Random pediatric facts

Question 1

Noninfectious cause of vulvovaginitis

Answer 1

Sarcoma botryoides (rhabdomyosarcoma)
-malignant lesions that have appearance of bunches of grapes

Question 2

Congenital diaphragmatic hernia associations

Answer 2

Pulmonary hypoplasia

Pulmonary HTN

Question 3

Omphalocele associations

Answer 3

Beckwith-Wiedemann syndrome

Trisomies

Question 4

Double bubble sign on X-ray

Answer 4

Duodenal artresia (air bubbles in stomach and duodenum proximal to site of artresia)

Question 5

Salmon colored macular rash

Answer 5

Juvenile Idiopathic Arthritis

Question 6

Salmon colored macular rash

Answer 6

Juvenile Idiopathic Arthritis

Question 7

Kawasaki disease symptoms

Answer 7

CRASH and BURN
Conjunctivitis
Rash
Adenopathy
Strawberry tongue
Hands and feet are red, swollen, and have flaky skin
BURN: fever > 40 for > 5 days

Question 8

Difference between Kawasaki and Scarlet Fever

Answer 8

Both may have strawberry tongue, fever, rash, desquamation of hands and feet, and erythema of the mucous membranes
But children with scarlet fever DO NOT have conjunctivitis and have normal lips

Question 9

Kawasaki’s disease diagnosis

Answer 9

The acute phase of Kawasaki lasts 1-2 weeks and presents with:
-fever > 40; bilateral, nonexudative, painless conjunctivitis (sparing the limbic area); polymorphous rash (truncal); cervical LAD (painful, unilateral); strawberry tongue with red, chapped lips; erythema of palms and soles with late desquamation of the fingertips; sterile pyuria, gallbladder hydrops, hepatitis, arthritis

Subacute: after the abatement of fever, lasts for 2-3 weeks; thrombocytosis and elevated ESR; begin to develop coronary artery aneurysms

Chronic: lasts until ESR returns to baseline; untreated children are at risk of aneyrusmal expansion and MI

Question 10

Tx of Kawasaki

Answer 10

IVIG + high dose ASA
-the IVIG prevents aneurysms and ASA treats inflammation and fever

Low dose ASA then continued x 6 weeks

Children with coronary aneurysms may require chronic anticoagulation

Question 11

APGAR score

Answer 11

0, 1, or 2 points in each category
Appearance (blue/pale, pink trunk, all pink)
Pulse (0, 100)
Grimace with stimulation (0, grimace, grimace and cough)
Activity (limp, some, active)
Respiratory effort (0, irregular, regular)