Whitish gray spot in the periphery of IRIS DS

PEDI 14 Flashcards by molla asnake

Cystinuria pathophysiology?

Inability to transport diphasic amino acid-like cysteine, ornithine.lysine, and arginine in renal tubular cell and intestine.

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CM?

Recurrent Cysteine stone(unlike other AA not water soluble)
Hexagonal,radiolucent stone
Cyanide NP test help to diagnose by detecting cysteine levels in urine
Family Hx of nephrolithiasis

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GI complication of HSP?

Intussusception(MC)–Iliocolic is common
GI bleeding
Perforation

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Treatment of neonatal Clavicular #?

Reasurance
Gentele handling
Analgesics
Place the affected limb on a long sling and 90-degree flexion
Heal by itself within 7-10 day

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lumbar vertebral spondylolisthesis CM?

Common in age 10-19(groeth spurt and phy. lordosis)
Athletes with repetitive lumbar flexion and rotation
Palpable steep off on lumbar area(vertebral bodies seepage)
Bilateral or unilateral radioculophaty
Due to # of pars interreticularis)

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x-ray feature of the cause of neonatal RD?

TTN: Bilateral Perihilar linear streaking
NRDS: Defuse ground-glass opacity, AB, low lung volume
PPHtn: Clear lung with a decrease vascularity

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NRD risk?

Prematurity (almost all neonates <28 weeks)
BW <1500
Due to immature lung inability to produce surfactant

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Management?

continuous PAPV

surfactant replacement and MV reserved for sever case

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MAS X-Ray?

Term or post-term
MSAF
Bilateral patchy infiltration
Coarse streaking on both lung fields
Flattening of diaphram

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Lisch nodule?

raised,tan-colored hamartoma of iris

NFT1

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Brushfield spot?

Whitish gray spot in the periphery of IRIS

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Cause of acute bacterial rhinosinusitis?

Non-typable H.influenza-45%
S,pnumonia–25%
M.Catheralis–25 %

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management?

Amoxacline and clavulanate

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Are sinuses present at birth?

ethmoid and maxillary

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Symptom of focal seizure?

Motor(Twitching…)
sensory(Parastesia…)
Autonomic(Sweating…)
May have semi purposeful automatism(chewing, picking)
May have LOC/Tods paralysis following the seizure

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Management?

EEG(during seizure there will be abnormality)
Brain MRI(more associated with ICSOL than GS)

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What signs make you suspect urethral injury?

Blood at meatus
Haematuria (pink urine)
Urinary retention

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what to do?

Retrograde cystourethrography(see contrast extravasation) immediately before any procedure?

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Duodenal atresia CM?

MC GI complication of DS
Bilious vomiting in first 2 day
Failure to pass meconium
On x-Ray(double bubble sign and Absent bowel gas)

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Management?

D/C oral feeding
NG tube decompression
Immediate surgical repair

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a sign that makes you suspect brain abscess in ABRS patients?

Persistent/focal headache
New fever
Morning vomiting
AMS
Neck pain/stiffness
Focal neurologic sign

Diagnosis and management?

CT(ring-enhancing lesion)

Drainage and antibiotic

Non-bullous impetigo CM?

Affect mainly face and extremity
Mild itching and pain
Papule, pustule and honey crust lesion

What about scabies?

Interdigious area
small papule
Highley pruritic

Bronchiolitis Epidimiology?

Age < 2 year | RSV is MC ethiology

CM?

antecedent URTI | weezing,crackle and RD

Treatment?

Supportive

Complication?

Apnea(Age <2) Respiratory failure Recurrent wheezing through childhood

Prevention?

Palamizumab for selected patients GA<29 week Chronic lung disease of prematurity Hemodynamically significant HF

Physiologic GERD In Infancy CM?

Post pradial regurgitation(spitt up) No failure to thrive or irritability Decrease by 6 months and resolve by one year

Why are infants at risk?

Short esophagus Relaxed LGES Spend at supine

Management?

Small frequent feed 20-30 min sit upright after feeding Decrease supine positioning(make prone when awake) Decrease activity increase IAP(tight diaper)

What about pathologic GERD?

Failure to thrive Significant irritability Sandifer syndrome(intermittent opisthotonus posturing)

Management?

Thick food | PPI

management of scabies?

P[ermethrin | Ivermectine

BHS(breath-holding spell)CM?

Episode of apnea Triggered by frustration, anger, or pain Classified as cyanotic or pallid Common in 6 months to 5 year

Cyanotic?

Crying and breath-holding Followed by apnea, limpness, and LOC Rapidly return to baseline

Pallid type?

Following trauma | LOC followed by BH, pallor, and diaphoresis

management?

reassurance resolve by age 5 some develop vasovagal syncope at adulthood

D/C B/N primary and secondary varicocele?

P: Left side, decrease in a supine position and associated with LRV obstruction by SMA and AA and due to valve I. S: Right side, Not decompress in supine and associated with IVC thrombosis or compression by abdominal mass.

Management?

L: Reassurance R: Abdominal u/s

Gaucher disease genetics?

AR MC lysosomal storage disease Glucocerebrocidase deficiency Glucocerebrocide accumulation in Lysosome

CM?

``` Sever splenomegaly Hepatomegaly Growing bone pain Anemia Thrombocytopenia Delayed in groweth Delay in puberty ```

management?

enzyme suplementation

Prevention of neonatal VZV infection?

If mother develop disease 5 days prior and 2 days after delivery Isolate neonate from mother give IV Ig for neonate

when to give antiviral?

If neonate becomes symptomatic

neonatal screening?

``` Genetic/metabolic disease Hyperbilirubinemia Hearing screening Pre and post ductal pulse oximetry Hypoglycemia(in selected one) ```

Paranoid syndrome in children?

``` occur due to pineal gland mass obstructive hydrocephalus sign Limited upward gaze Upper eyelid retraction Papillary abnormality(react to accommodation but not light) ```

where is the obstruction in the crop?

Proximal trachea

QT prolongation treatment?

Beta-blocker and Peacemaker

CM rubella?

Fever Cephalocaudal rash petechiae/erythematous rash on the soft palate Posterior auricular,subocipital and posterior Cr LDP Arthritis in adults