Q19$ Flashcards
Boy seemingly follows good diet and sleeps 9 hours but BMI is 97th percentile.
NBSIM
Because he’s over 95 it’s obesity
- obese children starting at 2 yo get fasting lipid Panel every 1-3 years
- obese Childern can get ALT to evaluate Nafld
-obese Childern can get a1c if risk factors for dm like family or acanthosis
Cerebral hemorrhage signs
- pathophysiology
Occipital headache which maybe radiating to neck and shoulders, neck stiffness, n/v, nystagmus, ipsilateral hemostasia of trunk (vermis or liken (cerebellar hemispheres)
HTN
MCCOD form IE
Heart failure
What to do urgent surgery in patients with IE
:
• Heart failure from valve dysfunction (as in this patient)
• Localized extension of infection (eg, abscess, fistula, heart block)
• Difficult-to-treat pathogens (eg, fungi, multidrug-resistant organisms)
• Very high risk of embolism (eg, large valvular vegetation (>1 cm]) or persistent septic embolization despite approprial antibiotic therapy
CSF rhinorrhea
Diagnostic
Complication
CHEck nasal discharge for CSF related proteins (beta2 transferrin, beta trace protein)
Meningitis due to nasal flora contaminating the CSF
Porcelain gallbladder
- complication
Gallbladder cancer
Postop patient is dehydrated, fasting, stresses Joe has unilateral throbbing headache , photophobia which they had before. Tried supportive F
(Fluids, dark room pain meds)
NBSIM
Migraine - Triptans
Antiemetics like promethazine or prochlorperazine
Long standing esrd stopped taking calcium and vitamin d due to elevated serum calcium
Labs today
Elevated ca? Phosphorous , pth
Cause of elevated calcium
Hyperplasia of parathyroid glands
Secondary hyperparathyroidism turned into tertiary because of long standing ckd. Chronic parathyroid stimulation lead to huperplasia causing autonomous pth secretion due to downregulated calcium sensing receptor and vitamin d receptor on the parathyroid glands .
Extremely high pth with high calcium and high phosphorous bc kidneys can’t excrete P
Prognosis of galactosemia
Good . End organ dysfunction resolves if diet doesn’t have galactose
In shock then has new bilateral pulmonary infiltrates
Diagnosis
Hypocemia correction with moderate flow oxygen
Lung compliance
Aa gradient
Sepsis caused by ARDs (pulmonary edema)
-fluid from the pulmonary edema fills the alveoli and causes the alveolar to collapse. If oxygen can’t get to the alveoli due to the pulmonary edema do doesn’t correct with oxygen. Aa gradient high
- bc mismatch
Hypocemia correction with moderate flow oxygen no
Lung compliance low (collapsed
Aa gradient increase
Hypoxemia correction with moderate flow oxygen
Aa gradient
Aa grad. Corrects
Reduced pio2 (high alt) N. Yea
Hupovent (cns dep, obese)N. Yea
Diffusion limitatio (emphy Inc Yea
Vq mismatch (pna, pe). I. Yes
Shunt diffuse pul edema ARDs I. No
dead space ventilation I no
Nephrotic syndrome complications
Accelerated atherosclerois is due to hyperlipidemia (mi and stroke), loss of anti thrombin 3 - thrombosis of arteriovenous leading to stroke and mi
<2 yo with cough and nasal congestion and increased work of breathing (tachypnea and retractions . Pe- wheezing and crackles
NBSIM
Discharge and close follow up only
- bronchiolitis caused by RSV
10 month old (6 mo- 3 years has abdominal pain and bright red stools . Other kids in day care have runny nose , vomiting and diarrhea over the past week . Fecal testing is positive for blood
Diaganosis
Diagnostic treatment
Intussusception/- recent viral illness or rotavirus vaccination, meckle diverticulum, HSP
Dx: US- target sign of telescoped bowel
Tx- air or saline enema is diagnose and therapeutic
