Peds Flashcards by Stephanie Hawks

Nontender abdominal mass associated with elevated VMA and HVA

Neuroblastoma

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Most common type of tracheoesophageal fistula

Esophageal atresia with distal TEF - 85%

Unable to pass NG tub

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Not CI to vaccination

Mild illness and/or low grade fever, current abx, prematurity

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Tests to RO shaken baby syndrome

Opthalmologic exam, CT, MRI

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Neonate has meconium ileus

Hirschsprung disease is associated with failure to pass meconium for 48 hrs

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Bilious emesis within hours of first feeding

Double bubble on AXR

Duodenal atresia

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2 month baby presents with nonbilious project emesis, olive shaped mass
Dx
Managment

Pyloric stenosis

Correct metabolic abnormalities (hypochloremic hypokalemic metabolic alkalosis) then pyloromyotomy

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Most common primary immunodeficiency

Selective IgA def

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Infant has high fever and onset of rash as fever breaks- what at risk for

Febrile seizure due to roseola infantum

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Immunodef: boy has chronic resp infection. Nitroblue tetrazolium test neg

Chronic granulomatous disease

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Immunodef: child has eczema, thrombocytopenia, high IgA

Wiskot Aldrich

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Immunodef: 6 month old boy life threatening Pseudomonas infection (or S pneumo or Haemophilus)
No tonsils or other lymph tissue

Bruton’s X linked agammaglobulinemia

B cell def

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Acute phase Tx Kawasaki

High dose ASA for infl and fever

IVIG to prevent coronary a aneurysms

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Tx mild and severe unconjugated hyperbili

Mild: phototherapy
Severe: exchanges transfusion
DO NOT PHOTOTX IF CONG

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Sudden onset mental status changes, emesis, liver dysfcn after ASA

Reye’s syndrome

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Child loss of red light reflex. Dx Inc risk of what cancer?

Suspect retinoblastoma

Osteosarcoma inc risk

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Vaccination at 6 months

HBV
DTaP
Hib
IPV
PCV
Rotavirus

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Tanner stage 3 in 6 yo female

PRecocious puberty

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Infection of small airways with epidemics in winter and spring

RSV bronchiolitis

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Current jelly stools, colicky and pain, bilious vomiting, sausage shaped mass in RUQ, target sign on US
Tx

Intussusception

Air barium enema

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Congenital heart disease causes secondary HTN

Find on PE?

Coarctation of aorta

Dec femoral pulses on exam

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1st line Tx otitis media

Amoxicillin x 10 D

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Most common pathogen causing croup

Parainfluenze type 1

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Homeless child small for age, peeling skin, swollen belly

Kwashiorkor- protein malnutrition

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Defect in X linked syndrome with mental retardation, gout, self mutilitaion, choreoathetosis

Lesch Nyhan - pruine salvage problem with HGPRTase def

Newborn girl with continuous machine like murmur | Rx

PDA | INdomethocain to close

Newborn with posterior neck mass and swelling of hands

Turner

Age reflexes disappear

6 months

Developmental milestones: 2 months

Social smile Lift head 45 degrees Eyes follow to midline Coos

Developmental milestones: 4 months

Laughs, aware of caregiver, localizes sound Lift head 90 degrees eyes follow past midline Rolls front to back, grasps rattle

Developmental milestones: 6 months

Differentiate parents from others; STRANGER ANXIETY Rolls over, holds self up with hands, sits without support Grasps, attempts to feed self, transfers from hand to hand Babbles

Developmental milestones: 9 months

``` Interactive games, separation anxiety (9-15 months) Crawls, pulls to stand Grasps with thumb (3 finger grasp) First words Waves, pat a cake ```

Developmental milestones: 12 months

Separation anxiety (9-15 mo) Walks with help/alone, throws object Pincer grasp, makes tower of 2 blocks 5-10 word vocabulary, follows 1 step commands

Developmental milestones: 18 months

Parellel play Walks well, walks backward Makes tower of four blocks, uses cup or sppob 10-50 word vocabulary with 2 word sentences

Developmental milestones: 2 yrs

Dresses self with help Runs and climbs stairs Makes tower of 6 blocks 50-75 word vocabulary with 3 word sentences

Developmental milestones: 3 yrs

``` Magical thinking Climbs and descends stairs Makes tower of nine blocks, draw circle Rides tricycle 3 word sentences ```

Developmental milestones: 4 yrs

Plays with others Hops 1 foot Able to draw line image then can draw closed image 250 word vocab with 4 word sentences - knows colors and numbers

Developmental milestones: 6 yrs

``` Distinguish fantasy vs reality Skips Draws person Fluent speech >5 word sentences ```

What is moro reflex When disappear CNS area

Extension head causes extension and flexion of limbs - startle reflex 3 months gone Medulla and vestibular nuclei

What is grasp reflex When disappear CNS area

Placing finger in palm causes grasping 3 months Medulla and vestibular nuclei

What is rooting reflex When disappear CNS area

Rubbing cheek causes turning of mouth to stimuli 3 months Medulla and trigeminal

What is tonic neck reflex When disappear CNS area

HEad turned, arm on faced side extendeds and opposite arm flexes 3 months Medulla and vestibular nuclei

What is Placing reflex When disappear CNS area

Rubbing foot dorsum causes foot to step up 2 months Cortx

Vaccines asplenic kid

Hib (do not give to normal kids >5 yrs) | Pneumo

Tanner 1-5 male

1: small genitals and no hair 2: testicular and scrotal enlargement with skin coarsening, fine hair 3: penile enlargement and further testicular growth, more hair 4: enlargement and darkening of skin, hair coarser and spreads over larger region 5: adult genitalia with coarse hair

Psychosocial issues 10-13 yrs

Concerte thinking and early independent behavior

Psychosocial issues 14-16 yrs

emergence of sexuality, increased desire for independence, abstract thought

Psychosocial issues 17-21 yrs

increased self awareness, increased confidence in one's own abilities, more open relationship with parents, cognitive maturity`

Chr deletion 22q11 - thymic and parathryoid hypoplasia, congential heart disease, tetany (2/2 hypocalcemia) Recurrent viral and fungal infections b/c insufficient T cells, PCP

DiGeorge

Persistent infection of skin, mucous membranes, naisl by Candida from T cel def Frequently adrenal pathology Possible dec IgG, poor reaction to cutaneous Candida anergy test

Chornic mucocutaneous candidiasis

Abnormal B cell differentiation resulting in low B cells, X linked, boys recurrent bacterial infections >6 mo No B cells in peripheral smear

X linked agammaglobulinemia

Abnromal Ig production by B cells, increased resp and GI infection; Dec IgA, all other Ig normal Anaphylactic transfusion reaction

IgA def DO NOT GIVE IVIG

Defect T cell CD40 resulting in poor interaction with B cells, Low IgG, excessive IgM ENCAPSULATED BACTERIA INFECTIONS Dec IgG and IgG with inc IgM

Hyper IgM disease

Autosomal disorder of B cell differentiation resulting in low Ig levels but normal B cell levels and DEC PLASMA CELLS; inc resp and GI infections in 2nd decade lif; inc risk malignant noeoplasms and AI Low Ig, poor response to vaccines, dec CD4: CD8; both men and women affected

Common variable immunodeficiency

Absent T cells and abnormal Ab fcn - severe immunocompromise 2/2 defect in stem cell maturation and dec adenosine deaminase Recurrent infections of ALL TYPES Frequently fatal at early age Dec WBC and Ig

SCID NEED PCP PROPHY

X linked, significant susceptibility to ENCAPSULATED bacteria and opportunistic pathogens, ECZEMA AND THROMBOCYTOPENIA, easy bleeding, recurrent otitis media, dec IgM, inc IgA or IgE, abnormal WASP gene

Wiskott Aldrich ``` WIPE Wiskot Infections Purpura Eczema ```

AR - CEREBELLAR DYSF, CUTANEOUS TELANGIECTASIA, inc risk cancer, impaired WBC and IgA development, cerebellar ataxia after 3 yrs of age, recurrent pulm infection Cause?

Ataxia telangiectasia | DNA repair defect

Defect in which neutrophils cannot digest engulfed bacteria (not able to make superoxide), recurrent bacterial and fungal infections - usu catalase + = S aureus, E coli, Candida, Klebsiella, Pseudomonas, Aspergillus Cut, pulmonary, perirectal abscess formation; chronic LNopathy DX: Nitroblue tetrazolium test

Chronic granulomatous disease Daily TMP SMX

Defect in neutrophil chemotaxis, T cell signaling, overproduction of IgE - chronic dermatitis, recurrent skin abscesses, pulm infections; coarse facial features, retained primary teeth Inc eosinophils

Hyper IgE/Job ``` FATED Coarse Facies Abscess - S auresus retained primary Teeth hyper igE - eosinophilia Derm- eczema ```

AR dysfcn of neutrophils chemotaxis and MT polymerization - inc Staph aureus, strep, Gram N, fungal infections Abnormal plts, neutropenia albinism, neuro dysfcn Large granules in granulocytes on peripheral smear

Chediak Higashi

Inability of neutrophils to leave circulation bc abnormal leukocyte integrins (type 1) or E selectin (type 2) Recurrent bacterial infection of resp and skin Delayed separation of umbilical cord Short stature, weird face

Leukocyte adhesion def - type 1 and 2

Multiple inherited deficiencies of one or more complement components; cannot form MAC = recurrent Neisseria, meningococcal or GC Recurrent bacterial infection and predisposition for AI disorders like SLE Hemolytic complement test abnormal

Complement deficiencies

Female with short stature, infertile, abnormal genitls, inc renal and cardiac defects (coarctation of aorta), craniofacial (protruding ears, neck webbing, low occipital hairline), possible horseshoe kidney

Turner 45 XO

Male with testicular atrophy, tall thin body, gynecomastia, infertile, mild mental retardation, psychosocial, female hair distribution

Klinefelter 47 XXY Tx: testosterone

Male tall body (>6 ft), ace, mild mental retardation

XYY

Female with increased incidence mental retardation, menstrual abnormalities

XXX

Mental retardation, craniofacial (protruding tongue, flat nose, small ears), vision and hearing loss, broad hands SIMIAN CREASE, cervical spine instability, increased space between 1st and 2nd toes, inc risk duodenal atresia, AD, ALL, cardiac defects

Trisomy 21 -Down (increase with maternal age)

Severe mental retardation, small mouth, limb abnormalities (rocker bottom feet, overlaping fingers on grasp), cardiac and GI, fatal in first year

Trisomy 18 - Edwards

Cleft lift and palate, cardiac defects, CNS defects, severe mental retardation, rounded nose, polydactyly, frequently fatal within first year

Trisomy 13- Patau

X linked, lots CGG codon repeats, large face with prominent jaw and large ears, mild hand and foot abnormalities, large testicles, mental retardation, hyperactivity, possible seizures Females only carriers Gene?

Fragile X FMR1 gene

Entire 5 p chromosome arm | High pitched catlike cry, small head, low birth weight, mental retardation, early mortality 2/2 FTT

Cri di chat

4p16 to end of arm | Mental retardation, multiple cranial abnormalities, seizures

Wolf Hirschhorn

15q11-15q13 deletion of paternal allele | Overeating, obesity, decreased mm tone, mental retardation, small hands and feet

Prader Willi

15q11-15q13 deletion of maternal allele | Puppetlike movement, happy mood, unprovoked laughter, mental retardation, seizure

Angelman

22q11, cleft palate, cardiac, mild mental retardation, significant overbite, speech disorder, T cell def, hypoCa, assoc with DiGeorge

Velocardiofacial

7q11.23 Elfin facies (short, upturned nose, long philtrum, wide mouth), short, mental retardation, cheerful/friendly, cardiac defects (supravalvular stenosis)

Williams

Child abuse - which more suspicious GC or Chlam

GC, Chlam can be acquired at birth and persist for 3 years

Cyanotic heart defects

5 T Truncus arteriosus- one atrerial vessel for both ventricles Transposition of great vessels - Two arteries are switched Tricuspid atresia Tetralogy of Fallot Total anaomlous pulm venous return

Noncyanotic heart defects

3d VSD ASD PDA

Acyanotic vs cyanotic -which direction A

Acyanoti: Lto R | Cyanotic R to L

Associated disorder: ASD and endocardial cushion

Down

Associated disorder: PDA

Congenital rubella

Associated disorder: Coarctation of aorta

Turner, also may be bicuspid aortic valve

Associated disorder: Coronary a aneurysm

Kawasaki

Associated disorder: congenital heart block

Neonatal lupus

Associated disorder: supravalvular aortic stenosis

Williams

Associated disorder: Cotruncal abnormalities

Tetralogy of Fallot, truncus arteriosus, DiGeorge and velocardiofacial

Ebsteins

Lithium

Associated disorder: heart failure

neonatal thyrotoxicosis

Associated disorder: Asymmetric septal hypertrophy and transposition of great vessels

Maternal diabetes

Harsh holosystolic murmur at left sternal border

VSD

Eisenmenger

L to R shunt leads to pulm HTN and shunt reversal

Wide fixed split S2 systolic ejeection murmur left sternal border

ASD

Continuous machine like murmur, loud S2, wide PP, bounding peripheral pulses Tx

PDA Indomethacin to close

ASx HTN, SP of UE>>LE, weak femoral pulses | CXR - 3 sign and rib notching

Coarctation of aorta

DiGeorge Syndrome S/S

``` CATCH 22 Cardiac - transposition Abnormal facies Thymic aplasia Cleft palate Hypocalcemia 22q11 deletion ```

``` Language development 12 mo 15 mo 18 mo 2 yrs 3 yrs ```

12: 1 word 15: 5 words 18: 8 words 2 yrs: 2 word phrase 3 yrs: 3 word phrases

Normal sexual development female

Thelarche-->Pubarche-->growth-->menarche

Normal sexual devo male

Gonadarche-->pubarche-->adrenarche-->growth

AR, normal at birth, few months later mental retardation, fair hair and skin, eczema, blond hair, blue eyes, musty urine odor; inc risk heart disease What? Enzyme defect Tx

PKU Dec phenylalanine hydroxylase or dec THB cofactor Tx: dec phenylalainne - artificial sweetener

CF - mutation where, AR or AD

CFTR gene on Chr 7 | AR

FTT, chronic sinopulm disease, recurrent pulm infection, digital clubbing, chronic cough, nasal polyposis, meconium ileus, greasy stools, rectal prolapse, male infertility, def fat soluble vitamins, DMII, salty skin, Testing?

CF Sweat chloride test, genetic testing Hypochloremic alkalosis

Def alpha galactoside A - inc ceramide trihexoside | Severe neuropathic limb pain, angiokeratomas, telangiectasias, renal failure, inc thromboembolic events

Fabry's X linked rec Fairy galactic

Absence galactosylceramide and galactoside - galactosylceramidase def = inc galacocerebreside in brain Progressive CNS degeneration, death 3 yrs of life

Krabbe's AR Krabbe-crab (GC)

``` Def glucocerbrosidase - inc glucocerbroside Gaucher cells - crinkled paper Anemia and thrombocytopenia Infantile form rapid neuro decline Adult- normal life span ```

Gaucher | AR

Def sphingomyelinase = inc sphingomyelin chol in RES and parenchymal cells Cherry red spot and hepatosplenomegaly

Niemann Pick AR Pick sphinger

Absence of hexosaminadse- inc GM2 ganglioside Normal until 3-6 mo - weakness and slowed development; death age 3 Cherry red spot and no hepatosplenomegaly European

Tay Sachs Sax- heXosaminidase

Def arylsulfatase A - inc sulfatide | Demyelination - progressive ataxia and dementia

Metachromatic leukodystrophy | AR

Def alpha Liduronidase | Corneal clouding, mental retardatin, gargoylism

Hurler's | AR

Def iduronate sulfatase | Mild form Hurler without corneal clouding and mild mental retardation

Hunter | X link recessive (Hunters need to see)

Cause Meckels

Failure of omphalomesenteric/vitelline duct to obliterate

Dx Meckels

Technetium 99 scan

Failure to pass meconium in 48 hrs, explolive discharge of stool following rectal exam

Hirschsprung - lack of ganglion cells in distal colon

First month of life bilous emesis, distention, bloody or mucous in stool, AXR bird beak

Malrotation with volvulus - form bands that predispose to obstruction and constriction

Premature infant, first few days or weeks of lif, feeding intolerance, bloody stools, Sx may rapidly progress, dilated loops of bowel, air in bowel wall (pneumatosis intestinal is)

Necrotizing enterocolitis

AD recurrent episodes of angioedema lasting 2- 72 hrs, provoked by stress or trauma

C1 esterase def - hereditary angioedema

Kawasaki disease Sx

``` CRASH and BURN Conjuctivitis Rash Adenopathy- unilat Strawberry tongue Hands and feet- red, swollen, flaky = desquamate fingertips, polymorphous rash (truncal) BURN - fever >40 for >=5 d ```

Scarlet fever vs Kawasaki

Both: strawberry tongue, desquamation hands and feet, erythema of mucous membranes Kawasaki: bilat nonexudate conjunctivits, dry, red chapped lips

AI disorder, morning stiffness, gradual loss motion at lest 6 wks <16 yrs old

Juvenile idiopathic arthritis

3 types JIA

- Pacuiarticular: 4 or less joints, ANA+ and RF-, uveitis common - slit lamp exam - Polyarthritis: 5+ joints, symmetric RF + means severe disease - Systemic onset/Stills disease: recurrent high fever, salmon colored macular rash, RF and ANA -

Common causes otitis media | Tx

S pneumo nontypable H flu Moraxella catarrhalis Influenza A, RSV, parainfluenza Tx: amoxicillin

Cause bronchiolitis Age S/S

RSV <2 yrs Tachypnea, wheezing, crackles

Acute onset fever, dysphagia, drooling, inspiratory retractions, hyperextended neck and chin protruding, tripod position, thumbprint sign Major problem

Epiglottitis Laryngospasm- do not exam throat without ENT or anesthesiologist

Steeple sign, barking cough, | Cause

Croup | Parainfluenza (RXV, influenza, adenovirus)

Cause epiglottitis

Before H flu | Now Strep, viral

Subglottic narrowing, cause generally S aureus, can follow viral URI, vaiable respiratory distress ,pseudomembrane

Tracheitis

HA, high fever, nuchal rigidity

Meningitis

Menigitis with petechial rash

N meningitidis

Tx meningitis neonates

Ampicillin + cefotaxime/gentamicin (no ceftriaxone due to risk of kernicterus) Consider acyclovir

Tx meningitis older kids

Ceftriaxone + vanc

Common bacterial causes meningitis neonates

GBS Listeria E coli

Common bacterial causes meningitis children and infants

S pneumo N meningitidis H flu

age 6mo-6yrs, acute onset high fever, hot potato voice, drooling, unilat, likes to have neck extended Common bug Tx

Retropharyngeal abscess GAS I and D or aspirate, abx

> 10 yrs, hot potato voice, drooling, UVULA DISPLACED TO OPPOSITE SIDE Common bug Tx

Peritonsillar abscess GAS I and D, tonsillectomy, abx

Cause whooping cough

Bordetella pertussis Gram N

Gold stand Dx pertussis Tx

Culture Erythromycin

Prodrome: low grade fever, Cough, Coryza, Conjunctivitis, Kopliks spots (red with gray center) Rash: maculopapular spreads from head to toe Complications: otitis media, pneumo, laryngotracheitis, subacute sclerosing panecephalitis

Measles by Paramyxovirus

Conj vs unconj hyperbilirubinemia in neonatal jaundice

Direct/conj pathologic (cholestatsis, Dubin Johnson, Rotors, TORCH) Unconj: physiologic or pathologic (hemolysis, breast milkd, inc circulation, bili metabolism disorder, Crigler Najjar, Gilbert)

Kernicterus - bili deposits where | Levels must be what to deposit

Pins, basal ganglia, cerebellum | >25-30

``` Phys vs path jaundice of newborn Time? Inc bili? Peak? Direct % total? Resolves? ```

``` Phys Vs Path 72 hrs after birth vs first 24 hrs life < 5 mg/dL/d vs >0.5 mg/dL/hr Peak 15 10% total Resolves 1 -2 wks vs persists beyond 1-2 wks ```

L: S ratio of what indicates need for surfactant

<2:1

Retained amniotic fluid results in prominent perihilar streakin in interlobular fissures, Resolves with O2

Transient tachypnea of the newborn

Associated defects tracheoesophageal fistula

``` VACTERL Vertebral Anal Cardiac Tracehal Esophageal Renal Limb ```

Herniation of intestine only through abominal wall next to umbilicus with no sac - GI tract exposed

Gastroschisis | Tx: SURGICAL EMERGENCY

Herniation of abdominal viscera through abdominal wall into a sac covered by peritoneum and amniotic membrane Assoc Beckwith Wiedmann and trisomies

Omphalocele Surgery

L: S ratio of what indicates need for surfactant

<2:1

Cerebral palsy: spastic paresis of any or all limbs, mental retardation common

Pyramidal / spastic

Hemihypetrophy, macroglossia, visceromegaly

Beckwith Wiedemann

Ages febrile seizures

6 mo - 5 yrs

Bone tumor from neuroectoderm, assoc 11:22 translocation, Caucasion male, local pain and swelling with systemic Sx, found in midshaft of long bones Dx: leukocytosis, inc ESR, lytic lesion with inion skinning

Ewing sarcoma | Excision w/ chemo and rads

Embryonal tumor of neural crest origin,

neuroblastoma

Children 2-5 yrs Assoc: Beckwith Widemann, NF, WAGR S/S: ASx nontender mass that does not cross midline

Wilms tumor

Intermittent abd pain, peripheral neuropathy w/ wrist or foot drop, acute encephalopathy Microcytic hypochromic anemia with basophilic stippling Tx -=70

Pb poisoning =70: EDTA + BAL

Hemihypetrophy, macroglossia, visceromegaly

Beckwith Wiedemann

Hx untreated strep infection, sandpaper-like rash on abd and trunk with circumoral pallor and strawberry tongue-->desquamate

SCarlet fever | Give penicillin to prevent rheumatic fever

Ewing sarcoma | Excision w/ chemo and rads

Strabismus normal until?

3 months

Leukocoria indicates

Rb Congenital cataracts Retinopathy of prematurity

Intermittent abd pain, peripheral neuropathy w/ wrist or foot drop, acute encephalopathy Microcytic hypochromic anemia with basophilic stippling Tx -=70

Pb poisoning =70: EDTA + BAL

Rick bite --> 1 wk later fever or chills, HA, prostration, severe malaise-->4 d later rash on palms and wrist an soles and ankles-->spreads to trunk and face Tx

RMSF | Doxy or chloramphenical (2nd line)

Hx untreated strep infection, sandpaper-like rash on abd and trunk with circumoral pallor and strawberry tongue-->desquamate

SCarlet fever | Give penicillin to prevent rheumatic fever

Bilateral renal agenesis causes oligohydramnios (fetus swallows but cannot excrete), limb deformities, abnormal facies, hyoplasia of lungs

Potter syndrome Pts die

AR degeneration of anterior horn cells (LMN) Hyppotonic at birth, all affectd by age 6 months Slowly progresive

Werdnig Hoffman disease

Sudden onset and hx honey ingestion, | Dx C botulinium tocin in feces

Infant botulism

X linked recessive, dystrophin | MM weaknes, elevated CK, pseudohypertrophy of calves, Gowers sign

Muscular dystrophy- Ducchenne

Expansile, lytic well demarcated lesion in proximal part of humerus Benign

Unicameral bone cyst

Osteochondritis of tibial tubercle, boys 10-15 yrs, usu bilat,

osgood schlatter | Tx rest and NSAIDS

First born girl with breech delivery, + barlow and ortolani

CHD

Delayed bone age, knee thigh and groin pain with a limp; 4-10 yrs old

Legg Calve Perthe

9-13 yrs, obese, knee, thigh, groin pain with limp

SCFE

Grayish pseudomembranes on pharynx, tonsils or uvual w/ myocarditis

Diptheria - Corynebacterium diptheriae | Tx: antitoxin, Pen G / erythromycin

Tx pneumo neonates

Ampicillin and gentamicin

Tx pneumo neonates after 3-5 d of life

Vanc + gentamicin

1-4 mo tx pneumo

Macrolide

4 mo- 4yrs Tx pneumo

Amox if bacterial suspected | Viral is most common in this age group

>5 Tx pneumo

Macrolide

benign vascular tumor present first days of life, increase in size, resolve within first 2-5 yrs in 50% No Tx

Cavernous hemangiomas

Diffuse swellling or edema of scalp that CROSSES midline

Caput succedaneum (2 words - either side of midline)

Prodrome: fever, anorexia, oral pain Rash: oral ulcers, maculopapular vesicular rash on hands feet and sometimes butt Complications - non

Hand foot and mouth - Coxsackie A

Prodrome: mild fever, anorexia, malaise that precede rash by 24 hrs Rash: pruritic teardrop vesicular; different stages of healing; face then spreads to reast of body but spares palms and soles infectious from 24 hrs before eruption until crusts over Complications: Meningoencephalitis, pneumo, hepatitis, bacterial infection, Reye's syndrome

Varicella - VZV

Prodrome: acute onset of high fever >60/104; no other Sx for 3-4 d Rash: maculopapular rash that appears as fever breaks begins trunk and spreads to face and extremities, last

Roseola infantum | HHV6 and 7

Prodrome: asymptomatic or tender LNopathy Rash: erythematous, tender, maculopapular from head to toe Fever is low grade, pt does not appear ill Complications: encephalitis, thrombocytopenia, congenital infection - PDA, deaf, cataracts, mental retardation

Rubella by rubella virus

Prodrome: none Rash: slapped cheek, pruritic, starts arms and spreads trunk and legs, worse with fever and sun Complications: arthropathy, congenital infection = hydrops; aplastic crisis

Erythema infectiosum - 5th disease | Caused by Parvovirus B19

Prodrome: acute onset of high fever >60/104; no other Sx for 3-4 d Rash: maculopapular rash that appears as fever breaks begins trunk and spreads to face and extremities, last

Roseola infantum/ exanthem subitum | HHV6 and 7

Subperiosteal hemorrhages do not cross midline

Cephalohematomas

Abnormal type 1 collagen

osteogenesis imperfecta

Glomerulonephritis and hearing loss

Alports

Abnormal mm in abdomen causing wrinkled apperance, renal dysplasia, markedley tortuous and dilated ureters, enlarged bladder, cardiac and GI, cryptoorchidism, underdeveloped prostate, resp compromise, bulging abdomen, clubfoot

PRUNE BELLY SYNDROME

Chlamydial conjunctivitis also called

Inclusion