Peds Block 3 Cram Flashcards
What is the MC nutritional d/o in the world?
What are the risk factors?
Fe deficient anemia
Cows milk intake @ 9-24mon
Under nutrition
Blood loss
Celiac/Giardiasis/H Pylori
Breast fed infants need to have iron supplementation starting @ ?
At what age can Fe foods be introduced to infant diets?
When can they start drinking cows milk?
4mon
6mon
12mon; <24oz/day
Microcytic anemia DDx
What is the MC congenital bleeding d/o
FLATS Fe deficiency anemia Lead poisoning Anemia of chronic Dz Thalassemia Sideroblastic anemia
Von Willebrand Dz
Functions of vWF?
How is it Dx?
How is it Tx?
Joins platelets and collagen
Protect Factor 8 from rapid clearance
Measured vWF quantity
Function measured w/ Ristocetin
Desmopressin for Type 1,2
vWF concentrate for Type 3
What Sx combo is a medical emergency for PTs w/ Sickle Cell?
By ? age they are functinoally asplenic leaving them vulnerable to ? microbes
If Sickle PT has osteomyelitis, consider ? microbes?
Fever + Sickle Cell anemia
5y/o
Encapsulated: HiB, Strep Pneumo, N Meningitidis
Salmonella
Staph A
What is the most common type of vasooclusive event?
What is the other form of this occlusive crisis?
Pain crisis
2-7 days of leg/arm pain w/ possible femoral head necrosis
Tx w/ Fluids, Pain, O2
Acute Chest Syndrome
CXR w/ new infiltrates
1st Sx= chest pain-> respiratory distress
Tx: Fluid Pain Transfusion O2 ABX Dilators
What meds are used for Sickle Cell management?
Hydroxyurea @ 9mon old- inc Hgb F and dec occlusive severity/frequency
Daily PO PCN
Vaccines: HIB, HBV Influenza
Folate
What is the most common childhood systemic vasculitis?
What adverse outcome can occur but usually in adults?
HSP after URIs
Inflammation of small blood vessels w/ Hemorrhage Ischemia and Leukocyte infiltration
IgA deposition= glomerulonephritis
How does HSP present?
What other outcomes can be seen?
Palpable purpura
Arthralgia
Renal involvement
Abdominal pain
Orchitis Pancreatitis
Edema Encephalopathy
What are the 3 phases od Kawasakis
Acute:
Fever Conjunctival erythema Cracked lips Strawberry tongue
Cervical lymphadenopathy
Subacute: desquamation, coronary aneurysms (Inc ESR, <1yr, >6yrs)
Convelescent: from Sx resolution until ESR normalizes
When are f/u Echos done for Kawasaki PTs?
How is it Tx?
2wks
6-8wks
IVIG- reduces aneurysm risk
High dose ASA
What are the “B-Sxs” of Hodgkins?
What 3 Sxs are less likely to be seen?
What will be seen on PE?
Fever x 3 days
Weight loss +10% in 6mon
Drenching night sweats
Fatigue Anorexia Pruritus
Cervical/Supraclavicular lymphadenopathy
Pleural effusion
What is seen on tissue biopsies in Hodgkin results?
Why are CXR and CTs ordered for these PTs?
What info do marrow aspirations provide?
Reed-Sternberg cells (owl eyes)
CXR- mediastinal mass eval
CT- Dz staging
Dz staging
+25% blasts= acute leukemia
What is the MC primary malignant tumor of childhood?
This type of tumor is #2 of?
Wilms Nephroblastoma tumor
2nd MC malignant abdominal tumor of childhood (#1= neuroblastoma)
What other abnormalities is Wilms tumors associated w?
Why are there so many issues w/ these PTs?
WAGR: Wilms tumor Aniridia GU malformation Retardation
Germline deletion Chrom #11p
Wilm tumors make PTs more susceptible for ? syndrome
What are the 3 common sites for these tumors to show?
Beckwith-Wiedemann- macroglossia, umbilical hernia, omphalocele
Lungs
Lymph nodes
Liver
What are the 2 MC presenting Sxs of a nephroblastoma?
What labs are drawn and what test is Dx?
What images are ordered?
Abdominal mass
Abdominal pain
CBC UA Liver/Renal function
Histology exam= Dx
Abd CT/US: renal or adrenal mass
CXR: pulmonary metastases
CT of chest, abdomen, pelvis
What are oncological emergencies in Peds?
Sepsis- chemo causes severe neutropenia TLS- common in leukemia/lymphoma Txs Anemia/Thrombocytopenia Inc ICP Airway obstruction
What is the MC childhood CA?
What are the 3 subtypes of this kind of CA?
Leukemia
ALL: males
AML: neonates, adolescence
CML
JMML
What will be seen on lab results of PTs w/ leukemia?
What type of analysis is done for Dx?
Peripheral smear w/ blast cells
Anemia
Thrombocytopenia
WBC >50K
Cytogenetic
Osteosarcomas are assoicated w/ ? hereditary issue
What syndrome is susceptible to this CA?
Retinoblastoma
Li-Fraueni Syndrome
What can trigger osteosarcoma and what would be seen on lab results?
What bones are MC affected?
Radiation
Osteoid substance
Distal femus
Proximal tibia and humerus
How does Ewing Sarcoma appear under microscopy?
What Sxs does it present w/ that causes it to be mis-Dx as osteomyelitis
Small Round Blue cell tumors
Pain and Fever
Although it can occur anywhere, where does Ewings occur MC?
What is the MC childhood solid neoplasm outside of the CNS?
Femur and Pelvis
Neuroblastoma