Pediatric Shelf Flashcards by Molly Thayer

osteosarcoma

location: metaphyses of long bones
risk: most likely in boys 13-16
presentation: pain for a few months that gets progressively worse
xray: sunburst and codman trianlge
labs: ESR, alk phos

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lead fingerstick screen is positive in child. what next?

test VENOUS blood lead levels, decide to treat based on levels

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causes of prepubertal vaginal bleeding (4)

1- withdrawal of maternal estrogen
2- trauma
3- rhabdomyosarcom –> will usually visualize tumor
4- foreign body –> TP is most common, will have foul smelling discharge

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a child develops isolated petechiae after a cold, what do you do?

ITP
just skin: watch, should resolve in 6 months
skin+ bleeding: IVIg and clucocorticoids

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how do you manage hydroceles in the newborn

watch and wait. most resolve by 12 months. If it doesnt, surgery to prevent inguinal hernia

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vague differentiation between sickle cell disease and trait on electrophoresis

Trait: HbA +HbS
Disease: NO hba, all HbS and HbF

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triad of brain abcess

fever
focal neuro change ***** this is differentiating factor between abscess and meningitis
HA (morning or night)

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signs of galactosemia in newborn infant

hypoglycemia (jerking movmeents)
bilateral cataracts
jaundice
HSM
FTT

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first step in workup of female OLDER than 14 with primary ammenorrhea and no breast development?

FSH
lack of breast= lack of estrogen
High FSH= peripheral cause
Low FSH= central cause

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CT with or without contrast for concussion w/u?

WITHOUT. contrast can confound appearance of accute blood.

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association: neonatal abstinence syndrome

opiate withdrawal

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classic demographic for SCFE?

obese male complaining of hip pain

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treatment for sickle cell yo reduce pain crises?

hydroxyurea

side effect: myelosuppression

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in sickle cell disease, how do retics respond in 1) aplastic crisis 2) splenic sequestration

1) decreased

2) increased

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complete androgen insensitivty aka…

testicular feminization syndrome

pt has absent uterus and upper vagina with cryptorchid testes

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differentiate a rathkes cleft pouch cyst from craniopharyngioma on CT

Craniopharyngioma is associated with Calcifications

sx of both: bitemp hemaniopsia, pituitary stalk compression –> endocrinopathies

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most common causes of microcytic anemia in children (2)

iron deficiency –> high TIBC, high RDW
thalasemia –> high retic, high iron

**beta thalasemia has increased HgbA2 on electropheresis

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down syndrome patient presents with upper motor neuron signs and changes in behavior. dx?

atlantoaxial insability

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hemophilic arthropathy

cause: repeated hemarthrosis in hemophilia A/B
why: hemosiderin and firbin deposition in joint

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trachoma

leading cause of blindness world wide
chlamydia A,B,C
follicular conjuncitivtis / inflammation

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ages that you check lipids for well visits?

9-11, 17-21

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polycythemia in newborn

hct>65%

risk factors: GDM, delayed cord clamping, maternal HTN

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androgen insensitivity karyotype

46,xy
genetically male but phenotypically female –> do not respond to androgens
normal female external genatalia, but lack uterus

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rash of scarlet fever:

sand paper rash

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effect of granulosa cell tumor in kid

precocious puberty --> malignant estrogen secreting

abd seq of HSP?

ileo-ileal intussusception second to bowel wall edema

no wheeze, tachypnea, high CO2 in an asthmatic

respiratory failure --> intubate!

most common cause of orbital cellulitis?

sinusitis h flu s aureus s pneumo

bx of aplastic anemia

hypocellular marrow with fatty infiltrate

most common offenders in viral myocarditis in kids?

adeno | coxsackie b

you see hepatomegaly in a babe looking like a bronchiolitic/asthmatic. Why?

viral myocarditis --> right heart failure causing hepatic congestion

equinovarus deformity

cerebral palsy - risk: prematurity - hypertonia/hyperreflexia in lower extremeties with both feet pointing downward and inward

most common presentation of cerebral palsy in babe

spastic parapalegia

features of craniopharyngioma (most common brain mass in children)

- endocrinophaties --> pit stalk compression - vis field defects --> bitemp hem - CALCIFICATION on imaging *** distinction from other masses - derived from rathkes pouch

comobrbidities of absence siezures?

AAA absence anxiety ADHD

signs of aplastic crisis in sickle cell anemia

- rapid drop in Hgb - low retics <1 - no splenomegaly

seq of PUV in utero?

- on ultrasound --> hydronephrosis from bladder obstruction and oligohydramnios from decreased urination - pulmonary hypoplasia

potter sequence

pulmonary hypoplasia limb deformities flat facies from low amniotic fluid

hereditary angioedema

C1 inhibitor dysfunction/ deficiency | -non inflammatory edema of face, lips, genitalia, trachea

metatarsus adductus vs congenital clubfood

MA- medial deviation of forefoot with nl position of hibd foot --> reassurance CC - medial/ upward deviation of forefoot and hindfoot with rigid poisitioning --> serial casting

congenital diaphragmatic hernia, and signs in utero

- abdonminal viscera herniates into chest --> pulm hypoplasia, pulm hypotension - 85% of cases on left --> decreased breathsounds - can cause concave and barrel shape chest In-utero: polybydramnios due to compression of esophagus

renal complications of sickle cell trait

hematuria --> papillary necrosis, shows normal RBC, usu resolves spont RCC UTI

mccune albright triad (3 Ps)

Precocious puberty Pigmentation: cafe au lait spots Polyostotic fibrous dysplasia: bone deformities

clinical manifestations of vitamin d deficiency rickets

- craniotabes (ping pong skull) - genu varum - delayed fontanel closure - rachitic rosary --> costochondral joint hypertrophy

lab value for neonatal polycythemia? name some common causes. how do you treat?

Hct > 65% delayed cord clamping, maternal diabetes, maternal smoking or HTN treat mainly with hydration

vomiting, jaundice, poor weight gain, HM, bilateral cataracts, convulsions

classic galactosemia | deficiecny of G-1-P uridyl transferase

bugs or orbital cellulitis + treatment

mrsa, strep, hemophilus IV abx!!

levonestral

plan b! progeterone

kallman

XLR do of GnRH and olfactory nerve migration - normal genotype - normal internal sex organs - delayed puberty - no GnRH --> low FSH, low LH

sickle cell dz on electrophoresis

85-95% HbS | 5-15% HbF

lab values in HSP

normal plt and coag studies hematuria with maybe RBC/ Protein mildly Cr treatment is supportive or steroids if req hospitalizations

maternal blood types at risk for hemolysis

O-, Rh-

cephalohematoma

subperiosteal hemeroage limited to one surface of bone with no crossing of suture lines -no discoloration

caput

crosses midline and suture lines | can be echymotic

ALL

tdt+ PAS + >25% lymphoblasts

how do you treat lymes? what if the patient is < 8?

doxy can't use doxy under 8 --> use amox

breast feeding failure jaundice. treatment?

first week of life -signs: dehydration, poor feeding lack of lactation leads to build up of bilirubin treatment: increase feeding to stimulate milk production

breast milk jaundice

>1 week of life | normal feeding, normal exam

herpangina

gray vesicles on post pharynx | summer/ early fall

LAD

serum: neutrophilia recurrent infx, impaired wound healing, absent pus skin and mucosal infections --> periodontal infections delayed cord separation CD18 (integrin)