Pediatrics Flashcards
Ophtalmia Neonatorum Day2
Is caused by and Tx
Neisseria Gonorrheae G(-) diplococci
Prevent with ointment
Tx Ceftriaxone
Ophtalmia Neonatorum Day 7
Chalmidia Trachomatis
Not effectively prevented by prophylaxis ointments
Tx Azythromycin PO
Ophtalmia Neonatorum Day 21
Herpes Simplex
Tx Systemic Acyclovir and topical Vidarabine
The most commonly tested disorders in the new born
G6PD deficiency
Phenylketonuria (PKU)
Galactosemia
Congenital Adrenal Hyperplasia
Congenital hypothyroidism
Hearing test
Cystic fibrosis
G6PD Deficiency
X-Linked Recessive characterized by Hemolytic crisis
Tx Reduce oxidative stress and specialized diets
Phenylketonuria PKU
AR
Deficiency in Phenyalanine Hydroxylase (PAH)
Leads to intellectual disability
Tx special diet low in phenyl alanine for at least the first 16 years of the patients life
Galactosemia
Rare genetic disorder that precludes normal metabolism of galactose and cause cataracts.
Tx cut out all lactose containing products.
Congenital adrenal hyperplasia (CAH)
AR
Resulting in errors of steroidogenesis
Tx replace mineralocorticoid and glucocorticoid deficiency and possible genital reconstructive surgery
Congenital Hypothyroidism
Compromises brain development
Must have normal thyroid function for brain development
Hearing test
Excludes congenital sensory - neural hearing loss
Necessary for early detection to maintain speech patterns and asses the need for cochlear implantation
Cystic fibrosis
Autosomal disorder
Thick mucus
Best initial test -> Sweat Chloride
Most Accurate -> Genetic Analysis of the CFTR gene.
Mothers with HBsAg +
Child should receive
Hep immunoglobulin (HBIG) + vaccine
Thyroglossal duct cyst
Midline and moves with swallowing
Becomes symptomatic after a respiratory infection
Tract between foremen cecum and base of the neck
Dermoid cyst
Midline cystic mass with trapped epithelial debris
Does not change with tongue movement or saying ahh
Brachial cleft cyst
Most common type SECOND Brachial cleft lesion
Located inferior to the angle of the mandible and anterior to the esternocleidomastoideo muscle
Cystic hygroma
Macrocystic lymphatic malformations
Translucent soft mask covered by normal skin
Common location: cervical facial lesion, axilla, lateral chest wall
Associated with Down syndrome
Thymic cyst
Located at midline between angle of the mandible and midline of the neck
Thymic cyst
Located at midline between angle of the mandible and midline of the neck
ACE Inh Neonate
Craniofacial abnormalities
Anesthetic in neonate
Respiratory and CNS deppression
Barbiturates in neonate
Respiratory and CNS depression, dilated pupils.
Phenobarbital is associated with vitamin K deficiency
Diethylstilbestrol (DES)
Clear cell adenocarcinoma (CCA) of the vagina or cervix
Isotretinoin
Facial and ear abnormalities, congenital heart disease
Magnesium Sulfate in the neonate
Respiratory depression
NSAIDS IN NEONATE
Premature closure of Ductus arteriosus
Phenytoin
Hypoplastic Nails, typical facies, IUGR
Sulfonamides in Neonate
Displaces bilirubin from albumin
Tetracycline in neonate
Enamel hyperplasia, discolored teeth
Valproate / carbamazepina
Intellectual disability, neural tube defects
Warfarin in newborn
Facial dimorphism and condrodysplasia, bone stippling
Congénital toxoplasmosis pathogenesis
Maternal consumption of undercooked meat
Inadvertent ingestion of cat feces
Congenital toxoplasmosis
Chorioretinitis
Diffuse intracranial calcifications
Macrocefaly (hydrocephalus or microcephaly)
Seizures
CONGENIATAL CMV PATHOGENESIS & Features
Maternal contact with infected bodily fluids (saliva)
Chorioretinitis
Periventricular intracranial calcifications
Microcephaly
Sensorineural hearing loss
Congenital toxoplasmosis Dx & Tx
Toxoplasma serology or CPR
Pyrimethamine, sulfadiazine, folinic acid
CMV Dx & Tx
Urine or saliva CMV PCR
GANCICLOVIR
VALGANCICLOVIR
If symptomatic.
Congenital heart defect that typically presents within the first 24hours of life with cyanosis and a single loud S2
Transposition of the great vessels
Pulsus Alternans
Sign of left ventricular dysfunction
Pulsus bigeminus
Sign of HOCM
Pulsus bisferiens
In aortic regurgitation
Pulsus tardus et Parvus
Aortic stenosis
Pulsus paradoxus
Cardiac tamponade
Tension pneumothorax
Irregularly irregular
Atrial fib
Irregularly irregular
Atrial fib
Combination of hearing loss, syncope, normal vital signs and physical exam and
The family history of sudden cardiac death
Consistent with long QT syndrome
Combination of hearing loss, syncope, normal vital signs and physical exam and
The family history of sudden cardiac death
Consistent with long QT syndrome
best treatment for Long QT syndrome
Beta blocker METOPROLOL
How beta blockers may shorten the QT interval
By decreasing activation from the left stellate ganglion and reducing cardiac excitation during exertion
The only beta blocker that prolongs QT interval
SOTALOL
However progressive symptoms leading to dilated cardiomyopathy with secondary mitral regurgitation can cause :
S3 Gallop and holosystolic murmur
Tourette Syndrome Tx
Behavioral Therapy (habit reversal training)
Anti Anyidopaminergic agents
—> Tetrabenazine (dopamine depleter)
—> Antipsychotics (Rc Bockers)
Alpha 2 Adrenergic receptor agonist.
Jejunal Atresia presents with bilious vomiting and abdominal distention
Abd X Ray shows:
Triple bubble sign and gasless colon
Risk factors: prenatal exposure to cocaine and other vasoconstrictive substances.
Tethered cord syndrome
Neurologic( LMN Signs (weakness and hyporeflexia)
Urologic (Incontinence/Retention; Recurrent UTI
ORTHOPEDIC (back pain, scoliosis, foot deformities
Patient with Ebstein Anomaly may have
Wolff-Parkinson White Syndrome
(Delta wave and short PR interval)
Hyperbilirubinemia is considered
Pathological when
Appears first day of life
Bilirubin rises more than 5MG/dL/day
Bilirubin rises above 19.5MG/dL in a term Child
Direct Bilirubin rises above 2mg/dL at any time
Hyperbilirubinemia persists after the second week of life
Kernicterus
Deposition of bilirubin in the basal ganglia
Hypotonia
Seizures
Choreoathetosis
Hearing loss
Croup / coqueluche
Parainfluenza 1 y 2
RSV
Tx croup
Racemic epinephrine + steroids
