Pediatrics Flashcards
child < 5 gets sick a week before (not always) patient appears well then has enlarged, erythematous, tender, cervical node possible abscess formation
Acute Unilateral Cervical Lymphadenitis
most commonly due to staph or strep
anaerobes associated with periodontal disease (poor dental hygiene)
use antibiotic therapy (clindamycin or amoxicillin-clavulanate)
do incision and drainage if abscess present
complications of bronchiolitis
apnea (especially infants age < 2 months)
respiratory failure
diagnostic criteria for acute bacterial rhinosinusitis
- persistent 10 or more days without improvement
- severe onset (fever > 39C or 102.2F + drainage) more than 3 days
- worsening symptoms following initial improvement
- need 1/3
- give amoxicillin + clavulanate
what do you give to a premature baby that is exclusively breast fed
IRON AND VITAMIN D
- preterm infants are at higher risk of iron deficiency so they should be on iron up till age 1
- all exclusively breast fed babies get vitamin D supplementation
*full term babies have enough iron for the first 4-6 months of life
management of a baby with hypospadias
defer circumcision
urologic evaluation for surgical repair
possible karyotype analysis, get pelvic ultrasound if severe
thyroglossal duct cyst vs pharyngeal cleft cyst
TDC –> anterior midline mass that moves with swallowing, embryologic anomaly made up of normal thyroid tissue
can present after URI
confirm presence of normal thyroid tissue then surgically resect the cyst , associated tract, and central portion of the hyoid bone
PCC –> lateral neck mass due to persistent cervical sinus that does not move with swallowing
how does cervical reactive lymphadenopathy present
enlarged neck mass after URI
lateral
involves multiple nodes
does not move with swallowing
kid has down syndrome and no meconium.. what do you think
hirschsprung
kid has CF and no meconium.. what do you think
meconium ileus
management of neonatal clavicular fracture
usually gets better within 7-10 days so do nothing but be gentle with them
you can also staple their shirt to the their sleeve so they dont move their arm for further damage
patient with very low fever or no fever with some hip pain and difficulty walking but can bear weight on it and was sick with a viral illness but has all normal labs
transient synovitis
full recovery within 1-4 weeks
conservative management with NSAIDs
how to treat patients and their families if someone has pertussis
its so contagious that you freaking treat them allllll with macrolides REGARDLESS OF VACCINATION STATUS
kid with purple “bruises” on his legs, arthritis/arthralgias, abdominal pain, and blood in urine
henoch-schonlein purpura
- IgA mediated vasculitis
- they are purpura not bruises
- abdominal pain, intussusception
- renal disease (hematuria- most common)
- symptoms often preceded by mild URI
supportive therapy (hydration and NSAIDs) hospitalization and systemic glucocorticoids in pts with severe symptoms
migratory arthralgias and no gram stain or culture found/grown
borrelia burgdorferi
decreased B cells due to absent T cells
severe combined immunodeficiency
common variable immunodeficiency
defect in B cell differentiation
decrease in plasma cells and immunoglobulins
most common cause of a child with back pain that has pain with extension and rotation but not flexion
spondylolisthesis
-fracture of pars interarticularis then usually pinches L5
risk factors for hypertrophic pyloric stenosis
first born boy
erythromycin
bottle feeding
*you will see an olive shaped abdominal mass
acute rheumatic fever
JONES criteria Joints O = shape of heart Nodules (subcutaneous) Erythemia marginatum Sydenham chorea
*give penicillin for group A strep
baby with pale stools and hepatomegaly
biliary atresia
*most common indication for peds liver transplant
transient tachypnea of newborn vs. respiratory distress syndrome
TTN –> tachypnea begins shortly after birth and resolves by day 2 due to inadequate alveolar fluid clearance at birth resulting in mild pulmonary edema, bilateral perihilar linear streaking … usually in term baby born via c-section
RDS –> premature infant with grunting, flaring, and retractions immediately after birth due to surfactant deficiency resulting in alveolar collapse and diffuse atelectasis, ground glass appearance on x-ray with granularities
*treat with continuous positive pressure ventilation
anaphylaxis
severe allergic reaction with HYPOTENSION or symptoms involving > 2 organ systems after exposure to allergen
*treat with IM epinephrine
what do patients have in turner syndrome (XO)
short, wide chest, webbed neck, narrow/high arched palate, coarctation of aorta (diff bp in upper vs lower extremities), bicuspid aortic valve, horseshoe kidney, and streak ovaries/amenorrhea/infertility
pts are at increased risk of osteoporotic fractures due to estrogen deficiency from ovarian dysgenesis
*more than 50% of these pts also have congenital lymphedema due to lymph network dysgenesis, presents as nonpitting carpal and pedal edema
what does organophosphate poisoning look like
acetacholinesterase inhibitors
Muscarinic: Diarrhea /diaphoresis Urination Miosis Bronchospasms, bronchorrhea, bradycardia Emesis Lacrimation Salivation
Nicotinic: muscle weakness, paralysis, fasciculations