Pediatrics Flashcards
Cholesteatoma
Benign growth of SQUAMOUS EPITHELIUM and accumulation of KERATIN DEBRIS
Cholesteatoma
Acquired, Unilateral
Cholesteatoma Risk Factors
Recurrent Acute Otitis Media
Chronic Middle Ear Effusions
Tympanostomy Tube Placement
Cleft Palate
Cholesteatoma Signs and Symptoms
Persistent otorrhea
Conductive Hearing Loss
Pearly white mass behind an intact TM
Wiskott-Aldrich features
Eczema
Recurrent infections: viral, bacterial and fungal
Microthrombocytopenia: petechiae, intracranial hemorrhage, hematemesis, hematochezia
:: WAS gene mutation. Cytoskeleton abnormalities in leukocytes and platelets
Fetal Hydantoin Syndrome
Maternal exposure to antiepileptics: phenytoin, carbamazepine, valproate
Cleft lip/palate Distal hypoplastic phalanges Neural tube defect Wide anterior Fontanelle Microcephaly Pulmonary/Aortic stenosis
Fetal Alcohol Syndrome features
Microcephaly
Midfacial hypoplasia
Mental retardation
Measles Virus (Rubeola)
Airborne transmission
Prodrome: cough, coryza, conjunctivits, fever
KOPLIK SPOTS
Maculopapular exanthema: Cephalocaudal, spares palm/soles
Live-attenuated measles vaccine
Treatmet: Vitamin A for hospitalized patients
Flaccid Paralysis, differential diagnosis
Infant Botulism
Foodborne botulism
Guillain-Barré syndrome
Infant botulism, features
Ingestion of C. Botulinum spores from environmental dusts (construction sites, new condos)
Descended flaccid paralysis
Tte: human-derived butolism Ig
Foodborne botulism, features
Ingestion of C. Botulinum toxin (honey)
Descending paralysis
Tte: Equine-derived botulism antitoxin
Guillain-Barré Syndrome, features
Autoimmune peripheral nerve denervetion
Ascending flaccid paralysis
Tte: pooled human Ig
Labor induced HSV
Meningoencephalitis
Chronic Granulomatous Disease
X linked
Impaired NAPDH, decreased superoxide production
Suceptibility to catalase MO: S.Aureus, Serratia, Arpergillus
Suceptibility to fungus
Right testicule varicocele that doesn’t decompress with supine position
IVC compression, consider wilms tumor
Abdomen US
Iron poisoning treatment
Deferoxamine: chelating agent that binds free iron
Billiary Atresia Features
2-8 weeks
Direct hyperbili
Pale/yellow stools
Meconium Ileus
Inspissated stool causes obstruction
Strong association w/ CF
failure to pass meconium in 24 hours, abdominal distension
no stool in rectal vault
Delayed pass of meconuim (48 hrs or more)
Hirschsprung
CF
Congenital Hypothyroidism
Bilious emesis in the neonate
Rotavirus Vaccine
2 - 6 months of age
contraindications: allergies to is components, history of intussusception, severe combined immunodeficiencicy
Necrotizing Enterocolitis RF
Premature
Very low birth weight (under 1,5 kg)
Enteral feeding
Beckwith Wiedemann Syndrome
Macrosomia
Large Tongue
Midline wall defects (hernias, omphalocele)
Hypoglycemia due to hyperinsulinemia
Meckel Diverticulum
Intussusception + anemia (due to asymptomatic bloody stools)
Abdominal distention + erythema
Necrotizing Enterocolitis
Biliary Atresia
Jaundice
light colored stools
direct hyperbilirubinemia
Reye Syndrome
Encephalopathy w/ cerebral edema
Acute fatty liver failure:
- high AST ALT
- high PT, INR, aPTT
- high NH3
- low glucose
Hepatomegaly w/o jaundice
Intussusception: location and cause
Ileocecal junction (ileum into the cecum)
Previous viral infection causing inflammation of the peyer patches
Cause of jejunum or ileum atresia
Vascular accident in utero
Causes necrosis and resorption of the fetal intestine
Leave a blind proximal and distal ends
Newborn jaundice: lactation failure jaundice
age less than 1 week
insufficient intake leads to decrease bilirubin elimination and higher enterohepatic circulation
signs of dehydration
Newborn jaundice: breast milk jaundice
age more than 1 week
high beta-glucoronidase in milk leads to deconjugation of intestinal bilirubin
Iron deficiency in infants
Maternal deficiency
Prematurity
Introduction to cow’s milk before 12 months of age
Intussusception recurrence
25% meckel diverticulum
order nuclear scintigraphy
Meconium Ileus and water soluble enema
Can be diagnostic and terapeutic in 20 - 40% of cases
DIATRIZOTE MEGLUMINE ENEMA
Serum bilirubin more than 20
Crigler Najjar syndrome
Physiologic Jaundice
bili less than 14
increase less than 5 per day
during the first 3 days is less than 5
resolves by day 7 (or 14 in pre-terms)
conjugated is always normal
When to order a Renal Bladder US
All < 2 y/o with UTI
After fever and symptoms have resolved to reduce false positives :: inflamation
When to order a COIDING CYSTOURETHROGRAM (VCUG)
> 2 febrile UTI
abnormal renal US
fever > 39 w/ bacteria other and E. Coli
signs of CKD (eg: HTN)
PUVs in utero
reduce urinary output
leads to oligohydroamnios
leads to pulmonary hypoplasia
Patient with aniridia
WAGR syndrome
Wils tumor
Aniridia
Genirourinary abnormalities
Retardation
Potter Sequence
Flatt Facies
Lung hypoplasia
Limb deformities (clubfeet)
Conditions leading to oligohydroamnios
Renal Agenesis
PUVs
Polycystic kidney disease
Premature rupture of membranes
Primary Nocturnal Enuresis
> 5 y/o, in children who have never achieved nighttime dryness
desmopressin is first line treatment, specially in those who want to achieve immediate improvement
Vesicoureteral reflux pathophysiology
fibrosis of renal interstitial space
Allergic Bronchopulmonary Aspergillosis
elevated IgE > 1.000
RSV complications
Apnea
Obstructive Sleep Apnea
Tonsillar Hypertrophy
Neonate with prolonged oxygen administration
Risk of?
Bronchopulmonary Dysplasia
Reduced septation of the alveoli
Risk of drowning even in healthy appearing children
Delayed pulmonary complications
Respiratory Insufficiency
Biliary atresia treatment
- KASAI procedure as bridge therapy
2. 80% requires a transplant
Claw sign on CT
Wilms tumor
Trisomy 21 cause
Meiotic nondisjunction of chromosome 21
Trisomy 21 cause
Meiotic nondisjunction of chromosome 21
Downsyndrome Prenatal US
Absent hypoplastic nasal bone Echogenic intracardiac focus Ventriculomegaly Dilated renal pelvis short humerus/femur AV canal heart defect
Downsyndrome features
dysmorphic face featurs
hyopotonia
poor feeding
upsalting palpebral fissures brachycephaly epicanthal folds anomalous low set ears protrunding tounge
Downsyndrome congenital heart anomalies
complete atrioventricular septal defect
trisomy 18
edward syndrome
Turner
Short stature Webb neck shield chest cardiac disease skeleton abnormalies
turner syndrome most common in
females
turner cause
monosomy X
45 X
turner heart syndrome
coarctation aorta
bicuspid aortic valve
Acute Phase Treatment for Kawasaki
High dose ASA
IVIG to prevent coronary aneurysm
Congenital heart disease that causes 2ry HTN
Coarctation of aorta
look for diminished femoral pulses
Most common cause of stroke in peds
Sickle Cell Disease
Pharmacological causes of idiopathic intracranial hypertension
Retinoids (isotretinoin)
Growth hormone
tetracyclines
Normal weight loss in neonates
up to 7% of birth weight in the first 5 days
Marfan syndrome
Autosomal dominant
Fibrillin 1 gen
Ectopia lentis causes
Homocystinuria
Marfan
Newborn with feeding cyanosis that relieves with crying
Coanal atrasia
Pass a catheter to asses
