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Peds Flashcards

1
Q

Pleiotropy

A

This is when a mutation of a single gene and it can create seemingly unrelated deviations in several organs or systems

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2
Q

What is diagnostic in cystic fibrosis?

A

An increased chlorine concentration in sweat is a diagnostic proof, a concentration above 60 mmol / l is a typical value

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3
Q

Causes of Pseudocroup

A

habitual and allergic-type mechanisms and it is mostly caused by viral infections

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4
Q

Which pathogens are likely to cause pneumonia among school-age children?

A

Mycoplasma pneumoniae, Chlamydia pneumoniae, Streptococcus pneumoniae

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5
Q

What is typical for Mycoplasma pneumoniae infection?

A

Incubation period is a couple of weeks

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6
Q

What helminth does not cause eosinophil pneumonia?

A

Oxyuris vermicularis

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7
Q

When do we consider foreign body aspiration?

A

Coughing attack and vomiting during eating

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8
Q

Fibrotic Alveolitis

A

This is a disease of unknown cause mainly involving the gas exchange. It may occur in isolation or can be in association with other diseases

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9
Q

Which is more common endogenous or exogenous bronchial asthma?

A

Exogenous is the more common variant. It is associated with different allergens that provoke the asthmatic attacks

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10
Q

Pseudocroup

A

This is the subglottic laryngitis that is typically due to viral infection

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11
Q

Treatment of Pseudocroup

A

Cool room temperature is desirable
Inhalation of adrenergic agents
In severe cases, giving inhaled or systematic steroids

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12
Q

What exam should we do in a child with bronchitis & fever?

A

Physical Examination

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13
Q

GERD can lead to the formation of what type of diseases?

A
  1. Esophagitis –> due to the irritation of the esophageal mucosa
  2. Bronchial asthma & Obstructive Bronchitis–> this is due to the gastric contents being aspirated into the respiratory tissues
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14
Q

Typical spread of childhood TB

A
  1. From mammals to humans
  2. From birds to humans via avian pathogens
  3. From humans to humans
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15
Q

Laryngotracheobronchitis

A

This is also known as Croup. This is a type of respiratory tract infection that is typically caused by viral infections, RSV.
This causes supraglottic swelling which will lead to:
barking cough, stridor & hoarse voice

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16
Q

How long do food allergies last?

A

Peanut allergy: lasts a lifetime
Seafood allergies: last a lifetime
Milk allergy: vanish by the age of 5
Egg allergy: lasts for older than 7 years of age

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17
Q

What causes proteinuria in Minimal Change Disease?

A

It is typically caused by the functional damage of the podocyte-basement immune-complex functional unit

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18
Q

Characteristics of Minimal Change Disease

A
  1. Hyper-cholesteromia
  2. Hypo-proteinemia
  3. Low serum calcium (but the ionized calcium level is normal)
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19
Q

Steroid resistant nephrotic syndrome in childhood?

A

If after 4 weeks treatment the patient is still proteinuric the patients is regarded steroid resistant.
Typically remission is usually achieved after 1-2 weeks of treatment; 95% of patients are in remission after 4 weeks

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20
Q

Characteristics of Acute poststreptococcal glomerulonephritis

A
  1. Hematuria
  2. Proteinuria
  3. Hypertension
  4. Elevated ASO titer
  5. Early antibiotic treatment of the primary infection may prevent the development of the disease
  6. It may be the consequence of scarlet fever
  7. The prognosis in childhood is usually good
  8. Hypertensive encephalopathy may be the first presenting sign
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21
Q

Complications of acute glomerulonephritis

A

Heart failure
Hyperkalaemia
Uraemia
Encephalopathy

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22
Q

Bacteriuria is determined if a mid-stream urine has:

A

100 000/ml uniform colonies of a single bacterium strain

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23
Q

How to treat acute renal failure

A
  • Fluid rescue should be done in the case of hypovolemia
  • Furosemide and Mannitol should be used as diuretic therapy
  • If oligo-anuria persists, then fluid intake should be restricted
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24
Q

Signs of Hypoglycemia in a Diabetic child

A

Irritability
Headache
Nausea, vomiting
Vertigo

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25
Q

How to stop the acidosis in DKA

A

Give insulin –> this will halt the development of the ketone bodies & decrease the acidosis

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26
Q

The diabetic child’s diet should consist of :

A

50% of the energy intake should be carbohydrates

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27
Q

What to do when a diabetic child presents to the hospital with fever and vomiting

A

Rapid blood sugar level examination has to be followed by the start of fluid therapy before the rest of the laboratory results arrive.
Saline infusion should be started in order to correct the hypovolaemia and the inadequate perfusion.

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28
Q

Hormones that increase in puberty

A

Estrogen
Growth hormone
IGF1
Testosterone

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29
Q

Laboratory findings for hypoparathyroidism

A

Hypocalcaemia
Hyperphosphatemia
Hypophosphaturia

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30
Q

Causes of Vit D deficient rickets

A

Lack of sunlight
Renal osteodystrophy
Hereditary hypophosphatemic rickets
Chronic anticonvulsive therapy

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31
Q

Features of Rickets

A

Costal cartilage swelling
Wrist and ankle swelling
Craniotabes–> thinning of the skull in infants & kids
Caput quadratum–> large, squarish shaped head with thickened frontal & parietal eminences

32
Q

Factors that can cause aplastic anemia

A

Ionizing radiation
Chloramphenicol
Parvovirus B19
Hepatitis C virus

33
Q

Indications of allogeneic hematopoietic stem cell transplantation

A
  1. Severe aplastic anemia
  2. Acute lymphoblastic leukemia in second remission
  3. High-risk acute myeloid leukemia in first remission
  4. High-risk acute lymphoblastic leukemia in first remission
34
Q

Beckwith-Wiedemenn syndrome

A

This is an overgrowth disorder characterized by macrosomia, macroglossia, organomegaly and developmental abnormalities

35
Q

Characteristics of Fanconi’s anemia

A
  1. Skeletal malformations
  2. Hyperpigmentation
  3. Spontaneous and induced chromosome fragility
36
Q

Average hemoglobin concentration in trimenon (‘physiological’) anemia

A

114 g/L

37
Q

Average hemoglobin concentration in late anemia of premature babies

A

80 g/L

38
Q

Average hemoglobin concentrations of healthy adult females

A

140 g/L

39
Q

Average hemoglobin concentrations of healthy adult males

A

155 g/L

40
Q

Clinical signs of iron deficiency anemia in infants and toddlers

A
  1. Restlessness
  2. Psychomotor retardation
  3. Pale skin and mucous membranes
  4. Somatic retardation
41
Q

Causes of iron deficiency anemia

A
  1. Excessive cow milk diet in toddlers
  2. Celiac disease
  3. Periods of rapid growth (e.g. infancy and puberty)
  4. Blood loss
42
Q

Hypochromic, microcytic anemias

A

β-thalassemia
Lead poisoning
Copper deficiency
Iron deficiency

43
Q

Frequent signs and complications of hemolytic anemia

A
  1. jaundice
  2. early development of gallstones
  3. dark urine with elevated urobilinogen level
  4. splenomegaly
44
Q

Hemolytic diseases in children

A
  1. Evan’s syndrome–> this is a rare autoimmune disorder in which there is immune mediated destruction of the RBCs, WBCs & Plts
  2. Glucose-6-phosphate-dehidrogenase deficiency
  3. Hereditary spherocytosis
  4. Kasabach–Merritt-syndrome–> this is hemangioma with thrombocytopenia. It is typically associated with vascular tumors & can be life-threatening
45
Q

Characteristic clinical and biological findings in patients with hereditary spherocytosis

A
  1. increased osmotic fragility of the red cells due to cell membrane defect
  2. presence of microspherocytes in the blood smear
  3. both hemolytic and aplastic crisis may occur
  4. hemolysis will stop after splenectomy
46
Q

Diseases associated with eosinophilia

A
  1. Allergic diseases
  2. IBD
  3. Scarlet fever
  4. Toxocariasis
47
Q

What contagious childhood disease is associated with Eosinophilia

A

Scarlet Fever

48
Q

Signs of hyperleukocytosis syndrome

A
  1. CNS bleeding
  2. ARDs
  3. Oligo-anuria
  4. Thrombosis
  5. Lung hemorrhage
49
Q

Tumor lysis triad

A

hyperuricemia, hyperkalemia, hyperphosphatemia

50
Q

Characteristics of AML

A
  1. Chloroma –> malignant tumor of granulocyte precursor cells
  2. Hemorrhagic hyperplasia of the gingiva
  3. HSM
51
Q

Signs of ALL

A
  1. HSM

2. Bone & joint pain

52
Q

Frequent signs of intracranial tumors in kids

A
  1. Endocrine disorders
  2. Focal neurological signs
  3. Increased ICP
  4. Change in personality
53
Q

Bad prognostic signs of Neuroblastoma

A
  1. Bone metastases
  2. N-myc amplification
  3. High levels of serum ferritin and LDH
54
Q

Osteosarcoma

A

This arises from the metaphysis of the long bones

55
Q

Ewings Sarcoma

A

This arises from the diaphysis of the long bones & also the flat

56
Q

Signs of Hemophilia

A
  1. frequent joint and intramuscular bleeds
  2. X-linked recessive inheritance, 30% of cases represent new mutations
  3. normal platelet count, bleeding time and prothrombin time, prolonged activated partial thromboplastin time
  4. the mainstream of treatment is factor VIII supplementation
57
Q

Factors that cause deep vein thrombosis in kids

A
  1. activated protein C resistance (factor V Leiden-mutation)
  2. deficiencies of anticoagulant factors (ATIII, PC, PS)
  3. nephrosis syndrome
  4. prothrombin gene mutation
  5. newborn period
58
Q

Langerhans cell histiocytosis

A

rare cancer that causes the proliferation of Langerhans cells, abnormal cells that are derived from the bone marrow and can migrate to the skin & LNs

59
Q

Frequent non-neoplastic causes of lymphadenopathy in children

A
  1. BCG-lymphadenopathy
  2. regional lymphadenopathy of inflamed organs and tissues
  3. acute, purulent lymphadenitis
  4. certain virus and protozoon infections, such as adenovirus, CMV, EBV, HIV, rubella and toxoplasma
60
Q

Iron supplementation facts

A
  1. physiological iron requirement in healthy infants is 1 mg/kgbw/day
  2. we prescribe 3-6 mg/kgbw elemental iron in form of ferrous sulfate to be taken b.i.d., orally, before meals
  3. iron supplementation is to be suspended temporarily during intercurrent infections
  4. Very low birth rate premature infants should be given 4 mg/kg bw/day iron supplementation after the first months of life
61
Q

Perthes Disease

A

This is the disruption of the blood flow to the femur, which will lead to avascular necrosis

62
Q

Scheuermann’s Disease

A

This is a condition in which the vertebrae grow unevenly with respect to the sagittal plane

63
Q

Adrenoleukodystrophy

A

This is due to the VLCFA accumulation in the brain –> destruction of the myelin sheaths
It will cause: Hearing loss, Loss of vision, Psychomotor retardation

64
Q

The most common type of childhood headache

A

Tension Headache

65
Q

Contraindications to maternal breastfeeding

A

Maternal TB, Galactosemia, Maternal HIV, Respiratory failure of the preterm baby

66
Q

Contents of maternal breast milk

A
  1. 9-1.0 g of protein
  2. 2 g of micronutrients
  3. 0 g of lactose
67
Q

How much fluid is supplemented in the case of diarrhea?

A

50ml/kg/d

68
Q

Holliday Sagar

A

1-10 kg: 100 ml/kg/day
11-20 kg: 1000ml + 50 ml/kg/day
>20 kg: 1500 ml+ 20 ml/kg/day

69
Q

Prevalence of neonatal HIV in non-treated HIV mothers

A

20-30%

70
Q

What to do if the amniotic fluid is yellow

A

This is typically associated with Rh incompatibility & is due to excessive bilirubin in the amniotic fluid –> so it is important to do early umbilical cord ligation

71
Q

Complication of high doses of phenobarbital

A

Respiratory arrest

72
Q

1st symptoms of salicylate overdose

A

Hyperventilation

73
Q

Signs of fetal hydrops

A

Organomegaly

Edema of the skin & vessels

74
Q

Edward’s Syndrome

A

*P–> Prominent occiput
*R–> Rockerbottom feet
*I–> IQ is low
*N–> Non-disjunction
*C–> Clenched fists
* E–> Low set ears
microcephaly, IUGR, Congenital heart defects

75
Q

Symptoms of Galactosemia

A 
Hyperbilirubinemia 
Hematomas 
Hepatomegaly 
Hepatic impairment 
Hypoglycemia 
Seizures
76
Q

Most severe consequence of intrauterine Listeria infection

A

Purulent meningitis

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