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Pediatrics > Pedi 11 > Flashcards

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
Q

what about Hirshusprung disease?

A

Narrow rectosigmoid
Dilated anal cannel
Proximal colon enlargement unlike Meconium ileus(micro colon)

26
Q

Congenital syphilis Bony complication?

A

Limited joint movement and pain

Frontal bossing and anterior tibia bowing(age >2)

27
Q

Acute unilateral cervical LDN in children cause?

A

S.A & S.P:MC/Suppration is common
Anaerobic: Hx of periodontal disease and dental caries
Francella: Hx of animal contact(rabbit)

28
Q

Acute unilateral cervical LDN in children causes management?

A

Clindamycin

29
Q

Chronic unilateral cervical LDN in children cause?

A

MAC: Violaceous

B.H: Papule at the site of scratch/bite

30
Q

Bilateral cervical LDP?

A

Acute: Adenovirus
Chronic: CMV/EBV–Infectious mono

31
Q

Physiologic jaundice pathophysiology?

A

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
Q

CM?

A

2-4 day
Resolve 1-2 week
Hogh UB

33
Q

Management?

A

Frequent feeding: Increase GI flora

Phototherapy if a rapid increment

34
Q

Pneumonia in CF patient management?

A

MRSA(MC):–Vanvomycine +

Anti-psudomonal(2nd C):-Cefempine/ceftazidime

35
Q

How to d/t cardiac failure in CAV and KD?

A

In CAV
No coronary abnormality
The rash is papulovesicular and involves feet, hands, and mouth.But polymorphic(confluent) in KD.

36
Q

Cxs of CHARGE syndrome?

A 
Coloboma(opening in one eye structure)
Heart defect
Atresia choanae
Retardation of growth
Genitourinary malformation
Ear abnormality
37
Q

Aditional finding?

A

Anosmia
Cleft palate
Hypotonia

38
Q

Diagnosis?

A

Clinical

CHD& testing

39
Q

Choanal atresia CM?

A

Cyanosis at rest and feeding and improve when cray

Inability to pass NG tube through the nose

40
Q

cause of cyanotic heart disease with single S2?

A

Transposition of the great vessel–+/- VSD
Tetralogy of Fallot–+VSD/Pulmonary harsh murmur
Trunks arteriosus–+ systolic ejection murmur
Tricuspid atresia:—+VSD

41
Q

S.A enterotoxin?

A 
Foods like salad, dairy items, egg, meat and produce
Vomiting predominant
Sx starts 1-6 Hr 
Resolve 24-48 hr
\+/- diarrhea
42
Q

If parents disagree on emergency care?

A

Proceed with treatment if one parent agree

43
Q

ITP management in children?

A

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
Q

why a fetus with 21 hydroxylase deficiency will have no aldosterone deficiency sx in the first 1-2 weeks?

A

Maternal Aldosterone

45
Q

C/I for rotavirus vaccination?

A 
normaly given 2-6 months in serious
Allergy
Hx of intussusuption
SCID
Delay until disease resolusion  in moderate and severe current rota illnes
46
Q

why DMD patients walk by toe?

A

Achilles tendon contacture

47
Q

DMD management?

A

Glucocorticoid

48
Q

DHN management in neonates?

A

<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
Q

Normal finding in the neonate?

A

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
Q

MaCcune Albright syndrome pathophysiology?

A 
GNAS gene(g-protein) mutation--excessive pituitary hormone release
LH/FSH--peripheral precocious puberty
TSH--Thyrotoxicosis
GH---Acromegaly
Cushing syndrome--ACTH
51
Q

other manifestation?

A

fibrous bone dysplasia–recurrent #

irregular border cafe-aue-lait-maccule

52
Q

What about NFT1?

A 
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
Q

benign murmur cx?

A 
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
Q

management?

A

reassurance

55
Q

Indication for voiding cystourethrogram inpatient with UTI?

A

> =2 UTI
Abnormal renal U/S(hydronephrosis)
Fever >39 with etiology other than E.Coli
Sign of CKD(HTN, Poor growth)

56
Q

High-grade(III & IV) VUR tx?

A

Daily antibiotics treatment

57
Q

when will be repeated urine culture be necessary?

A

Sx does not resolve within 48 hr

58
Q

Hypernatremia clinical feature?

A 
Lethargy 
Irritability
AMS
Seizure
Muscle cramp
Muscle weakness
Decrease DTR
59
Q

Pertussis post-exposure prophylaxis?

A

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
Q

Hypostenusia?

A

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
Q

Sign of malnutrition in DM patients?

A

Growth retardation
Recurrent hypoglycemia
Decrease insulin requirement
Anemia

62
Q

what to suspect?

A

celiac disease

do ATTG level

Pediatrics (15 decks)

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