Flashcards in BRS - Peds Deck (90)
what may be a cause of late onset CHF in an infant?
large VSD (ddx any outflow obstruction or valvular abnormalities)
What findings are consistent with a PDA?
loud machinery like murmur and brisk pulses
what is the only cyanotic congenital heart disease that presents with LVH at birth?
What may be seen on CXR in epiglottitis?
What is the most common cause of pneumonia in adolescents?
Mycoplasma pneumoniae and Chlamydia pneumoniae
What are the classic bugs that colonize the lungs of patients with CF?
Staph aureus initially and P. aeruginosa subsequently
What is classically seen on electrolyte exam of patients with CF?
Hyponatremic, hypochloremic, hypokalemic metabolic alkalosis
What are the PFT patterns of disease seen in patients with CF?
Obstructive lung disease early on, restrictive lung disease later in the course
What is the chance of a sibling of a patient with CF to get the disease?
Recessive pattern of inheritance, therefor 25% chance
What are the patterns of disease seen in patients with lung disease from CLD (bronchopulmonary dysplasia) from prolonged mechanical ventilation as a PreMe?
Combination of obstructive disease (from dysplastic and narrowed airways) and restrictive (from lung tissue fibrosis)
What are the signs and symptoms characteristic of epiglottitis? What are the common causative agents?
Fever, toxic appearance (retractions, increased work of breathing), muffled speech, tripod positioning when seated, drooling and neck hyperextension
H. Flu (HIB), Strep/Staph also possible
What is the proper management of epiglottitis?
Avoid excessive stimulation (e.g. examination of pharynx), evaluation of airway and intubation in controlled setting
What is the management of a moderate exacerbation of chronic asthma?
5-10 days of systemic corticosteroids, followed by inhaled corticosteroids and leukotriene inhibitors for long-term management
What are patients with nephrotic syndrome at increased risk of developing and how should they be treated?
Susceptible to infections with encapsulated organisms like pneumococcal --> increased risk of peritonitis, pneumonia, and overwhelming sepsis
Treat empirically with Abx
What is the presentation for Alport's syndrome, and how is this illness transmitted?
Renal manifestations including HTN, hematuria, and renal failure in males; hearing loss and ocular abnormalities of the lens and retina
X-linked dominant inheritance
What is the effect of infantile botulism on DTRs? What can aid in diagnosing this condition?
Electromyography may show brief, small-amplitude muscle potentials with incremental response during high frequency stimulation
What may be an unusual but significant presentation for Guillain Barre in up to 50% of children?
Low back pain and leg discomfort, with absent DTRs and normal spien imaging
What is the most common form of migraine in children? How long do these usually last?
Migraines WITHOUT aura
last for at least 1 hour
What may be the presentation at 6 months of a patient with congenital myotonic dystrophy?
Hypotonia, facial weakness, areflexia and history of feeding problems since birth
What are the features of chronic benign neutropenia of childhood? How do you distinguish from Chediak higashi and Kostmann syndrome?
Normal appearance and growth, hx of mild infections (sinusitis, cellulitis, otitis media), low ANC and WBC
The others present with more severe infection and growth/skin problems
What can result from a diet containing exclusively goat milk?
Folic acid deficiency and macrocytic anemia
What is transient erythroblastopenia of childhood and what is the likely cause?
Slow onset anemia after the first year of life
Post viral autoimmune reaction
What may result from Parvo B19 infection in Peds?
URTI and slapped cheek rash
What are the most common testicular tumors and what increases risk for these tumors?
Yolk sac tumor, risk increased from cryptorchid testes
What are patients with Beckwith Wiedemann syndrome at risk for?
Wilms tumor, rhabdomyosarcoma and hepatoblastoma
Where is one of the most common locations for rhabdomyosarcoma to occur?
Head and Neck 40% of the time, can involve orbit
How can infantile and childhood eczema be differentiated?
Infantile - extensor surfaces and cheeks, trigger by wool, foods harch chems and extreme temps
Childhood - flexural surfaces
What are the clinical features of Schwachman Diamond syndrome?
Recurrent soft tissue infections characterized by decreased neutrophil activity and cyclic neutropenia
What is concerning in a patient with Kawasakis presenting with RUQ pain?
Hydrops of gallbladder