Pediatric Shelf Flashcards
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
lead fingerstick screen is positive in child. what next?
test VENOUS blood lead levels, decide to treat based on levels
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
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
how do you manage hydroceles in the newborn
watch and wait. most resolve by 12 months. If it doesnt, surgery to prevent inguinal hernia
vague differentiation between sickle cell disease and trait on electrophoresis
Trait: HbA +HbS
Disease: NO hba, all HbS and HbF
triad of brain abcess
fever
focal neuro change ***** this is differentiating factor between abscess and meningitis
HA (morning or night)
signs of galactosemia in newborn infant
hypoglycemia (jerking movmeents) bilateral cataracts jaundice HSM FTT
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
CT with or without contrast for concussion w/u?
WITHOUT. contrast can confound appearance of accute blood.
association: neonatal abstinence syndrome
opiate withdrawal
classic demographic for SCFE?
obese male complaining of hip pain
treatment for sickle cell yo reduce pain crises?
hydroxyurea
side effect: myelosuppression
in sickle cell disease, how do retics respond in 1) aplastic crisis 2) splenic sequestration
1) decreased
2) increased
complete androgen insensitivty aka…
testicular feminization syndrome
pt has absent uterus and upper vagina with cryptorchid testes
differentiate a rathkes cleft pouch cyst from craniopharyngioma on CT
Craniopharyngioma is associated with Calcifications
sx of both: bitemp hemaniopsia, pituitary stalk compression –> endocrinopathies
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
down syndrome patient presents with upper motor neuron signs and changes in behavior. dx?
atlantoaxial insability
hemophilic arthropathy
cause: repeated hemarthrosis in hemophilia A/B
why: hemosiderin and firbin deposition in joint
trachoma
leading cause of blindness world wide
chlamydia A,B,C
follicular conjuncitivtis / inflammation
ages that you check lipids for well visits?
9-11, 17-21
polycythemia in newborn
hct>65%
risk factors: GDM, delayed cord clamping, maternal HTN
androgen insensitivity karyotype
46,xy
genetically male but phenotypically female –> do not respond to androgens
normal female external genatalia, but lack uterus
rash of scarlet fever:
sand paper rash
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)
