Pediatric Pathology - Phumiruk

Question 1

erythema toxicum**

Answer 1

rash - first few days after birth

can be anywhere - esp on trunk, palms, soles

harmless

Question 2

tiny white bumps on newborn nose/cheek

Answer 2

milia

benign

Question 3

miliaria

Answer 3

blocked sweat gland ducts

resolve on own

Question 4

neonatal acne

Answer 4

maternal adrogens

Question 5

baby dandruff

Answer 5

seborrheic dermatitis

scaling - scalp or eyebrows

Question 6

mongolian spots

Answer 6

blue-gray flat birthmark
-plaque

entrapment of melanocytes

Question 7

atopic dermatitis**

Answer 7

children 6mo to 10years

red, pruritic, papule/plaques

acute - erythema and scaly
chronic - scaly, pigment change

diaper area spared

unknown cause

dry irritated skin with malfunction of immune system

food causes flare

Question 8

tx atopic dermatitis

Answer 8

topical steroids

after shower - moisturize with thick ointment quickly afterwards

Question 9

black head

Answer 9

open comedone

Question 10

white head

Answer 10

closed comedone

Question 11

abdominal pain, rash on legs, arthritis in ankles

urinalysis - positive for blood/protein**

Answer 11

HSP - henoch schonlein purpura

palpable purpura

Question 12

henoch schonlein purpura**

Answer 12

vasculitis small vessels

palpable purpura

Question 13

complication of HSP**

Answer 13

renal involvement - during 1st month - acute glomerulonephritis

HTN uncommon

Question 14

lower sternal border musical low pitch murmur**

Answer 14

stills
-non-turbulent - not high velocity

age 3 to adolescence

Question 15

stills murmur**

Answer 15

benign

musical low pitched at lower left sternal border

Question 16

bounding pulse, murmur, tachypnea, poor feeding, SOB, sweat while feeding, tire very easily**

Answer 16

PDA

Question 17

PDA

Answer 17

more in girls

premature infants, neonatal resp distress

Question 18

tx of PDA

Answer 18

indomethacin or surgery

Question 19

steeple sign**

Answer 19

subclottic narrowing of trachea

croup

Question 20

croup**

Answer 20

steeple sign
inspiratory stridor
croupy cough, hoarseness, stridor

Question 21

tx of croup

Answer 21

if severe - inhaled epinephrine and oral steroids

Question 22

chronic cough in toddler**

Answer 22

foreign body

Question 23

unilateral nasal drainage that smells bad**

Answer 23

nasal foreign body

Question 24

tx of labial adhesions**

Answer 24

mechanical separation
-then petroleum ointment - diminish irritation

estrogen cream - premarin

Question 25

febrile seizures**

Answer 25

simple and complex

Question 26

simple febrile seizure

Answer 26

lasts few seconds to 5-10 minutes

period of drowsy or confusion - 30 minute post-ictal period

Question 27

complex febrile seizure**

Answer 27

longer than 15 minutes

only one part of body
occurs again during same illness

Question 28

osgood schlatter disease

Answer 28

traction apophysitis of tibial tubercle

more in males

tenderness/swelling over tibial tuberosity

Question 29

tx of osgood schlatter

Answer 29

rest, NSAIDs, cast/splinting if severe

CI - steroids

Question 30

coxsackie A16**

Answer 30

hand foot mouth disease

highly contagous
in preschoolers
incubation 4-6 days
prodrome 1-2 days before rash

Question 31

hand foot mouth disease**

Answer 31

coxsackie A16
-painful shallow yellow ulcers surrounded by red halos

on buccal mucosa

exanthem involves - palm, plantar, interdigital surfaces of hands and feet

Question 32

slapped cheek rash**

Answer 32

erythema infectiosum

parvivirus B19

fifth disease

Question 33

parvovirus B19**

Answer 33

erythema infectiosum
5th disease

children 4-10yo

infectious - until onset of rash

Question 34

dangerous in pregnancy

Answer 34

erythema infectiosum

-hydrops fetalis

Question 35

rocky mountain spotted fever**

Answer 35

rash begins distal and spreads centrally

test - for rickettsia - takes 1 week

Question 36

tx of rocky mtn spotted fever

Answer 36

immediately if suspected
-doxycycline - all children

within 1st week - prognosis good