Random Uworld 8/12 Flashcards
Osteomyelitis without fever or leukocytosis?
Sure
Indolent
Tenderness is best sign
another urease producing bacterium that can cause alkalotic urine and struvite stones other than proteus
Klebsiella
also urease producing and urine alkalinizing
antigen 19-9 is…
pancreatic cancer… not sensitive enough for screening
TF
abstain from coitus with placenta previa, even early at 20 weeks
T
penile contact with cervix can disturb… cervix does not have to be dilated
no digital vaginal exams either
guy with history of asthma gets MI, started on aspirin metoprolol and lisinopril, gets a cough
which med responsible for cough
any of them
aspirin can exacerbate asthma especially with chronic rhinitis and nasal polyps
cardioselective beta1 blockers not as likely as non-selective but still can exacerbate asthma
acei angioedema you know
TF
need fever and guarding/rebound tenderness to suggest spontaneous bacterial peritonitis
F
temp ^100.0
abdominal pain/tenderness but does not have to be peritonitic
how can spontaneous bacterial peritonitis manifest on abdominal xr
why
dilated loops of large bowel with air in colon and rectum
paralytic ileus
sounds PID-ish but now there is pleuritic RUQ pain
think
treat
perihepatitis/fitz-hugh-curtis disease from PID (GC)
treat the PID with hospitalization and the usual (ceftri plus azythro or doxy)
you are thinking acute viral hepatitis for RUQ pain with recent travel… what skin and stool findings do you look for
jaundice
changes in stool color
why can get hypotension with epidural in labor
bock nerves including sympathetics, vasodilation, venous pooling
pt v40yo, low back pain worse at night improves with exercise, dyspnea on exertion, inflammation at tendon insertions, systemic fever chills weight loss fatigue, eye pain photophobia blurry vision… maybe even IBD or aortic regurge….
think
PFTs
serum marker
ankylosing spondylitis
sacroiliitis limited spine mobility and chest (fixed chest but not pulmonary fibrosis usually, but sometimes) expansion enthesitis uveitis
restrictive pft pattern
HLA-B27 serum marker
pernicious anemia demographic disease association tongue findings neuro findings smear smear if severe
most common cause of B12 deficiency in Whites with
Northern European backgrounds especially
AI disease - eg thyroiditis and vitiligo
shiny tongue (atrophic glossitis)
shuffling broad based gate (ataxia) and position and vibratory sense abnorms
megaloblastic anemia - megaloblasts and hypersegmented neutrophils
thrombocytopenia and leukopenia too if severe
how many years of pure vegan diet to delete b12 stores (b12 found only in meat and dairy)
5 years
2 major side effects of isoniazid
peripheral neuropathy and hepatotoxicity
megaloblastic anemia atrophic glossitis (shiny tongue) vitiligo thyroid disease neurologic abnormalities
think
what demo
pernicious anemia
whites with northern european ancestry
Normal post void residual (ml) male vs female
v50 male
v150 female
Preggo confusion falling nausea vomiting nystagmus low chloride high bicarb… maybe hypokalemia hypoglycemia elevated transaminases
Think
Treat
Wernicke encephalopathy -ams gait ataxia nystagmus From thiamine deficiency From hyperemesis gravidarum -dehydration, hypochloremic hypokalemic metabolic alkalosis elevated transams from vomiting
Treat with fluids antiemetics Thiamine Then glucose
Suspect acute fatty liver of pregnancy given nausea vomiting hypoglycemia elevated transaminases starting when in pregnancy
3rd trimester for acute fatty liver of pregnancy… so after like 24 weeks
Young woman knee pain xr shows expansile and eccentrically placed lytic lesion of epiphysis of distal femur or proximal tibia aka _____ appearance
suggests
Prognosis
Treatment
aka “Soap bubble” appearance
(expansile and eccentrically placed lytic lesion of epiphysis of long bone)
Giant Cell Tumor of Bone
(tumor of osteoclasts)
Benign but locally aggressive
Curettage and bone grafting
Hyperparathyroidism from parathyroid carcinoma causing widespread bone resorption and replacement with fibrosis (brown tumors) describes this condition
Osteotis fribrosis cystica
Sclerotic cortical bone lesion with central lucency, pain worse at night not related to activity, improves with nsaids suggests
Osteoid osteoma
Fetal growth restriction defined by what weight percentile
v10th percentile
TF
well controlled hypertension in pregnancy can still cause fetal growth restriction
What pattern of fgr does hypertension cause
T
even well controlled can still cause spiral artery abnorms and fgr
Assymmetric fgr (abdomen relatively smaller than head… because abdominal growth happens 2nd 3rd trimesters and if htn or another placental insufficiecy blood to head and chest will be prioritized
vs Symmetric fgr in congenital disorders or infections
TF
Caffeine assoc with fetal growth restriction
F
Not caffeine… Smoking alcohol cocaine though yes
4 main substrates for gluconeogenesis
Where they come from
Where they enter pathway
Alanine from muscle breakdown, converted to pyruvate
Glutamine from muscle breakdown, enters kreb cycle
Glycerol3phosphate, from fat breakdown, enters higher up than pyruvate
Lactate from anaerobic metabolism, converted to puruvate
TF
Intensive bp control for diabetic nephropathy
T
The most important factor to slow progression
v130/80 for diabetic nephropathy
v140/90 for dm in general
So start acei arb (carefully because can acutely decrease gfr)
How to know large axonopathy vs small axonopathy in diabetic neuropathy
Small axonopathy positive symptoms pain paresthesias allodynoa
Large axonopathy Negative symptoms numbness loss of vibratory and proprioception loss of ankle reflexes
What serum pH to give bicarb for gap metabolic acidosis for underlying reason that has been resolved (eg seizure since stabilized)
v7.1 give bicarb
Otherwise recheck q2h… should resolve unless underlying reason not addressed yet
4 compx of epo administration
Worsening htn
Headaches
Flu-like symptoms
red cell aplasia rare
Give epo in ckd if hb and hct are
v10 or 30%
Differentiate
Hashimoto thyroiditis
Painless thyroiditis
Dequervain thyroiditis
By Aka hypo vs hyperthyroid symptoms Tenderness TPO antigen positivity RadioIodine uptake ESR CRP elevation
Hashimoto thyroiditis - chronic autoimmune thyroiditis, hypothyroid, tpo ab positive, riu variable
Painless thyroiditis - silent thyroiditis (variant of chronic ai hashimoto thyroiditis), mild brief spontaneously recovered hyperthyroid, nontender, positive tpo ab, low riu
Dequervain thyroiditis - subacute granulomatous thyroiditis, postviral fever and hyperthyroid, tender, elevated esr crp, low riu
Graves is ___thyroidism
Graves is HYPERthyroidism
Strumaovarii is ___toxicosis from __ production by ___
Strumaovarii is THYROtoxicosis from THYROID HORMONE production by OVARIAN TERATOMA
How to decide if esophageal injury from caustic ingestion in hemodynamically stable patient requires supportive care or tube feeds and possible surgery (esophagectomy)
EGD within 12-24 hours to assess extent if damage
TF
Activated Charcoal for Lye ingestion
F
Lye (hydroxide, alkalai) causes mucosal contact damage, not systemic absorption damage
Activated charcoal prevents systemic absorption poison damage
Follow up atypical glandular cells on pap
What are you evaluating for
Colposcopy
Endometrial curettage
Endometrial biopsy
Cervical OR Endometrial Adenocarcinoma
LEEP is a type of ____ that removes the ____
LEEP is a type of Cone Biopsy that removes the Transformation Zone
Pork consumption or travel
Seizures
Ring enhancing, non enhancing, and calcified brain mri lesions
Think
Treat
NeuroCysticercosis
Albendazole
(diff brain lesions depending on stage of cyst)
MAC
symptoms
Treatment
GI and Pulm symptoms
Clarythromycin and Ethambutol
(but ppx with azythromycin…)
TF
TB can have a diffuse reticulonodular pattern on cxr
T
Miliary tb
Mycoplasma pna symptoms usually limited to ___ weeks
2-3 weeks
treat old guy with ams glucose 1000 normal pH bicarb gap
Stepwise, Most Important Initial Step
HHS
1 AGGRESSIVE NS IV FLUID REPLACEMENT
-very hyperosmolar which prob also caused tons diuresis and dehydration so THIS FIRST
2 IV IV IV IVIVIVIV INSULIN
3 Watch K supplement if v5.3
Follow up atypical glandular cells on pap
What are you evaluating for
Colposcopy
Endometrial curettage
Endometrial biopsy
Cervical OR Endometrial Adenocarcinoma
LEEP is a type of ____ that removes the ____
LEEP is a type of Cone Biopsy that removes the Transformation Zone
Pork consumption or travel
Seizures
Ring enhancing, non enhancing, and calcified brain mri lesions
Think
Treat
NeuroCysticercosis
Albendazole
(diff brain lesions depending on stage of cyst)
MAC
symptoms
Treatment
GI and Pulm symptoms
Clarythromycin and Ethambutol
(but ppx with azythromycin…)
TF
TB can have a diffuse reticulonodular pattern on cxr
T
Miliary tb
Mycoplasma pna symptoms usually limited to ___ weeks
2-3 weeks
treat old guy with ams glucose 1000 normal pH bicarb gap
Stepwise, Most Important Initial Step
HHS
1 AGGRESSIVE NS IV FLUID REPLACEMENT
-very hyperosmolar which prob also caused tons diuresis and dehydration so THIS FIRST
2 IV IV IV IVIVIVIV INSULIN
3 Watch K supplement if v5.3
15 yo girl concerned about what is porbably a fibroadenoma of the breast. Reassure and do nothing or follow up after next menses?
Follow up
If improved reassure
If persistent, ultrasound. If fibroadenoma, reassure
Treat woman with breast engorgement seeking lactation suppression after her baby died
Bra
Ice packs
Nsaids
Avoid stim
No medical suppression – engorgement provides its own negative feedback and suppression will happen
And eg bromocriptine dopamine agonism has side effects
What to do for kid with elevated led level oncapillary fingestick
Get a venous lead level to confirm elevation
fingerstick can grt false positives
Lead chelation therapy for kid
VENOUS (for confirmation after initial capillary fingerstick) lead level ^45 dimercaptosiccinate
^69 or encephalopathy dimercaptosuccinate DMSA And dimercaprol EDTA
Fluorourocil cream is used for
Actinic keratosis
Or
Bowen’s disease (SCC in situ)
And other Low Risk SCC lesions
TF
Falling with an object in the mouth can cause unilateral hemiplegia via carotid artery dissection
T
Marfanoid, lens dislocation, intellectual disability, arterial or venous thrombi
Think
Homocysteinuria
How does maternal diebetes cause neonatal rds
Insulin suppresses cortisol
So less surfactant production
How do intrauterine growth restriction a d maternal htn affect neonatal rds
Decrease chance of rds…
TF ocp’s cause htn
T
They can
So in 39yo nononese lady with htn consider change
Buspirone treats
Buspirone treats GAD generalized anxiety disorder
Holosystolic 2/6 llsb murmur and an apical diastolic rumble in a tired skinny kid think
VSD
most common congenital heart defect
Holosystolic murmur is thru vsd
Diastolic rumble is increased flow across mitral
Pulm htn from rl shunt, later tired and sob like this kid from eisenmenger rl shunt reversal
Symptoms of cyanide poisoning
Headache vomiting abdominal pain flushed skin… butter almond odor if inhaled
Symptoms of tca toxicity
Neuro, cardiac, anticholinergic
Bedwetting is normal till age __ and merits no intervention before that time
Bedwetting is normal till age 5 and merits no intervention before that time
Eosinophilia with gi symptoms and
Myalgias with high ck and periorbital edema
Vs
Pulmonary symptoms
Think
Trichinillosis
vs
Ascariasis
Fever in first week
Abd pain and salmon rash second week
Hepatosplenomegaly and abdominal complications third week
Vs
Fever headache retroorbital pain rash myalgias arthralgias maybe skin or nose hemorrhage
Think
Typhoid fever
Vs
Dengue fever
Hematuria in
Adult within 5 days of uri, mesangial deposits
Vs
Kid 2 weeks after uri, low c3 complement, anti aso and anti dnaseb titers, subepithelial humps
IgA nephropathy
Vs
PSGN or PIGN post strep or post infectious
Xlinked collagen iv defect
Hearing loss, ocular abnormalities, hematuria, renal failure
Thinning of glomerular basement membrane
Think
Alport syndrome
Anti glomerular basement membrane disease
Vs
Goodpasture syndrome
Antigbm is igs against gbm that can cause rpgn or alveolar hemorrhage
Goodpastures syndrome is subtype when both occur, pulmonary renal syndrome
TF
Opioid withdrawal can have psulychotic delusions and resolve in a short ed stay
F
No delusions
3-5 day recovery
Think more amphetamine intoxication
How does hypomagnesemia cause hypocalcemia
Hypomag causes resistance to pth and decreased pth release
Schizo on mri
Atrophy of caudate think
Orbitofrontal cortex and basal ganglia abnorms think
Schizo on mri - ventricular enlargement, shrunk hippocampus and amygdala
Atrophy of caudate think Huntingtons
Orbitofrontal cortex and basal ganglia abnorms think OCD
TF
Sarcoidosis causes proteinuria
F Lung heart skin eye Hilar adenopathy Systolic or diastolic heart dysfunction E nodosum Uveiitis
Trear old guy with meningitis vs transplant with meningitis
Old guy vanc ceftri amp (strep nmening list)
Immunocompromised vanc amp cefipime (strep list nmening gnrs)
Plus dexamethasone till strep pneumo (deafness risk) ruled out
Ceftri = cefotaxime = 3rd gen ceph Amp = tmpsmx for listeria cover Cefipime = ceftazidime or meropenem
What cd4 count is immunocompetent enough to get live attenuated vaccines
^200 is good enough
Diagnose duchenne muscular dystrophy
Muscle biopsy?
Genetic testing
X linked Xp21 dystrophin gene
Muscle biopsy is supportive not difinitive
Fever malaise polyarthralgias maculopapular rash leukopenia thrombocytopenia after tropical travel think
Vector
Treatment
Chikengunya fever
Mosquito born virus
Supportive care
Guy stepped on nail
How do you treat for tetanus
Give Tdap if last vaccine ^10 years ago anf wound clean, ^5 years ago and wound dirty, or less than 3 doses and wound clean
Add ivig if less than 3 doses and wound dirty, or to treat active tetanus infection
What tremor does trihexyphenidyl treat
Parkinsons
(Anticholinergic used in young or early parkinsons
Fetal macrosomia
Omphalocele
Macroglossia
Hemihyperplasia
Diagnosis
Pathogenesis
Complications
Surveillance
Beckwith wiedemann syndrome
11p15 imprintment dysregulation
Wilm’s tumor, Hepatoblastoma
AFP, abdominal/renal ultrasound
Greater risk factor for aortic dissection
Atherosclerosis or HTN
HTN
4 symptoms of Li toxicity
Tremor hyperreflexia ataxia seizures
3 symptoms of phenytoin toxicity
NYSTAGMUS confusion ataxia
Greatest risk for cerebral palsy
Premature birth
Then other prenatal neuro insults
Disseminated gonococcus symptom triad
Polyarthralgia
Tenosynovitis
Vesiculopustular skin lesions
Selection bias includes inappropriste selection Or poor ___
poor Retention is also included in Selection Bias
Attrition bias is a subtype of ___ bias
Attrition bias is a subtype of SELECTION bias
TF
SSRI’s can cause SIADH in elderly
T
TF
SSRI’s can cause SIADH in elderly
T
HIV screening test
HIV P24 ANTIGEN and HIV ANTIBODIES
Benztropine is a _____ drug used to treat ____ side effects of ____ drugs
Benztropine is a ANTICHOLINERGIC drug used to treat EXTRAPYRAMIDAL side effects of ANTIPSYCHOTIC drugs
Cyproheptadine is a ____ drug used to treat severe ____
Cyproheptadine is a SEROTONIN ANTAGONIST drug used to treat severe SEROTONIN SYNDROME
Central retinal artery occlusion is emergently treated with
Ocular massage (to monilize clot more distally
And hyperbaric oxygen
Fever sore throat malaise headache lymphadenopathy (widespread, particularly EPITROCHLEAR SAILORS HANDSHAKE)
RASH GENERALIZED INCLUDING PALMS AND SOLES
Gray mucous patches
Condyloma lata
Dx
Tx
Secondary syphilis
Penicillin G - 1 intramuscular dose (lasts 3 weeks)
Confirm adequacy with 4x decrease in serologic titers at 6-12 months
Early symptomatic meningitis then Late Generalized paralysis, Dementia, Personality changes, argyll robinson pupil loss of dtr’s lost vibratory and positional sense (tabes dorsalis) Aortic aneurysm/insufficiency
Cutaneous gummas
Dx
Tx
Tertiary syphilis
Penicillin G - 1 intramuscular dose (lasts 3 weeks)
Confirm adequacy with 4x decrease in serologic titers at 6-12 months
Palm and sole rashes
Syphilis - starts at trunk generalizes including palms and soles
Rocky mountain spotted fever - starts palms somes peripherally spreads centripitally
LP CSF in MS
Oligoclonal bands
Normal cell count, t cell prediminance, total protein, but high proportion of Ig’s
Albuminocytologic dissociation in LP CSF
Means
Think
Means high protein normal cell count
Think Guillan Barre syndrome
14-3-3 protein in csf lp
Rapid dementia personality changes
Startle myoclonus
Dx
Prion disease (creuztfeldt jakob)
Pruritic tense bullae on flexural surfaces groin acilla, subepidermal cleavage, IgG deposits in basement membrane on immunofluorescence
Dx
Bullous pemphigoid
Antibodies to desmosomes Flaccid bullae and ulcers Mucosal erosions Nikolsky sign sloughing with rubbing Intraepidermal cleavage Acantholysis (detached keratinocytes) Tombstone cells along basal layer Netlike Chickenwire intercellular IgG
Dx
Tx
Pemphigus Vulgaris
Steroids
Wound care
Pruritic tense bullae on flexural surfaces groin acilla, subepidermal cleavage, IgG deposits in basement membrane on immunofluorescence Vs Antibodies to desmosomes Flaccid bullae and ulcers Mucosal erosions Nikolsky sign sloughing with rubbing Intraepidermal cleavage Acantholysis (detached keratinocytes) Tombstone cells along basal layer Netlike Chickenwire intercellular IgG
Dx
Bullous pemphigoid
Vs
Pemphigus vulgaris
Treat rhino orbital cerebral mucormycosis/rhizopus
Debride Amphotericin B (liposomal) Treat dka (if present, usually that or less commonly another form of immunocompromise)
Chronic oligoarthritis Daily fever Rash, macular, with fever Leukocytosis Thrombocytosis anemia Elevated ESR CRP In kid
Dx
Juvenile Idiopathic Arthritis
IUD for woman with heavy menses and anemia
Levonorgestrel IUD
-amenorrhea causing which can be used strategically here
(Copper can cause heavy menses)
Early short term memory loss
disorientation
Later personality changes
Early personality changes
Apathy, compulsive behavior
Visual hallucinations
Parkinsonism
Fluctuating cognition
Ataxia, urinary incontinence
Rapid progression behavioral changes, myoclonus, seizures
Cognitive decline with fnd’s
Alzheimers -Early short term memory loss disorientation Later personality changes
Frontotemporal dementia Picks dz - Early personality changes Apathy, compulsive behavior
Lewy Body Dementia - Visual hallucinations Parkinsonism Fluctuating cognition
Normal pressure hudrocephalus - Ataxia, urinary incontinence
Prion - Rapid progression behavioral changes, myoclonus, seizures
Vascular dementia - Cognitive decline with fnd’s
Lithium teratogenicity
Cardiac defects first trimester
-septal defects, ebstein anomaly (atrialization of the ventricle)
Goiter and neuromuscular dysfunction secknd and third
Carbemazepine and valproate teratogenicity
Craniofacial neurAl tube genutourinary
Abx for EHEC
Avoid – can worsen HUS
Spasticity bulbar hyperteflexia
Vs
Fasciculations
Umn
Vs
Lmn
Galactosemia causes
___ hyperbilirubinemia
And ___ and ___ due to ___
Galactosemia causes
CONJUGATED hyperbilirubinemia
And VOMITING and GROWTH FAILURE due to INABILITY TO DIGEST GALACTOSE IN MILK
Bili threshold for phototherapy vs exchange transfusion
20 for photo
25 or neuro symptoms for exchange transfusion
Normal breast feeding frequency for newborn
20-60 minutes (half at each breast) at least q3 hours
Dermatophyte tinea capitis
LAD?
Tx?
Yes can have lymphadenopathy
Oral griseofulvin or terbinafine
Selenium sulfide or ketoconazole shampoo for prevention
Antidote fir methemoglobinemia
Methykene blue – reduces met ferric 2 hb back to ferrous 3 hb
Dimercaprol is antidote for
Lead poisoning, chelating agent
Fomepizole is antidote for
Methanol or Ethylene glycolr
Inhibits alc dehydrogenase and conversion to toxic metabolites
Glucagon is antidote for
BB or CCB
Glucagon activated adenylate cyclase increasing intracellular ca and contractility
Pralidoxime is antidote for
AchE inhibitors (eg organophosphstes)
Given with Atropine
Methylene blue Dimercaprol Fomepizole Glucagon Pralidoxime
Antidotes
Methylene blue - methemoglobinemia Dimercaprol - lead poisoning Fomepizole - methanol or ethylene glycol Glucagon - BB or CCB Pralidoxime - AchE inhibitors (eg organophosphstes) Given with Atropine
Acetazolamide is a diuretic used to treat
Pseudotumor cerebri
Eg in obese women with headache and visual changes
Associated trisomy ntd’s cardiac defects with
Gastroschisis vs Omphalocele
With Ophalocele yes
Gastroschisis usually isolated
Kallman syndrome
Normal karyotype, x-linked recessive
Hypogonadotrophic hypogonadism
Rhinencephalon hypoplasia
Anosmia
Iatrogenic causes of idiopathic intracranial hypertension pseudotumor ceribri
Tetracyclines
Hypervotaminosis A isotretinoin
What to check before starting pt on clozapine or olanzapine
Fasting glucose and lipids waist circ bmi bp
-matabolic effects, weigt gain (second gen antipsychotics)
(Clozagranulocytosis only clozapine not olanzapine..follow cbcs with clozapine)
What antipsychotic needs ekg minitoring
Ziprasidone
Atypical antipsychotic
2nd line syphilis treatment
Doxy for 1 and 2 and latent
Ceftriaxonefor tertiary
(Benzathine Penicillin G 1st line unless allergy)
How young with first febrile uti merits 1-2 wks abx and renal us to rule out anatomic predispositon
v2 years – higher risk of complication from first febrile uti
Torus palatinus
Define/Presentation
Manage
Benign chronic bony growth at midline suture of hard palate, congenital/environmental, most common young female asians
Manage ntd unless symptomatic/problematic — thin epithelium easy bleeding slow healing poor vascular supply, interference within speech swallowing eating denture fitting etc
Young patient fleshy immobile hard mass midline soft palate
Most likely diagnosis
Manage
Torus palatinus
Benign chronic bony growth at midline suture of hard palate, congenital/environmental, most common young female asians
Manage ntd unless symptomatic/problematic — thin epithelium easy bleeding slow healing poor vascular supply, interference within speech swallowing eating denture fitting etc
Normal at birth, gradual apathy weakness hypotonia sluggish movement large tongue abdominal bloatig umbilical hernia... pathalogic jaundice, difficulty breathing, noisy breathing, hypothermia, refractory macrocytic anemia Think Presentation Cause Diagnose Treat
think Congenital hypothyroidism
present as Foreigner/lack of prenatal care, developes these symptoms over… weeks i think, presenting ~1 month old or so
(Neonates routinely screened in the US with serum TSH and T4, screened for other inborn errors lf metabolism galactosemia and phenylketonuria too)
caused by thyroid dysgenesis (aplasia, hypoplasia, ectopia) most often… also inborn error of thyroxine synthesis, transplacental maternal thyrotropin receptor blocking antibodies less commonly
dx with serum TSH and T4
treat with Levothyroxine 10mcg/kg then titrate as approproate
Another cause of floppy baby syndrome other than infant botulism
Werdnig-Hoffman syndrome
autosomal recessive degeneration of anterior horn cells and cranial nerve nuclei
Congenital Muscle weakness and atrophy especially in distal extremities Myotonia Testicular atrophy Baldness
Think
Inheritance
Myotonic congenital myopathy
autosomal dominant
Pediatric form of Myasthenia Gravis occurs when
Late childhood or adolescence
When to get electrolyte panel for kid with allarent febrile seizure
If in the setting of vomiting diarrhea or dehydration
If appears well hydrated with no other symptoms, don’t worry about it
Febrile seizure Risk factors 4 diagnostic criteria Management, hospitalize? Prognosis
Fever from mild viral/bacterial illness, family history of febrile seizures are risk factors
3mos-6years old
No afebrile seizures
No meningitis or encephalitis
No acute metabolic cause
Abort seizure if ^5 min Treat cause if possible Tylenol antipyresis for comfort (will not impact future seizures) Reassurance, no need to hospitalize for obs
Does Not impact development or intelligence,30% reoccur, 5% become epileptic,
_______ is an aggressive, rapidly growing tumor that involve the distal ileum and present as intussusception and massive ascites
Burkitt Lymphoma
is an aggressive, rapidly growing tumor that involve the distal ileum and present as intussusception and massive ascites
How can Henoch Schonlein Purpura cause intussusception?
What are the first manifestations of HSP usually?
HSP autoimmune vasculitis can cause a bowel hematoma that acts as a lead point for intussusception
Usually palpable purpura and joint pain
Pt older than 2 with recurrent intussusception you must think
Pathalogical lead point (not just peyers patches hypertrophy from viral illness like less than 2yos)
___ muscular dystrophy is injerited by ___ pattern and characterized by grip myotonia, facial weakness, foot drop, dysphagia, cardiac conduction abnorms… also baldness cataracts testicular atrophy
myotonic muscular dystrophy is injerited by autosomal recessive pattern and characterized by grip myotonia, facial weakness, foot drop, dysphagia, cardiac conduction abnorms… also baldness cataracts testicular atrophy
