Pediatric Disorders Flashcards

1
Q

What are some examples of transcervical (ascending) perinatal infections?

A

Beta hemolytic streptococcal (bacterial) and herpes (viral); may cause pneumonia, sepsis, meningitis; associated with chorioamnionitis and funisitis.

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2
Q

What are transcervical perinatal (ascending) infections?

A

Infections that spread through the cervicovaginal canal in utero or during birth. Fetus can also gain infection from amniotic fluic.

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3
Q

What are some exampls of transplacental (hematological) perinatal infections?

A

Viruses, parasites, some baterial. You have TORCH (toxoplasma, rubella, CMV, herpes), and T pallidum. Usually present with fever, encephalitis, chorioretinitis, hepatosplenomegaly, pneumonia, myocarditis, anemia.

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4
Q

What causes respiratory distress?

A

Most common casue is respiratory distress syndrome. Excessive maternal sedation during delivery, fetal head injury during deliery, aspiration of blood of amniotic fluid, intrauterine hypoxia.

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5
Q

What are the risk factors for respiratory distress syndrome (RDS)?

A

Mainly premature birth (<36 wks), but also maternal diabetes, C-section before labour, twins, male infants.

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6
Q

What is the pathogenesis of RDS (hyaline membrane disease)?

A

Immature lungs cannot create enough surfactant (made by type II pneumocytes). Alveoli collapse and infant tires from breathing. Hypoxia leader to epithelial/endothelial damage leading to formation of hyaline membranes.

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7
Q

What are treatments for RDS?

A

Corticosteroids for the mother if early delivery is unavoidable (increases surfactant synthesis), supportive ventlilation, aerosolized natural or recombinant surfactant.

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8
Q

What is sudden infant death syndrome?

A

Sudden and unexpected mysterious death <1 yrs of age. It is the leading cause of death during infancy in developed countries. Most babies are during age 2-4 months.

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9
Q

What are some maternal factors for SIDS?

A

Youth <20 yrs, unmarried, short intergestational periods, low SDS, smoking, and drug abuse.

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10
Q

What are some infant factors for SIDS?

A

Prematurity, low birth weight, male, multiple births, not 1st sibling, prior SIDS.

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11
Q

What are some environmental factors for SIDS?

A

Prone sleeping position (sleeping on belly), sleeping in soft surface, hyperthermia, postnatal passive smoking.

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12
Q

What are heterotopia or choristoma?

A

Microscopically normal cells or tissues present in abnormal locations. (pancreatic tissue)

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13
Q

What are hamartomas?

A

Excessive but focal overgrowth of cells and tissues native to the organ in which it occurs (pulmonary hamartoma of cartiladge, smooth muscle, respiratory epithelium.

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14
Q

What are teratomas?

A

Monster tumour, from all 3 germ layers; may be benign, lesions of indeterminate malignant potential or frankly malignant. Usually sacrococcygeal ,in the testes, ovaries, mediastinum, retroperitoneum, head/neck.

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15
Q

What are the two types of benign tumours?

A

Hemangiomas and lymphangiomas.

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16
Q

What are hemangiomas?

A

Usually capillary or cavernous, usually on the skin as well as within internal organs. Most common during infancy.

17
Q

What are lymphangiomas?

A

In cystic or cavernous spaces; usually in skin, deeper regions of neck, axilla, mediastinum, retroperitoneum, abdominal.

18
Q

What are the 3 types of small round blue cell malignant tumours in childen?

A

Neuroblastomas, retinaoblastomas, wilms tumours.

19
Q

What are neuroblastomas?

A

Originating from the neural crest and may have deletion in chromosome 1 (N-MYC). May arrise in adrenal glands.

20
Q

What is the chance of surviving to 5 years with a neuroblastoma?

A

55%

21
Q

What are retinoblastomas?

A

It is a malignant eye tumour and often congenital but may undergo spontaneous regression.

22
Q

Familial retinoblastoma is usually characterized by what?

A

Multiple focal points and bilateral (both eyes).

23
Q

Sporadic retinoblastomas are usually characterized by what?

A

Unilateral and unifocal.

24
Q

What is the pathogenesis of retinoblastomas?

A

Mutation in tumour supressor gene and retinoblastoma gene on ch13; both copies must be knocked out.

25
Q

What are Wilms tumours?

A

Most common type of primary tumour of the kidney in children (nephroblasoma). Often associated with other congenital malformations.

26
Q

How do Wilms tumours present?

A

Abdominal mass;

27
Q

What is the prognosis of wilms tumour patients?

A

90% long term survival.

28
Q

What are other imporant malignant in infants/children?

A

Leukemia, rhabdomyosarcoma (skeletal muscle), hepatoblastoma, CNS.