peds HY Flashcards
congenital malformation in males that consists of lax abdominal wall → marked distention, dilated urinary tract → Potter sequence, bilateral cryptorchidism
prune belly syndrome
vaginal irritation in little girls due to chemicals from bubble baths; Tx d/c bubble baths, wear cotton underwear,
wipe front-to-back after potty
bubble bath vaginitis
intestines protrude into umbilical cord w/ peritoneal covering, ↑risk of associated cardiac defects; first sterile wrapping,
then Dx echo to r/o cardiac defects, then Tx closure if small, silo if large
omphalocele
: intestines tear through abdominal wall w/o peritoneal covering; first sterile wrapping, then Tx closure if small, silo if large
gastrochisis
associated w/ neonatal hypothyroidism, Beckwith-Wiedemann syndrome; Tx reassurance (<2 cm), surgical repair (>2 cm
or persistent into kindergarten)
umbilical hernia
autoimmune demyelination after viral infx → multiple sclerosis-like sx but in kids <10 y/o; Dx
MRI shows white matter demyelination, Tx high-dose corticosteroids
ADEM
rapidly ascending paralysis after viral infx (or other infx), ↑risk of respiratory arrest (Tx mechanical ventilation);
Dx CSF shows ↑protein, Tx IVIG or plasmapheresis
guillian barre syndrome
presents w/ respiratory distress and unilateral decreased breath sounds in neonate (phrenic nerve innervates
hemidiaphragm); Dx chest U/S or fluoroscopy shows “seesaw diaphragm”
phrenic nerve palsy
Erb-Duchenne palsy:
C5/C6 palsy after difficult delivery → “waiter’s tip” posture
C7-T1 palsy after difficult delivery → total hand paralysis + ipsilateral Horner syndrome
Klumpke palsy:
“brief staring spells”; Dx EEG shows 3-Hz spike-and-wave pattern, Tx valproic acid > ethosuximide
Absence (petit mal) seizure: “
LOC + rigidity (tonic phase) + muscular jerking (clonic phase) + postictal confusion
Tonic-clonic (grand mal) seizure:
seizure-like activity w/o EEG changes, usually don’t have bowel/bladder incontinence or self-injury; Tx psych consult
pseudoseizure
AD ∆ryanodine receptor → T>104 + muscle rigidity + rhabdomyolysis following anesthesia; Dx caffeine contracture test, Tx dantrolene sodium, 100% O2, cooling blankets
Malignant hyperthermia:
: premature fusion of skull sutures → abnormal head shape + impaired brain development, 80% sporadic, 20% genetic (e.g. Crouzon syndrome); Tx surgical correctio
Craniosynostosis:
AD, craniosynostosis + syndactyly of fingers/toes
Apert syndrome:
craniosynostosis + wide-eyes w/ proptosis, “beak nose”
crouzon syndrome
isolated craniosynostosis of sagittal suture → long, narrow skull
Scaphocephaly:
at girl w/ pulsatile headache/tinnitus, high risk of blindness; first get imaging to r/o mass lesion (can have empty
sella), then get LP w/ opening pressure to r/o infx causes, Tx acetazolamide vs. serial LPs
pseudotumor cerebri
watery/bloody diarrhea, fever, tonic-clonic seizures can precede GI sx (Ekiri syndrome); Dx stool cx, Tx IV fluids + ceftriaxone
shigellosis
due to S. aureus TSST, often found in tampons; presents w/ septic shock, diffuse maculopapular rash
(desquamation of palms/soles is late finding), strawberry tongue; Tx admit + stabilize + IV nafcillin (prevents recurrence)
toxic shock syndrome
due to Trichophyton tonsurans; presents as boggy scalp lesion w/ hair loss; Dx KOH prep, Tx PO griseofulvin
tinea capitis
due to RSV; presents w/ wheezing, URI sx, respiratory distress; Tx supportive care (ribavarin if severe, pavilizumab ppx for
high-risk infants)
bronchiolitis
due to Parvovirus B19; presents w/ fever, URI sx, “slapped cheek” and lacy rash on extremities, can
cause aplastic anemia in SCD or spherocytosis, hydrops fetalis in pregnant women (rare)
erythema infectiousium (fifth disease)
ommonly found in bats, skunks, raccoons, foxes, coyotes; give reassurance if pet is sterile, kill animal for bx if unknown, give post-
exposure ppx for any bat exposure
rabies
cough, coryza (head cold), conjunctivitis, Koplik spots, then diffuse maculopapular rash; Tx vitamin A
measles
diffuse maculopapular rash (starts on face and migrates down) w/ low-grade fever, marked LAD, sore throat, ±arthralgias
rubella
due to HHV-6; high-grade fever for 3 days, then diffuse maculopapular rash
roseola
macrocytic RBC aplasia + short stature, webbed neck, cleft lip, shield chest, triphalangeal thumbs
black-fan diamond anemia
