pediatrics Flashcards
foreign body in kinderen
sudden onset of respiratory distress, geen koorts, unilateral wheezing, vaak rechts, en op de x thorax hyperinflation of the right lung with mediastinal shift to the left , to be removed by rigid bronchoscopy from the right main bronchus, to make the diagnosis hard you also need rigid bronchoscopy
kwashiorkor
have access to carbohydrates, bread grains or starches but no access to proteins, vocht in de buik = ascites
marasmus
deficiency of all macronutrients; M arasmus = M useebah; atrophy everywhere
how to calculate the expected height of a child
mid parental height is important or most important bedside test to evaluate short stature and it is of highest diagnostic value
insulin like growth factor
growth hormone defi, should you treat it immediately? no, evaluate after 1 year
consitutional growth delay
low igf1 but normal serum growth hormone with delay in teh grouth without other abnormalaities
nutritional rickets management?
give daily administration of vitamin D3
which combinations of rickets you might see?
low calcium, mildly high PTH, very high alkaline phsophatase, and widening of the growth plates on x ray
high calcium, low phsophate, lower leg long bone angulation and distal bone hypertrophy
familial hypophosphatemia rickets
the correct way to write an order of vitamin D?
vitamin D 400 units daily
een oude man met gastritis tgv nsaids met ijzer deficiencie
geen ijzer tabletten, alleen ijzer iv
een dame van 50 jaar oud, status na AVR met nu anemie en reiculocyte count percentage is high, hb laag , wbc en bloedplaatjes normaal
in the perpheral smear you see schistocytes and burr cells
een baby met ijzer defic
give iron supplements
ijnzer intox
to stop giv desferrioxamine iv
iron of 90 could be within normal range for some children but it could also indicate intox, so give desferrioxamine
recommended vaccines at 6 years old
mmr, varicella, dtp, en opv, these are pre schoold vaccination
most important quesiton in the assessment for the vaccination
whether the child has recently received ivig; intravenous imunoglobulin
hiv child from his mother with low t cell count
do not give them live vaccin such as varcella or mmr
in a mother with crohns disease on biological theray and azathiorpine, which vaccines should you avoid
live aatenuated vaccines for a period of 12 months
opv seems to be also live aatenautided
BCG is also live vaccine and it should not be given in verdenking immunodeiciency
true
is hepatitis b vaccine safe to any child with immunodeficieny or verdenkinging daarop ?
yes
moeder met chronishce hepatiis b, nu zwanger
geef het kind en het vaccine en immunoglobulin
een kind met nefrotisch syndroom en krijgt steroids, wanneer vaccineren
over 6 maanden en niet direct
contraindication vaccine during preganncy
live vaccines such as varcella , infleunza is safe
high fever alone is generally not a reason to dealy or withhold subsequent vaccines
true
child with diarrea came vaccination
give all if there are no concerning symptoms
what to do for child came for vaccines but he on antibiotics course
do NOT delay till finishing his ab
een kid die verkouden is met koorts maar verder stabiel en oogt niet erg ziek, zou je hem vaccineren als je al een afspraak heeft
ja proceed with vaccination
a
at birth
which vaccins should you give at 2 months old baby
vaccins at 4 months?
1 year vaccination
OPV, MMR, PCV, VARECILLA
d
egg allergy and vaccines
before you give yellow fever vaccination you should be assessed by an immunology specialist
Dtap vaccine least side effect
redness
which inidcate poor ivig response
increased crp
pilgrims vaccine required
meningitis
bed wetting overnight in 8 years old
detrusor muscle and pelvci floor weakness
bed wetting bij een kid die het al goed doet maar nu plotseling bed wetting
uwi
c
until which age is bed wetting considered normal behavior
5
treatment of congenital hypothyroidisim
lifelong levothyroxine
vertel wat je weet over cycstoic fibrosis
how to confirm the diagnosis
sweat chloride test in a sibling is important screening tool but to conifrm the diagonsins you need genetic testing (also in a sibling); hereditary autosomal recessive
nasal polyps are common in cystic fibrosis
chronic productive couf recurrent chest infections and sinusitits and poor growth
denk aan cystic fibrosis
In almost all cases of meconium ileus, cystic fibrosis is the underlying disease.An intestinal obstruction caused by failure to pass meconium. Typically manifests in the first three days of life with abdominal distension
cystic fibrosisi is usually the underlying caause
most common compliction of cystic fibrosisi
bronchiectasis
cf
a
c
multiple duodenal erosions or subtotal villous atrophy
celiac disease
abdomnal bloating , diarree, crampy pain, watery loos stool, mucus in stool, tissue transglutaminase IgA posititve, no blood in stool
celiac disease
skin lesion in celiac disease
dermatitis herpitiform
d
a
diagnosis celiac dsiease
positive serological test can confirm the diagnossi
celiac dsiease heb je vaak ijzer def
geef ijzer iv
d
d; inappropriate relaxation of the lower esophageal; vaak in pre term kinderen
b
hirschsprung disease presentation
constipation sicnce birth, empty rectum maar after finger..
hirschsprung disease diagnosis and treatment
treatment: refer to surgery; leveling colostomy
normal and abnormal crying
infantile colic
infentile colic behandeling
c
infentile colic wil resolve
at 6 months and associate with excessive passage of flatus
ileocolic
intussusception gold standard investigation and treatment
barium enema
intussusception best initial test
abdoimanl ultrasound; target sign; anders contrast enema where you see pneumatic insufflation
a
A
D
pyloric stenosis presentation
pyloric stenosis diagnosis
dd vomiting newborn
Gastroesophageal reflux in infants
Gastroesophageal reflux disease in infants
intussusception risk factors, prsentation , diagnosis and treatment
pyloric stenosis lab findings
hypochloremic, hypokalemic metabolic alkalosis
pyloric stenosis first steps in the behandeling
iv infuus (normal saline) en potasium suppletie, daarna ok
pyloric stenosis sign
single bubble, olive
pyloric stenosis best diagnostic
ultrasound
IgA vasculitis
also colled
(Henoch-Schonlein purpura); clinical presentation
most important LWII paar weken eerderer + petechial rash ; kan ook buik klachten, behandeling mainly supportive maar in bepaalde gevallen zoals bij LgAV nephritis of vervelende buik pijn of rectal bleeding, je kan systemaic glucocorticoids geven
knee en ankle most affected joints
IgA vasculitits
b
diphteria presentation
most common cause of ear infection or otitis media in children
is bacteria
most common virus causing acute otitis media
rhinovirus
d
but if only budling tympanic membrane the it is acute otitis media
conductive hearing loss because of
could be becuase of recurrent otitis media
limited range of motion at the hip joint
femoral slipped capital epiphyseal plate
honey colored crusted lesion
impetigo
impetigo presentation
staph aureus or streptococcus pygogenes, vaak geen koorts, geen ziek geweest , not itchy
tot rond 194
