Pediatrics Flashcards
Galactosemia Tx And Dx is made by
Galactose-free diet (eg, soy-based formula)
May be identified on newborn screening
Absent red blood cell GALT activity
Congenital myotinic dystrophy cataract devolops at
Adulthood
patient’s presentation—respiratory distress, unilaterally decreased breath sounds with increased brightness on transillumination—is consistent with
pneumothorax. Premature infants, particularly those with respiratory distress syndrome (RDS), are at particularly increased risk because insufficient surfactant makes the alveoli less expandable and more prone to rupture.
Accumulation of intrapleural air may cause displacement of the heart to the right, as in this case.
Increased brightness over the affected hemithorax on transillumination of the chest is supportive of the diagnosis.
Tension pneumothorax causes
1)positive cpap high intrapleural pressure decreases venous return and subsequent cardiac output, exhibit severe distress with hypotension and hypoxemia
2)muconium aspiration
bronchospastic airway disease (ie, wheezing, hyperinflation) triggered by recent viral upper respiratory infection. Given the severe bronchospasm, management is similar to severe acute asthma which ———-
Nebulized albuterol & ipratropium, IV corticosteroids ± IV magnesium
Short trial (<2 hr) of NIPPV
Low threshold for intubation & invasive mechanical ventilatio
Khraisat: An elevated or even (inappropriately) normal PaCO2, as in this patient, is concerning for respiratory failure due to respiratory muscle fatigue. Therefore, the next step is performing endotracheal intubation and initiating invasive mechanical ventilation.
Intubation when you go for it :
Intubation should ideally be performed in a proactive and controlled manner (eg, no improvement after a time-limited trial of NIPPV). Delayed (“crash”) intubation is associated with greater morbidity and mortality (eg, cardiopulmonary arrest, anoxic brain injury).
The presentation can include severe headache, morning vomiting, fever, and focal neurologic deficits. After ear infection the pts Hx recurrent ear infection ur next step in Ix
This patient has nocturnal headaches and morning vomiting, red flags for intracranial pathology. His coexisting otitis media and mastoiditis suggest direct spread of bacterial infection and formation of a temporal brain abscess
The next step in management of suspected brain abscess is contrast-enhanced CT scan or MRI of the brain
Oi pts can present with hyper laxity of the joint and multiple fractures but whalers dalis pts only
Hyperlaxity with no fractures
Functional constipation definition
Mx:
It’s the most common cause of constipation in childeredn presenting around the age of 6mth when diathermy changes happens usually duo to lack of fiber and less water content in the diet .
Mx: Add undigestable, osmotically active carbohydrate (eg, prune or apple juice/puree)
Hydrolyzed formulas, which contain preprocessed, less allergenic proteins, treat soy formula can also be considered. This disorder typically presents in infants age <6 months with loose stools that have mucus and blood mixed in. Is the TX OF ———
food protein-induced allergic proctocolitis (eg, cow’s milk protein allergy);
Enlargement of the optic nerve due to papilledema can also lead to an enlarged physiologic blind spot (which occurs because there are no rods or cones over the area of the optic nerve). On funduscopic examination, the optic disc appears elevated with blurred margins; vessels may be engorged or leaky (ie, splinter hemorrhages).
Idiopathic intracranial HTN MOST FOMMON PRESINTING Sx in adolescence age group is :
This patient has vision changes and optic disc swelling most likely due to idiopathic intracranial hypertensio
most commonly occurs in obese women of childbearing age, it can be seen in nonobese children. In the prepubertal population, headache may be a less obvious finding; vision abnormalities may be predominant.
Increased intracranial pressure (ICP) on the optic disc causes swelling (papilledema), leading to blurry vision that does not improve with refraction(glasses)
Myelomeningocele is an open neural tube defect in which the meninges and spinal cord protrude through the skin. It is often associated with ——- which disorder remember it’s can presented slowly as paralysis of the lower limb
a Chiari II malformation (ie, inferior displacement of the medulla and cerebellum through the foramen magnum), as well as obstructive hydrocephalus.
absolute infant contraindication to breastfeeding is m.
Galactosemia
The weight loss is more pronounced in exclusively breastfed infants as the mother’s milk supply gradually increases to meet infant demands. No treatment is required,
Ur Mx:
and exclusive breastfeeding should be continued,
Nothing
