Pedi 9 Flashcards
Risk factor for calcaneal apophysitis?
Running/jumping sports
Growth spurt
Athletic growth clit/footwear w/o padding
Common at age 8-12 –rapid growth
Clinical feature?
Heal pain(50 %,bilateral)
Pain with calcaniar palpation/compresion
Decrease GS/Solus flexibility–Inability of foot dorsiflexion
Pain worse with activity
Tx?
NSAID
Activity limitation
what about plantar fascitis?
Unilateral
Pain at a first walk then improve
Achilles tendinophaty?
tenderness at Achilles tendon
what about entities?
joint swelling and tenderness
Immunity for VZV acquired through?
Prior infection
Having 2 vaccines (1 and 4)
How do we treat exposure?
Immune–Observation
Non-imunized–Vaccine for immunocompetent and IVIG for immunocompromised
VZV vaccine cxs?
Live attenuated (not give Px,IC, and neonates) Not give VZIG simultaneously
MC complication in SC trait?
Renal
Haematuria(MC)
Hyposthenuria(Dec renal conc. capability)–Polyuria and nocturia
Optic glioma?
NFT1
Asymptomatic
Decrease vision
ICP sign
Cause of osteomyelitis in SCD women?
Salmonela enteritidis(MCC) S.Aures(2nd MCC)
managment?
Vancomycin +
3rd generation cephalosporine
pathogenesis?
Obstruction of B/F at the metaphyseal plate(narrow vessel)
Functional asplenia
Enterobius vermicularis (pinworm) CM?
Hand autoinfection and highly contagious
Anal pruritis worse at night
Anal area excoriation
Managment?
Pyrantel pamoate
albendazole
Primary VZV(Shingles) inf sign?
viral predoom(fever, sore through and headache) multiple-stage rash(clear vesicle,pustule & crusted papule)
Eczema Complication?
Impetigo(honey crusted)
Eczema herpiticum (punched out and hemorrhagic crust
POX
Tinea corporis
Ab prophylaxis for ARF?
Uncomplicated--5 years/until21 Carditis w/o VHD--10 years/until 21 with VHD--10 years/until 40 Every 4 weeks penicillin G Every 6-12 month echo for VHD/surgery
Premature infants vaccination schedule?
The same to the Term neonate(i.e based on chronological age)
when we use adjusted age to gestational age?
To assess milestone
hepatitis B vaccine in infants?
should wight >=2
Herpangina(CAV gingivostomatitis) CM?
Oropharnex(post.oropharynx,uvula,tonsils)
Gray vesicles/ulcer –Fibrin coated lesion
fever and pharengitis
What about HSV gingivostomatitis?
Attack anterior oral part(Lips, hard palate, buccal mucosa, tongue)
CVID pathogenesis?
failure of differentiation of B cell to P cell
Low IG
Normal lymphocyte and B cell count
Symptom starts in adolescence
Recurrent SP and GI infection
Recurrent viral/encapsulated organism infection
Complication
Autoimmune disease(RA, Thyroid disease)
Pulmonary(bronchiectasis)
GI(chronic diarrhea and IBD like sx
diagnosis?
low IgG/M/A
No response to vaccination
Managment?
IG replacement therapy
Risk factor for brain abscess?
Cyanotic heart disease
OM/Mastoiditis
Sinusitis
Dental infectio
CM of ADHD?
Inattentive &/or hyperactive sx for more than 6 months
Sx start before age 12
Occur in 2 seting
Inattentive Sx?
Difficulty to focus Unable to follow instruction Forgetfulness Disorganized Misplace objects
Hyperactive?
More motor fidgety unable to sit interrupt speech impulsiveness
TX?
Stimulant(methylphenidate/amphitamine)
Non stimulant(atomoxatine,alpha 2 agonist)
Behavioral
Cyclic vomiting syndrome?
patent with family migraine Hx
An episode of vomiting cx by inciting event, headache, vomiting, abdominal pain
Resolve with 1-2 days by itself
2-4 week asymptomatic period
managment?
Supportive(RHN and Antiemitic)
Abortive(triptans)
Usually, resolve in adolescence
Constipatin and recurent UTI?
Rectal distension—Bladder obstruction–stasis
Suggestive feature of gonococcal artheritis?
SFA<50,000(unlike other S,A)
May have additional
Pustular rash involves hand/foot or trunk
Tenosinovitis
Managment?
rd gen cephal. + azithromycin
managment of conj.Hydrocele?
Transilluminating mass
Reasurance
spontaneously resolve within 1 year
Sx of hydrocephalus?
Irritability
Decrease activity
Poor feeding
Irritability
Sign?
rapidly increase in HC>97%
Bulged fontanelle
Swollen scalp veins
widened scalp suture
Dx?
CT: symptomatic/rapid enlargement
MRI: asymptomatic
tinea pedis managment?
topical azole
terbinafine
Not give nystatin
Activity that Improved laryngomalacia?
Prone position(supination will worsen) Protruding Tongue
cause of congenital SNHL?
CMV
Turner syndrome hormonal level?
streak ovary—Low estrogen, inhibin, and progesterone–Low feedback inhibition–High FSH/LH
The benefit of estrogen treatment in TS?
Induce sexual development
Increased growth in height/weight
Increase bone mineral density
Infratentorial tumor in pediatrics?
Craniopharyngioma Brain stem glioma Infratentorial Ependimoma Medulloblastoma Medullary astrocytoma
Supratentorial tumor in pediatrics?
Astrocytoma
Pinealoma
Optic glioma
Supratentorial tumor in pediatrics menifestation?
Headache
Seizure
Change speech, memory, and personality
Hemiparesis and hyperreflexia(MC in partial lobe inv)
MC brain tumor in pediatrics?
Low-grade astrocytoma(PA and DA)
Present within months
Cerebral(DA) and Cerebellar(PA)
High-grade astrocytoma?
Glioblastoma multiformis
Rare in children
Acute(days to weeks presentation)
preseptal cellulitis dfn?
preseptal cellulitis occurs in the tissue of the eyelids and periocular region anterior (in front of) the orbital septum.
pathogenesis?
Trauma to skin cover eyelid–the entrance of S.A and S.P to preceptal space.
Unlike orbital cellulitis does not involve retroorbital structure(Fat and Extraocular muscle)
CM?
Eyelid erythema or swelling
Chemosis
What about orbital cellulitis?
The result from contagious inf. spread from sinusitis,PCC)
Retroorbital structure involvement manifestation i.e
1-EOM–opthalmoplagia,painfully eye movt and visual change
2-Orbital fat:proptosis
Managment D/C?
PC: Oral Ab
OC:IV Ab +/- surgery
Tests to do in Duchene MD?
ECG–Conduction abnormality
Echo–Dilated cardiomyopathy
Asses the presence of scoliosis
