Prep 3 Flashcards
How does Necator americanus (hookworm) infect humans? Like how do you get it?
through the soil
so by being barefoot in endemic areas like really it’s all over the world actually
Name two hookworms
Necator amercanus
Ancylostoma duodenale
How do you diagnose hookworm?
will see the eggs on microscopy
of stool O+P
Blank infections (Necator americanus, Ancylostoma duodenale) are transmitted through soil, often during barefoot outdoor activities in endemic regions.
hookworm
Symptoms of hookworm infection
either asymptomatic or
microcytic anemia
and also eosinophilia will be present on CBC
This infection presents with intense anal pruritis
PINworm
aka enterobius vermicularis
How is giardia transmitted
can be waterborne, foodborne or transmtted via fecal-oral route
Giardia exists in 2 forms, which are
cyst and trophozoites
it’s a protozoa
How to diagnose giardia
a few options:
-antigen assay
-nucleic acid amplification test
-or stool microscopy detecting cyst and trophozoites
Name two tapeworms. What are their symtoms?
Taenia saginata (beef tapeworm)
Taenia solium (pork tapeworm)
get infected when eat undercooked meat infected with the tapeworm
symptoms are N/V and epigastric pain
Stage 1 hypertension in adolescents definition
same as adults
130/80 is stage 1 htn
and 140/90 is stage 2 htn
120 SBP is still considered elevated BP
NORMAL is LESS THAN 120
When to start bp meds for adolescents with essential htn:
stage 2 htn (so bp of 140/90 or higher)
stage 1 not responsive to life style modifications
symptomatic
or any evidence of end organ damage (like LVH)
What is “little league shoulder?”
= when a baseball pitcher who is not skeletally mature throws so much that the proximal humeral physis widens and gets a stress fracture. It’s the weak link – where as in adults the weak link is the rotator cuff.
tx: don’t throw for 3 mo. rest
Infants with ischemic perinatal stroke should be evaluated for these two things
thrombotic disorders
congenital heart disease
Which blood vessel is most commonly affected in ischemic perinatal stroke?
left middle cerebral artery
Besides fluoxetine, what is the one other med that is FDA approved for the treatment of depression in adolescents?
Escitalopram (which is also an SSRI)
Decreases in these three hormones/neurotransmitters are associated with increased aggression
decreased serotonin, oxytocin and GABA
Increases in these three hormones/neurotransmitters are associated with increased aggression
vasopressin and dopamine
The most compelling and successful method of engaging clinicians in quality improvement endeavors is to…
regularly provide them with specific data and frequent reminders to promote process change.
Patients with psoriasis are at increased risk of developing this other medical conditoin
metabolic syndrome
huh, interesting
The most strongly associated comorbidity of psoriasis is
obesity
huh, interseting.
For neonates born to Hep C positive moms, what test should you get at 18 mo?
Hep C antibody test
Glycogen storage disease type 5 (V) is also known as
McArdle disease
Classic feature of McArdle disease
second wind phenomenon
Symptoms of McCardle disease, aka glycogen storage disease type 5
AR disease where adolescents present with exercise intolerance, fatigue/pain/cramps in muscles after exercise or during, second wind phenomenon, and can get recurrent episodes of myoglobinuria after exercise
when not exercising tho they are typically totally fine
Glycogen storage type 2 other name
Pompe disease
remember this because there are two types: infant onset nad late onset
How does glycogen storage disease type 1 present?
in the first few months of life with FTT, severe hypoglycemic episodes, seizures and developmental delay
The 2 forms of Pompe disease (aka GSD type 2) are…
infantile onset: hypotonia, FTT and hypertrophic cardiomyopathy before age 1
late onset: proximal muscle weakness and respiratory insufficiency (no cardiac involvement)
Kids who get cochlear implants are at risk for what type of meningitis specifically
strep pneumo
so if over age 2, they should get the PPSV23 vaccines
Kids who get cochlear implants are at risk for what type of meningitis specifically
strep pneumo
so if over age 2, they should get the PPSV23 vaccines
The PPSV23 vaccine is also called….
the pneumococcal polysaccharide vaccine
What are the two types of pneumococcal vaccines and how are they different?
Standard one that all babies/toddlers should get 4 doses of is the pneumococcal conjugate vaccine. It’s also called PCV13 (stands for pneumococcal conjugate vaccine). It is made of polysaccharide antigen CONJUGATED to a protein carrier (which is actually Diptheria toxin) as a way to deliver the antigen to the body
The other type is the pneumococcal POLYSACCHARIDE vaccine. It is also called the PPSV23 and protects against 23 serotypes.
What causes herpangina and what are the symptoms?
Caused by coxsackie viruses.
= affects the oral mucosa and presents with painful vesicles in the mouth, fever, and sore throat
kids ages 3-10 most commonly get it
Coxsackie virus is a type of
enterovirus
(polio and echo virus are other types of enterovirus)
Vesicular rash on hands and feet + oral vesicles =
Hand foot and mouth disease
caused by coxsackie virus
If a preterm infant fails the car seat test, the next step should be
a car bed test
What is strabismus?
= eye misalignment
will cause a lazy eye on exam
What is pseudostrabismus?
= when the eyes are both properly aligned, but one of the properly aligned eyes APPEARS misaligned due to a wide nasal bridge, prominent epicanthal folds, etc.
Do children with pseudostrabismus need to be referred to ophtho?
No!
But children with strabismus do, so they can get treatment to optimize their visual outcome
What is the difference between latent and manifest strabismus?
latent means it’s only revealed when doing certain maneuvers like the cover/uncover test
manifest means it’s manifesting all the time, constantly present
latent–use the word phoria
manifest – use the word tropia
Esophoria vis esotropia
both mean medial misalignment of the eye
but esophoria means only sometimes present
and esotropia means ALWAYS present
(exo refers to lateral misaligment)
What is amblyopia?
= loss of visual acuity caused by a disruption of the cortical visual pathway that exists between the eye and brain in early childhood
has multiple causes, such as manifest strabismus, retinoblastoma, congenital cataracts, high refractive error, etc.
The danger of not treating manifest strabismus is that it can result in
amblyopia
Pathophys of why strabismus can cause permanent vision damage
When children have strabismus, eye misalignment causes incongruent visual input to the brain (ie, “double vision”); the brain learns to “ignore” input from the affected eye. If not corrected before age 7 ish, this will become permanent.
