Peds Flashcards
When do you change your antibiotics for AOM?
After 48-72 hours to a stronger antibiotic. Augmentin
What’s the significance of the ‘golden’ crusty child
Impetigo from staph, strep or MRSA
What’s a modified centor score?
Estimates probability that pharyngitis is streptococcal in nature, which suggests management.
Fever persists for five days and start to have conjunctivitis or strawberry tongue
Kawasaki disease. sequels of concern would be coronary arterial aneurysm.
Leading cause of acquired heart disease.
Hoe common is functional type of encopresis, as compared to the rest of the causes of chronic encopresis?
It’s the most common form, comprising more than 90%.
Abdominal colic with mental status changes in a 4 yo is indicative of what disease?
Intussusception. “Fewer than 15% of patients with intussusception present with the classic triad of colicky abdominal pain, palpable sausage-shaped abdominal mass, and currant jelly stool.”
How is intussusception diagnosis confirmed and treated?
Dx: ultrasound with bullseye lesion
Tx: air enema and/or surgery
Eye exam in a child reveals retinal hemorrhages, what is your primary consideration?
Child abuse. “Retinal hemorrhages, especially when extensive and involving multiple layers, are highly suspicious for abuse. Nonabusive causes of retinal hemorrhages are very rare. Vaccinations, mild head trauma, CPR, seizures, and routine play do not cause retinal hemorrhages.”
What are the signs, symptoms and treatment of henlock-schoenlin purpura?
“The symptoms and signs of HSP are a rash (typically nonthrombocytopenic purpura), abdominal pain (from submucosal hemorrhage and edema), arthritis/arthralgia, and renal disease. Typically, the vasculitis follows an upper respiratory infection or streptococcal pharyngitis, such as in this case. Treatment for HSP is supportive”
What are 2 signs and symptoms pathognomic for congenital syphillis?
“Neonatal manifestations of congenital syphilis include hepatosplenomegaly, lymphadenopathy, jaundice, rash, hemolytic anemia, and thrombocytopenia. Unfortunately, these findings overlap considerably with many of the other congenital TORCH (toxoplasmosis, rubella, CMV, herpes) infections. Abnormalities more specific to congenital syphilis include white, patchy mucocutaneous lesions, edema, rhinitis (snuffles), osteochondritis, and pseudoparalysis. Congenital syphilis is caused by transplacental transmission of the spirochete T. pallidum (“D”). Intrauterine infection can result in stillbirth, hydrops fetalis, or prematurity.
HELPFUL TIP: Late sequelae of congenital syphilis involve the bones and joints, teeth, eyes, and CNS and include bowed shins (Saber shins), frontal bossing, saddle nose, pegged central incisors, interstitial keratitis, and sensorineural deafness. The Hutchinson triad includes interstitial keratitis, deafness, and notched, peg-shaped teeth”
Intracranial calcifications are found in which congenital infectious process/es?
“The clinical manifestations of congenital cytomegalovirus and toxoplasmosis are often similar. Infants are typically asymptomatic at birth, but a significant number ultimately develop visual impairment, learning disabilities, and mental retardation months to years later. Those infants who are symptomatic at birth may demonstrate intrauterine growth retardation, hepatosplenomegaly, jaundice, hemolytic anemia, and thrombocytopenia. Intracerebral calcifications also occur in both CMV and toxoplasmosis. The calcifications tend to be periventricular in CMV (remember this by the fact that the calcifications look like a “C” in CMV) and more dispersed throughout the cortex in toxoplasmosis (remember by noting the X in both cortex and toxoplasmosis). Additional central nervous system abnormalities include microcephaly, chorioretinitis, and sensorineural hearing loss”
What do patients with congenital rubella present like?
“Cardiac, ophthalmologic, auditory, and neurologic findings predominate in the symptomatic infant with congenital rubella. Up to 85% of infants infected during the first 12 weeks of gestation will have some form of congenital defect. This decreases to 5% when the primary infection occurs after the third to fourth month of gestation. Ophthalmologic findings include microphthalmia, cataracts, glaucoma, and salt and pepper retinopathy. Infants are often microcephalic and develop sensorineural hearing deficits, meningoencephalitis, and mental retardation. Additional findings of hepatosplenomegaly, thrombocytopenia, and osteitis may be present. A characteristic “blueberry muffin” appearance may be present due to the combination of jaundice and extramedullary (skin) hematopoiesis”
What is the most common cardiac lesion associated with congenital rubella?
“The most common cardiac lesions associated with congenital rubella are PDA (patent ductus arteriosis) and peripheral pulmonary artery stenosis. PDA is characterized by a continuous “washing machine” murmur heard best over the left upper sternal border”
