UWorld V Flashcards
Definition of infant colic
Three 3’s: Crying in an otherwise healthy infant for 3+ hours, 3+ times a week, for 3+ weeks
Usually resolves spontaneously by 4 months of age
Symptoms of celiac disease?
Gastrointestinal:
- Abdominal pain
- N/V
- Diarrhea
- Flatulence & bloating
Extra intestinal:
- Short stature and weight loss
- Iron deficiency anemia
- Dermatitis herpetiformis
How do you treat an asymptomatic child with recent exposure to varicella?
If child received 2 doses of vaccine: reassure and observe
If less than 2 doses and immunocompetent: VZV vaccine
If immunocompromised: VZV immunoglobulin
Symptoms of congenital rubella?
Sensorineural hearing loss
Cataracts
Patent ductus arteriosus
Pharmacologic treatment of Tourette’s?
Antipsychotics -typical or atypical
Alpha-2 agonists (clonidine, guanfacine)
Behavioral therapy
Associated with ADHD and OCD which may be treated with methylphenidate or SSRIs respectively
Splenic sequestration crisis vs aplastic crisis in SS anemia?
Splenic sequestration: High reticulocytes, splenic vasoocclusion causes rapidly enlarging spleen, precedes auto-splenectomy in children
Aplastic crisis: Low reticulocytes, caused by transient arrest of erythropoiesis, often secondary to infection (Parvovirus B-19)
Osteoid osteoma vs osteosarcoma
Osteoid osteoma pain respons rapidly to NSAID treatment
Osteosarcoma does not respond to NSAIDs
Three complications of mumps?
Parotitis
Orchitis
Aseptic meningitis
Nieman-Pick vs Tay-Sachs disease differences
Neiman-Pick: Sphingomyelinase deficiency, Hepatosplenomegally, Areflexia
Tay-Each: B-hexosaminidase A deficiency, hyper-reflexia
Both have regression of milestones, cherry red spots, hypotonia, and feeding difficulties
Krabbe disease presentation and deficiency?
Regression of milestones, hypotonia, and a-reflexia like Neiman-pick, but NO CHERRY RED SPOT
Galactocerebrosidase deficiency (Space crab in the galaxy)
Gaucher disease presentation and deficiency?
Anemia, thrombocytopenia, hepatosplenomegaly, but NOT loss of milestones or cherry red spots
Glucocerebrosidase deficiency (Glucose has a Gauche orientation)
Hurler syndrome presentation and deficiency?
Coarse facial features, inguinal or umbilical hernias, corneal clouding, hepatosplenomegaly
Lysosomal hydrolase deficiency, a mucopolysaccharidosis disease (along with Hunters which is X-linked, but Hurlers can present in girls)
When to order renal and bladder US in children with UTI?
If febrile UTI in patient under 2 years
Recurrent febrile UTI
UTI in any age child with family history of renal, urologic disease or hypertension or poor growth
Children who do not respond to appropriate antibiotic treatment
Features of septic arthritis in children
Fever above 38.5/101 Inability to bear weight WBC over 12,000 ESR above 40 CRP above 20mg/L
Features of congenital toxoplasmosis?
Macrocephaly
Diffuse intracranial calcifications
Non-specific signs of congenital infection (Jaundice, growth restriction, hepatosplenomegaly, blueberry muffin spots)
Risk factors and treatment of congenital toxoplasmosis
Cat feces, undercooked or raw meat
Pyrimethamine, sulfadiazine, folate
Granulosa Cell tumors vs Sertoli-Leydig cell tumors in girls?
Granulosa cell: Produces estrogen, causes precocious puberty with breast buds, pubic hair, and growth spurt. PE may reveal a pelvic mass. US = Ovarian mass, thick endometrium
Sertoli-Leydig: Produces testosterone, de-feminization and masculinization, Hirsutism, coarsening of features, voice deepening, clitoral enlargement
What is a dysgerminoma?
Ovarian tumor appearing in women under 30. May produce LDH and b-HCG, but does not cause precocious puberty
What is primary dysmenorrhea? Vs secondary?
Primary dysmenorrhea is the pain of cramping during (not before) menses without a secondary cause. Onset is typically with adolescence and may improve with age.
Secondary dysmenorrhea is pain associated with menses caused by endometriosis, adenomyosis, pelvic infection, or leiomyomata. These typically occur in adult women because they need time to develop. They also have different pain patterns and timing.
Risk factors for intussusception?
Anything that causes a mass in the intestines that can be caught in peristalsis and dragged further down the gut.
Viral illness or rotavirus vaccine (Viral illness causes hypertrophied Peyer’s patches)
Meckel’s diverticulum (Diverticulum)
Henoch-Schonlein Purpura (Hematoma formation)
Celiac disease (??)
Intestinal tumor (Burkitt lymphoma causes lymphoid mass)
Polyps (Mass)
Treatment and life threat of neonatal tetanus?
Tx: Antibiotics, Tetanus IVIG
Threat: Stridor and respiratory failure due to contraction of diaphragm and upper airway muscles
What causes hypokalemia in pyloric stenosis?
Dehydration leads to decreased renal perfusion and RAAS activation, increased Aldosterone causes K+ excretion and hypokalemia
Initial steps of treatment of a child with ingestion poisoning?
1- ABC’s first!
2- Remove contaminated clothing (stops ongoing damage)
3- Upper GI study in first 24 hours - Extent of damage may not be noticeable immediately, and delay past 24 hours increases the risk of perforation.
Risk factors and clinical features of milk or soy protein induced colitis?
Risk factors: family history of allergies, eczema, or asthma
Clinical features: Presents age 2- 8 weeks
Regurgitation or vomiting
+/- painless bloody stools
+/- eczema
