Pediatric Disease Flashcards
What are the 8 factors of growth failure
- genetically determined short stature
- muscular dystrophy/chromosome disorders
- IUGR - smoking, alcohol, infection, bleeding
- skeletal dysplasia - achondroplasia; supportive care
- constitutional delays in growth and puberty
- malnutrition
- chronic system disorders, eg CHF
- endocrine disorders (hypothyroid)
What is the number one reason for growth failure in the world
Malnutrition
What is the most common endocrine disorder of childhood
Diabetes mellitus
What is the mean age of onset of T1DM and what age are we now seeing it at
Mean age = 12
Now seeing it at 2
What is the presentation of T1DM
- acute onset
- poor appetite and malaise
- hyperglycemia leading to DKA
- emergency
- child is flushed, bright eyed, Kussmaul breathing
What is the most common presentation of T1DM
DKA
Describe the fasting blood glucose in T1DM
Elevated
Treatment for T1DM
Insulin for duration of life
What are some clinical signs of DM
- polyuria, polydyspia
- nocturnal enuresis
- weight loss
- lethargy
- infection
What are the complications of DM in children
- Vascular - artherosclerosis,
- Retinopahty
- Nephropathy
- Neuropathy
- Thyroid
- Celiac disease
Prevalence of retinopathy is most prevalent with a history of
Childhood diabetes
What is a predictor of nephropathy
Microalbuminuria
What are factors leading to nephropathy
HTN
T1DM > 5 years
Poor glycemic control
Lipid abnormalities
Control of _____ alone can slow the progression of nephropathy
BP
_______ control can help with microalbuminuria
Glycemic
What is the best test for evaluation of neuropathy in peds
Motor nerve conduction velocities
What is the most common form of neuropathy
Peripheral sensory neuropathy
Neuropathy can affect which nervous system, leading to impotence, nocturnal diarrhea and postural hypotension
ANS
What is T2DM
Body develops a resistance to insulin and no longer uses insulin properly, As the need for insulin rises, the pancreas gradually loses its ability to produce sufficient amounts of insulin to regulate blood sugar
What is HIV characterized by
T-cel disturbance
What is the intrauterine transfer of HIV
80% of cases
What are the common symptoms of HIV
Candidiasis
Opportunistic infections
Pneumocystis carnii
What is the most common coagulation disorder
Hemophilia -family history-recessive trait
What is the most common platelet disorder in pediatrics
Idiopathic thrombocyptopenia purpura (ITP) - eccymoses with petechial rash over extremities
How do you diagnose idiopathic thrombocytopenia purpura
Tourniquet test with bleeding time prolonged beyond ten minutes
What is ascending lymphangitis
Red streaking in the pathway of the Lymph
What is Milroy’s disease
Pitting edema of the lower limbs
What is the most common form of anemia
Iron deficiency anemia - present in 10% of ages 1-3
What is hematogenous osteomyelitis
Encountered primarily in children
Lack of phagocytic lining cells in bones of pediatric patients making them susceptible
What is the primary organism causing hematogenous osteomyelitis
Staph aureus - 74%
If there is a UTI, what is the primary organism causing hematogenous osteomyelitis
Streptococci
What is bone dysplasia
Deformity and irregularity at multiple epiphyseal sites in bones can cause malformation of cartilage and bones resulting in dysplasia
Types of dysplasia’s
Acondroplasia
Osteopetrosis
Osteopoikolosis
Mafans
Osteogenesis imperfecta
Fibrous dysplasia
What is achodroplasia
Long bones that are short and broad
What is osteopetrosis
Bone within a bone appearance at the metaphysis and MTs are expanded
What is osteopoikolosis
Increase sclerosis with moldy spotty appearances
Spots in the bone
How does Mafans look in the foot
Foot bones are unusually long with joint laxity
What is osteogenesis imperfecta
Thin osteoporotic bones often times seen with multiple fracture sites
What is fibrous dysplasia
Lack of bone modeling so you have sclerosis
What are the benign bone tumors in peds
Osteochondroma
Osteoid osteoma
Aneurysmal bone cyst
Simple bone cyst
Enchondroma
Chondroblastoma
What is the most common benign bone tumor in peds
Osteochondroma
Describe osteochondroma
Occurs in 2nd decade
Peripheral boney projection with flaring and cortical bone is continuous
Describe osteoid osteoma
Highly cellular fibrovascular tissue found in immature bone
Generates osteoblastic response
in the diaphysis
Describe aneurysmal bone cyst
Rare in the foot
Seen in tarsals? and phalanges
Cavernous blood filled spaces
Turns into an egg shell around the tumor
Describe simple bone cyst
Found in calcaneus
Creates another carvern
Can make the bone fragile
Doesn’t hurt - incidental finding
Describe enchondroma
Benign hyper cellular neoplasm of the cartilage
Most common in phalanges
Is intramedullary
Describe chondroblastoma
Chondrocytes
Cartilage source
What are the malignant bone tumors in peds
Osteosarcoma
Ewing’s sarcoma
What are common soft tissue tumors in peds
Lipoma
Fibroma
Hemangioma
Describe Ewing’s sarcoma
Moth eaten appearance of the bone
