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Z Pediatrics > Conditions And Diseases > Flashcards

Conditions And Diseases Flashcards

1
Q

Asthma summary

A

Eval:
Physical exam and history

Txt:
nebulizer

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2
Q

Allergy summary

A 
SS:
reaction within 3-4 hours
rhinitis
asthma
atopic dermatitis
Txt:
Diet
Diphenhydramine, 4 mg/kg/a6hr
Epi Pen
child education
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3
Q

FTT summary

A

Def: kid not growing like you expect to

Cause: multifactoral

SS:
dysmorphic
teeth
stigmata of abuse
lack development
temperment
affect
Eval:
cbc
ferritin
BMP
Vit D
Txt:
feeding therapy (sos)
dietary management
medication
g-tubes
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4
Q

Blunt abdominal trauma

A

Causes: falls, bike accidents, seatbelt injury, kick to abdomen
S/s: diffuse abd pain, vomiting, distensiton, sudden collapse if splenic injury
Dgx:Serial CTs
Tx conservatively

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5
Q

Infantile Acne

A

Who:2-4 weeks of life

S/s: pink, small papules

Tx: time/reassurance

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6
Q

Miliaria Rubra ( Heat Rash)

A

Who:Infants and adults

S/s: covered areas, flexural areas; clear vesicles on an erythematous base

Tx: symptomatic, avoid over heating

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7
Q

Milia

A

Who: neonates

S/s: little white bumps on forehead, cheeks, nose

Tx: reassurance

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8
Q

Erythema Toxicum

A

who: *neonates in the first 24-48 hours of life

S/S: 1-4mm central vesicle or pustule over large, blotchy erythematous base

Tx: reassurance

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9
Q

Measles (Rubeola)

A

Who: rare with adequate vaccination

S/s: *High fever, *cough, coryza, conjunctivitis, prodromal symptoms that *persist during the rash; *RASH that starts on face and spreads out *but still remains on face

Tx: close monitoring, symptomatic

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10
Q

Rubella (German Measles)

A

Who: rare with adequate vaccination

S/s: *rash that starts on face and spreads to trunk and extremities but the *face clears up; mild viral illness with tender lymphadenopathy

TX: symptomatic

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11
Q

Roseola

A

Who: children under 2

S/s: predominately on the trunk; after prodrome with a *High fever, children develop faint *blanchable pink maculopapules which *coalesce but the *fever disappears once rash appears

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12
Q

Erythema Infectiosum (Fifth’s disease)

A

Who: school aged children

S/s: after prodrome, child feels better but rash erupts on face (slapped cheek) and extremities (SPARES hands and feet) that is *lacy and caolesces

Tx: reassurance, symptomatic

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13
Q

Coxsackievirus (hand, foot, and mouth)

A

Who: children under 10

S/s: *rash or spots appear on hands and feet, parent complains child doesn’t want to eat and just doesn’t feel well

Tx: symptomatic

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14
Q

Scarlet Fever

A

Who: anyone

S/s: sunburn like rash that feels like sandpaper

Tx: oral abx

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15
Q

Dystocia

A
  • brachial plexus injury (waiter’s tip hand)

- clavicle fracture (can’t move one arm)

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16
Q

Jaundice

A

high hemoglobin at birth because liver is immature and can’t get rid of broken down RBC’s
Dgx: coomb’s test
Tx: phototherapy

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17
Q

Kernicterus

A

Higher amounts of bilirubin in the brain
Bilirubin induced neurologic dysfunction-baby isn’t sleeping or eating well which leads to less pooping and peeing to get the bilirubin out
Leads to chronic bilirubin encephalopathy and hypotonia

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18
Q

Necrotizing Enterocolitis

A

most common in premature babies

GI signs

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19
Q

Respiratory Distress Syndrome

A

premature babies

tachypnea, retractions, nasal flaring

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20
Q

Trisomy 21

A

Down Syndrome
hypotonia, hyperflexibility, excess skin on back of neck, flat facies, simian crease, cardiac abnormalities
low IQ

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21
Q

Fragile X syndrome

A

repeat of trinucleotide in the FMR1

S/s:MC inherited cause of mental retardation, hand flapping and biting, poor eye contact, autism, macrocephaly, prognathia after puberty, large ears, thickening of nasal bridge

Full life expectancy

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22
Q

Meconium Aspiration Syndrome

A

when meconium is the first intestinal discharge from newborns
need to get it out to prevent bacterial infections

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23
Q

Spina Bifida/Neural tube defect

A

Etiology: congenital deformities involving coverings of the nervous system

S/s:myelomeningoceles-spinal cord and nerve roots herniate into a sac comprising the meninges
meningocele-herniation of the eninges through the bony defects
Encephalocele-herniation of meninges and neural tissue

Prevent: folic acid supplementation-occurs between days 17-30 of gestation

Tx: surgery, therapies, medications for complications

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24
Q

Muscular Dystrophy

A

MC hereditary neuromuscular disorder
inherited x linked recessive trait
defect is dystrophin protein

S/s: Gower’s sign, wheelchair bound by age 12, cardiomyopathy, resp complications

Dgx: elevated CK, muscle biopsy

tx: no medical cure or method to slow progression
death by age 22

25
Q

Cerebral palsy

A

motor or postural abnormalities noted during development
assoc with prenatal, perinatal, or postnatal etiologies
many children and adults function at a high educational and vocational level

s/s: spastic diplegia, spastic quadriplegia, hemiplegia, extrapyramidal

26
Q

Urinary Tract Infection

A

Etiology: E. coli, enterococcus (always get a culture even if UA looks clean)

Risk Factors: F:39, fever>2d; M: white, temp>39, fever>1d

Pathogenesis: Renal scarring from retrograde flow of urine (preventing kidney disease, HTN)

S/s:Neonate=sepsis, hypothermia, cholestatic jaundice; infant=F,V,D,irritable, FTT, malodorous urine; Preschool=change in voiding patterns,GI sx, fever; adolescent=dysuria, frequency, urgency, abd pain

Dgx: UA/UC

Tx:abx

F/U: within 48 hours of onset of any subsequent febrile illness

27
Q

Vesicoureteral Reflux

A

regurgitation of urine from the bladder up to the kidney

incidence: higher in white and siblings
etiology: congenital or bladder outlet obstruction

classified by grades 1-5

Dgx: RUS, *VCUG, *RNC (identifies reflux), DMSA

tx: prophylactic abx, bladder training, antihcolinergics
STING-subureteric transurethral injection

28
Q

Voiding dysfunction summary

A

Enuresis - refers to a repeated inability to control urination

  • Primary : never achieved control
  • Secondary : control for at least 6 months
Mild
- pollakiura
- giggle incontinence
- vaginal reflux
Moderate
- lazy bladder
- unstable bladder
Severe
- hinman syndrome

Eval:
UA/UC
RUS
cystogram

Txt:
motivation
DDVAP
Tofranil
time voiding
conditioned response therapy
29
Q

SIDS summary

A

Def: sudden death of infant 5

Txt:
help family cope with loss

30
Q

Hemolytic Uremic Syndrome summary

A

Def: MC renal failure

Cause: infectious (ecoli), endothelial cell injury

SS:
age

31
Q

Kawasaki disease summary

A

Def: mucocutaneous lymph node syndrome or infantile polyarteritis

SS:
microvasculitis
fever > 5 days and
- peripheral extremity changes
- polymorphous rash
- oropharyngeal changes
- bilateral, nonexudative painless conjunctival infection
- acute lymphadenopathy
4 stages:
- acute
high fever and main symptoms
- subacute
desquamation of fingers and toes
greatest risk of coronary aortic aneurysm
- convalescent
- chronic
Eval:
elevated ESR/CRP
2 urine proteins
Platlets > 450,000
pyuria
ALT > 50
albumin
32
Q

henoch schonlein purpura summary

A

Def: immune-mediated vasculitis

SS:
purpura (lower extremities)
ab pain
joint pain and swelling
N/V
D, bloody stools
scrotal edema

Eval:
UA
ab US

Txt:
self limiting
supportive

33
Q

Leukemia summary

A

Acute lymphoblastic Leukemia MC

SS:
fever
bleeding
bone pain
lymphadenopathy
Eval:
CBC diff
clotting tests
metabolic panel
Uric acid
LP
bone marrow biopsy
US

Txt:
meds

34
Q

Seizures summary

A

Def: provoked (infections, etc.) and febrile

Generalized: engage both hemispheres

  • absence
  • grand mal

Focal: originate in 1 hemisphere

  • simple (aware still)
  • complex
35
Q

Epilepsy summar

A

Def: chronic seizures

Benign focal - generalized occur during sleep; occasional occur when awake

Petit mal - 4-8 yr loss of consciousness that lasts seconds

juvenile myoclonic - 13 - 19 yr frequent morning within first hour due to sleep deprivation

grand mal - any age

Infantile seizures - sudden flexion or extension of trunk or both

Lennox-Gastaut Syndrome - intractable seizures (no good txt)

36
Q

Status Epilepticus summary

A

Def: 5 min sustained convulsions

Eval:
MRI
CT
CBC
LFT
blood glucose
EEG

Txt:
Benzo
Phenytoin

37
Q

Scoliosis summary

A

def: lateral curvature of spine
cause: idiopathic

SS: illiac wings and shoulder not level

Eval:
PA/lateral xray
MRI

Txt:
close follow up
braces
surgery

38
Q

Genu Varum/valgum summary

A

Def: abnormal alignment of femur and tibia

SS:
vause or valgus

Txt:
Observation

39
Q

Osgood Schlatter summary

A

Def: knee pain over tibial tubercle

SS:
pain with running and jumping

Eval:
pain over tibial

Txt:
NSAIDs, Ice, rest

40
Q

Juvenile Idiopathic Arthritis summary

A

Def: MC chronic arthritis in kids

SS:
morning stiffness
joint swelling
redness
warmth
high fever
rheumatoid rash
Eval:
CRP/ESR
Hgb
WBC
tap joint

Txt:
NSAIDs
DMARDs
steroids

41
Q

Developmental Dysplasia of Hip summary

A

Def: disorders of sublet, dislocation

SS:
painless limp
short leg

Eval:
Barlow/Orotoni exam

Txt:
Observe
harness or casting

42
Q

Salter-Harris Fractures summary

A

1 - growth plate

  1. growth and metaphysics
  2. growth and epiphysis
  3. all elements
  4. crush
43
Q

Legg-Calve Perthes summary

A

Def: avascular necrosis of femoral head

SS:
pain in hip with limp
painless limp
externally rotated leg
mild atrophy of thigh
Eval:
CBC
ESR
AP/frog-leg lateral X-rays pelvis
MRI

Txt:
bed rest
bracing or surgery

44
Q

Slipped Capital Femoral Epiphysis summary

A

Def: MC hip disorder in adolescent

SS:
obesity
limp no known trauma
externally rotated leg
flexed leg will externally rotate

Eval:
AP/frog-leg lateral x-rays

Txt:
hospitalization
surgery

45
Q

Nursemaid elbow summary

A

Def: sublet of radial head from capitellum due to immature annular ligament

cause:
axial pull on arm

Eval:
xray

Txt:
external rotate with flexion

46
Q

Inguinal hernia

A

Hx: asymptomatic groin or scrotal swelling, most prominent with crying/straining/active, rarely painful, unless incarcerated

Exam: reducible inguinal/scrotal mass; thickening of spermatic cord/inguinal content; ovary frequently out into hernia sac in girls

47
Q

Hydrocele

A

discreet sac of fluid (intrascrotal)

Dgx: spermatic cord proximal to an isolated hydrocele will be normal

Tx: infant: await spontaneous resolution
>1y: surgery for a persisting hydrocele as a hernia is likely also present

48
Q

ADHD

A

def: combo of hyperactivity, impulsivity, and inattention that affects functioning in cognitive, academic, behavioral, emotional, and social

Cause: atypical frontal-striatal activation causing impaired function, imbalance of catecholamine metabolism in the cerebral cortex, high genetic component, environment and society

Dgx: look at criteria

Tx: combo of meds, behavioral, and educational

  • make goals, special services at school
  • Methylphenidate (Ritalin, Concerta, Metadate, Daytrana patch)
  • Amphetamine (Dexedrine tabs, Vyvanse, Adderall)
  • Nonstimulant: Strattera-norepi reuptake inhibitor; Buproprion, SSRI, Clonidine, TCA
49
Q

umbilical hernia

A

persisting defect in the abd wall fascia at the site of umbilical cord attachment

tx: spontaneous closure is frequent without requiring surgical repair

50
Q

Belly button anomalies

A

Umbilical polyp-moist, red umbilical nodule; tx with cauterization

Patent omphalomesenteric duct- embryologic connection to intestine (ileum), substantial drainage, requires surgery

Patent urachus- embryologic connection to urinary bladder, substantial drainage, urinary content flows into umbilical cord, requires surgery

51
Q

Urachal cyst

A

urachus-connection to urinary bladder

s/s: umbilicus usually normal with lower midline abdominal wall mass; often infected with abd pain, fever, infraumbilical mass, erythema

Dgx: hx, exam, US

Tx: antibiotics to treat infection, surgical excision

52
Q

Meckel’s Diverticulum

A

remnant of intestinal end of omphalomesenteric duct

Rule of 2s: 2% of pop, 2 years old, 2 feet from ileocecal valve, 2 inches long

S/s: bleeding per rectum, inflamm/meckel’s diverticulitis, small bowel obstruction, or asx

Tx: surgical excision of diverticulum

53
Q

Autism

A

Cognitive differences: theory of mind, implicit learning and nonverbal sensitivity

S/s: poor social skills, rigid and inflexible adherence to routines, preoccupation with parts of an object or particular subject, sensory issues (can’t block out stimuli, hypersensitivity, fine motor problems, gross motor problems)

Dgx: interview, medical workup, psych assessment

Tx: social skills training, peer training, communication and conversational training, behavioral management, academic and educational support, tx of comorbid issues
No meds tx autism

54
Q

Intussusception

A

form of bowl obstruction, intestine telescopes into itself
mainly idiopathic

S/s: cramping, bloody mucoid stools (currant jelly); sausage shaped abd. mass

Dgx: confirmed by radiology but only when it’s late, US, CT scan

Tx: hydrostatic/pneumotic reduction by the radiologist; if unsuccessful proceed to immediate surgery

55
Q

Pyloric stenosis

A

concentric hypertrophy of pyloric muscle

S/s: 3-6 weeks old, progressive projectile, non bilious vomiting eventually with every feeding, dehydration, palpable epigastric abd mass “olive”

Dgx: “string sign” on Upper GI; US

Tx: NPO, Iv hydration, Pyloromyotomy

56
Q

Thyroglossal duct cyst

A

thyroglossal duct originates from foramen cecum of the tongue

s/s: midline neck mass at hyoid cartilage level, infection can occur

Dgx: midline mass that moves during swallowing, no labs necessary

Tx: abx, surgical incision

57
Q

Dermoid cyst

A

more superficial and mobile than TDC, still midline

Tx: surgical excision

58
Q

Branchial cleft cyst/sinus

A

derived from branchial structures present at 4-8 weeks gestation

S/s: anterior border of SCM muscle and mucoid drainage

Tx: abx, surgical excision

Z Pediatrics (15 decks)

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