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STEP2 > Peds > Flashcards

Peds Flashcards

1
Q

Newborn respiratory distress ddx w/ path, presentation, dx, tx

A

Transient tachypnea:
Mild edema
Tachypnea through first 2 days
XR: bilateral perihilar streaking

Respiratory distress syndrome:
Surfactant insufficiency 2/2 premature birth & maternal diabetes*
Severe cyanosis, grunting, flaring
XR: diffuse opacities
Antenatal glucocorticoids

Pulmonary HTN:
Resulting in R-L shunting
Severe cyanosis
XR: clear

Meconium aspiration:
Non-clear amniotic fluid, usually term or post-term

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2
Q

Torticollis path, presentation, dx

A

Twisting neck to L or R
2/2: respiratory infection, retropharyngeal abscess, or neck trauma

Neck XR: to rule out C-spine fx or dislocation

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3
Q

Hirschprung’s disease path, association, presentation, dx, tx

A

Failure of neural crest migration ==> aganglionic colon ==> failure to relax

Down’s syndrome

Failure to pass stool for 24+ hours post birth

XR: obstruction
Squirt sign: rectal exam produces stool EXPLOSION
Barium enema: narrow distal colon with proximal dilation
Biopsy: REQUIRED ==> showing no ganglion

Surgical

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4
Q

Meconium ileum path, association, presentation, dx, tx

A

Thickened meconium (usually 2/2 CF) causes impaction in ileum

Failure to pass stool for 24+ hours post birth

No squirt sign
More proximal (ileum) transition point
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5
Q

Pyoric stenosis path, presentation, dx, tx

A

Pyloric stenosis

Non-bilous vomiting
3-5 weeks post birth
Palpable “olive” mass in RUQ
Visible peristaltic wave

Hypochloremic, hypokalemic metabolic alkalosis 2/2 vomit
Ultrasound: long, thick pylorus

CORRECT METABOLIC DERANGEMENTS*==> surgical repair

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6
Q

Foreign body aspiration anatomy, presentation, dx, tx*

A

Airway anterior to esophagus ==> usually lands in R mainstem bronchus

Airway: stridor, wheeze, cough, hyperinflation ==> rigid bronchoscopy (*XR may not show foreign body if radiolucent)

Esophagus: vomiting, cough, dysphagia, feeding refusal ==> flexible endoscopy*

Distal to esophagus: observe patient until it passes spontaneously*

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7
Q

Child abuse presentation, management

A

History: vague, implausible, sibling implicated, mental handicapped children
PE: injury to genitals, hands, back, buttocks; late-healing wounds; spiral fractures of humerus and femur; epiphyseal-metaphyseal “bucket” fractures; posterior rib fractures; retinal hemorrhage 2/2 “shaken baby syndrome” (non-con head CT too); Mongolian spots are NOT abuse
Caregiver: argumentative, late-presenting

  1. Full body examination
  2. CBC and X-rays
  3. CPS if concerned
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8
Q

Parent refusing vaccines approach*

A

Provide recommendation
*Document risk vs benefits discussion in chart
No further workup needed because HERD IMMUNITY still exists

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9
Q

Selective mutism dx*, ddx

A

Total refusal to engage others in specific setting despite normal behavior at home

Stranger anxiety: stops at age 3
Separation anxiety: 3+ signs of extreme distress when separated from loved one

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10
Q

When to get a court order*

A

Parents refusing treatment for non-emergent but potentially fatal condition (e.g. ALL)

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11
Q

Congenital heart disease ddx, associated risk factors/diseases

A

Cyanotic R-L shunts
Acyanotic L-R shunts

PDA:  rubella
Coarctation:  Turner's
Coronary aneurysm:  Kawasaki's
Heart block:  lupus
Supravalvular aortic stenosis:  william's
Ebstein's RV malformation:  lithium
Heart failure:  neonatal thyrotoxicosis
Septal hypertrophy:  maternal DM
Transposition:  maternal DM
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12
Q

Cyanotic heart defects path, ddx, presentations, dx, tx

A 
5T's
Truncus arteriosus
Transposition:  severe cyanosis @ birth (only one)
Tricuspid atresia
Tetralogy of fallot
Total anomalous pulmonary venous return
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13
Q

Noncyanotic heart defects ddx, path, presentations, dx, tx

A

3D’s ==> L-R shunt

  1. VSD:
    Down’s/fetal alcohol/TORCH etc.
    Small: harsh holosystolic @ LLSB
    Large: respiratory infection, CHF; softer holosystolic
    Dx: echo
    Tx: small ones close; surgery for severe or non-resolving
  2. ASD
    Fetal alcohol, Down’s
    Usually asymptomatic; sometimes respiratory infections
    Ostium primum: presents early in childhood
    WIDE, FIXED, SPLIT S2
    Dx: echo
    Tx: small ones close; surgery for severe
  3. PDA
    L-R shunt from aorta to pulmonary artery 2/2 rubella, prematurity
    Machine murmur @ 2nd L intercostal; wide/bounding pulses
    Dx: echo
    Tx: Indomethacin ==> surgery if >6 months
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14
Q

Eisenmanger’s path, presentation, dx, tx

A

Reversal of L-R shunt 2/2 pulmonary HTN

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15
Q

Coarctation of aorta path, presentation, dx, tx

A

Constriction of aorta, usually proximal to PDA in infants
2/2 Turner’s
Often w/ bicuspid aorta

UE systolic > LE
Murmur over scapulae

3 sign: CXR showing pre & post dilation (looks like a 3)
Rib notching 2/2 collateral circulation
Dx: echo

Infants: MAINTAIN PDA!!! ==> prostaglandin E1

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16
Q

Transposition of great vessels path, association, presentation, dx, tx

A

Aorta:RV & PA:LV ==> incompatible with life without ASD, VSD, or PDA
Often 2/2 diabetic mothers

Severe cyanosis (@ birth! earliest presenter)

CXR: egg shaped silhouette
Dx: echo

Prostaglandin E1
Balloon atrial septostomy and/or sugery

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17
Q

DiGeorge syndrome path, presentation, dx, tx

A

Congenital…

"CATCH-22"
Cardiac:  transposition of great vessels
Abnormal facies
Thymic aplasia
==>virus, fungi, PCP infection
==>XR absent thymic shadow
==>bone marrow transplant + IVIG
Cleft palate
Hypocalcemia
==> tetany at birth
22q11 deletion
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18
Q

Tetralogy of fallot path, associations, presentation, dx, tx

A

4 things: pulmonary stenosis, VSD, RVH, “overriding aorta” (receives RV and LV blood) ==> cyanotic R-L shunt
Often 2/2 DiGeorge, maternal PKU

Cyanosis within 2 years of life
“Tet spells”: squatting for relief to increase SVR

CXR: boot-shaped heart
Dx: echo

PGE-1 ==> surgery

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19
Q

Milestones: motor, language, social

A

2 months: social smile
4 months: rolls front-back; laughs
6 months: sits; babbles; stranger anxiety
12 months: walks; 1 word; separation anxiety
2 years: walks stairs; 2 word phrases
3 years: tricycle; 3 word sentences

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20
Q

Infant weight patterns through 2 years; failure to thrive (FTT) ddx

A

May lose 10% at birth
Should return to birthweight by 2 weeks
Double birthweight by 6 months
Quadruple birthweight by 2 years

Organic: underlying medical condition
Inorganic: maternal depression, neglect abuse

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21
Q

Precocious / delayed puberty ages; gender growth phases

A

Girls: 13
Boys: 14

Girls: thelarche (boobs) ==> pubarche ==> growth spurt ==> menarche
Boys: gonadarche (nuts) ==> pubarche ==> adrenarche (hair) ==> growth spurt

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22
Q

Down’s path, associated diseases*, presentation

A

Nondisjunction (95%), Robertsonian (4%)

GI: duodenal atresia, Hirschprung’s
Cardiac: AV canal; ASD, VSD, PDA
ALL & Alzheimers
MSK: atlantoaxial instability ==> cord compression causing upper motor neuron dysfunction*

Upslanted eyes; simian crease; hypotonia

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23
Q

Edward’s syndrome path, presentation, prognosis

A

Trisomy 18

Severe retardation
Micrognathia (small jaw) 
Rocker-bottom feet*
Clenched hands w/ overlapping 4/5 digits*
Heart disease (VSD*) 
Horseshoe kidney

Death by 12 months

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24
Q

Patau’s syndrome path, presentation

A

Trisomy 13

Micropthalmia (small eyes)
Microcephaly
Holosprocencephaly (single undivided brain lobe)
Polydactyly

Death by 12 months

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25
Q

Kleinfelter’s path, presentation, tx

A

47 XXY (Barr body X)

Testicular atrophy
Tall, lanky
Gynecomastia (gay Jay Murphy)

Testosterone

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26
Q

Turner’s syndrome path, presentation

A

45 XO

Ovarian dysgenesis (primary amenorrhea)
Coarctation / bicuspid aortic valve
Hand/foot lymphedema

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27
Q

47 XYY

A

Tall acne prisonmates

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28
Q

Phenylketonuria path, presentation, tx

A

Autosomal recessive enzyme deficiency ==> phenylalanine buildup ==> tyrosine becomes essential to diet

Retard with blond hair and blue eyes

Increase tyrosine and decrease phenylalanine in diet

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29
Q

Fragile X syndrome path, presentation

A

X-linked dominant

Mental retardation
Large jaw, testes, ears
Autistic

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30
Q

Fabry’s disease path, presentation

A

X-linked recessive alpha-galactosidase A deficiency ==> ceramide trihexoside accumulation in heart, brain, kidneys

Severe limb pain
Telangiectasias
Renal failure
Thromboembolic risk

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31
Q

Krabbe’s disease path, presentation

A

Autosomal recessive enzyme defiency ==> galactocerebroside accumulation in brain

CNS degeneration ==> death by 3

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32
Q

Gaucher’s disease path, presentation, dx

A

Autosomal recessive glucocerebrosidase defiency ==> glucocerebroside accumulation in brain, liver, spleen, bone

Anemia
Thrombocytopenia

“Crinkled paper cells”

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33
Q

Niemann-Pick path, presentation

A

Autosomal recessive sphingomyelinase deficiency ==> sphingomyelin accumulation

Cherry-red spot
Hepatosplenomegaly

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34
Q

Tay-Sach’s path, presentation

A

Absent hexosaminidase ==> GM2 ganglioside accumulation

Jews
Cherry red spot without hepatosplenomegaly
Regression beginning at 3 months ==> weakness and death by age 3

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35
Q

Metachromatic leukodystrophy path, presentation

A

Autosomal recessive aryl-sulfataste A deficiency ==> sulfatide accumulation in brain ==> demyelination

Ataxia and dementia

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36
Q

Hurler’s syndrome path, presentation

A

Autosomal recessive alpha-iduronidase deficiency

Corneal clouding
Gargoylism
Mental retardation

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37
Q

Hunter’s syndrome

A

X-linked recessive iduronate sulfatase deficiency

Milder than Hurler’s
No corneal clouding

38
Q

Cystic fibrosis path, presentation, dx, tx

A

Autosomal recessive chromosome 7 CFTR chloride channel dysfunction ==> widespread exocrine dysfunction

Failure to thrive
Pulmonary: Psuedomonas & S. aureas pneunomia, nasal polyps
GI: Greasy stools, *meconium ileus (bilious vomiting), fat-soluble vitamin deficiency (ADEK)
Endocrine: type 2 DM, male infertility

Chloride sweat test > 60 ==> genetic test to confirm

PT, bronchodilators, corticosteroids, antibiotics covering Pseudomonas
Pancreatic enzymes
Fat soluble vitamins (ADEK)
High-calorie diets

39
Q

Intussusception path, presentation, dx, tx

A

Telescoping bowel, often proximal to ileocecal valve

Bowel obstruction TRIAD: 
Abdominal pain
Vomiting
Bloody "currant jelly" stool
SAUSAGE-SHAPED RUQ mass

XR: not sensitive
Ultrasound: Target sign
Air-contrast barium enema (diagnostic and therapeutic) ==> surgery if failed

40
Q

Pyloric stenosis associations, presentation, dx, tx

A

Firstborn males
Tracheoesophageal fistula
Erythryomycin

Nonbilious vomit
Olive-shaped epigastric mass

Hypochloremic, hypokalemic, metabolic alkalosis (2/2 vomiting)
Abdominal ultrasound

Surgery

41
Q

Meckel’s diverticulum path, presentation, dx, tx

A

Vestigial remnant containing gastric and pancreatic tissue ==> causing ulcer and bleeding

Sudden, painless rectal bleeding
Progressing to obstruction, intussusception
RULE OF 2’S
s technetium scintigraphy scan

Surgical excision

42
Q

Malrotation with volvulus*

A

Midgut malrotation ==> cecum misalignment and Ladd’s bands causing obstruction and ischemia

Bilious emesis
Bloody stool

XR: “bird-beak” +/- air fluid levels
Upper GI: diagnostic

Surgery

43
Q

Necrotizing enterocolitis path, presentation*, dx, tx

A

Necrotizing bowel

Usually pre-term infants
Presenting in days-weeks post-birth
Bloody stools & vomiting
Rapid progression to sepsis and peritonitis

XR: pneumatosis intestinalis (bacterial gas bubbles in bowel wall)

Surgery and broad spectrum abx

44
Q

Bruton’s agammaglobulinemia path, presentation, dx, tx

A

X-linked recessive (boy’s only) B-cell deficiency

Boys only after 6 months (when mother’s IgG wanes)
Life-threatening encapsulated infections (Pseudomonas, Strep, Haemophilus)
Absent tonsils

Quantitative IG levels
High T-cell levels

IVIG
Prophylactic antibiotics

45
Q

Common variable immunodeficiency path, presentation, dx, tx

A

Combined B & T cell defect

Presenting 15-35 y/o
Pyogenic upper and lower respiratory infections
Risk of lymphoma and autoimmune disease

Quantitative IG levels

IVIG

46
Q

IgA deficiency path, presentation, dx, tx

A

IgA deficiency

Mild sx
Mild recurrent respiratory of GI infection
*Anaphylaxis to transfusion rxn 2/2 IgA antigbodies

Quantitative IgA levels

NO IVIG ==> anaphylaxis
Treat infections

47
Q

SCID severe combined immunodeficiency path, presentation, dx, tx

A

Low adenosine deaminase ==> severe T & B cell lack

Severe infections w/ PCP, candida, herpes

Lymphopenia

Bone marrow transplant
IVIG
Sterile confinement

48
Q

Wiskott-Aldrich syndrome path, presentation, dx, tx

A

X-linked recessive (males only) ==> low IgM and high IgE / IgA

"WIPE"
Wiskott
INFECTION: otitis media, encapsulated (S pneumonia, S aureus, H Influenza B)
PUPURA: thrombocytopenia ==> bleeding
ECZEMA
49
Q

Chronic granulomatous disease path, presentation, dx, tx

A

CONGENITAL deficiency of NADPH superoxide dismutase ==> catalase + (S aureus, E. coli, Klebsiella, Aspergillus)

Chronic skin, LN, pulm, GI, UTI, osteo, hepatitis

Gram stain: bacteria-filled neutrophils
Nitroblue tetrazolium test
Low ANC

Daily TMP-SMX

50
Q

Leukocyte adhesion deficiency path, presentation, dx, tx

A

Chemotaxis defect

Recurrent skin, mucosal, pulmonary infection
Newborn: omphalitis and delayed cord separation

Wounds: showing minimal pus and inflammation
High WBC

Bone marrow transplant

51
Q

Chediak-Higashi path, presentation, dx, tx

A

Autosomal recessive neutrophil chemotaxis

Recurrent pyogenic infection
Oculocutaneous albinism
Peripheral neuropathy
Neutropenia

Giant granules in neutrophil

Bone marrow transplant

52
Q

Job’s syndrome path, presentation, dx, tx

A

Neutrophil chemotaxis defect

FATED
Facies: coarse
Abscess: S aureus
Teeth: retained primaries
IgE: elevated
Dermatologic: eczema

Abx
IVIG

53
Q

C1 esterase deficiency path, presentation, dx, tx

A

Autosomal dominant angioedema

Provoked by stress or trauma
Life-threatening

54
Q

Terminal complement deficiency path, presentation, dx, tx

A

Inability to form MAC

Recurrent Neisseria, meningococcal, gonococcal

55
Q

Kawasaki path, presentation, dx, tx

A

Multisystemic vasculitis

Asians <5
ACUTE: CRASH & BURN

Conjunctivitis (unlike Scarlet fever)
Rash (truncal)
Adenopathy (unilateral)
Strawberry tongue / chapped lips (unlike Scarlet fever)
Hands/feet (erythema, desquamation)
BURN: 104 fever 5+ days

SUBACUTE:
Finger desquamation
Coronary aneurysm

CHRONIC:
Coronary aneurysm
MI

Clinical
Echo for aneurysm

ASA (high tapering to low)
IVIG to prevent aneurysm

56
Q

Juvenile idiopathic arthritis path, presentation, dx, tx

A

Autoimmune

6+ weeks morning stiffness
5 joints
ANA+

Systemic (Still’s)
Fever
Salmon rash
ANA -

NSAIDs

57
Q

Otitis media path, presentation, dx, tx

A

Middle ear cavity; S pneumonia, H influenza, Moraxella

Ear pain
Tugging ears
Fever

Otoscope: erythema, bulging, stiffness, loss of light reflex

EMPIRIC amoxicillin high dose
Tympanostomy if recording

58
Q

Bronchiolitis path, presentation, dx, tx

A

RSV

can progress to respiratory failure

Clinical

Supportive nebs

59
Q

Croup laryngotracheal bronchitis path, presentation, dx, tx

A

Parainfluenza larynx / epiglottis inflammation

Inspiratory stridor
Barking cough

Clinical
XR: steeple sublottic narrowing

Mist ==> IM steroids ==> IM epi

60
Q

Epiglottitis path, presentation, dx, tx

A

Epiglottis infection ==> H. Influenza B (unvaccinated), Strep etc

High fever
Drooling
Neck/chin forward
Tripod inspiratory distress

XR: thumbprint @ epiglottis
Dx: direct visualization

SECURE AIRWAY before XR

61
Q

Bacterial meningitis path, presentation, dx, tx

A

Neonates: GBS, Listeria, E Coli
Infants: S pneumonia, N meningitidis, H influenzae

Headache
Fever
Nuchal rigidity
Kernig: pain w/ knee extension
Brudzinki: passive flexion pain
Neonates / children ==> rarely symptomatic!

LP:

Neonates: amp & gent (or cefotaxime) [ceftriaxone causes kernicterus]
Kids: vanc & ceftriaxone

62
Q

Pertussis (whooping cough) path, presentation, dx, tx

A

Gram - bacillus Bordatella pertussis

Catarrhal: mild URI x2 weeks
Paroxysmal: cough, inspiratory whoop, post-cough emesis x2 months
Infants: apnea

Lymphocytes >70%
Dx: Culture

Erythromycin FOR ALL CONTACTS

63
Q

Erythema infectiousum / 5th disease path, presentation, dx, tx

A

Parvo B19

Slapped cheek rash
Rash spreading from arms ==> trunk
Aplastic crisis (in pts with preexisting heme disease)

64
Q

Measles path, presentation, dx, tx

A

Paramyxovirus

COUGH
CORYZA
CONJUNCTIVITIS
Koplik spots (grey on lips)
Rash head ==> toe
Low fever
65
Q

Rubella path, presentation, dx, tx

A

Rubella virus

Lymphadenopathy (post-auricular)
Rash head ==> toe
Less severe than measles

66
Q

Roseola infantum path, presentation, dx, tx

A

HHV6/7

High fever >104
Rash trunk ==> face
Possibly seizure

67
Q

Varicella path, presentation, dx, tx

A

Varicella VZV

Fever
Rash: pruritic, teardrop face ==> body (not palms/sole)
Not infectious once crusting

68
Q

APGAR scoring

A

0-2 for each

Appearance 
Pulse 
Grimace
Activity 
Respiratory 
8-10 = good
4-7 = may need resuscitation 
0-3 = immediate
69
Q

Neonatal hyperbilirubinemia path

A

Pathologic: conjugated, within 24hrs post-birth, kernicterus (unconjugated >25 ==> irreversible cerebellum)

DONT phototherapy conjugated/direct

70
Q

Respiratory distress syndrome path, presentation, dx, tx

A

2/2 pre-term surfactant deficiency

48-72hrs post-birth
Cyanosis

71
Q

Cerebral palsy path, presentation, dx, tx

A

Non-hereditary 2/2 perinatal neuro insult

Hyperreflexia
Spasticity
Mental retardation

No tx

72
Q

Febrile seizure path, presentation, dx, tx

A

2/2 rapid temperature increase

Simple 15 min or focal or multiple within 24 ==> increased risk for epilepsy

Tylenol
No aspirin ==> Reye’s

73
Q

Tracheoesophageal fistula path, presentation, dx, tx

A

Tract b/w trachea and esophagus

Polyhydramnios
Aspiration pneumonia

Air in GI tract

Surgical

74
Q

Congenital diaphragmatic hernia path, presentation, dx, tx

A

GI protrudes through L diaphragm

Bowel sounds in hemithorax

XR or ultrasound

Surgery

75
Q

Gastroschisus path, presentation, dx, tx

A

Herniation of intestine WITHOUT sac around umbilicus

Polyhydramnios

Clinical

Vaginal delivery unless C-section routinely indicated
Sterile wrap ==> surgery and abx

76
Q

Omphalocele path, presentation, dx, tx

A

Intestines protrude WITH sac through umbilicus

Polyhydramnios

Clinical

Vaginal delivery unless C-section routinely indicated
Sterile wrap ==> surgery

77
Q

Duodenal atresia path, presentation, dx, tx

A

Failure of duodenal canalization

Polyhydramnios
Bilious emesis hours post-birth

XR: DOUBLE-BUBBLE in duodenum and stomach

Surgical repair

78
Q

Neuroblastoma path, presentation, dx, tx

A

Embryonal neural crest tumor ==> abdominal, thoracic, cervical

s
HTN
Myoclonus

Elevated VMA & HVA
FNA: small round blue cells

79
Q

Wilm’s tumor path, presentation, dx, tx

A

Renal tumor

Beckwith Wiedeman, neurofibromatosis association

Nontender abdominal mass

Resection + nephrectomy + chemo

80
Q

Ewing sarcoma path, presentation, dx, tx

A

Neuroectoderm tumor of midshaft

Systemic symptoms
Local pain and swelling

Lytic lesions w/ onion skin

Local excision + chemo + radiation

81
Q

Osteosarcoma path, presentation, dx, tx

A

Osteoblasts tumor of metaphysis

Local pain and swelling
RARELY systemic (unlike Wilm’s)
Often lung mets

Alk-p elevation (unlike Wilm’s)
Sunburst lesion
CHEST CT

Local excision + chemo

82
Q

Baby care guidelines

A

Water 20lbs

No solids <12 months

83
Q

Strabismus path, presentation, dx, tx

A

Normal until 3 months

Surgery

84
Q

Lead poisoning path, presentation, dx, tx

A

Lead

Usually asymptomatic
Headache
Abdominal pain
Peripheral neuropathy (foot drop)
Confusion, seizure, coma

Fingerstick screening ==> if greater than 5 ==> venous level
Microcytic, hypochromic, basophilic stipling

If 45-70 ==> DMSA
If >70 ==> British anti-lewisite + EDTA

85
Q

Preterm infant vaccine dating

A

Chronological age, not gestational

86
Q

Bedwetting workup*

A

Normal 5 ==> urinalysis for diabetes, infection ==> alarm and/or desmopressin therapy

87
Q

Galactosemia path, presentation, dx, tx

A

Galactose-1-phosphate uridyl transferase deficiency ==> elevated blood galactose

Newborn with:
Failure to thrive
Bilateral cataracts
Hypoglycemia
Jaundice

Clinical

Eliminate galactose from diet

88
Q

Pinworm path, presentation, dx, tx*

A

Enterobius adults in cecum/appendix ==> females lay eggs on anus at night

Nocturnal butt-itching
N/V/abdominal pain

+Scotch tape test

Albendazole or mebendazole

89
Q

Glycogen storage disease names, path, presentation, dx, tx

A

Type 1: von-gierke’s
G6P deficiency
Doll-like fat cheeks, thin extremities, hypoglycemic seizures, enlarged liver and kidneys
Hyperuricemia, lactic acidosis, hyperlipidemia

Type 2: Pompe’s
Acid maltase deficiency
Floppy baby with heart failure, macroglossia

Type 3:
Glycogen debranching enzyme
Hypoglycemia, enlarged liver, enlarged spleen, normal kidneys
Elevated transaminases, normal uric acid

Type 4: amylopectinosis
Branching enzyme deficiency
Hepatosplenomegaly
Cirrhosis

90
Q

Friedrich ataxia path, presentation, dx, tx*

A

Autosomal recessive trinucleotide overexpression

Wide gait
Decreased reflexes
Heart failure (myocarditis, fibrosis)

EKG: T-wave inversions 2/2 myocarditis
MRI: Atrophy of cervical cord and cerebellum

Progresses to death

91
Q

Neonatal tetanus presentation*

A

2/2 unimmunized mothers
Often 2/2 poor obstetric care, such as umbilical stump infections
Poor suckling, lethargy, rigidity, spasms

92
Q

SIDS sudden infant death syndrome tx*

A

Unclear etiology

Lie babies on back (supine)

STEP2 (16 decks)

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