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Pedi 11 Flashcards

1
Q

Absence seizure CM?

A

4-10 year
Sudden impairment of consciousness” staring spell”
Preserved muscle tone
Unresponsive verbal/tactile stimulation
Short duration(<20 sec)
Simple motor automatism(chewing/lip smacking/eye blinking/fluttering) is frequently present
easily provoked by hyperventilation

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2
Q

Diagnosis?

A

EEG:3-Hz spike-wave discharge during an episode

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3
Q

Management?

A

Ethosuximide
Usualy resolve in adolecence
No long term sequelae

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4
Q

D/t from ADHD?

A 
In ADHD
Staring spells responsive to vocal/tactile stimulation
Forgetfulness
Difficulty in organization
Easy distractibility
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5
Q

Cause of vaginal bleeding in neonates?

A 
Hormonal(estrogen withdrawal)--mucoid, self resolved
Trauma--Sexual abuse/unintentional fell
vaginal foreign bodies-Foul-smelling discharge
Vaginal malignancy(pr. Mass)--main rhabdomyosarcoma
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6
Q

Leukocoria in infancy?

A

Absent Of normal red reflex in the eye

or presence of white reflex

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7
Q

Cause?

A

Cataract
Eye tumor (retinoblastoma)
Severe retinopathy of prematurity
Retinitis pigmentosa

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8
Q

Cataract?

A 
Congenital infec (CMV, RUBELLA)--microcephaly, bilateral and other congenital inf sign
Metabolic--Bilateral
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9
Q

Eye tumor (retinoblastoma)?

A 
Age < 2
Mostly unilateral/bilateral in inherited case
Strabismus
Nystagmus
Diagnose with MRI of brain and orbit
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10
Q

Severe retinopathy of prematurity?

A

An infant born <30 week

Retinal detachment

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11
Q

Retinitis pigmentosa?

A

Decrease night vision
Decrease vision acuity and power
Rare to see cataracts in age <1

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12
Q

Metatarsus adductus?

A 
Common in children of primigravida
Flexible positioning
Medial positioning of the forefoot
Normal hindfoot position
Overcorrect by forefoot lateralization during active/passive foot movt
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13
Q

What about club foot?

A

Flexible positioning
Medial/upward positioning of the forefoot and hindfoot
Hyperplatar flexed foot
Highley associated with C.A(Karyotaype is necessary)

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14
Q

Management D/C?

A

MA:reassurance
CF:Serial manipulation/casting & surgery for refractive cases

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15
Q

Wiskot andrich syndrome pathogenesis?

A

X-LR
WAS protein gene defect–Defect in cytoskeleton signaling after cell signaling.
Defect in hematopoietic cell
WBC and Platelet will be affected
Impaired WBC migration and immune synapse formation

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16
Q

CM?

A

Triads
1-Eczema
2-Small and low platelet–bleeding
3-Recurrent infection (viral/bacterial and fungal)

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17
Q

Risk factor for developmental dysplasia of hip?

A

Breech presentation
Family hx
Tight swaddling(the traditional practice of wrapping a baby up gently in a light, breathable blanket)
Female and white

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18
Q

Clinical feature?

A 
Red flag(Hip dislocation,+ Barlow and Ortolani test, Impaired hip abduction)
Supportive(Leg discrepancy, unequal crease in gluteal, inguinal, and thigh area)
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19
Q

Management?

A 
Red flag: refer to orthopedics center
Supportive/risk factors depend on
1-< 4month--U/S
2-> 4 month--X-ray
Definitive tx is Pavlik harness maneuver(use splint to make hip flexion and abduction and prevent extension and adduction)
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20
Q

EYe complication of Marfan?

A

Upward and lateral lense
Iridodonesis(rapid dilation and constriction of iris)
MYopia(due to elongated aye)

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21
Q

CVS complication of marfan?

A

aneurysm
dissection
MVP
Aortic dilation–AR

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22
Q

Bilious vomiting in neonate indicates?

A

Distal bowel obstruction

Hemodynamically stable–Immediately do X-Ray(r/o perforation)

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23
Q

Meconium ileus?

A 
CF patient
Distended S.Bowel
Empty rectum
Microcolon(due to notusing collon)
failure to pass muconium>48 of birth
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24
Q

Management?

A

First, do an x-ray to r/o perforation
Do hyperosmolar enema(dissolve plug)
Surgery if enema fails

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25
what about Hirshusprung disease?
Narrow rectosigmoid Dilated anal cannel Proximal colon enlargement unlike Meconium ileus(micro colon)
26
Congenital syphilis Bony complication?
Limited joint movement and pain | Frontal bossing and anterior tibia bowing(age >2)
27
Acute unilateral cervical LDN in children cause?
S.A & S.P:MC/Suppration is common Anaerobic: Hx of periodontal disease and dental caries Francella: Hx of animal contact(rabbit)
28
Acute unilateral cervical LDN in children causes management?
Clindamycin
29
Chronic unilateral cervical LDN in children cause?
MAC: Violaceous | B.H: Papule at the site of scratch/bite
30
Bilateral cervical LDP?
Acute: Adenovirus Chronic: CMV/EBV--Infectious mono
31
Physiologic jaundice pathophysiology?
High RBC turnover(High HCT and Short BilirubinLS) Low Hepatic Clearance(Unmatured HGT until 2 weeks) High EH reabsorption:Low colonic flora-Low UB formation
32
CM?
2-4 day Resolve 1-2 week Hogh UB
33
Management?
Frequent feeding: Increase GI flora | Phototherapy if a rapid increment
34
Pneumonia in CF patient management?
MRSA(MC):--Vanvomycine + | Anti-psudomonal(2nd C):-Cefempine/ceftazidime
35
How to d/t cardiac failure in CAV and KD?
In CAV No coronary abnormality The rash is papulovesicular and involves feet, hands, and mouth.But polymorphic(confluent) in KD.
36
Cxs of CHARGE syndrome?
``` Coloboma(opening in one eye structure) Heart defect Atresia choanae Retardation of growth Genitourinary malformation Ear abnormality ```
37
Aditional finding?
Anosmia Cleft palate Hypotonia
38
Diagnosis?
Clinical | CHD& testing
39
Choanal atresia CM?
Cyanosis at rest and feeding and improve when cray | Inability to pass NG tube through the nose
40
cause of cyanotic heart disease with single S2?
Transposition of the great vessel--+/- VSD Tetralogy of Fallot--+VSD/Pulmonary harsh murmur Trunks arteriosus--+ systolic ejection murmur Tricuspid atresia:---+VSD
41
S.A enterotoxin?
``` Foods like salad, dairy items, egg, meat and produce Vomiting predominant Sx starts 1-6 Hr Resolve 24-48 hr +/- diarrhea ```
42
If parents disagree on emergency care?
Proceed with treatment if one parent agree
43
ITP management in children?
Only cutaneous manifestation--Observe regardless of platelet count(unlike adult PLT should be>30,000) Glucocorticoid, IVIg. Ani-D(RH + & Cb-) if have Bleeding Spontaneous recovery in 3 month
44
why a fetus with 21 hydroxylase deficiency will have no aldosterone deficiency sx in the first 1-2 weeks?
Maternal Aldosterone
45
C/I for rotavirus vaccination?
``` normaly given 2-6 months in serious Allergy Hx of intussusuption SCID Delay until disease resolusion in moderate and severe current rota illnes ```
46
why DMD patients walk by toe?
Achilles tendon contacture
47
DMD management?
Glucocorticoid
48
DHN management in neonates?
<7 % wt loss--continu feeding and apint after 10-0-14 day | >7% wt loss--asses oromotor function,asses lactational failure,dailey wight,consider formula suplementation
49
Normal finding in the neonate?
Uric acid crystals(pink stain and brick dust on diaper) 5% weight loss in the first week Regain birth weight at 10-14 day No of wet diaper = age in days and >6 after the first week.
50
MaCcune Albright syndrome pathophysiology?
``` GNAS gene(g-protein) mutation--excessive pituitary hormone release LH/FSH--peripheral precocious puberty TSH--Thyrotoxicosis GH---Acromegaly Cushing syndrome--ACTH ```
51
other manifestation?
fibrous bone dysplasia--recurrent # | irregular border cafe-aue-lait-maccule
52
What about NFT1?
``` Precocious puberty(optic glioma affecting hypothalamus) and #(long bone dysplasia) But the cfe-aue-lait spot will have a regular border and >=6 and have associated axillary freckling and angiofibroma ```
53
benign murmur cx?
``` no cardiac symptom I-II grade mid systolic murmur Decrease on standing and Valsalva Low pitched musical, pure and squeaky on LSB(still murmur), and High pitch in LUSB(pulmonary outflow murmur) No additional feature ```
54
management?
reassurance
55
Indication for voiding cystourethrogram inpatient with UTI?
>=2 UTI Abnormal renal U/S(hydronephrosis) Fever >39 with etiology other than E.Coli Sign of CKD(HTN, Poor growth)
56
High-grade(III & IV) VUR tx?
Daily antibiotics treatment
57
when will be repeated urine culture be necessary?
Sx does not resolve within 48 hr
58
Hypernatremia clinical feature?
``` Lethargy Irritability AMS Seizure Muscle cramp Muscle weakness Decrease DTR ```
59
Pertussis post-exposure prophylaxis?
Regardless of immunization To all close contact Partial contact with high-risk people like Px Age <1 M. azithromycin Age >1 M, azithromycin, clindamycin, and erythromycin
60
Hypostenusia?
Common in sickle cell T/D Difficulty in renal water reabsorption Polyuria/Nocturia unresponsive to water restriction Normal kidney concentrating ability(normal Na) Low urine specific gravity Ni treatment require Transfusion decrease symptoms
61
Sign of malnutrition in DM patients?
Growth retardation Recurrent hypoglycemia Decrease insulin requirement Anemia
62
what to suspect?
celiac disease | do ATTG level

Pediatrics (15 decks)

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