Peds 12 Flashcards
Tx of cat scratch fever
Macrolides
Tx of bacillary angiomatosis
Doxycycline or Macrolides
Sx of Brucellosis
Fever, chills, anorexia, hepatosplenomegaly, osteomyolitis
Tx of Brucellosis
Tetracyclines
Tx of Tularemia
Aminoglycosides (streptomycin)
Stage 1 of Lyme disease
- Erythema chronic migrans (Bulls eye rash)
- Fever and sweats
Stage 2 of lyme disease
Heart block
Bell’s palsy
Stage 3 of Lyme disease
- Joint pain - migratory polyarthritis
- Encephalopathy
Tx of Lyme disease
Stage 1 = doxycycline
Later stages = ceftriaxone
Tx of Immune thrombocytopenia
- Usually a self-limited disease – observe and get a peripheral blood smear to rule out other disease
- Steroids and IVIG (autoimmune treatment) – if severe bleeding
What is CHARGE syndrome
• Coloboma (congenital malformation of eye), Heart defects, Atresia choanae, Retardation of growth/development, Genitourinary anomalies, Ear abnormaltiie/deafness
What bug presents with grayish ulcerated lesions on posterior pharynx
Herpangina caused by Coxsackie virus
Describe pathophys of agammagloblulinemia
♣ Defect in BTK gene (tyrosine kinase)
♣ No B-cell maturation
♣ Decrease in all immunoglobulin levels
Clinical manifestations of agammaglobulinemia
♣ Recurrent sinopulmonary and GI infections
♣ Absence of lymphoid tissue on exam (e.g. tonsils, lymph nodes)
Lab findings of agamma
♣ Decreased immunoglobulins and B cells
♣ Normal T cell concentration
♣ No response to vaccinations
Tx of Brutons
aka agamma
♣ Immunoglobulin replacement therapy
♣ Prophylactic antibiotics if severe
Contact dermatitis (poison ivy) is a Type __ HSR?
Type IV = T-cell mediated
Thumb print sign on X-ray = ?
Epiglottitis
Complications that can occur with slipped capital femoral epiphysis (SCFE)
Osteonecrosis and chondrolysis
What is chondrolysis
Breakdown of the femoroacetabular joint cartilage with no clear etiology
Management of SCFE
Consult ortho surgery for in situ pinning
Describe Legg Calve Perthes disease
o Idiopathic avascular necrosis of the femoral head
o Typically presents as thigh or knee pain with limp in a child
o X-ray in the frog position will show joint space widening due to loss (necrosis) of the femoral head height
Tx of Legg Calve Perthes
♣ Pt made non-weight bearing with immediate ortho referral
♣ Goal is to prevent further necrosis and promote bone remodeling by maintaining femoral head within the acetabulum
♣ Best accomplished by casting the affected leg in abducted and internally rotated fashion
What are prophylaxis meds for migraines
Topiramate, valproic acid, beta blockers, TCAs, CCBs
What heart disorder is associated with “snowman” appearance on X-ray
Total anomalous pulmonary venous return
What bug is responsible for Otitis externa
Pseudomonas (“swimmers ear”)
Describe transmission of Coxiella
o Forms spore-like structure that comes in animal droppings (can survive GI of animals)
o It gets into humans through aerosol transmission - outbreaks from farm animals to farmers or placental excretions
Describe presentation of Q fever
Pneumonia, HA, fever, hepatitis
Tx of coxiella
Not needed - is self- limiting
Tx of hydrocele
Observation - most are self-resolving
How can constipation lead to recurrent UTI
Fecal retention can cause rectal distension, which in turn compresses the bladder and prevents compelete voiding. Residual urine is a potential breeding ground for bacteria that ascend to the urethra from the perineum
What leads to hemophilic arthropathy (joint pain and swelling) in pts with hemophilia
Caused by iron/hemosiderin deposition leading to synovitis and fibrosis within the joint
Sx of Lupus
- R = rash
- A = arthalgias
- S = Serositis (pleuritis or pericarditis)
- H = Hematologic disorders
- O = oral/nasopharyngeal ulcers
- R = Renal disease
- P = photosensitivity
- A = antinuclear antibody
- I = immunologic disease (anti-dsDNA, anti-Smith, anti-histone, anti-phospholipid)
- N = neruologic (seizures, psychosis)
What strep infection can lead to RF vs PSGN
PSGN can follow pharyngitis or skin lesions
RF only follows pharyngitis
Abx for pharyngitis can prevent RF or PSGN?
Can prevent RF
What is the most important laboratory test for post-strep glomerulonephritis
Serum C3 and C4 levels
C3 will be low and C4 will be normal
Txt of PSGN
Supportive:
- Fluid balance (diuretics, fluid restriction)
- Restriction of Na and K
- CCBs to control HTN
Describe levels of C3 and C4 in Lupus
Low C3 and low C4
vs PSGN which will have low C3 and normal C4
How do you diagnose celiac disease?
Duodenal biopsy
Lab test used to diagnose rhabdomyolysis
Elevated CK levels
Complications of rhabdomyolysis
cardiac arrhythmias secondary to hyperkalemia, AKI, compartment syndrome, DIC
Tx of rhabdomyolysis
Aggressive rehydration and correction of electrolyte abnormalities
What is Spondylolisthesis and how does it present
o Developmental disorder characterized by a forward slip of vertebrae (usually L5 over S1) that usually manifests in preadolescent children
o Often presents with back pain, neurologic dysfunction (e.g. urinary incontinence), and a palpable “step off” at the lumbosacral area
What substance is responsible for effects of refeeding syndrome
insulin
What is the primary deficient electrolyte in refeeding syndrome
Phosphorus (required for energy via ATP)
Describe language of a 9 month old
Says “dada” “mama”
Tx of HUS
• Supportive (e.g. fluid/electrolyte management), blood transfusions, dialysis
What is a cholesteatoma
o Abnormal skin growth that can develop in middle ear (behind TM)
o Can be congenital or acquired secondary to chronic otitis media
o Complications include hearing loss, cranial nerve palsies, vertigo, and potentially life-threatening infections (e.g. brain abscess, meningitis)
Tx of laryngomalacia
• Management = reassurance in most cases; supraglottoplasty in severe cases
