methadone(given for heroin-addicted px women) complication?

A

IUGR
SIDS
Neonatal abstinence syndrome

47
Q

Neonatal abstinence syndrome CM?

A 
48-72 hr delayed upto 4 week
High pitched cry
Sleeping and feeding difficulty
Tremor 
Seizure
Autonomic dysfunction(seating,sneezing)
Tachypnea
Vomiting 
Diarrhoa
48
Q

managment?

A

supporting(frequent small diet, keep in a quiet environment, and help to sleep)
Pharmacologic(morphine, methadone, and buprenorphine)–if supportive treatment fails

49
Q

Vesicourethral reflex pathogenesis?

A

retrograde flow of urine

50
Q

Presentation?

A

Febrile UTI

51
Q

Diagnosis?

A

U/S: Hydronephrosis/focal wedge-shaped fibrosis in kidney

Voiding Cystourethrogram: Urethral filling and dilated collecting system!

52
Q

complication?

A

recurrent UTI

renal fibrosis–RF/HTN

Pediatrics (15 decks)

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