Pedi 15 Flashcards by molla asnake

Which disease-related GBS has a worse prognosis?

C.Jujni related
Long duration to recovery
Residual neurologic effect

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when to diagnose PP?

Water deprivation 2-3 HR

Then U OSM becomes>600mos/l

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when to give desmopressin?

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

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when do we say urine dilute?

0sm<300mosm/l

Specific gravity<1.006

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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)

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The complication of transfusion-related acute hemolytic reaction?

Hemoglobinuria
ARF(ATN)
SHOCK
DIC

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Transfusion-related bacterial infection in common in?

Platelet transfusion(stored at room To)

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Tx of AOM for penicillin-allergic patients?

Clindamycin

Azithromycin

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management of AOM?

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

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Tests to be done in strabismus?

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

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Factors associated with strabismus?

mostly idiopathic
intraocular mass(retinoblastoma)
ICP

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A sleep-related complication of OSA?

Enuresis

Parasomnia (Sleep waking and terror)

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Macrocephaly defn?

HC >97 %

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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

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management?

reassurance and cont observation

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child abuse sign-in #?

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

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what to do?

Skeletal survey
CT scan(subdural heamorage)
Fundoscopy(retinal hemorrhage)

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

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

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OME management?

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

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when do we consider tympanostomy tube placement?

Chronic(>3month with hearing loss)

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

Retinal detachment

Macular degeneration

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Battery swallowing S/E?

Localize tissue necrosis(if spills alkaline content)

E.Corrosion–By creating an external current

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Acute management?

Endoscopic removal

After a month of barium swallowing–To assess stricture

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Post-concussion syndrome CM?

> 4 week
Headache
Sleep disturbance
Diiness
Cognitive impairment
Mood change

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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