Ped1 Flashcards
which vitamin is deficient in milk?
VitD and Vit A
X-ray in ricket?
Winding of metaphysis
Ricket treatment?
Vit D and Ca
Cause of Niemann-pick disease?
sphingomyelinase deficiency
AR
CM?
loss of motor milestone 2-6 month
Chery red macula
Hepatosplenomegaly
Hyporeflexia/areflexia
How to d/t from tay-sacks disease?
in Tay saks
b-hexosaminidase deficiency
No hepatosplenomegaly
Hyperreflexia
Biliary duct cyst?
cystic dilation of bile duct
single and extrahepatic form common
CM?
majority of patients <10 RUQ pain RUQ palpable mass Obstructive Jaundice with acholic stool Elevated Panc.Enzyme due to pancreatitis in old children or reflex of pan. enzyme
Diagnosis and Managment?
Diagnose with abdominal U/S Managment Tumor resection(relieve obstruction and reduce risk of cholangiocarcinoma transformation)
How to d/t from biliary atresia?
In biliary atresia, there will be Hepatomegaly Absent visible gallbladder Present with infancy (2-8) week No pancreatic enzyme elevation In U/S absent gall bladder/BD/CBD Intraoperative cholangiography is GS for diagnosis
Managment of BA?
Surgical hepato-portoenterpstomy (Kasai procedure)
Liver transplant
Breast milk jaundice?
A peak in the second week
Due to B-glucoronidase in milk-deconjugate intestinal bilirubin
Unconjugated hyperbilirubinemia
Neuroblastoma pathogenesis?
Neural crest origin
Involve adrenal medulla and sympathetic chain
CM?
Midian age < 2 Abdominal Mass Fever, weight loss Opsoclonus(rapid eye movt-Myoclonus(rapid extremity jerking movt) syndrome Periorbital echemosis Spinal metastasis
Diagnostic evaluation?
Increase catecholamine metabolite
Small, round blue cell tumor
N-myc gene amplification
Indications for non-contrast CT in pediatric TBI?
LOC
AMS
Foccal nurogic sighn
sever mechanism of head injury((fall(in-age <2,>0.9m in >2(fall >1.5m//MVC?high impact)
Non frontal scalp hematoma and palpable skul # in <2
Vomiting,S.Headache,basilar Skul # in age 2-18
Steeps of neonatal resuscitation?
Dry and stimulate
Clear suction
Provide warmth(skin to skin)
when to do first?
Term
Breath/cry
Appropriate tone
If above the APGAR will be 9
Ahy tracheal suctioning is not recommended?
Stimulate vagus–apnea/bradychardia
Indication for the cardiac monitor?
Bradycardia(<100)
Apnea
Gasping
The patient requires chest compression
Friedrick ataxia?
Autosomal resecive
Due to GAA repitision
Fraexine gene defect
CM?
Dysarthria LE weakness Loss of position and vibration(DCI) Loss of DTR(PRG injury) MSK(Kyphoscloliosis, High arched palate) High risk of Hypertrophic CM(Death by age 40)
Imaging?
Cervical spinal cord atrophy
Managment?
Supportive
Genetic testing for diagnosis and for family for feaucher risk
Not have disease-modifying drug
Acute severe anemia cause In pt. with SCD?
Aplastic crisis
Splenic sequestration crisis
Splenic sequestration crisis feature?
Anemia Hypotension-shock Thrombocytopnia Rapideley Splenomegaly High reticulocyte Manage with saline, small volume
Aplastic crisis?
Viral flu symptom
Anemia
Thrombocytopenia
Low reticulocyte
Fluid managment in DKA patients?
10ml/kg NS over one hour
Risk factor for sudden infant death syndrome?
Smoking exposure Age < 20 Inconsistent prenatal care Prone/side position Soft sleep surface/loos bedding Bed-sharing Prematurity Sibling with SIDS
Definition?
Sudden unexplained with symptom or autopsy death
NEC risk?
Prematurity
Wight, 1.5 kg
Enteral formula feeding
CM?
V/S instability
Bilious vomiting
Bloody stool
Abdominal Distension
X-ray finding?
Pnumatosis intestinae
Portal venous gas
Pneumoperitoneum
Managment?
Bowel rest/TPF
Broad-spectrum IV antibiotic
+- surgery
Neonate for C/Difficele infection?
Not develop due to absent receptor for Toxine
Craniopharyngioma SX?
Cystic/Calcified mas in the suprasellar region
Bitemporal HA
LOW pituitary hormon
Osteogenesis imperfecta pathogenesis?
Autosomal dominant
Collagen 1 gene defect
CM?
Recurrent # Blue sclera Cond.Hearing loss Short/normal stature Hypermobile joints Dentinogenesis imperfecta In sever(T2)-pulmonary failure/inutro or neonatal #
Sliped capital femoris ephyphisis risk factor?
Obesity
Adolescence
CM?
Dull hip pain Refeered knee pain Alerd gait Limited internal rotation Lateral hip rotation during passive hip flexion
Diangnosis?
Posyterior displacment of femoral head
Treatment?
Non-wight bearing
Surgical pining
Complication?
Avascular necrosis
Osteoartheritis
Bedweting is normal at what age?
Untill child become 5 year
When doea incontinence need investigasion in childrens?
When persist more than 4
C/I for breast feeding?
Active untreated TB HIV Herpti breast lesion Varicella infection < 5 day prior or 3 day post partum Specific maternal indication abuse of street drug or alcohol
Benifit of breast feeding?
Improved immunity
Improved GI infection
Prevension of infectious disease(OM,GI,RI and UTI)
Dec risk of childhood ca,T1DM and NEC
Bedweting managment?
Urinalysis to r/o other disease urinate before bed avoid water before alarm avoid sugary and caffeinated beverages institute reward system Enurasis alarm Desmopresine TCA(impiramne),if not respond to desmopresine
symptome of compartment syndrome?
pain and swelling unresponsive to anangesics
4P
cause of meningitis in age <1 month?
GBS
E.Coli and other gram negative
L.Monocytinogene
HSV
> 1 month?
S.Pnumonia
N.meningitis
