Pediatrics Charts Flashcards
skin rash found in newborns and infants: common yellow or white pustules that are surrounded by a red base
erythema toxicum
skin rash found in newborns and infants: red pustules and papules are most prominent over the cheeks and nose of some normal newborns
neonatal acne
skin rash found in newborns and infants: the salmon red, scaly eruption often involves the face, neck, axilla, diaper area, and behind the ears
seborrhea
skin rash found in newborns and infants: erythema, scaling, dry skin, and intense itching. Found on flexor surfaces
atopic dermatitis (eczema)
skin rash found in newborns and infants: more than 5 cafe au lait spots and axillary freckling. Later findings include neurobribromas and Lish nodules
neurofibromatosis
skin rash found in newborns and infants: this bright red rash involves the intertriginous folds, with the small “satellite lesions” along the edges
candidal diaper dermatitis
skin rash found in newborns and infants: this irritant rash is secondary to diarrhea or irritation and is noted along contact areas
contact diaper dermatitis
skin rash found in newborns and infants: this infection is due to bacteria and can appear bullous or crusty and yellowed with some pus (honey crusted yellow)
impetigo
what is the most common dysrhythmia in children?
paraoxysmal supraventricular tachycardia
what do infants with paraoxysmal supraventricular tachycardia present with?
some may look well or may be somewhat pale with tachypnea, but have a heart rate of greater than or equal to 240 beats per minute. Others are ill and in cardiovascular collapse. This requires medial therapy for conversion to normal rate and rhythm.
childhood hypertension is typically more likely to have what kind of causes?
renal, cardiac, or endocrine causes
in children: dry rough warts on hands
verruca vulgaris
in children: small, flat warts
verruca plana
in children: tender warts on feet
plantar warts
in children: dome-shaped fleshy lesions
molluscum contagiosum
open and closed comedones and inflamed pustules
acne
intensely pruritic, red, distinct papules characterize these lesions
bites
scaling, crusting, and hair loss are seen in the scalp, along with painful plaque and occipital lymph node
tinea capitis
this pruritic, allergic sensitivity reaction changes shapes quickly
urticaria (hives)
intensely itchy papules and vesicles, sometimes burrows, most often on extremities
scabies
this annular lesion has central clearing and papules along the border
tinea corporis
oval lesions on trunk sometimes with a herald patch
pityriasis rosea
appears within the first 24 hours from subperiosteal hermorrhage involving the outer table of one of the cranial bone. It is swelling, that is initially soft, and then develops a raised bony margin within a few days from calcium deposits at the edge of the periosteum. It tends to resolve within a few weeks
cephalohematoma
anterior fontanelle is bulging and the eyes may be deviated downward, revealing the upper scleras and creating the “setting sun” sign. This sign is also seen briefly in some normal newborns
hydrocephalus
this is a condition of premature closure of one or more sutures of the skull. This results in an abnormal growth and shape of the skull because growth will occur across sutures that are not affected but not across sutures that are affected.
craniosynostosis
which types of craniosynostosis are most common?
scaphocephaly and frontal plagiocephaly (see page 881 in bates for pictures)
babies born to women with chronic alcoholism are at increased risk for growth deficiency, microcephaly, and mental retardation.
fetal alcohol syndrome
Facial characteristics of this disease include short palpebral fissures, a wide and flattened philtrum (vertical groove in midline of upper lip) and thin lips
fetal alcohol syndrome
children with this disease have coarse facial features, a low-set hair line, sparse eyebrows, and an enlarged tongue. Children with this have no physical stigmata
congenital hypothryoidism
What are some associated features with congenital hypothryoidism?
associated features with this disease include a hoarse cry, umbilical hernia, dry and cold extremities, myxedema, mottled skin,and mental retardation.
in utero infection caused by treponema pallidum usually occurs after 16 weeks gestation and affects virtually all of the fetal’s organs. If this condition isn’t treated, 25% of infected babies die before birth and another 30% shortly after
congenital syphilis
facial stigmata of congenital syphilis include what?
bulging of the frontal bones and nasal bridge depression (saddle nose), both from periostitis; rhinitis from weeping nasal mucosal lesions (snuffles); and a circumoral rash. Mucocutaneous inflammation and fissuring of the mouth and lips, craniotabes tibial periostitis, and dental dysplasia may also occur
peripheral paralysis of the facial nerve may be from?
- an injury to the nerve from pressure during labor and birth 2. inflammation of the middle ear branch of the nerve during episodes of acute or chronic otitis media 3. unknown causes (bell’s palsy).
The nasolabial fold on the affected left side is flattened and the does not close in what condition?
facial nerve palsy (nerve paralysis)
What does a child with down syndrome typically present with? (trisomy 21)
usually has a small, rounded head, a flattened nasal bridge, oblique palpebral fissures, prominent epicanthal folds, small, low-set, shell-like ears, and a relatively large tongue.
how does a battered child typically present?
may have old and fresh bruises on the head and face and may either look sad and forlorn or be actively seeking to please, sometimes even particularly involved with and attentive to the abusing parent.
A child suffering from this disease has an open mouth (can’t breathe through the nose) and edema and discoloration of the lower orbitopalpebral grooves (allergic shiners).
Periennial allergic rhinitis
A child who often pushes his/her nose upward and backward with a hand (allergic sallute) and grimaces (wrinkle the nose and mouth) to relieve nasal itching and obstruction
periennial allergic rhinitis
what do effected children with thyrotoxicosis (Graves’ disease- hyperthyroidism) present with?
exhibit hypermetabolism and accelerated linear growth. They have “staring” eyes but not true exopthalmos, and has an enlarged thyroid gland (goiter).
abnormal speckling spots on the iris that suggest down syndrome
brushfield’s spots
misalignment of the eyes that can lead to visual impairment.
strabismus
esotropia
inward deviation of eye
what is one of the most common conditions in young children
otitis media
red, distorted, bulging tympanic membrane in a highly symptomatic child. Can present with bullae formation and fluid visible behind the tympanic membrane
acute otitis media
yellowish fluid behind a retracted and thicken tympanic membrane
otitis media with effusion
common infection in infants. Presents with white plaques in the mouth that do not rub off
oral candidiases (thrush)
tender ulcerations on the oral mucosa that are surrounded by erythema
herpetic stomatitis
this is a major global health and pediatric problem
dental caries
what causes can lead to staining of the teeth in children?
intrinsic stains such as tetracycline or extrinsic stains such as poor oral hygiene.
True or False: Extrinsic stains on teeth cannot be removed
FALSE
classically presents with erythema of the posterior pharynx and palatal petechiae. A foul smelling exudate is also commonly found
streptococcal pharyngitis (strep throat)
enlarged and tender cervical lymph nodes typically caused by viral and bacterial infections. It can be bilateral
lymphadenopathy
total anomalous pulmonary venous return and an oxygen saturation of level of 80%
Generalized cyanosis
mild cyanosis above the lips, but the mucous membranes remains pink
perioral cyanosis
normal pigment deposition in the vermilion border of the lips gives them a bluish hue, but mucous membranes are pink
bluish lips, giving appearance of cyanosis
commonly found on the feet and hands of babies shortly after birth.
acrocyanosis
usually a normal valve anulus with fusion or some or most of the valve leaflets, restricting flow across the valve
pulmonary valve stenosis
usually a bicupsid valve with progressive obstruction, but there may be a dysplastic valve or damage from rheumatic fevere or degenerative disease
aortic valve stenosis
complex defect with ventricular septal defect, infundibular and usually valvular right ventricular outflow obstruction, malrotation of the aorta, and right-to-left shunting at ventricular septal level
tetralogy of fallot
a severe defect with failure of rotation of the great vessels, leaving the aorta to arise from the right ventricle and the pulmonary artery from the left ventricle
transposition of the great arteries
blood going from a high-pressured left ventricle through a defect in the septum to the lower-pressured right ventricle creates turbulence, usually throughout systole
ventricular septal defect
continuous flow from aorta to pulmonary artery throughout the cardiac cycle when ductus arteriosus does not close after birth
patent ductus arteriosus
left-to right shunt though an opening in the atrial septum possible at various levels
atrial septal defect
physical signs of possible sexual abuse:
- Marked and immediate dilation of the anus in knee-chest position, with no constipation, stool in the vault, or neurologic disorders. 2. hymental notch or cleft that extends > 50% of the inferior hymenal rim (confirmed knee-chest position) 3. condyloma acuminata in a child older than 3 4. bruising, abrasions, lacerations, or bite marks of labia or perihymenal tissue 5. herpes of the anogenital area beyond the neonatal period 6. purulent or malodorous vaginal discharge in a young girl (culture and view all discharges under a microscope for evidence of STI)
Strong indications of sexual abuse:
- lacerations, ecchymoses, and newly healed scars of the hymen or the posterior fourchette. 2. no hymenal tissue from 3 to 9 o clock (confirmed in various positions) 3. healed hymenal transections, especially between 3 and 9 o clock (complete cleft) 4. perianal lacerations extending to external sphincter
most common congenital penile abnormality. The urethral meatus opens abnormally on the ventral surface of the penis.
hypospadias.
common musculoskeletal findings in young children
- flat feet 2. inversion of the foot 3. metatarsus adductus. The forefoot is adducted and not inverted