Random Peds Stuff 3 Flashcards
What is the best way to prevent epiglottis?
Immunization against HIB (haemophilus influenzae type b)
What is hypertrophic cardiomyopathy?
left ventricular hypertrophy and normal camber size without a clear etiology
What is the physiology behind hypertrophic cardiomyopathy?
due to asymmetrical left ventricular hypertrophy leading to left ventricular outflow tract obstruction (LVOT)
14 year old African American boy whose brother died on a hiking trip. Carotid pulse with dual upstroke. Systolic ejection murmur along left sternal border with strong apical impulse. What is the diagnosis?
Hypertrophic cardiomyopathy
What happens to preload and afterload during squatting
both increase
what happens to preload and afterload during sustained handgrip?
increased afterload only
What happens to preload and after load during passive leg raise?
increased preload only
what does valsalva do to the murmur intensity of HCM
valsalva decreases preload, increases murmur intensity
What does sustained hand grip, squatting and passive leg raise due to murmur intensity of HCM?
decreases it
Describe the physiology behind why increasing preload or afterload decreases the intensity of the murmur in HCM
increases LV cavity size and thereby decreases outflow obstruction, decreasing the intensity of the murmur.
When is varicella vaccine given?
at age 1 and 4 years
When is the varicella vaccine contraindicated?
- in pregnant women
- immunocompromised hosts
- neonates
If a pregnant woman is exposed to varicella, what can be done to protect her?
give varicella immunoglobulin ASAP within 10 days of exposure
Describe the pathophysiology of meckel’s diverticulum
incomplete obliteration of the fetal vitelline (omphalomesenteric) duct. Most diverticula contain gastric tissue that secrets HCL causing mucous ulceration and bleeding
Clinical features of biliary atresia
initially well-appearing, followed by development of the following over 1-8 weeks
- jaundice
- acholic (pale) stools or dark urine
- hepatomegaly
- conjugated hyperbilirubinemia
- mild elevation in transaminases
what is the gold standard for diagnosis of biliary atresia
intraoperative cholangiogram showing biliary obstruction
what is the treatment for biliary atresia ?
Hepatoportoenterostomy (kasai procedure)
What is the first step in evaluation when suspecting biliary atresia?
u/s showing absent or abnormal gallbladder
jaundice that appears in the first 24 hours of life and resolves within the first week
physiologic jaundice
nephrotic syndrome features
- edema
- fatigue
- proteinuria
- absence of hematuria
- hypoalbuminemia
What is the usual paediatric aetiology of nephrotic syndrome?
minimal change disease
What are the usual adult aetiologies of nephrotic syndrome
- membranous nephropathy
- focal segmental glomerulosclerosis (FSGS)
What is a major risk factor for membranous nephropathy?
hepatitis B infection
HBsAG - positive
HBeAg - negative
anti-HBsAg antibody -negative
active hepatitis B infection
