pwdi 12 Flashcards
Sturge-Weber-Syndrome pathophysiology?
GNAQ gene mutation
CM?
Port-wine stain TN(V1 & V2) distribution Leptomeningeal capillary-venous malformation Seizures +/- Hemiparesis Intellectual Disability Visual field defect Glaucoma
Diagnosis?
MRI of the brain with contrast
management?
Leser therapy
Antiepileptic drug
Intraocular pressure reduction
Indication for immediate removal in case of esophageal foreign bodies?
Being high risk(2 magnets, battery, and sharp object)
Esophageal obstruction symptom
Respiratory conpromise
If a sharp object is observed in the distal to the first part of the duodenum?
Asymptomatic: repeat Cxr after 24-48 hr
If symptomatic: immediate removal
CM?
HTN in upper extremity
Low perfusion to the lower extremity (Dec. post ductal o2 sat., dec. femoral pulse and lower extremity claudication)
Heart failure
Palpable intercostal vessel
Systolic ejection murmur at left intercostal area
Low perfusion to the lower extremity?
1-Dec. post ductal o2 sat.,
2-Dec. femoral pulse
3-Lower extremity claudication
Heart failure symptoms?
Start to develop when DA began to close on day 3 Irritability Poor feeding Diaphoresis Cardiogenic shock Tachypnea
Treatment?
Surgical repair
When do we need cast after closed reduction in radial head subluxation?
If a patient is not able to have full for arme activity
NB: Hyperpronation with head compression is more successful than Flexion and supination.
When do we need an X-Ray?
Focal arm pain in age >5
High force injury, focal swelling, and deformity in age <5
But in 3-5 age X-ray difficult b/c poor ossification
cause of Premature adrenarche?
early activation of adrenal androgens
CM?
precocious puberty
normal bone growth
Complication?
T2DM
Metabolic syndrome
PCOS
most specific finding in AOM?
Bulging TM
Decrease TM movement
Middle ear effusion
Air fluid level
Pathophysiology of sunburn?
DNA damage
A complication of orbital cellulitis?
Visual loss(optic nerve) CNS extention(infection and CST)
Willms tumour(Nephroblastoma) CM?
The MC childhood malignancy Peak age 2-5 Usually asymptomatic Unilateral mass \+/- Abd.Pain, haematuria, and HYTN Mass arise from metanephros
Associated genetic disease?
WAGR
Beckwith-Widman-Syndrome
Danys-Drash-Syndrome
What about neuroblastoma?
MC age <5
HTN less common
Arise from the neural crest (maybe adrenal)
Pheochromocytoma?
Arise from adrenal
PKD?
Bilateral
Cyst on US
Serum sickness-like reaction etiology?
Immune complex
Antibiotics(Beta-lactam and CTM)
Acute hepatitis B
CM?
1-2 weeks after exposure Fever Rash Polyarteralgia LDP
Treatment?
Remove offending agent
Supportive care
Plasmapheresis/Corticosteroid
How to d/t from a rash of IM after Amoxaclin TX?
IN IM with Amoxapine
Rash not involve extremity
No artheralgia
LCPD and TS d/c?
TS: Symptome resolve within 4 weeks, able to bear weight
LCPD: More chronic and not bear weight
LCPD may have normal X-rays in early lesions like TS
Childhood depression-associated symptom?
Headache
Abdominal pain
CM of acute iron poisoning?
Abdominal pain Haematemesis Diarrhea Shock Hepatic necrosis
Diagnostic finding?
Anionic GAP metabolic acidosis
Elevated serum Iron
Radiopeque pills on Bdominal X-ray
Treatment?
Deferoxamine
Whole bowel irrigation
Shock and Iron poisoning?
Myocardial injury: Cardiogenic shock
Hepatic necrosis
Distributive shock due to systemic vasodilation
Abnormal aortic arch ring?
The abnormal second aortic arch formation that encircles the esophagus and trachea
CM?
Food impaction
Recurrent aspiration pneumonia
Biphasic stridor due to tracheal obstruction
Indentation around esophagus at T4
How d/t Asprin toxicity from IRON?
In Asprin toxicity
Tablet will not be visible
There will be tinitus
Spinal muscular atrophy(WHD) and botulism?
In WHD
Paralysis more on; lower extremity
Not affect pupil
IVH hemorrhage cause?
lesion on germinal matrix
CM?
Prematurity and LBW Seizure Apnea Bulging fontanel Acute Anemia Increase HC Bradycardia Lethargy and hypotonia
Diagnosis?
Cranial ultrasound
IVH hemorrhage cause?
lesion on germinal matrix
CM?
Prematurity and LBW Seizure Apnea Bulging fontanel Acute Anemia Increase HC Bradycardia Lethargy and hypotonia
Diagnosis?
Cranial ultrasound
