Pediatrics CDB Flashcards
Pituitary Gland: Location?
Sella Turcica
Anterior Pituitary Gland
Adenohypophysis
Posterior Pituitary Gland
Neurohypophysis
Pituitary Gland: Embryology?
Rathke’s pouch
The most common type of tumor in the pituitary gland in pediatrics
Cranipharyngiomas
Definitive diagnosis of Hypopituitarism
Absent or Low levels of Growth Hormone
Polyuria (>5cc/k/hr) and polydypsia
Diabetes Insipidus
Master Gland
Pituitary Gland
Located in Supraoptic nuclei
Vasopressin (ADH)
Located in Paraventricular nuclei
Oxytocin
Vasopressin Deficiency
Central Diabetes Insipidus
Vasopressin insensitive kidneys
Nephrogenic Diabetes Insipidus
Most common etiology of central diabetes insipidus
Brain Tumors
2nd Most common etiology of central diabetes insipidus
Idiopathic
In Diabetes Insipidus, AVP acts on the
Distal Tubules
Significant diagnostic result of Diabetes Insipidus
HYPERnatremia
Precious Puberty
Polyostotic fibrous dysplasia
UNILATERAL café-au-lait spots
McCune Albright Syndrome
The Coast Of Maine TRIAD:
McCune Albright Syndrome:
Precious Puberty
Polyostotic fibrous dysplasia
UNILATERAL café-au-lait spots
DOC for McCune Alright Syndrome
Leuprolide acetate
21-hydroxylase Deficiency
Congenital Adrenal Hyperplasia
Mutation of CYP21A2 on short arm of chromosome 6
Congenital Adrenal Hyperplasia
Define Tall Stature?
Taller than 2 standard deviation ABOVE the mean
Cerebral Gigantism
Sotos Syndrome
Define Short Stature?
More than 3 standard deviation BELOW mean for age and gender
Male phenotype of Turner’s Syndrome
Noonan Syndrome
Pigeon breast
Web neck
Hypertelorism
Noonan Syndrome
Most common caused by thyroid dysgenesis
Hypothyroidism
Seen in maternal autoimmune disease like Hashimoto’s Ds.
Thyrotropin Receptor-Blocking Antibody
Most common cause by some form of THYROID DYSGENESIS of which ectopic thyroid is the most frequent
Congenital Hypothyroidism
Most common location of congenital hypothyroidism
Base of the tongue or sublingual
Earliest sign of congenital hypothyroidism
Prolonged jaundice
Earlobe crease + Macroglossia
Beckwith Syndrome
Thyroid panel result of Congenital Hypothyroidism
TSH ⬆️
T3 ⬆️
T4 ⬇️
Most common cause of thyroid disease in children
Thyroiditis
Most common cause of acquired hypothyroidism
Thyroiditis
Lymphocytic thyroiditis
Hashimoto’s Thyroiditis
Autoimmune thyroiditis
Hashimoto’s Thyroiditis
Components of Triple Screen Test
Beta HCG
Estriol
Alpha Fetoprotein
Triple Screen Test aka
Kettering Test
Barts Test
Catecholamine secreting tumor of the chromaffin cells
Pheochromocytoma
Guthrie Test
Newborn Screening
Guthrie Test Includes:
Congenital Adrenal Hyperplasia Congenital Hypothyroidism G6PD Deficiency Galactosemia PKU Maple Syrup Disease
Prolonged physiologic jaundice + genital edema
Congenital Hypothroidism
Female Pseudo-Hermaphroditism
21 Hydroxylase Deficiency
11 alpha-hydroxlase Deficiency
3 beta hydroxysteroid dehydrogenase Deficiency
5 alpha reductase deficiency
Male PseudoHermaphrodism
Persistent Mullerian Duct Syndrome
Male PseudoHermaphrodism
Deficiency of Cortisol
Congenital Adrenal Hyperplasia
Classic form of Galactosemia
Galactose-1-phosphate uridyl transferase deficiency (GALT)
Episode or chronic hemolytic anemia
G6PD Deficiency
Heinz bodies + Reticulocytosis
G6PD Deficiency
Mousy or Musty Odor
Phenylketonuria
Deficiency of Tetrahydrobiopterin
Phenylketonuria
PAH Gene associated with Seizures
Folling’s Disease
Required to convert Phenylalanine to Tyrosine
Tetrahydrobiopterin
Pre-natal diagnosis of defects in phenylalanine hydroxylase deficiency or dihydropterin reductase
DNA Probes
Less reliable screening test employs FeCl3 to detect phenylpyruvate
Urinalysis
Tyrosine Precursors except:
Tryptophan
Niacin
Serotonin
Tyrosinemia Type 1
Fumaryl Acetoacetate Hydroxylase (FAH) deficiency
Tyrosinemia Type II
Tyrosine aminotransferase (TAT) Deficiency
Tyrosinemia Type III
4-hydroxy-phenylpyruvate dioxygenase (4-HPPD) Deficiency
Clinical Manifestation of TYROSINEMIA
Acute hepatic Crisis
Renal involvement
Acute peripheral neuropathy
Diagnostic result of Tyrosinemia found in Urinalysis
Succinyacetoacetate
Succinylacetone
Most common inborn error of METHIONINE metabolism
Homocystinuria
Basic Defect of Homocystinuria
Cystathione synthase deficiency
Tx of Homocystinuria
Vitamin B6 (Pyridoxine) 200mg-1g/day
Branched chain alpha ketoacid dehydrogenase deficiency
Maple Syrup Urine Disease
On Physical Exam:
Hypertonicity
Muscular rigidity
Opisthotonus
Maple Syrup Urine Disease
Urine Odor: Sweaty Feet
Glutaric Acidemia (Type III)
Urine Odor: Acrid
Glutatic Acidemia (Type III)
Urine Odor: Swimming pool
Hawkinsinuria
Urine Odor: Boiled Cabbage
Hypermethioninemia
Urine Odor: Tom Cat Urine
Multiple Carboxylase Deficiency
Urine Odor: Rotting Fish
Trimethylaminuria
Urine Odor: Rancid Butter + Boiled Cabbage
Tyrosinemia
Peroxisomal Deficiency
Zellweger Syndrome
Infantile Refsum Disease
Adrenoleukodystrophy
7-dehydrocholesterol reductase deficiency
Smith-Lemi-Optiz Syndrome
Mutation in the Sterol Delta - 7 - Reductase Gene (DHCR7)
Smith-Lemi-Optiz Syndrome
Characterized of hypospadias and syndactyly between toes 2 & 3 (fusion)
Smith-Lemi-Optiz Syndrome
Hexosamide A Deficiency
Tay-Sachs Disease
GM2 Gangliosidosis
Tay-Sachs Disease
Cherry-Red Spot with Optic Atrophy
Tay-Sachs Disease
Hexosaminidase A and B Deficiency
Sandhoff Disease
Coarse granulation in bone marrow histiocytes
Sandhoff Disease
Glucocerebrosidase Deficiency
Infantile Gaucher Disease
Crumpled Paper/Tissue Appearance
Gaucher Cells
Oculomotor Apraxia and Bilateral Strabismus
Infantile Gaucher Disease
Spingomyeline Deficiency
Infantile Neimann-Pick Disease
Vacuolated Histiocytes (Foam Cells)
Infantile Neimann-Pick Disease
Lipogranulomatosis
Farber Disease
Ceramidase Deficiency
Farber Disease
Horse Cry
Farber Disease
CerebroHepatoRenal Disease
Zellweger Disease
Pipecolate Oxidase Deficiency
Zellweger Disease
Lorenzo’s Oil
Adrenoleukodystrophy
Kinky or Steely Hair Disease
Menkes Disease
Trichopoliodystrophy
Menkes Disease
2nd most common Deficiency in Copper-dependent enzyme
Menkes Disease
Most common Deficiency in Copper-dependent enzyme
Willson’s Disease
Pili Torti
Menkes Disease
Arylsulfatase A Deficiency
Metachromatic Leukodystrophy (MLD)
Fronto-Occipital Demyelination
Metachromatic Leukodystrophy
Globoid Cell Leukodystrophy
Krabbe Disease
Galactocerebrosidase Deficiency
Krabbe Disease
Chromosome 14
Krabbe Disease
Pellagra-like Dermatosis
Hartnup Disease
Tryptophan Deficiency
Hartnup Disease
Phytanoyl-CoA Hydroxylase(Chromosome 10) or Peroxin-7(Chromosome 6)
Deficiency
Refsum Disease
Cannot Digest Dairy Products
Refsum Disease
Glycogen Deficiency Type 1
Von Gierke’s Disease
Glucose-6-Phosphate Deficiency
Von Gierke’s Disease
Galactose 1-Phosphate Uridyl Transferase (GALT) Deficiency
Galactosemia
Hypoxanthine guanine phosphoribosyl transferase (HPRT) Deficiency
Lesch-Nyhan Syndrome
Clinical Manifestation:
Self injurious behavior
Self mutilation
Lesch-Nyhan Syndrome
MOA: Inhibits xanthine oxidase
Allupurinol
- Progressive external ophthalmoplegia
- Retinitis pigmentosa
Kearans-Sayre Syndrome
Bony Spicule Appearance
Retinitis Pigmentosa
Most frequent mitochondrial disease of the perinatal period and early infancy
Leigh Encephalopathy
Subacute Periventricular Necrotizing Encephalopathy (SPNE)
Leigh Encephalopathy
Most common vasculitis in children
Henoch-Schonlein Purpura
Anaphylactoid purpura
Henoch-Schonlein Purpura
Vasculitis of SMALL VESSELS
Henoch-Schonlein Purpura
Rash describe as palpable purpura on dependent area
Henoch-Schonlein Purpura
Mucocutaneous Lymphadenopathy
Kawasaki Disease
Polyarteritis nodosa
Panarteritis nodosa
Necrotizing vasculitis of small and medium sized vessels
Panarteritis nodosa
Vasculitis of large vessels
Takayasu’s Arteritis
Pulseless Disease
Takayasu’s Arteritis