Pedi 15 Flashcards
Which disease-related GBS has a worse prognosis?
C.Jujni related
Long duration to recovery
Residual neurologic effect
when to diagnose PP?
Water deprivation 2-3 HR
Then U OSM becomes>600mos/l
when to give desmopressin?
When S.Na?>145 or S.OSM.>295
when do we say urine dilute?
0sm<300mosm/l
Specific gravity<1.006
water deprivation test principle?
Should be done in a hospital setting in old children
Should not be done in very young children(risk of hypernatrimia)
The complication of transfusion-related acute hemolytic reaction?
Hemoglobinuria
ARF(ATN)
SHOCK
DIC
Transfusion-related bacterial infection in common in?
Platelet transfusion(stored at room To)
Tx of AOM for penicillin-allergic patients?
Clindamycin
Azithromycin
management of AOM?
Amoxicillin
(amoxa-clav if patient Tx in last 30 days
Ciprofloxacin ear drop inpatient with placed ear tube with otorrhea.
Tests to be done in strabismus?
first access using dilated fundoscopic assessment for intraocular mass(retinoblastoma0
then possible ICSOL
Factors associated with strabismus?
mostly idiopathic
intraocular mass(retinoblastoma)
ICP
A sleep-related complication of OSA?
Enuresis
Parasomnia (Sleep waking and terror)
Macrocephaly defn?
HC >97 %
when we consider benign(Fam. Macrocephaly 2nd to megaloencephalophaty)
Normal Devt No syndromic feature No sign of ICP No sign of infection Normal U/S
management?
reassurance and cont observation
child abuse sign-in #?
posterior rib #
Femoral # in non-ambulatory child
Metaphysical corner #(buckle #)
# in different stages of healing
what to do?
Skeletal survey CT scan(subdural heamorage) Fundoscopy(retinal hemorrhage)
Otitis media with effusion(OME) d/t From AOME?
OME
No TM inflammation
No fever and severe ear pain
Non-prulent inflammation
OME management?
Follow Up(ass. with speech delay and CHL if chronic(>3 months)
when do we consider tympanostomy tube placement?
Chronic(>3month with hearing loss)
a complication of high(>6 diopter lens) complication?
Retinal detachment
Macular degeneration
Battery swallowing S/E?
Localize tissue necrosis(if spills alkaline content)
E.Corrosion–By creating an external current
Acute management?
Endoscopic removal
After a month of barium swallowing–To assess stricture
Post-concussion syndrome CM?
> 4 week Headache Sleep disturbance Diiness Cognitive impairment Mood change
Risk factor?
Nonadherence to a gradual return to play protocol
Multiple concussion
Management?
Symptomatic care only
Activity as tolerated
Transfusion-associated circulatory overload?
Age <3 and >60
Underling renal or cardiac disease
Large/Fast transfusion
CM?
RD
Increase B/P and PR
Pulmonary edema
Management?
02
diuretics
what about ATRLI?
No HTN bt may have hypotension
No sign of circulatory overload(S3 gallop and rales)
Respiratory support only
what triggers headache of concussion?
Physical activity Noise Visual activity Emotional experience Cognitive tasks
Late presentation for an infant who not given VitK?
2 week to 6 month
Intracranial Hemorrhage—Obstructive hydrocephalus
May not have other area bleeding
ICH sign On CT?
layered hyperdense fluid in Ventricles
Hydrocephalus
sign of midbrain compression?
upward gaze difficulty(patient will have persistent down ward gaze)
cause of hemorrhagic stroke in children?
vascular malformation(AVM,anurithm) Heamatologic abnormality(SCD and heamophilia)
AVM?
Anomalous connection B/N veins and artery
Create high-pressure flow in weak vessels–Hemorrhage
Hereditary Hemorrhagic telangiectasis?
AD
AVM
Mucocutaneous telangiectasias
Multiorgan TE(Liver,brain Lung)
HHD and stock?
Intraventricular/parenchymal/subarachnoid hemorrhage
Hyperdense lesion on CT
What to do in a patient with TBI with no high-risk feature?
reassurance and discharge
Not need imaging
what to do if have high-risk feature?
Head non-contrast CT
Observation(2-6 hr after symptom-free)
What are high-risk features for both <2 years and >2?
AMS
LOC
High impact
MVA
specific for <2?
Non frontal heaamatoma
palpable skul #
fall > 0.9 m
specific >2?
ICP sign
Basilar skull # sign
Fall >1.5 m
when fontanel closed?
9-18 month
effect of hydrocephalus on child devt?
Developmental delay(Speech, Both motor)
what to do?
U/S for fontanelle non closed and
MRI for closed fontanel
how to d/t from rett?
rett have to decrease HC devt(microcephaly)
MCC of viral GI?
Rota in unvaccinated and age <2
Norovirus in all age
CM of noro?
sx develop 1-2 days of exposure watery diarrhea (Non-inflammatory) Nonbilious/non-bloody vomiting can occur as an epidemic Flacco oral tx \+/- fever
what about toxin-related(S,A, and B,C)
sx start in 6 hr
organophosphate poisoning Nicotnic manifestation?
weakness
paralysis
fasiculation
management?
decontamination
atropine
pralidoxime
risk?
pesticide
nerve gas: present multiple people at once
Chiari 2 malformation?
Obstructive hydrocephalus
Herniation of medulla and cerebellum
Mylomeningiocele
CM of aspiration to lung?
wheezing/stridor
diminish breath sound in affected lung
X-ray?
Hyperinflation in incomplete obstruction
Atelectasis incomplete obstruction
Normal in 30 %
management?
rigid sigmoidoscopy if clinically suspicious even in normal x-ray
galactosemia and E.Coli sepsis?
galactose accumulation–Impair WBC function nad SO formation
other CM due to galactose accumulation?
Hypoglycemia
Hepatomegaly
Accumulate in kidney and lead to MA
Accumulate in RBC–hemolytic anemia
prophylaxis for N.Meningitidis?
Close contacts
7 days prior and 2 days after AB started in the index case
Given regardless of vaccination status
one dose rifampin/ceftriaxone/ciprofloxacin(adult)
immediately or within 2 week
Norma vaccination?
at age 11-12(quadrivalent)
booster at 16
eustacian tube dysfunction pathophysiology?
infec(rhinosinusitis),allergy(al.rhinitis),enviromental irritant(cigarett)–tube obstrucion
CM?
Ear pain Tinnitus Cond. hearing loss Pooping sound in yawing and eating ear fullness or discomfort retracted TM
Complication?
AOM
Hearing loss
TM rapture
Cholesteatoma
spiral #?
common in age <3
management?
Stabilization
Pain management
what test to do in all premature babies delivered <32 weeks?
Head U/S to detect IVH
asymptomatic in 50 %
1-2 weeks after delivery
AOM risk factors?
6-18 months age
day care center
smoking exposure
lack of breastfeeding
