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Pediatrics > Pedi 15 > Flashcards

Pedi 15 Flashcards

1
Q

Which disease-related GBS has a worse prognosis?

A

C.Jujni related
Long duration to recovery
Residual neurologic effect

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2
Q

when to diagnose PP?

A

Water deprivation 2-3 HR

Then U OSM becomes>600mos/l

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3
Q

when to give desmopressin?

A

When S.Na?>145 or S.OSM.>295

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4
Q

when do we say urine dilute?

A

0sm<300mosm/l

Specific gravity<1.006

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5
Q

water deprivation test principle?

A

Should be done in a hospital setting in old children

Should not be done in very young children(risk of hypernatrimia)

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6
Q

The complication of transfusion-related acute hemolytic reaction?

A

Hemoglobinuria
ARF(ATN)
SHOCK
DIC

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7
Q

Transfusion-related bacterial infection in common in?

A

Platelet transfusion(stored at room To)

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8
Q

Tx of AOM for penicillin-allergic patients?

A

Clindamycin

Azithromycin

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9
Q

management of AOM?

A

Amoxicillin
(amoxa-clav if patient Tx in last 30 days
Ciprofloxacin ear drop inpatient with placed ear tube with otorrhea.

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10
Q

Tests to be done in strabismus?

A

first access using dilated fundoscopic assessment for intraocular mass(retinoblastoma0
then possible ICSOL

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11
Q

Factors associated with strabismus?

A

mostly idiopathic
intraocular mass(retinoblastoma)
ICP

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12
Q

A sleep-related complication of OSA?

A

Enuresis

Parasomnia (Sleep waking and terror)

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13
Q

Macrocephaly defn?

A

HC >97 %

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14
Q

when we consider benign(Fam. Macrocephaly 2nd to megaloencephalophaty)

A 
Normal Devt
No syndromic feature
No sign of ICP
No sign of infection
Normal U/S
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15
Q

management?

A

reassurance and cont observation

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16
Q

child abuse sign-in #?

A

posterior rib #
Femoral # in non-ambulatory child
Metaphysical corner #(buckle #)
# in different stages of healing

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17
Q

what to do?

A 
Skeletal survey
CT scan(subdural heamorage)
Fundoscopy(retinal hemorrhage)
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18
Q

Otitis media with effusion(OME) d/t From AOME?

A

OME
No TM inflammation
No fever and severe ear pain
Non-prulent inflammation

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19
Q

OME management?

A

Follow Up(ass. with speech delay and CHL if chronic(>3 months)

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20
Q

when do we consider tympanostomy tube placement?

A

Chronic(>3month with hearing loss)

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21
Q

a complication of high(>6 diopter lens) complication?

A

Retinal detachment

Macular degeneration

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22
Q

Battery swallowing S/E?

A

Localize tissue necrosis(if spills alkaline content)

E.Corrosion–By creating an external current

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23
Q

Acute management?

A

Endoscopic removal

After a month of barium swallowing–To assess stricture

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24
Q

Post-concussion syndrome CM?

A 
> 4 week
Headache
Sleep disturbance
Diiness
Cognitive impairment
Mood change
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25
Q

Risk factor?

A

Nonadherence to a gradual return to play protocol

Multiple concussion

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26
Q

Management?

A

Symptomatic care only

Activity as tolerated

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27
Q

Transfusion-associated circulatory overload?

A

Age <3 and >60
Underling renal or cardiac disease
Large/Fast transfusion

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28
Q

CM?

A

RD
Increase B/P and PR
Pulmonary edema

29
Q

Management?

A

02

diuretics

30
Q

what about ATRLI?

A

No HTN bt may have hypotension
No sign of circulatory overload(S3 gallop and rales)
Respiratory support only

31
Q

what triggers headache of concussion?

A 
Physical activity
Noise
Visual activity
Emotional experience
Cognitive tasks
32
Q

Late presentation for an infant who not given VitK?

A

2 week to 6 month
Intracranial Hemorrhage—Obstructive hydrocephalus
May not have other area bleeding

33
Q

ICH sign On CT?

A

layered hyperdense fluid in Ventricles

Hydrocephalus

34
Q

sign of midbrain compression?

A

upward gaze difficulty(patient will have persistent down ward gaze)

35
Q

cause of hemorrhagic stroke in children?

A 
vascular malformation(AVM,anurithm)
Heamatologic abnormality(SCD and heamophilia)
36
Q

AVM?

A

Anomalous connection B/N veins and artery

Create high-pressure flow in weak vessels–Hemorrhage

37
Q

Hereditary Hemorrhagic telangiectasis?

A

AD
AVM
Mucocutaneous telangiectasias
Multiorgan TE(Liver,brain Lung)

38
Q

HHD and stock?

A

Intraventricular/parenchymal/subarachnoid hemorrhage

Hyperdense lesion on CT

39
Q

What to do in a patient with TBI with no high-risk feature?

A

reassurance and discharge

Not need imaging

40
Q

what to do if have high-risk feature?

A

Head non-contrast CT

Observation(2-6 hr after symptom-free)

41
Q

What are high-risk features for both <2 years and >2?

A

AMS
LOC
High impact
MVA

42
Q

specific for <2?

A

Non frontal heaamatoma
palpable skul #
fall > 0.9 m

43
Q

specific >2?

A

ICP sign
Basilar skull # sign
Fall >1.5 m

44
Q

when fontanel closed?

A

9-18 month

45
Q

effect of hydrocephalus on child devt?

A

Developmental delay(Speech, Both motor)

46
Q

what to do?

A

U/S for fontanelle non closed and

MRI for closed fontanel

47
Q

how to d/t from rett?

A

rett have to decrease HC devt(microcephaly)

48
Q

MCC of viral GI?

A

Rota in unvaccinated and age <2

Norovirus in all age

49
Q

CM of noro?

A 
sx develop 1-2 days of exposure
watery diarrhea (Non-inflammatory)
Nonbilious/non-bloody vomiting
can occur as an epidemic
Flacco oral tx
\+/- fever
50
Q

what about toxin-related(S,A, and B,C)

A

sx start in 6 hr

51
Q

organophosphate poisoning Nicotnic manifestation?

A

weakness
paralysis
fasiculation

52
Q

management?

A

decontamination
atropine
pralidoxime

53
Q

risk?

A

pesticide

nerve gas: present multiple people at once

54
Q

Chiari 2 malformation?

A

Obstructive hydrocephalus
Herniation of medulla and cerebellum
Mylomeningiocele

55
Q

CM of aspiration to lung?

A

wheezing/stridor

diminish breath sound in affected lung

56
Q

X-ray?

A

Hyperinflation in incomplete obstruction
Atelectasis incomplete obstruction
Normal in 30 %

57
Q

management?

A

rigid sigmoidoscopy if clinically suspicious even in normal x-ray

58
Q

galactosemia and E.Coli sepsis?

A

galactose accumulation–Impair WBC function nad SO formation

59
Q

other CM due to galactose accumulation?

A

Hypoglycemia
Hepatomegaly
Accumulate in kidney and lead to MA
Accumulate in RBC–hemolytic anemia

60
Q

prophylaxis for N.Meningitidis?

A

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

61
Q

Norma vaccination?

A

at age 11-12(quadrivalent)

booster at 16

62
Q

eustacian tube dysfunction pathophysiology?

A

infec(rhinosinusitis),allergy(al.rhinitis),enviromental irritant(cigarett)–tube obstrucion

63
Q

CM?

A 
Ear pain
Tinnitus
Cond. hearing loss
Pooping sound in yawing and eating
ear fullness or discomfort
retracted TM
64
Q

Complication?

A

AOM
Hearing loss
TM rapture
Cholesteatoma

65
Q

spiral #?

A

common in age <3

66
Q

management?

A

Stabilization

Pain management

67
Q

what test to do in all premature babies delivered <32 weeks?

A

Head U/S to detect IVH
asymptomatic in 50 %
1-2 weeks after delivery

68
Q

AOM risk factors?

A

6-18 months age
day care center
smoking exposure
lack of breastfeeding

Pediatrics (15 decks)

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