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Flashcards in BRS - Peds Deck (90)
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61

what may be a cause of late onset CHF in an infant?

large VSD (ddx any outflow obstruction or valvular abnormalities)

62

What findings are consistent with a PDA?

loud machinery like murmur and brisk pulses

63

what is the only cyanotic congenital heart disease that presents with LVH at birth?

tricuspid atresia

64

What may be seen on CXR in epiglottitis?

Thumbprint sign

65

What is the most common cause of pneumonia in adolescents?

Mycoplasma pneumoniae and Chlamydia pneumoniae

66

What are the classic bugs that colonize the lungs of patients with CF?

Staph aureus initially and P. aeruginosa subsequently

67

What is classically seen on electrolyte exam of patients with CF?

Hyponatremic, hypochloremic, hypokalemic metabolic alkalosis

68

What are the PFT patterns of disease seen in patients with CF?

Obstructive lung disease early on, restrictive lung disease later in the course

69

What is the chance of a sibling of a patient with CF to get the disease?

Recessive pattern of inheritance, therefor 25% chance

70

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)

71

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

72

What is the proper management of epiglottitis?

Avoid excessive stimulation (e.g. examination of pharynx), evaluation of airway and intubation in controlled setting

73

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

74

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

75

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

76

What is the effect of infantile botulism on DTRs? What can aid in diagnosing this condition?

Decreased DTRs

Electromyography may show brief, small-amplitude muscle potentials with incremental response during high frequency stimulation

77

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

78

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

79

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

80

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

81

What can result from a diet containing exclusively goat milk?

Folic acid deficiency and macrocytic anemia

82

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

83

What may result from Parvo B19 infection in Peds?

URTI and slapped cheek rash

NO ANEMIA

84

What are the most common testicular tumors and what increases risk for these tumors?

Yolk sac tumor, risk increased from cryptorchid testes

85

What are patients with Beckwith Wiedemann syndrome at risk for?

Wilms tumor, rhabdomyosarcoma and hepatoblastoma

86

Where is one of the most common locations for rhabdomyosarcoma to occur?

Head and Neck 40% of the time, can involve orbit

87

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

88

What are the clinical features of Schwachman Diamond syndrome?

Recurrent soft tissue infections characterized by decreased neutrophil activity and cyclic neutropenia

89

What is concerning in a patient with Kawasakis presenting with RUQ pain?

Hydrops of gallbladder

90

What is the indication for surgery in scolios?

After growth spurt of puberty if angle >50