Peds 1 Flashcards
perianal pruritus and erythema, vulvar eyrthema
pinworm (helminth), tx with albendazole or pyrantel pamoate
is atrophic glossiitis present in many nutriend deficiencies?
yes
when this nutriend is low, you get macrocytic anemia, glossitis, neuropyshc sx (paresthesias, depression)
B12
4 causes of Pellagra
Alcohol, Anorexia, GI malabsorption (Crohns) and Low Dietary Intake
This syndrome can result in coarctation of aorta, bicuspid aortic valve, horseshoe kidney and streak ovaries with amenorrhea and infertility
turners
FTT, bilateral cataracts, jaundice, hypoglycemia
galactosemis
bruising, LAD, hepatosplenomegaly, petechia, mucosal bleeding
ALL, can impact platelet function in addition to causing anemia and neutropenia
prevention and tx or gonococcal conjunctivitis
prevention = erythromycin eye ointment, tx = IM ceftriazone or cefotaxime
what 4 clinical findings can be found on all congenital infections?
intrauterine growth restriction, hepatosplenomegaly, jaundice, blueberry muffin spots
periventricular calcifications
CMV
diffuse intracerebral calcifications
toxo
rhinorrhea (snuffles) abnormal long-bone radiographs (metaphyseal lucencies), rash
syphillis
this type of newborn jaundice is due to suboptimal breastfeeding
breastfeeding jaundice
scabies tx
permethrin or oral ivermectin
on evaluation of a newborn’s head, you detect firm scalp swelling that does not cross the suture lines. What is it?
Cephalohematoma/ subperiosteal hemorrhage
1 day old with acute onset cyanosis and no response to oxygen
PDA-dependent congenital heart disease; given Prostaglandin E1 to keep open
5 types of PDA-dependent congenital heart disease
Coarctation of the aorta D-transposition of the great arteries Hypoplastic left heart syndrome Total anomalous pulmonary venous connection Tricuspid atria
What facilitates PDA closure
indomethacin
pinworm tx
pyrantel pamoate or albendazole
workup for wilson disease
ceruloplasmin levels, 24 hr urinary copper excretion, ocular slit lamp examination
These two diseases present in 2-6 m.o. and result in hypotonia, feeding difficulties, loss of motor milestones and the children will have cherry-red macula
Niemann Pick and Tay Sachs
Unlike Tay Sachs, Niemann Pick presents with ____ and _____ and is the result of ______ deficiency
Niemann pick = hepatosplenomegaly, areflexia, Sphingomyelinase deficiencey
4 emergency contraception options
Copper IUD
Ulipristal pill
Levonorgestrel pill
OCPs
These 3 emergnecy contraception options delay ovulation
ulipristal, levonorgestrels, OCPs (all progestin derivatives)
4 causes of exudative effusions
Empyema
Chylothroax
Malignancy
Tuberculosis
organism in cellulitis of kid with SCD
salmonella
3 muscular dystrophies
Duchenne
Becker
Myotonic
These 2 muscular dystrophies are XLR
Duchenne and Becker
This muscular dystophie typically onsets 2-3 y.o., the youngest of all
Duchenne
This muscular dystrophy presents in 12-30 yo with fascial weakness, dysphagia, and hand grip myotonia
Myotonic
The following meds can trigger hemolysis in \_\_\_\_\_: Diaminodiphenyl sulfone (dapsone) Isobutyl nitrite Nitrofurantoin Primaquine Rasburicase
G6PD deficiency
Short, macules of varying colors, abnormal thumbs, GU abnormalities
Fanconi anemia (inherited DNA repair defect)
Is Fanconi anemia the most common congenital cause of aplastic anemia (pancytopenia)?
YES - AR disorder caused by a DNA repair defect
What are bleeding and bruising a sign of?
thrombocytopenia
macrocytic anemia, craniofacial anomalies, triphalangeal thumbs
diamond blackfan anemia
can anemia result in a flow murmur?
yes
eczema, thrombocytopnia, hypogammaglobulinemia
wiskott-aldrich syndrome - X-linked
precocious puberty with nl bone age and isolated breast development
premature thelarche
premature adrenarch
child with precocious pubic hair development and normal bone age
Endocardial cushion defect, Umbilical hernia, Duodenal atresia, Alzheimers, and Hirschsprung
Downs Syndrome
Child determine to have choanal atresia, what else to look for?
CHARGE syndrome Coloboma (missing eye tissue) Heart defects Atresia of choanea Retardation of growth Genital abnormalities Ear abnormalities
sx of pellagra (niacin deficiency)
Diarrhea, Dermatitis (like sunburn), Dementia (also depression, distraction), Death
Causes of Bell Palsy
HSV and Lyme
What does Hib vaccine protect against
epiglottitis, pneumonia, AOM, meningitis
What is MCHC
meausre of Hg concentation in each RBC (decreased in iron deficiency anemia and thalassemia; increased in hereditary spherocytosis)
XLR, factor VIII deficiency, hemarthrosis
Hemophilia A
purpura, arhtritis, abdominal pain, intussusception, renal disease, IgA mediation vasculitis
HSP
impaired oxidative burst, recurrent skin and pulmonary infections, infxn with catalase + bacteria (s. aureus, serratia)
chronic granulomatous disease
hypocalcemia, cardiac defects, FTT, recurrent infections, thymic hypoplasia, dysmoprhic fascies
DiGeorge Syndrome
impaired T cell development, severe recurrent viral, fungal and bacterial infections
Adenosine Deaminase Deficiency/ SCID
absent lymphoid tissues, absent serum Ig, recurrent sinopulmonary and GI infections, no B cell development due to tyrosine kinase deficiency
x-linked agammaglobulinemia (XLA)
4 causes of bilious emesis
meconium ileus, hirschsprung, malrotation, duodenal atreisa
bilious emesis, GI series with corkscrew
malrotation with midgut volvulus
double bubble on XR
duodenal atresia
bloody diarrhea followed by fatigue and pallor, labs indicate hemolytic anemia, thrombocytopenia, and AKI
HUS due to shiga toxin
recent skin or throat infection, now hematuria, HTN and AKI
PSGN
ADHD first line tx
STIMULANTSmethylphenidate, amphetatmines
ADHD but doesn’t want a stimulant
atomextine, alpha 2 adrenergic agonists
cause of croup
parainfluenza
cause of epiglottitis
haemophilus influenza
cause of bronchiolitis
RSV
should children with SCD be given twice daily ppx penicillin up to age of 5 for protection against encapsulated organisms?
YES
vaccine for SCD
s pneumo
high arches, cardiomyopathy, scoliosis, ataxia, AR with GAA repeats
friedreich ataxia
recent salmonella or chlamydia infection followed by arthritis of lower extremities
reactive arthritis
examples of IgE mediated hypersensitivity reactions
anaphylaxis and urticaria
examples of T cell and macrophage mediation hypersensitivity reaction
contact dermatitis
Tuberculin skin reaction
aspirin during viral infection, encephalopathy, acute liver failure with microvesicular steatosis, transaminitis, coagulopathy (elevated PT, INR and PRR), hyperammonemia
Reye syndrome
age of onset gonococcal vs chlamydial conjunctivitis
gonococcal = 2-5 days (tx is IM cephalopsporin) Chalmydia = 5-14 days (tx if PO macrolide)
turns blue and loss of consciousness with exercise, temper tantrums, crying
TofF
gastrochisis vs omphalocele
omphalocele = sac
omphalocele, macrosomia, macroglossia
Beckwith-Wiedemann syndrome
Is gastrochisis typically an isolated defect?
Yes
periodid belly pain, sausage shaped mass RUQ, target sign on US, tx with air or contrast enema
intussusception
rash of posterior auricular LAD
rubella
high fever, cough, coryza, conjuncitinivits, rash
measles
what is a SGA baby at risk of
meconium aspiration, hypothermia, hypoglycemia, hypoxial, perinatal asphyxiation, hypocalcemia, plycythemia,
children with SCD are at particular risk of sepsis with these 3 bugs
s. pneumo
h. influenza
n. meningitidis
why are pt < 5 with SCD given ppx penicillin
protect against s. pneumo which can lead to spesis
is a CT required prior to LP in a young child with open fontanelles during workup of suspected meningitis
nope, fontanelle is a pop-off valve allowing room for increased ICP
these two immunodeficiencies present with absent lymphoid tissues
SCID and XLA
these two immunodeficiencies prsent with recurrent sinopulmonary infxn and GI
XLA and CVID
In contrast to XLA, CVID presents ___
less severe, at older age, and with nl T and B cell counts
tx for XLA
serum Ig
tx for SCID
stem cell transplant
defective T cell deve
SCID
defective B cell development
XLA
isotonic solutions (NS) for volume resusciation?
YES, hypotonic can lead to electrolyte derangement and cerebral edema
rx mgmt of primary noctural enuresis
desmopressin
pH, glucose, and WBC that indicate complication bacterial invasion
pH < 7.2
Glucose < 60
WBC > 50,000
RDS risk factors
prematurity, perinatal asphyxia, maternal diabetes, c-section w/o labor
cholesteatoma
benign growth of squamous epithelium and accumulatino of keratin debris - seen as pearly white mass, may develop conductive hearing loss