PEDI 14 Flashcards
Cystinuria pathophysiology?
Inability to transport diphasic amino acid-like cysteine, ornithine.lysine, and arginine in renal tubular cell and intestine.
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
GI complication of HSP?
Intussusception(MC)–Iliocolic is common
GI bleeding
Perforation
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
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)
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
NRD risk?
Prematurity (almost all neonates <28 weeks)
BW <1500
Due to immature lung inability to produce surfactant
Management?
continuous PAPV
surfactant replacement and MV reserved for sever case
MAS X-Ray?
Term or post-term MSAF Bilateral patchy infiltration Coarse streaking on both lung fields Flattening of diaphram
Lisch nodule?
raised,tan-colored hamartoma of iris
NFT1
Brushfield spot?
Whitish gray spot in the periphery of IRIS
DS
Cause of acute bacterial rhinosinusitis?
Non-typable H.influenza-45%
S,pnumonia–25%
M.Catheralis–25 %
management?
Amoxacline and clavulanate
Are sinuses present at birth?
ethmoid and maxillary
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
Management?
EEG(during seizure there will be abnormality) Brain MRI(more associated with ICSOL than GS)
What signs make you suspect urethral injury?
Blood at meatus
Haematuria (pink urine)
Urinary retention
what to do?
Retrograde cystourethrography(see contrast extravasation) immediately before any procedure?
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)
Management?
D/C oral feeding
NG tube decompression
Immediate surgical repair
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
