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Peds > BRS Ch 16-20 > Flashcards

BRS Ch 16-20 Flashcards

1
Q

What’s the deal with Kawasaki disease?

A
  • acute febrile vasculitis, 5 criteria, most common cause of acquired heart disease in children
  • look for coronary artery aneurysms, hydrops of the gallbladder
  • triphasic course of disease
  • tx: IVIG, ASA, steroids
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2
Q

What are the subcategories of JRA?

A
  • pauciarticular (early-onset=ANA+, late-onset=male,HLA-B27+)
  • polyarticular (RF+, RF-) RF = anti-IgG IgM
  • systemic-onset (fevers, salmon rash, HSM, lymphs)
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3
Q

What tests should you run to diagnose SLE?

A
  • elevated ESR/CRP, anemia, leukopenia, thrombocytopenia, proteinuria
  • rheum: ANA, RF, dsDNA***, anti-Smith
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4
Q

What rheum disease presents with muscle inflammation and characteristic skin disease?

A

Dermatomyositis. Look for rashes in sun-exposed areas and proximal muscle weakness.

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5
Q

What disease is a complication of URI by Strep pyogenes (GABHS)?

A

Rheumatic fever - inflammation of the connective tissues
Features: cardiac involvement, polyarthritis, Sydenham’s chorea, skin involvement
Tx: penicillins, NSAIDs after dx, corticosteroids with heart failure

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6
Q

What are the neurologic symptoms seen in Lyme Disease?

A

Aseptic meningitis, facial nerve palsy, encephalitis

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7
Q

What is the triad of symptoms in Sjogren’s syndrome?

A

Sicca syndrome, high autoantibodies (ANA/RF), connective tissue diseas

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8
Q

What is the CREST syndrome?

A

Seen in scleroderma

Calcinosis, Raynaud’s, Esophageal involvement, Sclerosis, Telangiectasia

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9
Q

What are the two flavors of brachial plexus injury?

A
  1. ) Erb’s palsy - C5, C6 (waiter’s tip)

2. ) Klumpke’s palsy - C7, C8 (claw hand)

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10
Q

What is the name of the syndrome characterized by fusion of the spinal vertebrae?

A

Klippel-Feil syndrome

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11
Q

Where is the fracture in spondylolysis?

A

The pars interarticularis, which connects the superior and inferior articular facets of the vertebral body.
Occurs due to repetitive hyperextension of the spine.

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12
Q

What is the epidemiology of Development Dysplasia of the Hip?

A

Girls > boys (6:1), 60% left hip, 20% right hip, 20% both. Increased risk with breech presentation, family history of DDH.
Can lead to avascular necrosis of the femoral head, limb length discrepancy, abnormal gait, osteoarthritis

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13
Q

What position is the hip held in to reduce pressure within the joint capsule?

A

Flexion, abduction and external rotation

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14
Q

What etiologies should you think when evaluating a limp in kids?

A 
Septic arthritis
Transient synovitis
Legg-Calve-Perthes (idiopathic avascular necrosis of femoral head)
Slipped Capital Femoral Epiphysis
Osteomyelitis
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15
Q

What are three causes of in-toeing? (pigeon feet)

A 
Metatarsus adductus (medial curvature of the mid-foot)
Talipes equinovarus (clubfoot)
Internal tibial torsion (medial rotation of the tibia, common 2yo)
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16
Q

Who is Blount’s disease (tibia vara, progressive angulation at the proximal tibia) seen in?

A

Obese African-American boys who are early walkers

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17
Q

Overuse can cause inflammation or microfracture at the tibial tuberosity, which is known as what disease?

A

Osgood-Sclatter disease

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18
Q

What cause of knee pain is common in adolescent girls?

A

Patellofemoral syndrome. Look for pain directly under or around the patella, and a laterally-positioned patella.

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19
Q

Why is a supracondylar fracture (fall on outstretched hand) an orthopedic emergency?

A

Risk of neurovascular injury and compartment syndrome. Look for posterior fat pad sign, pain with passive extension of fingers

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20
Q

What are the 5 P’s of compartment syndrome?

A

Pallor, pulselessness, paralysis, pain, parasthesias

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21
Q

What are the four eye screening principles?

A

I-ARM: inspection, acuity assessment, red reflex, motility assessment

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22
Q

What are the two important requirements for vision development?

A
  1. ) Proper alignment

2. ) Constant and equal retinal stimulation

23
Q

What is the most common cause of poor vision in childhood?

A

Ambylopia.
Abnormal stimulation, such as eye misalignment, blurred visual images, anisometropia (diff. in refractive errors).
Screen with red reflex test.

24
Q

CONJUNCTIVITIS

A

pg. 518-525

25
Q

What medication, used to prevent mother-fetus gonorrhea transmission, will cause chemical conjunctivitis in the newborn?

A

1% silver nitrate, but also 1% tetracycline and 0.5% erythromycin

26
Q

What three TORCH infections can cause neonatal conjunctivitis?

A

Neisseria gonorrhea, Chlamydia, HSV

27
Q

What etiology would you suspect for purulent discharge, conjunctival erythema, lid swelling and bilateral involvement?

A

Bacterial conjunctivitis. H. Flu, Strep pneumo, Moraxella, Staph aureus.

28
Q

What etiology would you suspect for a URI, pharyngitis, fever and bilateral conjunctivitis with watery discharge?

A

Viral conjunctivitis, caused by adenovirus.

29
Q

A skin eruption with corneal ulcers suggests what etiology of conjunctivitis?

A

Herpes simplex virus

30
Q

Allergic conjunctivitis is mediated by what type of hypersensitivity reaction?

A

Type 1 (IgE mediated)

31
Q

Re-bleeding, glaucoma, blood staining the cornea and optic nerve damage are all complications from what eye injury?

A

Hyphema (blunt trauma, juvenile xanthogranuloma)

32
Q

What is a blow-out fracture?

A

Blunt trauma to the eye or orbital rim. Lead to diplopia, then strabismus, then enopthalmos.
There may also be numbness of the cheek due to infraorbital nerve injury

33
Q

Optic injury and expansion of the size of the eye from increased intraocular pressure are results of what eye lesion?

A

Congenital glaucoma. Can be caused by outflow blockage of aqueous humor, infections like rubella.
Tx: surgery to open outflow channels

34
Q

Premature infants are at risk for what ocular lesion?

A

Retinopathy of prematurity (ROP): proliferation of vessels.

Prevention: minimize O2 delivered and treat hyaline membrane disease.

35
Q

What does an obstruction at Hasner’s Valve cause?

A

Nasolacrimal duct obstruction, leading to abnormal tearing.

36
Q

What does a white pupil indicate?

A

Cataract, opacity in the vitreous humor, or retinoblastoma

37
Q

On which chromosome is the mutation in retinoblastoma?

A

Loss of both alleles on the long arm of chromosome 13

38
Q

Allergic contact dermatitis is mediated by what cell?

A

T cell. There must be an initial challenge and then a rechallenge.

39
Q

Why is it important to note the inguinal creases while evaluating diaper rash?

A

A rash within the folds might indicate a candidal superinfection of the affected area.

40
Q

What condition may be the result of a hypersensitivity rxn in response to a fungus that lives near sebaceous glands?

A

Seborrheic dermatitis. Eruption of red scales and crusts on scalp, face, chest, groin.

41
Q

What derm condition presents with a herald patch followed by oval lesions in Christmas tree distribution?

A

Pityriasis Rosea.

42
Q

Psoriasis is inherited in what genetic pattern?

A

Autosomal dominant. Scaling papules and plaques. Koebner phenomenon (scales at sites of trauma).

43
Q

A fungal infection of the nails is called what?

A

Tinea unguium. Look for thickening and yellow discoloration.

44
Q

Parvovirus B19 causes what dermatologic disease of childhood?

A

Fifth disease, erthyema infectiosum. Look for URI symptos followed by slapped-cheek rash then lacy, reticular rash.

45
Q

A pink papular eruption that follows 3-5 days of high fever is what derm lesion?

A

Roseola infantum, caused by herpes infection

46
Q

Grouped vesicles on an erythematous base are considered what derm lesion?

A

HSV. Look for lesions on lips/mouth/tongue, or thumb/fingers. Note that the virus resides on the dorsal root ganglion.

47
Q

Flesh-colored papules with central umbilication are a sign of what derm lesion?

A

Molluscum contagiosum, caused by infection with poxvirus (and rarely HIV).

48
Q

Alopecia areata is mediated by what mechanism?

A

Autoimmune lymphocyte-mediated injury to the hair follicle.

49
Q

What are three possible mechanisms of acne vulgaris?

A

1.) Excessive shedding of cells that line the sebaceous follicles. 2.) Production of sebum under the influence of androgens. 3.) Inflammation as a result of the P. acnes bacteria

50
Q

Tearing of the middle meningeal artery can lead to what cranial lesion?

A

Epidural hematoma. Look for signs of increased ICP, dx with CT (lens-shaped, ovular density)

51
Q

How are burns classified?

A

First-degree: epidermis only, red/blanching skin
Second-degree (superficial/partial thickness): entire epidermis and part of the dermis
Third-degree (full thickness): destruction of epidermis and dermis and part of subQ tissue

52
Q

What is the pathophysiology of acetaminophen toxicity?

A

Depletion of glutathione due to increased acetaminophen metabolism by p450 system –> hepatic damage
Toxic intermediates from above process cause hepatocellular necrosis
Tx: gastric lavage, activated charcoal

53
Q

What is the pathophysiology of salicylate toxicity?

A

Direct stimulation of respiratory control centers

Uncoupling of oxidative phosphorylation, leading to lactic acidosis

54
Q

What is the pathophysiology of iron toxicity?

A

Direct damage to GI tract
Hepatic injury and necrosis
Pooling of blood in vasculature (hypotension)

Peds (6 decks)

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