UW Flashcards
Prolonged PTT
Normal Plt, BT, PT
Decreased F8 v. F9
Hemophilia A and B
Hemarthrosis, intramuscular hematoas, GI/GU bleeding
X-R
Hemphilia A and B
Presents at 3-4m with hypoglemia induced seizures, lactic acidosis, hyperuricemia, hyperlipidemia. Thin extremities, doll like face, short stature, protuberant abdomen (HM).
Glucose-6-phosphatase deficiency (type 1 - von gierke)
HM, glucocerebrocide accum in macrophages in liver, spleen, marrow = bone pain, cytopenia.
Glucocerebrosidase enzyme deficiency - Gaucher
When do you NOT CT a kiddo with head trauma
GCS=15
Non-severe mechanism
No vomiting, HA, LoC, signs of fracture
Management of a kiddo with head trauma and
GCS=15 w/any:
Vomiting, HA, brief/questionable LoC, high-risk mechanism, severe mechanism
Observe for 4-6hrs
OR
Head CT WITHOUT contrast
Sore throat, dysphagia, odynophagia, pharyngeal/tonsillar erythema
+ cough, rhinorrhea, conjuctivitis, oral ulcers
Viral pharyngitis
Sore throat, dysphagia, odynophagia, pharyngealtonsillar erythema
+ edema, palatal petechiae
Next step?
Rapid antigen test for strep pharyngitis
MCC: GAS
Rapid antigen strep pharyngitis test is negative, next step?
Rapid antigen strep pharyngitis test is pisitive, next step?
If NEGATIVE - throat culture (if negative again, then viral dx)
If POSITIVE - tx with oral amoxicillin or penicillin
Hemophilia A and B are what type of bleeding disorder (clotting defect, platelet aggregation defect, thrombocytopenia)
Clotting defect
Increased PTT with hemarthrosis and deep tissue hematomas. Dx?
Hemophilia a or B
vWD and bernard soulier syndrome - what type of bleeding disorder? (clotting defect, platelet aggregation defect, thrombocytopenia)
Platelet aggregation
Easy or prolonged bleeding, ecchymosis, and petechiaex
Easy or prolonged mucosal bleeding, ecchymosis, petechiae, and decreased platelet count. Bleeding disorder type?
Thrombocytopenia
ITP or leukemia
HBsAg
HBeAg
IgM Anti-HBcAg
Which is marker of viral replication
Which is first evidnce of infection
Which is antibodiy to hep B core antigen?
Which is marker of viral replication - HBeAg
Which is first evidnce of infection - HBsAg
Which is antibodiy to hep B core antigen?
IgM Anti-HBcAg
What is the clinical feature of iron poisoning present at 2d?
What about during 2-8wk?
2d = hepatic necrosis
2-8wk = pyloric stenosis
MCC of otitis externa
Tx
Pseudomonas *fluoroquinolones
Vitamin deficiency - diarrhea, dermatitis, dementia, possible death
Associated with UC/nutritional absorption deficiencies and third world countries
Pellagra - niacin (B3) deficiency
Vitamin deficiency - cheilosis, glossitis, seborrheic dermatitis, pharyngitis, erythema/edema of mouth
Riboflavin (B2)
Vitamin deficiency - irritability, depression, dermatitis, stomatitis, elevated homocysteine concentraiton (atherosclerosis and venous thromboemb RF)
Pyridoxine (B6)
Genu varum
Rickets - vit D def
Three signs of pancreatic insufficiency in CF
Vitamin D deficiency
Vitamin K defiiency - easy bruising
Poor growth
Cat bites (pasteurella) and anaerobic bacteria - ppx tx after bite
Amox/clav
Preceeding triggers for intussusception
Gastroenteritis, meckel’s, polyps, hematomas (HSP - dt bowel wall edema and localized hemorrhage)
MCC acute bacterial sinusitis
Tx
Strep pneumo or nontypable Haemoph. Infl
Amox-clav
MCC of otitis externa
Pseudomonas
Asian child with sore throat and joint swelling and new onset heart murmur - name the dz, the heart defect, and the abx ppx.
Pharyngitis dt GAS –> RF
MS
Penicillin
Tx for enterobius vermicularis pinworm
Albendazole for the whole house
Ectopic/upward facing lens and joint hypermobooloty, pectus excavatum
Marfans - fibrillin1
Lens downward, pectus deformity, tall stature, arachnodactyly, fair complexion, *thromboembolic events/CVAccident, intellectual disability
Homocystinuria (AR - def cystathionine synthase - met. Methionine)
Marfanoid body habitus with the triad of CVA, fair complexion, intellectual disability
3-4m with hypoglycemia (seizures), lactic acitosis (glycogen b/u in liver), doll like face, hyperuricemia/lipidemia, HM
G6PD (type 1 glycogen storage dz - von Gierke)
HM, bone pain, cytopenia due to ___ b/u in macrophages of liver, spleen, marrow
Gaucher - glucocerebrosidase enzyme deficiency
Hypoketotic hypoglycemia during fasting states
MCAD
When do you give seizure abortive therapy
If >5min (dt increased risk of airway compromise)
HA, jaundice, SM, increased MCHC, incrased osmotic fragility test on ACIDIFIED GLYCEROL LYSIS TEST
And ABNORMAL EOSIN-5-MALEIMIDE BINDING TEST
Hereditary spherocytosis
Define IgA-mediated leukocytoclastic vasculitis and tx
Nml to inc creatinie
Hematuria +/- RBC casts +/- protienuria
Hx: infection
HSP
Supportive or if severe, systemic GC
Tetrad: palpable purpura, GI pain, hematuria, arthralgia
Posttussive emesis in a child w/o vacinnations after 4y - think?
Pertussis
Tx with macrolides - azythro or clarithro
Common complication in neonates born <30wk or <3.3lb
Presents with lethargy, hypotonia, high pitched cry, rapidly increasing head circumference, buldging fontanelles)
Intraventricular hemorrhage
2-6m with HM, protuberant abdomen, hporeflexia, cherry red macula
Neimann pick disease (sphingomyelinase)
2-6m with hyperreflexia, cherry red macula, loss of motor milestones
Tay sachs (beta hexosaminidase A def(
Pertussis ppx for household:
<1m
>1m
<1m = azithromycin x5d
> 1m = azithromycin x 5d; clarithromycin x 7d; erythromycin x 14d
Tx for radial head sublixation
Hyperpronate the forearm
OR
Supinate forearm and flex elbow
3-10y male with hip pain. Follows viral infection. Pain, deceased ROM, limping. Flexed, abd, ER.
Dx
Transient synovitis
High pitched cry in newborn. Mom drug user. What drug
Heroin
G.C testing in what aged
all sexually active females < or equal to 24y
DKA following a viral illness -what happens to potassium?
Decreased total body K due to net renal loss. Serum K may be elevated dyue to acidemia and decreased insulin activity, causing K reditribution into Extracellular space
DKA causes... K RAAS Lipolysis Volume status Gluconeogenesis
Loss of K Increased RAAS Increased lipolysis Hypovolemia/osmotic diuresis Incrased gluconeogenesis dt increased ration of circulating glucagon:insulin
Turners are at increased risk for what due to ovarian dysgenesis?
Estrogen deficiency –> decrersed inhibition of osteoclast-mediaeted bone resorption –> decreased bone density –>
OSTEOPOROSIS
Difference between laryngomalacia and vascualr rings in presentation
Laryngomalacia is INSPIRATORY stridor that is worse in supine and better prone.
Vascular rings are BIPHASIC stridor that is better with neck extension
Precocious ouberty, cafe au lait spots, multiple bone defects (responsible fo r5% of female precocious puberty)
Mccune-albright
LAD HSM anemia/pallor petechiae/thrombocytopenia bone pain marrox bx: >25% blasts
ALL
- Low pitched muscial, pure, or squeaky tone at LLSB
- Name
- B9 or pathologic? - High pitched at LUSB
- Name
- B9 or pathologic?
- Stills, b9
2. Pulmonary flow murmur, b9
Subcutaneous emphysema secondary to severe coughing… next step in management.
CXR to r/o pneumothorax
Tx for tourette disorder (>1y)
Antipsychotic - risperidone
Pericardial effusion can lead to ____ after cardiac surgery?
Cardiac tamponade, a result of postpericardiotom syndrome
