Random Flashcards
what are the rule of 2’s in Meckel’s diverticulum?
2 feet from ileocecal valve 2 in long 2 times more common in males 2% of population 2% develop complication over course of their lives
what conditions mimic acute appendicities
Yersinia enterocolitis mesenteric adenitis constipation crohn's meckel's ectopic pregnancy UTI ovarian torsion
what murmur is associated with marfan ?
aortic root dilatation leading to diastolic decrescendo murmur (aortic insufficiency)
can also have mitral valve prolapse
can lead to aortic dissection
what is DiGeorge syndrome
facial features
- low-set ears
- eyes wide apart
- palate anomalies
- widened area below nasal bridge
- short philtrum
- micrognathia
cardiac lesion
- abnormal heart sounds
- murmur
- right sided aortic arch
- conotruncal anomalies
No thymic shadow seen on CXR
Hypocalcemia- parathyroid hypoplasia - (tetancy, seizures)
results from failure of the third and fourth pharyngeal pouches
**lots of viral and fungal infections b/c of lack of thymus
what are the common conotruncal anomalies associated with DiGeorge
transposition of great vessels, truncus arteriosus, right sided aortic arch
by age 12 months, infants should weigh how much compared to birth weight
3 times
what is the point of substituting medium chain triglycerides for long chain triglycerides in a babies diet?
if a baby has malabsorption and steatorrhea this will help because MCTs do not require bile acids for absorption.
preterm infants have steatorrhea b/c of poor absorption of fat due to small bile acid pool
what is a mongolian spot
hyperpigmentation found in 66% of all infants of hispanic, asian and native american ethnicity
sometimes mistaken for bruise
vomiting in a 10 month old, with lethargy, dehydration, full anterior fontanelle , no diarrhea, posturing
administer dexamethasone to decrease the intracranial pressure
most likely a brain tumor
resp tract infection neonatal jaundice recurrent bronchiolitis nasal polyps chronic diarrhea features of malabsorption meconium ileus recurrent sinus infection
cystic fibrosis
obstructive airway disease
clubbing
what antibiotics do you use for CF treatment
tobramycin plus antipseudomonal (ticarcillin/piperacillin)
tobramycin pluse third gen cephalosporin (cefepime, ceftazidime)
tobramycin plus carbapenem (imipenem/cilastatin, meropenem)
what antibiotic is used to cover pasturella multocida
penicillin is the treatment of choice, but rare isolates with B-lactamase activity have been reported.
amoxicillin-clavulanate helps with resistance
if penicilin allergy use azithromycin
dog/cat bites
symptoms occur within a 24 hour period
if you suspect a lactase deficiency in a kid, what test should you do
lactose breath test
Its prevalence
in subjects of Asian (Far-Eastern) extraction is at least 85%
sucrase-isomaltase deficiency is the most common congenital disaccharidase deficiency
what is the lactulose breath test used for
useful in evaluation of suspected bacterial overgrowth, particularly pt’s who have undergone prior bowel surgery and present with symptoms that suggest a blind or stagnant intestinal loop
what are watery, acidic stools indicative of
carbohydrate malabsorption
“thumb sign”)
epiglottitis
lateral radiograph
Affected patients typically
present between the ages of 2 and 8 years with the rapid onset of fever,
sore throat, and the “four Ds” (drooling, dysphagia, dysphonia, and
dyspnea). Patients often assume a position of comfort by sitting upright,
leaning forward, and bracing themselves with their arms, known as the
tripod position.
steeple sign
AP view of croup
what is the treatment for acute rheumatic fever in a peds patient
Penicillin G or 10 days of oral penicillin even if throat culture is negative
what are the major criteria for rhf
polyarthritis carditis subcutaneous nodules sydenham chorea erythema marginatum
what are the minor manifestations for RHF
fever
arthralgia
prolonged PR interval on ECG
Elevated acute phase reactants (ESR, CRP)
hyponatremia
postural hypotension
hyperkalemia
lack of response to cosyntropin stimulation test
plus
neurologic deficits -weakness, spasticity, dementia, blindness, quadraparesis
Adrenoleukodystrophy
x-linked disease where there is a mutation in the transportation of very long-chain fatty acids (VLCFA) into peroxisomes, thereby preventing beta-oxidation and breakdown of VLCFA
accumulation of VLCFA in neurons and adrenal cortex causes symptoms
adrenal stuff is usually detected before neuro stuff
hypotonia upslanting palpebral fissures epicanthal folds excess nuchal skin enlarged tongue clinodactyly of the fifth fingers single transverse palmar crease
trisomy 21
small palpebral fissures low set ears low birth weight microcephaly rocker bottom feet cleft lip hypotonia clenched hands
Edward syndrome (Trisomy 18)
what are the cyanotic diseases of the newborn
truncus arteriosus tricuspid atresia tetrology of fallot transposition of the great arteries total anomalous pulmonary return and pulmonary stenosis
what is rx for scabies
premethrin cream
what anomalies are associated with diabetes during pregnancy
small left colon anencephaly meningomyelocele cardiac- assymetric septal hypertrophy, transposition of great vessels, VSD -sacral agenesis renal vein thrombosis renal agenesis
what heart defect is associated with turner
coarc of aorta
rash that spreads from the trunk to the extremities and is particularly associated with high fevers ….
roseola infantum caused by human herpes virus 6
Patient presents with short stature, webbed neck, shield like chest and widely spaced nippled, no secondary sex characteristics…. what will the levels of FSH, LH and Estradiol be? What will a buccal smear show?
High FSH
High LH
Low estradiol
Buccal smear shows normal appearing epithelial cells with no barr bodies
Rx: Estrogen Therapy
Turner = XO
X-linked
causes low or absent numbers of B cells leading to panhypogammagloblulinemia
cellular immunity is intact
pt develops infections after approximately 6 months of age when maternal ab’s have decreased to low levels
recurrent infections
Bruton Agammaglobulinemia
eczema
thrombocytopenia
recurrent infection
Wiskott -Aldrich Syndrome
positive whiff test
gardnerella or bacterial vaginitis
Rx. Metronidazole
most common cause of neonatal meningitis
strep agalactiae - group B strep
other common bugs are e coli and listeria monocytogenes
consumptive thrombocytopenia
microangiopathic hemolytic anemia
fever
renal dysfunction
fluctuating neuro deficitis
thrombotic thrombocytopenic purpura
anemia, thrombocytopenia, leukopenia and/or bone pain, hepatosplenomegaly, lymphadenopathy
ALL
what eye findings are seen in neurofibromatosis
lisch nodules (iris hamartomas)
what skin findings are seen in tuberous sclerosis
ash-leaf macules facial angiofibromas (adenoma sebaceum) and shagreen patches (connective tissue nevi)
seizures are the most common presenting symptom
Cerebral calcification
facial nevus
glaucoma in the ipsilateral eye
seizures contralateral to the side of the nevus
sturge weber
freckling in the axillary or inguinal region
NF-1
history of neonatal jaundice recurrent bronchiolitis nasal polyps chronic diarrhea malabsorption meconium ileus
cystic fibrosis
antidote for iron poisoning
deferoxamine
what is the antidote for lead poisoning
EDTA + either DMSA or BAL (Dimercaprol )
with encephalopathy?
EDTA + BAL
most common pathogen in young children with CF
staph aureus
Rx. assume there is methicillin resistance and start vancomycin
what drugs can be used to treat pseudomonas in CF pt’s
amikacin
ceftazidime
ciprofloxacin
