Peds Flashcards
Normal Pubertal development in female. the sequence?
- breast budding (thelarche) 2. axilary hair, body odor, mild acne (pubarche) 3. growth spurt 4. menarch
Normal Pubertal development in male. the sequence?
- testicular enlargement 2. penile enlargement 3. axilary hair, body odor, mild acne (pubarche) 4. growth spurt
ambiguous genitalia. workup?
- chromosome analysis
- pelvic ultrasonogram ifMullerian structures are present (uterus)
- if gonads palpable
- testosterone and dihydrotestosterone (DHT) ratio
- LH and FSH
- hCG stimulation test
if gonads not palpable (most likely congenital adrenal hyperplasia due to 21 hydroxylase deficiency)
- 17-hydroxyprogesterone
- serum electroytes
- plasma renin activity
Community acquired pneumonia in children.
Abx?
Abx for severe pneumonia?
what defines severe pneumonia?
- Amoxicillin 30mg/kg TDS 3-5 days
- severe pneumonia means one of following
- severe respiratory distress
- severe hypoxia or cyanosis
- marked tachycardia
- altered mental state
- empyema
- children with severe pneumonia require ICU admission and
Ceftriaxone 50mg/kg IV daily
AND
Flucloxacillin 50mg/kg IV 6 hourly
(consider azithromycin if pneumonia progresses)
down-slanting papebral fissure, wide spread eyes, low set ears, +- ptosis
Dx? etiology?
what other features?
Noonan’s syndrome
chromosome 11 autosomal dominant mutation
short stature
pulmonary valve stenosis
webbed neck
failure to thrive, mild
abnormal cardiac rhythm,
intellectual disability
a toddler with jaundice, lethargy, splenomegaly
Hx of neonatal jauntice, Family Hx of gall stones
Dx and blood film?
hereditary spherocytosis
- microsphercytes on blood flim
- autosomal dominant
HCV + mother,
what to do with the baby?
breast feeding ?
HCV-PCR at 2-6months
anti-HCV at 18-24 months
breastfeeding ok except in the presense of cracked or bleeding nipples
croup Tx? Management?
- dexamethasone 0.6mg/kg for all.
- mild, consider sending home
moderate, observe four 4 hours
severe, add nebulized epinephrine, oxygen, observe 4 hours. If not improved, consider hospitalization.
the pattern of inheritance for
Huntington’s disease
cystic fibrosis
G6PD deficiency
Thalassemia
hemochromatosis
hereditary hemorrhagic telangiectasia
Huntington’s disease : autosomal dominant
cystic fibrosis : autosomal recessive
G6PD deficiency : X-linked recessive
Thalassemia :autosomal recessive
hemochromatosis : autosomal recessive
hereditary hemorrhagic telangiectasia : autosomal dominant
sore throut 3 weeks ago,
polyarthralgia
fever
Dx? and Management?
acute rheumatic fever
admission. confrim Dx with throat swab
Tx with PO penicillin V or amoxicillin for 10 days, NSAIDS,
IM benzathine penicillin for secondary prevention.
echocardiography
pertussis
exclusion from school? how long?
- 21 days from the onset of any cough (catarrhal period)
- 14 days from the onset of paroxysmal cough
- 5 days after starting appropriate antibiotics.
congenital infections that affect the fetus or infant?
TORCH (Toxoplasma, others, rubella, CMV, HSV)
others include parvoB19, enterovirus, VZV, coxackie, listeriosis, syphilis
5 months old, runny nose, fever 40 C for the past two days, otherwise active and healthy.
Temperature dropped normal and maculopaular rash on trunk.
Dx?
roseola infantum
a toddler with lethargy and inactivity,
a fundoscopic exam shows a macular cherry spot.
Dx ? etiologu?
Tay -Sachs syndrome
autosomal recessive
deficiency in beta hexosaminadase A
a toddler with
anemia, leukopenia, bone pain, enlarged spleen, thrombocytopenia
+
loss of muscle tone, loss of motor skills, muscle spasm, trouble swallowing
Gaucher disease
autosomal recessive
glucocerebrosidase deficienty
lysosomal disease
