Pediatrics Flashcards
gonorrhea vs chlamydia in child
gonorrhea is diagnostic of sexual abuse, chlamydia may be contracted during labor and remain + for up to 3 years
Cyanotic heart defects (5)
5 T’s:
Truncus arteriosis, TOGV, Tricuspid atresia, ToF, TAPVR
Noncyanotic heart defects (3)
3 D’s:
VSD, PDA, ASD
MCC congenital heart disease
VSD
peds heart cond. ass. with Kawasaki disease
coronary artery aneurysms
CHD ass. with congenital rubella
PDA
peds heart cond. ass. with neonatal lupus
heart block
CHD ass. with Downs
ASD and endocardial cushion defects
Peds heart cond. ass. with maternal DM
asymmetric septal hypertrophy and ToGV*
peds heart cond. ass. with maternal Li intake
Ebstein’s anomaly
Tx PDA
indomethacin
Cyanosis in left arm and legs vs. normal right arm
coarctation of the aorta (post vs pre ductal)
Drug to keep PDA open
PGE1
DiGeorge Syndrome CATCH 22
Cardiac (ToF) Abnormal facies Thymic aplasia Cleft palate Hypocalcemia 22q11 del
RF for ToF (2)
Maternal PKU, DiGeorge Syndrome
Single S2
think ToF (overriding aorta)
Boot shaped heart
ToF
Tx tet spells (hypercyanosis) (5)
O2, propranolol, phenylephrine, fluids, knee-chest position
6 conditions associated with Down’s
CHD, Hirschsprung’s, duodenal atresia, ALL, hypothyroidism, early-onset Alzheimer’s
Rocker-bottom feet, micrognathia, clenched hand
Trisomy 18 (Edwards syndrome)
polydactyly, microphthalmia, microcephaly, holoprosencephaly
Patau’s Syndomre (Trisomy 13)
Tetrology of Fallot (PROVe)
pulmonary stenosis, overriding aorta, RVH, VSD
+ Sweat chloride test cut-off
> 60mEq/L
fair skin, eczema, blond hair.blue eyes, musty odor
PKU
Fabry’s has increased risk of:
RF and MI (TOE)
Tx PKU
limit phenylalanine, increase tyrosine
severe neuropathic limb pain, angiokeratomas and telangiectasias
Fabry’s disease
Trisomy ass. with horseshoe kidneys
Trisomy 18
LSD with progressive CNS degeneration
Krabbe’s disease
Glucocerebrosidase deficiency, crinkled paper histology
Gaucher’s disease
Hexosaminidase deficiency
Tay-Sachs
LSD with cherry red spot but NO HSM, developmental decline
Tay-Sachs
Sphingomyelinase deficiency
Niemann-Pick disease
LSD with cherry red spot and HSM
Niemann-Pick
X-linked recessive Lysosomal storage diseases (2)
Hunter’s, Fabry’s
Anaphylactic transfusion reaction, think…
Think IgA deficiency
LSD with corneal clouding, gargoylism
Hurler’s
Wiskott-Aldrich Syndrome “WIPE”
Wiskott-aldrich
Infections (OM)
Purpura (thrombocytopenic)
Eczema
Tx IgA deficiency
NOT IVIG bc it will form anti-IgA IgG ab’s, simply treat recurrent infections
Infections in chronic granulomatous disease (6)
Organisms are catalase +: s aureus, e coli, candida, klebsiella, pseudomonas, aspergillus
decreased IgM
Wiskott-Aldrich syndrome
Dx CGD
nitroblue tetrazolium
Tx CGD
daily bactrim +/- IFN-gamma
delayed separation of umbilicus
Leukocyte adhesion deficiency
Wounds with no pus and minimal inflammation
leukocyte adhesion deficiency
immunodef. with increased PYOGENIC infxns
Chediak-Higashi syndrome
Job’s Syndrome “FATED”
coarse Facies Abscesses (S. aureus) retained primary Teeth hyper-IgE Dermatologic (eczema)
abd mass with rosette pattern histology
Neuroblastoma
Differentiate scarlet fever and kawasaki d/s
both have strawberry tongue, desquamative hands, rash but scarlet fever will NOT have chapped lips or conjunctivitis
oculocutaneous albinism, peripheral neurophathy and neutropenia
Chediak-Higashi Syndrome
Tx Kawasaki d/s
high dose ASA and IVIG
Kawasaki “CRASH and BURN”
Conjunctivitis, Rash, Adenopathy, Strawberry tongue, Hands (desquamation), BURN (fever>104F for 5+ days)
What medication can induce tumor lysis syndrome?
Corticosteroids
abd mass with myoclonus, HTN and crosses midline
Neuroblastoma
abd mass with aniridia, hemihypertropy, HTN and does NOT cross the midline
Wilm’s Tumor
Still’s Disease
systemic JIA with recurrent high fever, HSM, and salmon-colored macular rash