Peds Shelf Flashcards
what is the murmur heard in tetrology of fallot?
systolic murmur along the left sternal border
what 4 anatomic abnormalities are seen in tetrology of fallot?
- VSD
- Overriding aorta over the R and L ventrivles
- R ventricular outflow obstruction
- R ventricular hypertrophy
what are the 3 most common bugs that cause acute bacterial rhinosinusitis? treatment of choice?
- Strep pneumo
- H influ
- Moraxella catarrhalis
tx: amoxicillin-clavulanic acid
impetigo is most commonly associated with what disease?
post-strep glomerulonephritis
what 2 bugs cause impetigo? tx of choice?
- GABS
- Staph aureus
tx: topical mupirocin
what vaccine has a weight requirement and what is that requirement?
Hepatitis B
must be at least 2kg before receiving it
what are the characteristics (4) of Edwards syndrome? trisomy 18
- Low birth weight
- Closed fists with the index finger overlapping the 3rd digit and the 5th digit overlapping the 5th
- Prominent occiput
- Rocker bottom feet
what causes cri-du-chat?
5p deletion
tx of choice for septic arthritis?
surgical drainage
pt has rapidly increasing head circumference, imaging? what is it?
hydrcephalus
get CT scan of brain
continued ear drainage for several weeks despite appropriate antibiotic therapy?
cholesteatoma
how is a cholesteatoma formed?
chronic middle ear disease leads to formation of a retraction pocket in the tympanic membrance which can fill with granulation tissue and skin debris
at what age should children follow a moving toy in the side to side AND vertical plane?
3 months
at what age does an infant maintain a seated position?
6-8months
At what age can a child copy a square?
4-5 years
what is the major morbidity of pauciarticular rheumatoid arthritis?
blindness: iridocyclitis (tx with steroids)
what is Nikolsky sign and what does it indicate?
- peeling of the epidermis in response to mild shearing forces
- Ritter disease = staph scalded skin disease
what are the major symptoms observed in anaphylactoid purpura? (3)
- Generalized acute vasculitis of small blood vessels
- Arthritis of large joints
- GI symptoms: colicky abdominal pain, vomiting, melena
what is the most serious complication of anaphylactoid purpura?
renal disease
Syrup of ipecac should not be given in what isntances?
- Ingestion of strong acid or alkali
2. Obtunded, comatose, or impending seizures
herald patch -> diffuse rash involving the upper extremities and trunk
pityriasis rosea
what else should be on the differential for pityriasis rosea?
secondary syphilis
at what age does neonatal acne peak?
2-4 weeks (due to maternal hormone transmission)
tx for symptomatic organophosphate poisoning in children?
atropine
what are the typical symptoms of GBS pneumonia?
- Rapid onset of respiratory distress, hypothermia, hypotension
- low WBC count with left shift
at what age do children start to pincer grasp?
12 months
what CANT you use as treatment for lice in a small infant?
1% lindane
what STD goes along with sexual abuse?
gonorrhea
in what 3 types of bites do you need antibiotic prophylaxis?
- cat
- human
- monkey bites
child ingests aunt’s pills, prolonged QRS and QT interval
TCA
a rash that waxes and wanes over the first days to weeks of life- examination of fluid shows eosinophils
erythema toxicum
what does the rash in erythema toxicum look like?
splotchy areas of erythema with a central clear pustule
vascular lesions that are more prominent during crying/exercise, face lesions fade over the first weeks of live, occipital and nuchal lesions remain
salmon patches
what is pustular melanosis?
newborn disease- more common in AA
- 1-2mm pustules that rupture and cause a hyperpigmented lesion
fine yellow-white 1-2mm lesions scattered on face and gingivae of neonate
milia
what is a sebaceous nevi?
small sharply edged lesions that occur on the head and neck of infants
- yellow and orange, slightly elevated
- hairless
- malignant degeneration is possible after adolescence
greasy scaly and erythematous rash in newborn that involve the face, neck, axilla and diaper area
seborrheic dermatitis
what stage of sleep do nightmares occur?
REM sleep
what is somnambulism? when does it happen?
sleepwalking
occurs in stage 4 non-REM sleep
what is somniloquy? when does it occur?
sleeptalking
can occur at any sleep stage and is seen in all ages
age most likely for asphyxiation and choking?
1 year
age most likely to drown in a swimming pool?
1-3years
leading cause of death in children aged 5-9years?
pedestrian injuries
pellagra is a deficiency of what?
niacin
niacin is an essential component of what two enzymes?
- NAD
2. NADP
pellagra is most common in what areas?
areas that rely on corn as a basic food
beriberi is a deficiency of what?
thiamine (vitamin B1)- essencial for synthesis of acetylcholine
what are the clinical disturbances seen in thiamine deficiency? (3)
- Heart failure
- Peripheral neuritis
- Psychic disturbances
rachitic rosary, craniotabes, scoliosis, pelvic and leg deformities
rickets: disorder of vitamin D
what is Waardenburg syndrome?
- Autosomal dominant
- deafness + pigment changes
- white forlock
- heterochromia irides
- uni or bilateral congenital deeafness
- lateral displacement of the inner canthi
what is prader-willi syndrome?
- infantile hypotonia and poor feeding
- as get older hyperphagia and obesity
- almond shaped eyes
- hypogonadism
- mild mental retardation
what is treacher collins syndrome?
Autosomal dominant
- normal intelligence
- facial abnormalities- malar hypoplasia
- micrognathia, abnormally shaped ears
- hearing loss
what is legg-calve-perthes disease?
avascular necrosis of the femoral head
- boy around age 6-7
- painless limp (though can have pain as well)
what age group do you most commonly see slipped capital femoral epiphysis?
adolescent- obese male
how does osteomyelitis typically present?
focal bone tenderness and fever
treatment of lead poisoning?
dimercaprol and calcium EDTA
treatment for acetaminophen poisoning
N-acetylcysteine (NAC): removes hepatotoxic metabolites
- should be given within 16 hours of ingestion, ineffective after 36 hours
what is the antidote for morphine/narcotic overdose?
naloxone
treatment of salicylate poisoning?
acetazolamide and IV sodium bicarb: enhances the urine excretion of salicylates
treatment of organophosphate poisoning?
pralidoxime
symptoms of iron toxicity?
phase 1: hematemesis, diarrhea, abdominal pain
phase 2: cardiovascular collapse after 12 hours
treatment of iron toxicity?
deferoxamine
methanol toxicity treatment?
ethanol~ saturates the enzyme systems that convert methanol to toxins
toxic effect of vitamin A?3
- hyperostosis
- Hepatomegaly
3, Increased CSF
toxic effect of nicotinic acid? long term toxicity (3)?
erythema of skin and pruritis
longterm: tachycardia, liver damage, hyperglycemia
toxic effect of vitamin C?
kidney stones
diarrhea
cramps
toxic effect of vitamin D?
calcification of the heart/kidney/blood vessels/bronchi/stomach
also: weight loss, polyuria, diarrhea
toxic effect of pyridoxine?
sensory neuropathy & altered sensation of touch, pain and fever
Anomalies in fetus assoc with maternal diabetes? (4)
- Sacral agenesis (pathognomonic)
- Cardiac defects: transposition and VSD
- Renal defects
- Anencephaly
fetal hypoplasia of distal phalanages and nails
phenytoin in utero: fetal hydantoin syndrome
Phenytoin causes what in fetuses? Valproate?
Phenytoin: fetal hydantoin syndrome
Valproate: neural tube defects
what anomalies are seen in neonatal lupus erythematosus?
- Skin lesions
2. Cardiac abnormalities: AV block, transposition, valvular/septal defects
most babies with lupus erythematosus will have what kind of antibodies?
anti-rho
potential complication of impetigo?
poststreptococcal glomerulonephritis
what does the rash in molluscum contagiosum look like?
skin colored dome-shaped, 1-5mm
central umilication
classic presentation of poststreptococcal glomerulonephritis?
- Change in urine color to bloody
- Edema
- HTN
- Renal insufficiency
what vitamin should be given w isoniazid therapy?
pyridoxine: vitamin B6
what vitamin should be given to a child with measles in a developing country?
Vitamin A
pts with sickle cell disease should be given what supplement?
folate- bc of the ongoing compensatory erythopoiesis
what test is done to diagnose: Wiskott-Aldrich syndrome
platelet count
what test is done to diagnose:Asplenia
CBC: see howell-jolly bodies
what test is done to diagnose: b-cell defects
immunoglobulin: see low A, G, and M levels
what test is done to diagnose:t cell deficiencies
intradermal skin test
what test is done to diagnose: chronic granulomatous disease
nitroblue tetrazolium
what is the etiology behind marfans syndrome?
mutations of the fibrillin-1 gene
what are the differences in lens dislocation between Marfans and homocystinuria?
Marfans: dislocated upward
Homocystinuria: dislocated downward
what are the symptoms of homocystinuria?
- thromboemblic events
- osteoporosis
- fair complexion
- similar to marfans syndrome
what is congenital contractural arachnodacylyl?
- autosomal dominant condition that presents with tall stature
- arachnodactyly
- multiple contractures involving large joints
why do pts with turners syndrome have swollen hands and feet?
congenital lymphedema: due to abnormal development of the lymphatic network
what two bugs are the most common causes of neonatal sepsis?
- GBS
2. Escherichia coli
Accentuated cupids bow of the upper lip
dilantin exposure
what are the findings of Alport syndrome in a newborn? (4)
hematuria progressive nephritis deafness ocular defects (Cant see, cant pee, cant hear)
what drug has been used to induce glucuronyl transferase in newborn infants and can reduce neonatal jaundice?
Phenobarbital
what is the treatment of choanal atresia?
surgical correction with placement of nasal tubes
when should VZV immunoglobulin be administered to an infant immediately after delivery? (2 instances)
if the mother had the onset of varicella within 5 days prior to delivery
and if mom if diagnosed with chickenpox within 2 days of delivery
what is the gold standard for diagnosis of CMV?
urine viral culture for CMV
how does symptomatic congenital disease occur?
when a mother has a primary CMV infection in the first trimester of pregnancy
what is the apt test?
a test that differentiates fetal from adult (moms) hemoglobin in a bloody specimen
what medications are CLEARLY contraindicated in breast feeding? (6)
- Lithium
- Cyclosporin
- Antineoplastic agents
- Illicits: cocaine and heroin
- Ergotamines
- Bromocriptine (suppresses lactation)
what do you find on plain radiographs in a neonate with NEC?
pneumatosis intestinalis
when should you consult surgery in a pt with NEC?
when theres presence of free air under the diaphragm on XR indicating perforation or if infant clinically worsens with medical management
what are the symptoms of NEC? (3)
- usually prematurely born infant
1. feeding intolerance
2. distended abdomen
3. grossly bloody stool
breast milk has insufficient ____ and ___ for catch-up growth in premies?
Calcium and Phosphorus
what are the major pulmonary problems found in small-for-date infants?
- Neonatal asphyxia
2. meconium aspiration syndrome -> pneumothorax, pneumomediastinum or pulmonary hemorrhage
what is periodic breathing in low birth weight babies?
recurrent breathing pauses of 3-10 seconds
what are apneic episodes?
absence of respirations for more than 20s
+ bradycardia
+ cyanosis
what is the main cause of hypothyroidism in neonates?
thyroid dysgenesis
what can untreated hypothyroidism lead to?
cretinism
what does the neonatal metabolic screen test for?
PKU and hypothyroidism
what nerves does erb duchenne paralysis affect?
C5 & C6
what is klumpke paralysis?
injury to C7, C8 & T1
- palsy to the hand and can produce Horner’s syndrome
how do you check for suspected phrenic nerve palsy in a pt with Erb-duchenne or Klumpke’s palsy?
- CXR: paralyzed diaphragm can be noted to remain elevated during deep inspiration, cannot see this on expiration
- Fluoroscopy: shows unilateral paralysis of diaphragm
tx of erb duchenne or klumpke?
frequently improve spontaneously
what are common outcomes of SGA infants born to moms w toxemia?
- Hypoglycemia
2. Polycythemia
Manifestations of Polycythemia in a newborn
definition: Hct >65% persistently
- increases blood viscosity causing hyperviscosity syndrome: tremulousness that can progress to seizures
- renal vein thrombosis
- NEC
- tachypnea
tx of polycythemia in newborn?
partial exchange transfusion with albumin prior to significant symptoms
what is the etiology based on time frame of development of opthalmia neonatorum:
- 6-12hrs
- 2-5 days
- 5-15 days
- 6-12 hrs: Chemical conjunctivitis (from use of silver nitrate or erythromycin ppx)
- 2-5 days: Gonococcal conunctivitis
- 5-14 days: Chlamydial conjunctivitis
treatment of chlamydial conjunctivitis?
systemic antibiotics for pt and both parents to prevent risk of chlamydial pneumonia
what do you do w a healthy infant born to an HIV positive mom who received HAART therapy for the weeks prior to delivery?
give a course of zidovudine
when can you expect a mongolian spot to disappear?
1-2 years of age
babies not given vitamin K and are fed breast milk start showing hemorrhagic manifestations when? what are these symptoms? (4)
2nd-7th day of life
- Melena
- Hematuria
- Bleeding from the circumcision
- Intracranial Hemorrhage/shock (severe)
what are the complications of bilateral cleft lip and palate?
recurrent otitis media
hearing loss
speech impairment
when is cleft lip repaired versus cleft palate?
Cleft lip: first 2-3 months
Cleft palate: 6months-5years
what does the CXR show in TTN? (3)
- Prominent pulmonary vascular markings
- Fluid in fissures
- Hyperexpansion of lungs (flat diaphragms)
Symptoms of untreated congenital syphilis? (5)
- Infiltrative maculopapular PEELING raash on face, palms, and soles (scrapings contain treponemes)
- Rhinitis (blood tinged)
- Hepatosplenomegaly
- Lymphadenopathy
- Early jaundice
late manifestation of congenital syphilis?
Interstitial heratitis:
- photophobia
- corneal haziness
- lacrimation
- eventual scarring
fifth finger polydactyly in a white child warrants what?
careful examination of the cardiac system
what is Harlequin syndrome?
transient change in the skin color of an otherwise asymptomatic premature newborn
- dependent side of the entire body turns red while the upper side remains pale
when should you suspect twin-twin transfusion syndrome?
when the Hct of twins differs by more than 15mg/dL
Polyhydramnios is associated with what?
- Duodenal atresia
- TEF
- Trisomy 18
- Anencephaly
Oligohydramnios is associated with what?
Renal agenesis: inhibit formation of fetal urine
Treatment of RSV in children?
inhaled epinephrine
Treatment of pt with pertussis?
isolated with droplet precautions
what is the most common cause of short stature and pubertal delay in adolescents?
Constitutional growth delay
what is constitutional growth delay?
- pts have normal birth weight and heigh but between 6mnths-3yrs their growth slows and follows the curve at the 5th-10th percentile
- puberty and growth spurt are delayed but eventually occur
which 3 congenital heart defects cause cyanosis and require a patent ductus arteriosus?
- Pulmonary atresia
- Tricuspid atresia
- Tetrology of Fallot
when should you get surgery for an umbilical hernia? (5)
- Persists to 3-4 years
- Exceeds 2cm in diameter
- Causes symptoms
- Becomes strangulated
- Progressively enlarges after the age of 1-2 years
what are the 4 parts of tetrology of fallot?
- Overriding aorta
- Right Ventricular Hypertrophy
- Subpulmonary stenosis (single S2)
- VSD (pansystolic murmur)
stridor in a pt 4-8 months that worsens in supine and improves in the prone position
Laryngomalacia
stridor that improves with neck extension
vascular ring
what is laryngomalacia?
increased laxity of the supraglottic structures that results in collapse during the inspiratory phase
what is the treatment of Kawasakis disease?
Aspirin plus IVIg
- get baseline ECG and f/u in 6-8 weeks
what are two complications of kawasakis disease?
- Coronary Artery Aneurysm
2. Myocardial infarction and ischemia
How do you diagnose Kawasakis disease?
- Fever for >5days plus >4 of:
1. Bilateral nonexudative conjunctivitis
2. Mucositis
3. Cervical lymphadenopathy
4. Erythematous polymorphous rash
5. Extremity changes (edema & erythema)
Describe the rash in scarlet fever and what is the treatment?
- sandpaper texture that spares the palms and soles
- amoxicillin and throat culture are necessary
Symptoms of rocky mountain spotted fever? treatment?
- Rash on the palms and soles
- HA
- GI symptoms
tx: doxycyline for 5-7 days
What are some potential complications of the pertussis component of the DTaP?
- Immediate anaphylactic reaction
- Encephalopathy
- CNS like seizures
what is atlantoaxial instability? association?
- associated with Downs syndrome
- pts have excessive laxity in the posterior transverse ligament which causes increased mobility between the atlas and axis
at what age should toilet training begin and how do you know when to start?
2-4 years
- the kid should be able to communicate the need to urinate and can withold potty for a brief period of time
MOA of hydroxyurea in sickle cell and side effects?
- Increases fetal hemoglobin Side effects: 1. Leukopenia 2. Anemia 3. Thrombocytopenia
What is diamond-blackfan anemia? how does it present?
Congenital pure red cell aplasia
- presents in the first 3 months with pallor and poor feeding
- CBC= normocytic or macrocytic anemia with reticulocytopenia
What is the most common causes of death in pts with Friedreich ataxia?
Cardiomyopathy & Respiratory complications
what two conditions should you think of with delayed meconium passage in neonates?
- Hirschsprung disease
2. Meconium Ileus
how does trachoma present? cause?
- caused by chlamydia trachomatis serotype A-C
- follicular conjunctivitis
- pannus (neovascularization)
- concurrent infection occurs in the nasopharynx
how do you diagnose trachoma?
giemsa stain examination of conjunctival scrapings
tx of trachoma?
topical tetracycline or oral azithromycin
tx of choice for absence seizures? (2)
ethosuximide
valproic acid
most common congenital cause of aplastic anemia?
Fanconi anemia
- autosomal recessive/X-linked disorder
- caused by chromosomal breaks
treatment of aplastic anemia?
hematopoietic stem cell transplantation
what is the appearance of a pt w fanconi anemia? (5)
- Short stature
- Microcephaly
- Abnormal thumbs
- Hypogonadism
- Hypo/Hyperpigmented areas, cafe au lait spots, large freckles
what industrial chemical can cause aplastic anemia?
benzene
symptoms of henoch-schonlein purpura? pathogen?
- IgA mediaed vasculitis
- palpable purpura symmetric over legs, buttocks and arms
- arthralgias/arthritis
- colicky abdominal pain
biopsy of a pt with HSP?
deposition of IgA in the mesangium
linear deposition of IgG on the basement membrane of kidney
Goodpasture syndrome
edema + hematuria
- EM shows flattening of the podocytes
minimal change disease
what is the best diagnostic test for meckels diverticulum?
technetium-99m pertechnetate scan (meckels scan)
What are the symptoms of Rubella in neonates exposed in utero? (8)
- Hepatosplenomegaly
- Deafness
3 Microcephaly - Growth retardation
- Chorioretinitis
- Thrombocytopenia
- Blueberry muffin appearance (purpura)
- Sensorineural hearing loss
purpura w a blueberry muffin appearance
Rubella as a TORCH
what is the most common predisposing factor to orbital cellulitis?
bacterial sinusitis
what are the 4 key symptoms of orbital cellulitis?
- Pain with eye mvmts
- Proptosis
- Ophthalmoplegia
- Diplopia
if the heart rate of a newborn drops below ___, chest compressions should be performed
60
what are the most common causes of torticollis in a child? (4)
- URI
- Minor trauma
- Cervical lymphadenitis
- Retrophayngeal abscess
why are patients with turners syndrome (XO) at a higher risk of osteoporosis & bone fractures?
low estrogen levels from gonadal dysgenesis
if you cant get IV access via a peripheral site, what is the best site to obtain IV access?
intraosseous
what are the two infections most commonly seen in hyper-IgM syndrome?
- Recurrent sinopulmonary
2. Pneumocystis jiroveci pneumonia
what are the 4 findings of X linked agammaglobulinemia (XLA)?
- Recurrent bacterial infections <5yrs
- Low serum IgG, IgM and IgA
- Absent isohemagglutinins or poor response to vaccines
- Less than 2% CD19+ B cells
How is Common variable immunodeficiency different from XLA?
- Low IgG, IgM and IgA but not as severe as XLA
2. do not become symptomatic until 15-35 years of age
what is the most common cause of hip pain in children, esp in boys aged 3-10?
transient synovitis: usually follows a viral infection or mild trauma
what is the testicular volume in prepubertal boys?
<3 mL
what is the diagnostic study of choice when a patient presents with accidental alkali ingestion?
upper GI endoscopy
what are the symptoms of neonatal tetanus?
- Poor suckling and fatigue followed by rigidity, spasms and opisthotonus
what causes mortality in neonatal tetanus in the first week versus second week?
First week: apnea
Second week: septicemia from infection orinally from umbilical stump
Clinical features of iron poisoning:
- Within 30min - 4 days
- Within 2 days
- Within 2-8 weeks
- abdominal pain, hematemesis, melena, hypotensive shock, metabolic acidosis
- Hepatic necrosis
- Pyloric stenosis
diagnostic findings of iron poisoning?
- Anion gap metabolic acidosis
- Radiopaque pills
- Measure serum iron levels
Treatment of iron poisoning?
- Whole bowel irrigation
- Deferoxamine
- Supportive care for circulation, airway, breathing
Symptoms of acute acetaminophen poisoning?
Asymptomatic for first 24 hours
then nausea and vomiting
symptoms of acute aspirin poisoning?
- Tinnitus
- Fever
- Hyperpnea (resp alkalosis, metabolic acidosis_
* not radiopaque and cannot see on xx ray
symptoms of lead poisoning in children?
- Abdominal pain
- Vomiting
- anemia
- Behavioral problems
- radiopaque on xray
seizures, mental retardation, port wine stain or nevus flammeus along territory of trigeminal nerve
sturge weber synrome
Diagnostic study of choice for pyloric stenosis?
Ultrasound of the abdomen
what two things can cause HYPERvolemic hypernatremia?
- Exogenous sodium intake
2. Mineralocorticoid excess (eg hyperaldosteronism)
what is the most common cause of croup?
parainfluenza virus
what are the 3 characteristic findings on lateral neck x ray for epiglottitis?
- Swollen epiglottis (thumb sign)
- Thickened aryepiglottic flods
- Obliteration of the vallecula
What are 3 complications of prolonged Cystic fibrosis?
- Gallstones
- Cirrhosis with portal hypertension
- Pancreatic fibrosis
what is the protein excretion cutoff for diagnosis nephrotic syndrome?
Greater than 3g/day
what nephrotic syndrome is associated with Hepatitis B infection?
membranous glomerulonephritis
Describe the rash of scarlet fever?
- starts initially on neck, axilla, and groin within 12-48 hours and subsequently generalizes within 24 hours of rash onset
- finely papular texture “sandpaper like”
how often and how much should a baby be breastfeeding and stools/diapers?
- 15-20minutes on each breast eight times/day (q3H)
- 4-6 wet diapers mixed with
- 8-12 stools/day
Difference between duchenne and beckers muscular dystrophy?
age of presentation- Duchennes presents before the age of 5 and beckers presents around the age of 12
what is and when do you see peptostreptococcus?
anaerobic bacteria that causes unilateral lymphadenitis
- usually in older children with a hx of periodontal disease
what is the theorized pathophys of jejunal or ileal atresia?
vascular accident in utero
risk factors include poor fetal gut perfusion from maternal use of vasoconstrictive medications or drugs like cocaine and tobacco
- not associated with chromosomal abnormalities
when does cocaine withdrawal in a newborn usually present?
day 2-3 of like
what is the cause of duodenal atresia?
failure of the duodenum to recanalize
what are the 3 most common bacteria of acute otitis media? 2 viruses?
- Strep pneumo (40%)
- H flu (25-30%)
- Moraxella catarrhalis (10-15%)
viruses: - RSV
- Rhinovirus
what does light microscopy show in minimal change disease?
normal renal architecture
what does electron microscopy show in minimal change disease?
diffuse effacement of foot processes of podocytes
treatment of minimal change disease?
4-6 weeks of steroids
erb duchenne palsy involves what nerves?
C5, C6 and sometimes C7
marfans features + thromboembolic events
classic homocystinuria
difference in lens dislocation between marfans and homocystinuria?
marfans = dislocated upward homocystinuria = dislocated downward
bullous type impetigo is caused by what?
staphylococcus
genetic defect and inheritance of Osteogenesis imperfecta?
autosomal dominant mutation of COL1A1
complications of prader willi syndrome?
- Sleep apnea
- DM type 2
- Gastric distension/rupture
- Death by choking
How do you confirm diagnosis of ALL?
bone marrow biopsy shows presence of >25% lymphoblasts
What is the classic triad of Hemolytic Uremic syndrome? (HUS)
- Uremia
- Thrombocytopenia
- Hemolytic Anemia
maternal lupus is associated with what?
first degree AV block
what does apgar stand for?
Activity Pulse (0 points for 0 pulse, 1 point for less than 100) Grimace Appearance Respiration
Large anterior fontanelle is seen in what instances?
- Hypothyroidism
- Osteogenesis imperfect
- Some chromosomal abnormalities
When does the anterior fontanelle close?
9-12months
large tongue in newborn assoc w what 3 disease?
- Downs
- Hypothyroidism
- Beckwith Wiedemann syndrome
omphalocele versus gastroschisis- main difference?
omphalocele is covered by an amnioperitoneal membrane!
immediate care of newborn with omphalocele or gastroschisis?
sterile wrapping of the bowel to preserve heat and minimize insensible fluid loss
omphalocele versus gastroschisis- which one is assoc with other congenital abnormalities?
omphalocele
what is the most common cause of infantile febrile seizures?
HHV-6 aka Roseola aka Exanthema subitum aka sixth disease
what is the most common extracranial solid tumor of childhood?
neuroblastoma NBL (median age of diagnosis = 2)
in TOF what is the most important factor in determining the severity of symptoms?
the degree of pulmonary stenosis
which vaccine is most likely to cause delayed fever?
MMR
what is the most common long-term sequelae of meningitis?
hearing loss
what is the causative organism of congenital rubella infection?
toga virus
what are the 3 symptoms seen in McCune-Albright syndrome?
- Precocious puberty
- Cafe au lait spots
- multiple bone defects
+ endocrine disorders
What are craniopharyngiomas derived from?
epithelial remnants of Rathkes pouch
cyclical vomiting syndrome is high in pts who have what family history?
parentts have migraines!
how does one differentiate between transient synovitis and legg-calve-perthes disease?
transient synovitis usually follows a viral infection and symptoms resolve within 1-4 weeks, LCP have symptoms for >1 month
what is the classic triad of a brain abscess?
- Fever
- Nocturnal or morning HA severe
- Focal neurologic changes
inheritance of duchennes MD?
x-linked recessive
when does beta thalassemia usually present? ie what age?
presents at 6-12 months of age
at what age does sickle cell disease usually present? why?
after 6 months, bc the presence of HgF protects the infants from sickling during the first 4-6 months of life
what is the treatment for immune thrombocytopenia and when should you intervene?
Corticosteroids: used in all age groups for thrombocytopenia less than 30,000 and/or for severe symptoms
what is a side effect of oral erythromycin in newborns?
hypertrophic pyloric stenosis
what are 3 earlier complications of measles? what are 2 late complications?
Earlier: 1. Pneumonia 2. Vitamin A deficiency 3. Bronchiectasis Late: 1. Immunosuppression 2. Subacute sclerosing panencephalitis
What virus causes measles?
paramyxovirus
WHat virus causes roseola infantum?
HHV-6
What virus causes rubella?
togavirus
what virus causes erythema infectiosum?
parvovirus
what virus causes croup?
parainfluenza virus type 1 (most commonly)
almost 90% of viral meningitis are caused by what two viruses?
non-polio enteroviruses like
- Echovirus
- Coxsackie
