Pedi 8 Flashcards
Cause heavy menstrual bleeding at an early age?
VWD
A complication of FVIII tx for hemophilia?
Development of anti FVIII Ab
Occur in 25% of population
The patient will have Tx resistant hemophilia
Increase severity of bleeding
ALL epidemiology?
MCC of childhood tumor
2-5
Male > female
CM?
Non-specific Sx Bone pain/tenderness(mainly affect long bone, femur, Tibia) LDP HSM Pallor and petechia
Diagnosis?
> 25% lymphocyte in BM biopsy
How to D/T from SLE?
In SLE joint swelling and effusion rather than bone tenderness
MC type of headache in children?
Migraine Headache
The typical age for OSD?
During rapid growth
Boys:13-14
Girls:10-12
Traction apophysitis in the site of the tibial tuberosity(G.P)
CM?
Pain and tenderness at tibial tuberosity site
Exacerbate during activity
Mainly unilateral
No soft tissue swelling
Pain reproduced by knee extension against resistance
managment?
X-ray if atypical(soft tissue swelling) Physical therapy NSAID Activity as tolerated Sx resolve as ossification of the growth plate at adolescence
Giardiasis malabsorbiton mechanism?
Disruption of epithelial tight junction b/n enterocyte in the small intestine
A complication of Ch.jardiasis?
Malabsorption
Vitamin deficiency
Weight loss
What will position be kept in hip septic arthritis?
Abducted, flexed and externally rotated to maximize joint space.
D/T glycogen storage disease from Classic Galactosemia?
GSD: Hypoglycemia delay to 3-6 months and will have negative reducing sugar in the urine.
Foreign body insertion in Nose CM?
Unilateral purulent nasal discharge
Epistaxis
Erythematous nasal turbine
Mostly age 1-6
Managment?
Positive pressure
Mechanical extraction
Complication?
Sinusitis
Periorbital celulitis
a child with hearing loss can present with?
Poor language development
Lack of social skill
Self-isolation
Neonatal HIV manifestation?
Failure to thrive Chronic diarrhea LDP Candidiasis PCP
Cryptorchidism risk factor?
Genetics
Low birth weight
IUGR
Prematurity
Complication?
Inguinal hernia
Testicular torsion
Infertility
Testicular ca(GCT)–Increase even after orchidopexy
orchidopexy should be done?
< 1 year
When to do inpatient with clinically suspected of nephrotic syndrome?
Empiric steroid
What immediate thing should be done in septic arthritis?
Immediate drainage and irrigation
Sickle cell disease HB pattern?
HbA–0%
HbS–85-95 %
HBF–5-15%
Sickle cell trait?
HBA-50-60%
HBS–35–45%
HBF–<2%
Turner associate behavioral disorder?
Cognition usually normal
Low non-verbal skill(Maths)
Poor executive function
Gonococalconjectivitis feature?
2-3 day
Eye Swelling
Purulent discharge
Periorbital Echemosis
Managment and prevention?
P: Erythromycin ointment
T: IM 3rd gen cephalosporine
First, tx in epiglottitis?
Maintain airway
T1DM onset?
4-6 year
10-14 year
CM?
Polydipsia Polyuria, enuresis, and nocturia Wt loss Blurring of vision Fatigue
Reye syndrome pathogenesis?
Using aspirin for MC in influenza and VZV infection
Asprin–Mitochondrial Toxine
Liver failure and encephalopathy
Aspirin in children and adolescents reserved for Kawasaki and rheumatologic disease
Liver pathology?
Microvesicular hepatostetiaosis
What if hepatic Macrovesicular hepatosteatiosis?
Alcoholic liver disease
Non-alcholic heapatosteatiosis
erythema marginatum cxs lesion?
Pinc
Central cleared
Raised border
Multiple unlike Erythema Migrant(LD)
papilledema fundoscopic finding?
Enlarged Blindspot
Blurred marigion
Congested vessel(splinter heamorage)
Humoral immunodeficiency with Low B cell count?
X-Linked(brutton) gamaglobulinimia
Normal B-Cell count?
100-600
When will be maternal IgG wean?
at 6 month
Foreign body ingestion approach?
Imaging on X-ray and CT if not visible
If in esophagus: stomach what to do?
Symptomatic–Endoscopic removal
Asymptomatic–If high risk(2 magnets, battery, and sharp object)–Immediate removal.
Asymptomatic and low risk(non-sharp and small, one magnet..coin)–manage with serial X-ray after 24 hours–If not progressing–Endoscopic removal but if progressing leave it
Magnet complication?
atach d/t bowel–necrosis–perforation/fistula
If beyond stomach?
Colonoscopy and serial X-ry(4-6 hr)
Polyethylene glycol(Laxative) can hasten
SYmptomatic–surgical removal
Barium contrast in the Foreign body is C/I why?
Risk of aspiration
Obscure visualization by endoscopy
A complication of I.Mono?
Acute airway obstruction
Hemolytic anemia
Thrombocytopenia
Splenic rupture
Acute airway obstruction sign?
Marked oropharyngeal infn and tonsillar enlargement
Hyper oral secretion
Respiratory disease
Managment?
Steroid
Conj rubella syndrome sign?
SN hearing loss
Cataract
PDA
Other(HSM, Blue me fine rash and growth restriction)
Maternal Sx?
In first TM
Fever
Mild/no rash
arthritis/arthralgia
prevention?
Prenatal screening for immunity and Vaccination
Recurent respiratory papilomatosis?
Multiple finger-shaped papules in vocal cord
HPV 6 and 11 are risks
Usually aquired by vertical transmission
Prevented by maternal HPV vaccination
complication?
Voice change Airway obstruction recurrent surgery(Papilloma is tx with surgery,antiviral are not effective)
the pattern of joint pain based on cause?
Septic–Constant,not bear wight,acute
Infl/rhu–Worse in the morning, able to bear weight,chronic
Neoplastic–Worse in evening/night
Systemic juvenile idiopathic arthritis CM?
> 2 weeks of daily fever
6 weeks fixed arthritis with inf/rhu cxs
Pink macular rash worse during fever
Unlike poly/monoarticular form(no fever and rash)
Lab?
Leukocytosis
Thrombocytosis
Anemia
Increase inflammatory marker
managment?
NSAID
CM of the vaginal foreign body?
Prepubertal girl Malodoures, purulent vaginal discharge Spotty bleeding urinary sx..dysuria No trauma sign: No laceration Usually toilet paper
Managment?
Warm irrigation
Vaginoscopy under sedation/anesthesia
why not speculum in prepubertal?
Narrow Vagina
Sensitive hymen due to low estrogen
The most common cause of Macrocytic anemia in SCD?
Folate deficiency
How do we d/t normal separation anxiety (6-18 months) with separation anxiety syndrome?
In SAS there will be panic attach and vomiting
Traumatic carotid artery injury cause?
Fall while holding the object on the mouth (ICA located just posterior to tonsillar pillars
Penetrating trauma
Neck manipulation(yoga,sport)
CM?
Neck pain
Thunderclap headache
Gradual onset ischemic stroke sign(hemiplegia, aphagia..)
diagnosis?
CT/MRI angiography
How to d/t from CAV malformation induced SAH?
SAH
Spontaneous
Acute headache, vomiting and AMS
What about hemipelagic migraines?
Aura
Transient heamiplagia
Px headache Hx
Disease-associated with IgA deficiency?
Autoimmune disease like Celiac
Allergic-Eczema disease like asthma
Anaphylaxis during Transfusion(wear an alert bracelet and should recive IgA reduced blood or from IgA deficient donor)
In which type of LDP do we consider benign and only reassure?
Size < 2 CM Soft Mobile Localized Absent systemic sx
