Peds NBME Facts Flashcards
defect in which vitamin causes increase in ICP
vitamin A
what is pellagra?
def of B3 - Niacin = dermatitis, dementia, diarrhea
def of vita B2/riboflavin sx
cheilosis, ocular(keratitis, conjunctivitis), anemia, dermatitis, photophobia
what is serous otitis media?
Serous Otitis Media – nonpurplent(clear) effusions of the middle ear
o Usually involves hearing loss and fullness
o Typically does not have pain or fever
baby being fed cows milk can be deficient in what…
- Cows milk is a poor source of iron = can cause iron deficiency anemia in children strictly fed this
HTN emergencies tx
- Sodium Nitroprusside = #1 for HTN emergencies
Neoblastoma Vs Wilms Tumor
*Neuroblastoma = MC extracranial tumor in children. Commonly presents as an abdominal mass. Often calcified Doesn’t invade vascular Poorly marginated May extend to chest Elevated aorta away from vertebra More commonly will cross the midline
Nephroblastoma(Wilms Tumor) Usually not calcified Displaces structes Well circumscribed “Claw Sign” w/kidney May invade vascular = IVC/Renal vein
9 yo kid with T1 DM, lethargy, labored breathing, vomiting, flushed appearance and appears severly dehydration, fruity odor to breath, blood glucose is >500. Tx? why high glucose?
DKA = def of insulin = glucose builds = body tries to remove by peeing it out + body hungry = making ketones trying to produce glucose for body
Management:
REPLACE FLUIDS = isotonic saline
When glucose reaches 200 give dextrose + saline
If K <3.3 give K + IVF
If K is above 3.3 and pt is not volume deplete you can give insulin
Criteria for Physiologic Jaundice
Physiologic: Appears 2-3 day Peaks 2-3 d Disappears by day 7 Peak bilirubin <13 Rate of bilirubin rise <5
What is Right Middle Lobe Syndrome? causes?
This is “RIGHT MIDDLE LOBE SYNDROME”
Clinical presentation: Most pt present w/chronic cough Haemoptysis Chest pain Dyspnea
Path: largely unknown!
Chronic bronchitis, Bronchiectasis, granulomatous inflame, pneumonia
Radiographic Shit:
Right middle lobe collapse – linear consolidation, wedge-shaped density
Bronchiectasis obstructing bronchial lesion is usually not found
Sx of ALL in 4 yo kid?
fever, recurrent infections, bleeding(bone marrow failure) fatigue, mediastinal mass due ot thymus infiltration, hepatosplenomegaly, lymphadenopathy, TdT+(pre B/T cell marker)
heat exhaustion vs Heat stroke
Heat exhaustion is the precursor to heat stroke. Body tries to compensate for excess body heat. Profuse sweating Weakness NV, HA, lightheadedness M cramps
Heat stroke is a failure of the body to compensate for excess heat = temp will be above 40. AMS Lethargic Seizure >40 C
Galactosemia inheritance pattern? defect?
Galactosemia – AR absence of Galactose-1-P = accumulation in liver, kidney, & brain.
when would you see sx of galactosemia?
1st week of life!
sx of galactosemia
tx?
Sx: Enlarged liver(galactose accum) Vomiting, nausea, irritability Mental retardation(gala in brain) Cataracts if dnt stop feeding baby shit The urine tests positive for reducing substances, indicating the presence of sugars with aldehyde groups
Tx:
Remove galactose & lactose(dairy, breast milk)
Start on soy
4yo girl with vaginal bleeding for 12 hours, 3m history of purulent vaginal discharge. pubic hair stage 1. dx?
vaginal foreign body
6hr old baby with cyanosis of extremities since birth. temp = 97, bp 80/45, been breast feeding well. whatcha gonna do to her?
put her under a warming lamp!
Acrocyanosis – blue hands and feet due to vasomotor instability = warm baby up and they will be fine. Often seen w/Cutis Marmorata(lattice like mottling seen when baby gets cold)
You should be concerned about —– murmers in kid or murmers that are grade — +.
diastolic, 3
congenital hypothyroidism
Thyroid Dysgenesis(Cretinism) – Increased TSH Decrease T4 Normal APGAR Prolonged Jaundice/indirect hyperbili Large posterior fontanelle 6-12 weeks: Poor feeding Lethargy Hypotonia Coarse facial features LARGE PROTRUDING TONGUE Developmental delay
**TX by replacing hormone!!
gynocomastic in boys is normal till….
Normal in prepubertal boy! Usually subsides within 1 year. If mass doesn’t regress by 16-17 yoa then it should be removed.
7yo boy with progressively worsening HA, difficult walking over the past 6 weeks, bilateral papilledema, right abductions palsy & gait ataxia. dx?
Medulloblsatoma can impair CSF flow = causing the papilledema
17 yo Low WBC, splenomegaly, hepatomegly, lymph nodes enlarged, and now has diarrhea.
Leukocytes = 2100
IgA 340(low) others are normal
Platelet 180,000
dx?
Low WBC, splenomegaly, hepatomegly, lymph nodes enlarged, and now has diarrhea! = immunocomp! Since hes 17 its prob due to HIV
14 yo girl w/lower ab pain, intermittent pain in knee & hips for 6wks, cramps relieved by bowel movements. 6-10 urgent, bloody bowel movments daily. PE: swollen, tender L knee. WBC 16K, Platelet 790,000 joint fluid: straw colored, wbc = 2000. dx?
UC! = bloody stools, leukocytosis, thrombocytosis, ab pain, arthralgias.
Any of the IBDs can be associated with joint pain & can be relieved with bowel movement!
*knee aspirate <10,000 = not likely infection
Normal Synovial Fluid = ~200 wbc & <25%PMN
Non-inflammatory = 200-2,000 Inflamm = 5,000-50,000 Septic = >50,000
12 yo boy is concered he is the shortest kid in the class. father says he was short untill his senior year in high school. Which test would you do to confirm the dx?
check bone age to distinguish constitutional vs familial
