Pedi 10 Flashcards
Infantile Colic diagnostic criterion?
Diagnosis of exclusion >3h/day,>3/Week cry Age < 3 month At the same time(evening) Parents have difficulty in consoling at this time
Risk factor?
Inappropriate feeding(many breaths of air) Gut immaturity
Management?
Check sooting
Reassurance and support
Good feeding(upright feeding in bottle feding)
Decrease environmental stimuli - Keep in a dark room
Gerd in children?
Irritability Spit up Back arching after feeding refusal to eat weight loss
Tourette syndrome?
Present before 18
Multiple motor ticks
one or more vocal tics
Common in male
Motor tics?
shoulder shrugging eye blinking grimacing nose touching head jerking
Vocal tics?
Throughout clearing Coughing Barking Grunting Squawking Coprolalia
Comorbid condition?
MC(ADHD,OCD)
LC(AD,LD,CD,D,ASPD)
Growing pain?
age 2-12
Occur primarily at night and resolve in the morning
Affect bilateral lower extremity
Normal physical finding and activity
Treatment?
Parental education and reassurance
Massage,stretching exersise,heat and analgesics
Risk factor for IDA?
Prematurity
Lead exposure
Age <1(Exclusive breast feeding > 6 months, Cow, Goat, soy milk)
Age >1(>24 oz/day cow milk,<3 serving iron reach food )
A complication of IDA?
Neurocognitive development can be affected
Why is cow milk a risk for IDA?
Low content
Ca and casinophosphatide impair Iron absorption
High intake decreases another food intake
Cental cyanosis?
Involve oral mucosa and trunk
Indicate Hypoxia
Peripheral cyanosis?
Acrocyanosis/only peripheral cyanosis
Present on many healthy newborns
Renal and bladder U/S in first UTI indication?
Age < 2
alpha thalassemia feature?
Microcytosis Elevated RBC count HbH(Beta tetramer) Barts Hb(Gama(fetal Hb) thetramer Target cell
Acute chest syndrome sign?
Fever
Cough/Chest pain
Pulmonary infiltration
Congenital cause of recurrent UTI?
MCC is VUR(diagnosed with cystourethrogram)
Posterior Urethral valve(Onley in boys)
Renal scarring diagnosis?
Renal Scintigraphy followed by dimercaptosuccemic acide
Congenital TOXO sx?
Hydrocephalus
Intracranial calcification
Hepatosplenomegaly
jaundice
Bluberi muffin
Chorioretinitis(At adulthood,due to reactivation)
Maternal fever, LDP after cat feces, or undercooked food exposure?
Management?
Sulphadiazine/pyramitamin + folic acide
Anovulatory AUB?
Heavy,irregular, and painless bleeding
In adolescence
Due to HPO axis immaturity
Due to anovulation
When to suspect VWD in AUB?
Other areas bleeding like epistaxis
HSP purpura complication in severe disease?
RF
HTN
Nephrotic range proteinuria
CM of choanal atresia?
Depend on weather
Unilateral
Bilateral
Unilateral?
Chronic nasal discharge
Maybe symptomatic at childhood
May be Associated with CHARGE syndrome
Bilateral?
Cyanosis that worsen with feeding and improve with crying
Noisy breathing
Symptomatic at birth
diagnosis?
Inability to pass the nasal catheter
Confirm with CT scan
Management?
oral airway
surgical repair
CM of congenital infection?
IUGR
HSM
Jaundice
Bluberin mufine
Is syphilis specific?
Rhinorrhea
Abnormal long bone
Desquameting rash involves hand and palm
Management?
Penicillin-prevent late complication like Atchison thieth and frontal bossing
complications?
Open–osteomyelitis
Displaced–Malunion
Physis involvement–bone length shortening
Femoral neck–Avascular necrosis
Jujinal/ilial atresia sign on X-Ray?
Triple buble(Stomach,dodnum and jujnum) Absent colonic and rectal gas
Pathogenesis?
Intrauterine vascular accident(small bowel resorption)
Maternal vasoconstrictor usage(Cocaine and smoking will increase risk)
Fragile -X - syndrome genetics?
X-linked
MCC of inherited intellectual disablity
CGG TN repeat
FMR protein hypermitilation
Fragile -X - syndrome sign?
ID Long face Protruding ear Macroorchiadism ADHD and ASD Delay in speech and motor function
Post cardiac surgery pericardial effusion?
Develop within weeks
Fever and other effusion sign
Pericardial effusion sign
Due to autoimmune rxn
CM of causteic ingestion?
Chemical burn/Liquifactive necrosis
Affect lip, tongue, oral mucosa, and esophagus
Chest/abdominal pain
Haematemesis/dysphagia and odynophagia
Management?
Prehospital
Hospital(emergency)
At admission
Prehospital?
Decontamination
do not induce vomiting or charcoal
Hospital?
Confirm decontaminasion
Abd and Chest X-ray–confirm perforation
ETI–If significant OP injury
Consider lavage if NG tube placed
At admission?
12-24 hr–endoscopy if stable/No RD/Perforation
Serial X-ray
Tube feeding and Surgery for a severe case
Atlantoaxial Instability in down S?
Laxity of TL B/N C1 and C2
result in Compression of SC
CM?
Weakness with High reflex
Hypotonia
Urinary incontinence
Vertebro basilar Sx(dizziness,vertigo,imbalance, and diplopia
Tethered cord syndrome?
Associated with Spina bifida
T12/L2 lesion
No UMS
JRA menifestation?
Depend on the type Systemic Polyarticular Oligoarticular all have morning stiffness,symmetric joint involvement and may have small joint effusion?
Systemic?
10% Age < 18 Fever for more than 2 week Arthritis >1 joint > 6 weeks HSM LDP Event rash
Polyarticular?
> =5 joint
May have uveitis
No systemic symptome
Oligoarticular?
<5 joint
May have uveitis
No systemic symptoms
Management?
NSAID
DMARD if not responding
Management of C.diaphramatic hernia?
ET intubation
NG tube placement
Surgical correction
Breastfeeding jaundice?
first week Due to inadequate B/F Due to I.EH circulation and D.Bilirubin elimination Inadequate B.F and DHN In.IB
Breast milk jaundice?
2-5 day
I.EH circulation
Adequate B.F and Normal examination
management for BFJ ?
B/F frequency>10-20 min every 2-3 hr
MC cause for SCD in exercise?
HCM(may have no prior symptoms)
Small for gestational age newborn?
<10 % weight for GA
Symmetric (W/H/HC will be affected)
Asymmetric (W spared)
Complication?
Hypoxia Aspexia Hypothermia Hypoglycemia Polycythemia
