Peds Flashcards
Recurrent sinopulmonary infections, nasal polyps, and digital clubbing are most likely associated with what condition?
Cystic Fibrosis
*disclaimer: Primary Ciliary Dyskinesia has similar symptoms but less common
What is the next step of management for a child who is living in a house built in 1940s and found to have greater than 5 micrograms/deciliter in cap blood test?
Draw venous lead level (cap blood results have high false positives)
When should chelation therapy be started for lead?
at 45 micrograms/deciliter
At what lead level is dimercaptosuccinic acid be used? Dimercaprol plus calcium disodium edetate (EDTA)?
DMSA, Succimer at 45-69; EDTA at greater than 70 or signs of acute encepholopathy
Pancreatic insufficiency, meconium ileus, chronic metabolic alkalosis, and absence of vas deferens are signs of what?
Cystic Fibrosis
How do you dx CF?
1) one or more symptoms, CF in sibling, or + newborn screening
2) sweat Cl greater than 60 on 2 or more occasions, id of 2 CF mutations, or abnormal nasal epithelial ion transport
What is the gold standard dx test for CF and what method does it use?
Sweat testing via quantitative pilocarpine iontophoresis
What tx for CF?
high calorie diet, pancreatic enzyme replacement, and fat-soluble vitamin supplementation
How do you screen for primary ciliary dyskinesia?
Exhaled nasal nitric oxide
Why do newborns have jaundice in days 2-4 of life?
They have unconjugated hyperbili because of
1) [RBC] (hematocrit 50-60%) with shorter life span causing high Hb turnover and bili production
2) Bili clearance is slow becuz hepatic UGT doesn’t reach adult levels until age 2 weeks (Asians have lower UGT activity)
3) more bili is reabsorbed becuz of sterile newborn gut can’t break it down to urobilinogen for fecal excretion
This in indicated in newborns with bili levels greater than 20-25
exchange transfusion
This dx test can be negative in the first few weeks after the following symptoms appear: fever, pharyngitis, fatigue, posterior cervical lymphadenopathy, palatal petechiae, splenomegaly, bilateral upper eyelid edema
hterophil antibody (Monospot) test *can do EBV-specific antibodies if monospot negative
This virus is suspected if both the Monospot and EBV specific dx test come back negative in a patient who is suspected to have mono
CMV
This is the main difference between breastfeeding failure jaundice and breast milk jaundice.
Level of hydration (no signs of dehydration in breast milk jaundice)
This type of jaundice is in a patient of 4 days old who has 3 wet diapers, brick red urate crystals in diaper, decreased urine and stool output, and total bili 15 with direct 0.9
breastfeeding failure jaundice
Breast milk jaundice has this to cause increase of bili.
High levels of beta-glucuronidase which deconjugate intestinal bilirubin and increases enterohepatic circulation
This is the best management for breastfeeding failure jaundice.
breastfeed 15 min per side every 2-3 hours
This is the threshold to treat hyperbili with phototx
20
This is used to tx a 2 yo who presents with a fever that began 5 days ago with URI symptoms w/o relief, subcostal retractions and scattered wheezes w/o relief, and a holosystolic murmur at the cardiac apex.
Supportive measures like diuretics and inotropes (for viral myocarditis)
This steroid is most likely increased in a 1 week old female patient with a BP of 74/52, sunken eyes, enlarged clit, and fusion of labioscrotal folds.
17-hydroxyprogesterone (from deficiency in 21-hydroxylase)
This is the most common cause of urinary tract obstruction in newborn boys.
posterior urethral valves
This is the mechanism for Potters sequence.
Urinary tract anomaly leads to anuria or oliguria in utero leads to oligohydramnios leads to pulm hypoplasia, flat facies, and limb deformities
Low birth weight, closed fists with overlapping digits, microcephaly, micrognathia, and rocker-bottom feet are signs of this.
Trisomy 18 (Edward’s)
Hypotonia, flat face, upward and slanted palpebral fissures, epicanthal folds, intestinal atresia, and high arched palate are signs of this.
Trisomy 21 (Down)
Cleft lip, flexed fingers with polydactyly, ocular hyptelorism, low-set ears, microphthalmia, and absent ribs are signs of this.
Trisomy 13 (Patau)
An infant with a cat like cry had this genetic malformation occur to cause this syndrome
5p deletion (cri-du-chat)
This most common benign vascular tumor grows rapidly and regresses spontaneously unless there are complications of which can be treated with this.
Beta blockers (for strawberry hemangiomas)
This transilluminated-capable mass is associated with Turner’s, trisomy 21, 18, and 13
cystic hygroma
These are blanchable, pink-red pathces on eyelid, glabella, and neck
nevus simplex
The lower the birth weight, the greater the likelihood of this.
intraventricular hemorrhage
Absence of pus formation at infection site, delayed umbilical cord separation, bleeding of gums, necrotic periodontal infection with high WBC with high neutrophils has a deficiency expression of this protein
CD 18 (Leukocyte adhesion deficiency type 1)
Patients who present with necrotic periodontal infection and no pus formation have the inability of this type of leukocyte to travel to infected area and thus have a bx of infected tissue devoid of this.
Neutrophils
This is an autosomal recessive form of SCID with deficient B and T lymphocutes and labs showing severe lymphopenia
Adenosine deaminase deficiency
Patients with complement deficiencies are at risk of these type of bacterial infections.
Encapsulated (Strep pneumo, H influz, N. mening)
Patient with developmental defects in pharyngeal arch, T cell deficiency, facial and cardiac anomalies, and thymic hypoplasia has this.
DiGeorge syndrome
An infant with crepitus of clavicular bone, asymmetic moro reflex, and risk factors like macrosomia and shoulder dystocia should be managed with this.
Reassurance and gentle handling (healing usually occurs spontaneously after 7-10 days)
An infant with jaundice, tonic-clonic seizures, hydrocephalus, chorioretinitis, and intracranial calcifications has this.
congenital toxoplasmosis
An infant that gets chorioretinitis, encephalitis, and disseminated disease but no congenital anomalies
herpes simplex (passed through birth canal)
An infant with deafness, cataracts, and cardiac defeats (like PDA or ASD) has this.
Congenital Rubella Syndrome
Arthritis for greater than 6 weeks as well as a rash can be seen with this.
Juvenile idiopathic arthiritis
