Peds Mnemonic Flashcards

0
Q

NF1 criteria

A
Cafe an lait spots
Axillary freckling
Lisch nodules
Bony deformity
Optic glioma
Relative affected
Neurofibromas

a first-degree relative with NF1
6 or more cafe-au-lait spots
2 or more neurofibromas or 1 plexiform neurofibroma
axillary/inguinal/or other intertriginous freckling
2 or more Lisch nodules
a distinctive osseous lesion (e.g. sphenoid bone dysplasia)
optic nerve glioma

A “pilocytic astrocytoma” of the optic nerve is equivalent to an optic glioma. On neuro-imaging, optic gliomas often appear as “fusiform” or “sausage-shaped” or “kinked” enlargements of the optic nerve.

NF1 may be assoc/w/synchial angle closure (and rarely NVI/NVA).

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1
Q

U6B10

A

The “fake” chemistry formula “U6B10” is a way to remember that unilateral cataracts should be taken out by 6 weeks, and bilateral cataracts by 10 weeks

Also, babies don’t start to make eye contact until 6 wks of age, and don’t develop vertical eye movements until 6 mo.

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2
Q

Congenital nystagmus

A

Congenital nystagmus
Convergence and eye closure dampen the nystagmus;
Oscillopsia is usually absent;
Null zone is present;
Gaze position does not change the direction of nystagmus;
Equal amplitude and frequency of nystagmus in each eye;
Near acuity is good because convergence dampens the nystagmus;
Inversion of optokinetic nystagmus occurs;
Turning of head or abnormal head posture to allow eyes to enter a null zone leads to better visual acuity;
Absent nystagmus during sleep;
Latent nystagmus occurs.

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3
Q

Phakomatoses and chromosome numbers

A

chromosome 9 – tuberous sclerosis (also chromosome 16)
chromosome 22 – NF-2
Chromosome 17– NF1

Ch3 = VHL

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4
Q

Scheie

A

“she (Sheie) has the cloudiest corneas!”

Scheie syndrome is an inherited disease of metabolism in which the body cannot properly break down long chains of sugar molecules called glycosaminoglycans. The syndrome belongs to a group of diseases called mucopolysaccharidoses (MPS). The enzyme defect in Scheie syndrome is of lysosomal alpha-L-iduronidase. Scheie syndrome is actually the mildest form of MPS type 1 which also includes the entities Hurler syndrome and Hurler-Scheie syndrome. MPS type 2 is equivalent to Hunter syndrome whose major ophthalmic sign is retinal degeneration. All of the syndromes listed, besides Scheie syndrome, do not feature corneal clouding as part of their stigmata.

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5
Q

Lens position

A

Marfan’s syndrome – imagine a tall marfinoid basketball player reaching out and dunking –> superotemporal subluxation
Homocystinuria – “uria” –> goes down toward the bladder –> inferonasal subluxation.

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6
Q

Pediatric glaucoma - law of 2/3

A

peds glaucoma - law of 2/3

affects 2/3 of males, and affects OU 2/3 of the time

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7
Q

Ectopia Lentis DDx

A
WATCH HIM SEE
Weil Marchesani
Aniridia
Trauma
Congenital glaucoma
Homocystinuria

Hereditary ectopia lentis
Iris coloboma
Marfans

Sulfite oxidase deficiency
Ehler Danlos
Ectopia lentis pupillae

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8
Q

Rhabdo

A

Everyone gets Embryonal (most common 80%, superonasal quadrant) Alveolar is Awful (most lethal, lower orbit, survival <10%) Pleomorphic Please (best survival rate, 97%, so if someone gets rhabdo please let it be this type)

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9
Q

Genetic association with Axenfeld Reiger

A

Axe the Foxy (FOXC) Pix(pics) (PITX): Axe for Axenfeld, FOXC1 for first word, PITX2 for second word

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10
Q

Cloudy cornea at birth

A
Peter's anomaly is on the list of causes of cloudy cornea at birth. These can be remembered by the mnemonic STUMPED:Sclerocornea,
Trauma (forceps),
Ulcer,
Mucopolysaccharidoses,
Peters,
Endothelial (CHED)
Dermoid.
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11
Q

ROP screening

A

For ROP screening, the first dilated fundus exam should take place between 4 and 6 weeks of postnatal age (or within the 31st to 33rd week of postconceptional or postmenstrual age, whichever is later). Since this child is currently 2 weeks old, he should be screened 2 to 4 weeks from now.
Mnemonic: 3+1= 4, 3+3= 6

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12
Q

A and V pattern

A

If a resect-recess surgery is decided upon, then displacement of the rectus muscles should be in opposite directions according to the normal rules in managing “A” or “V” patterns. In this case of an A-pattern exotropia, the medial rectus should be tightened and displaced toward the “apex” (i.e. superiorly in this case) while the lateral rectus should be loosened and displaced toward the “open area” (i.e. inferiorly for an “A” pattern).

A good mnemonic to remember these rules is: “MALE” – Medials to the Apex; Laterals to the Empty space.

10 for A pattern and 15 for V pattern

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13
Q

Myotonic dystrophy

A

for myotonic dystrophy – imagine Frankenstein! He would have a hard time releasing a handshake, isnt too bright, cant see very far (xmas tree cataracts) definitely has ptosis, his eyes dont move around much (CPEO), and certainly has cardiac conduction issues from those bolts on his neck they electrocute him with.

Answer:Ptosis, orbicularis weakness, progressive external ophthalmoplegia, and pigmentary retinopathy similar to that of Kearn’s Sayre syndrome. Aside FROM Christmas tree cataracts which contain multicolored iridescent crystals, patients with myotonic dystrophy may also have spokelike cortical opacities along the suture line.

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14
Q

Kearns Sayre

A

Eyes can’t track, retina is black, heart attack.
Lids are slack.

This patient demonstrates the classic clinical findings of Kearns-Sayre syndrome: chronic progressive external ophthalmoplegia (CPEO), retinal pigmentary changes, and cardiomyopathy. An EKG is necessary to diagnose the presence of possible heart block.

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15
Q

Violators of Sherrington and Hering

A

Possibly useful mnemonic: “Duane doesnt like sharing his DVD with Hering” –> helps to remember that Duanes violates Sherings Law, and DVD violates Herings Law.

16
Q

Goldenhar

A

Explanation:Congenital colobomas of the UPPER eyelid are commonly found in patients with Goldenhar syndrome which is also known as the “oculo-auriculo-vertebral spectrum.”

This syndrome also features limbal dermoids, preauricular skin tags, vertebral abnormalities, congenital heart disease, and CNS abnormalities as part of its clinical spectra.

As an aside, colobomas of the LOWER eyelid are found in Treacher-Collins.

GoLdenhar has one “L” -. UL (upper lid) has one “L”
Treacher- CoLLins has two “Ls” - LL (lower lid) has two “L”s

Goldenhar

  • we put gold weights in the upper eyelid, so upper eyelid coloboma
  • we put gold earrings in ears, ear involvement, preauricular skin tags, limbal dermoids “near the ear”.
17
Q

Crouzon/Apert/Pfeiffer

A

Crouzon pts (Gene FGFR2) can hold a crouton while Apert and Pfeiffer patients can’t (syndactyly)

18
Q

Megalocornea

A

Mega = Large or size XL. The inheritance of megalocornea is X-Linked (XL). Therefore, MEGAlocornea = XL (a large sized cornea and X-Linked)

19
Q

Brown syndrome

A

Brown syndrome: whereby there is a restriction to elevation on ADDuction of the involved eye. Brown syndrome can be caused by a variety of problems with the tendon-trochlea complex including sinusitis as in this case. CT of the orbits and sinuses is indicated to rule-in/out this possibility especially for an acute presentation of Brown syndrome. Also remember that, in contrast to inferior oblique paralysis which has an “A” pattern, Brown syndrome is associated with a “V” pattern (MNEMONIC: “Victor Brown”).

20
Q

SIN RAD

A

related to the functions of the superior/inferior recti and obliques: SIN-RAD (Superiors INtort; Recti ADduct).

21
Q

Spiral of Tillaux

A

The Spiral of Tillaux is an important anatomical landmark. It is a good approximation for the underlying ora serrata and thus denotes where it is safe to perform intravitreal injections. It is made up only of the recti muscles.

This “spiral” delineates the distance of the rectus muscles from the limbus. These relative distances can be remembered by the mnemonic “M-I-L-S”:

Medial rectus: 5.5 mm
Inferior rectus: 6.5 mm
Lateral rectus: 6.9 mm
Superior rectus: 7.7 mm

22
Q

Mucopolysaccharidoses

A

Tay-Sachs disease is caused by a deficiency of hexosaminidase A; Gaucher’s disease is caused by a deficiency of glucocerebrosidase; and Niemann-Pick Is caused by a deficiency of sphingomyelinase.

He uses his Sphinger to pick his nose

23
Q

Where do the extraocular muscles penetrate the Tenon capsule?

A

EOM penetrate the TENon capsule=TEN(10mm) posterior to their insertions
The extraocular muscles penetrate the Tenon capsule approximately 10 mm posterior to their insertions. This is important to know for “slipped muscles” and also for overall anatomical knowledge. You should also know where the extraocular muscles attach to the sclera.

24
Q

Gillespie syndrome

A
Dizzy Gillespie plays music on AM radio
Aniridia
Ataxia
MR
AR

Don’t forget about aniridia/angle closure glaucoma,
assoc/w/Wilm’s tumor (WAGR)

25
Q

Anophthalmos, nanophthalmos, microphthalmos

A

ANophthalmos = Almost Never happens (AN = almost never)
-has to be complete absence of ocular tissue to be anophthalmos
Nanophthalmos = Normal eye (only everything smaller) (N = normal) Microphthalmos = Messed up eye (everything disorganized and smaller) (M = messed up)

26
Q

Mucopolysaccharidosis

A

Fabry’s disease is caused by mutations in the alpha-galactosidase A gene which causes an accumulation of ceramide trihexoside.

For review: Tay-Sachs disease is caused by a deficiency of beta-hexosaminidase; Gaucher’s disease is caused by a deficiency of glucocerebrosidase; and Niemann-Pick is caused by a deficiency of sphingomyelinase.

Try to remember that Fabry and Hunter syndromes are both X-linked recessive. This can be remembered by imaging a “fabulous” hunter aiming a bow and arrow at a target shaped like an “X”.

27
Q

Muscle distance

A

5.5, 6.5, 6.9, 7.7

The order of these muscles can be remembered by the mnemonic “M-I-L-S”.

28
Q

Morning glory ON

A

In the morning we get REM sleep
R = retinal detachment (serous)
E = encephalocele (transphenoidal) - assoc/w/ON hypoplasia. Can mimic nasal polyps on exam
M = moya moya dz = chronic progressive CVA with bilateral stenosis/occlusion of arteries around the Circle of Wilis –> TIAs, strokes, epilepsy.

Abnormal closure of the embryonic fissure or abnormal development of the distal optic stalk
funnel shaped excavation of the posterior fundus
increased disc size
orange color
surrounding pigmentary changes
Poor VA, MC in women, u/L

30
Q

CRYO ROP

A

Threshold disease
Zone 2 + stage 3 = 5 = contiguous clock hours
3+ 5 = 8 cumulative clock hours

CRYO-ROP study was a multicenter, randomized clinical trial that compared cryotherapy retinal ablative treatment in the study eye with observation of the fellow eye in 172 subjects with threshold retinopathy of prematurity (ROP). Threshold disease was defined as five or more contiguous or eight cumulative clock hours of stage 3 ROP in zone 1 or 2 in the presence of “plus” disease. An unfavorable outcome was defined as posterior retinal detachment, retinal fold involving the macula, or retrolental tissue. Unfavorable outcomes were significantly less in the eyes that underwent cryotherapy (21.8%) compared with the untreated eyes (43%). This study defined threshold ROP and established peripheral retinal ablation as the standard of care in subjects with threshold ROP.

31
Q

Crytophthalmos/Fraser

A

Fraser syndrome associated with cryptophthalmos: think Brendan Fraser in the movie Mummy (crypts).

The syndrome associated with cryptophthalmos is called Fraser syndrome. In this syndrome, there are malformations in the genitals (e.g. micropenis, cryptorchidism) as well as possible malformations of the nose, ears, larynx and renal system.

Fraser syndrome is an autosomal recessive disorder that results from mutations in the FRAS1 gene which codes for an extracellular matrix protein.

Cryptophthalmos is where the eyeball is covered with skin. Eyes can be malformed. Rare. Bilateral. Eyelids and assoc structures of brows and lashes fail to form. Cornea is merged with epidermis and anterior segment structures are variable formed or absent.

Pseudocryptophthalmos occurs when the eyelids form but fail to separate and gives the appearance of the eye not forming.