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Flashcards in early childhood path Deck (29):
1

major cause of death in 1mo t0 12mo

SIDS - 1/2 of death

2

def. sudden unexpected death

instant death occurring within 24hrs of onset of Sx under 12months

3

def. SIDS

sudden unexpected death with death occuring in sleep and cause remains unknown even after investigations including autopsy and clinical Hx

4

what is cause of SIDS

unknown - diagnosis of exclusion

5

peak of SIDS

1-4 mos

6

major SIDS intervention

sleep in back

7

risk factors for SIDS

1. prone or side sleep
2. soft bedding
3. maternal smoking
4. overheating
5. late or no prenatal care
6. young mom
7. premature
8 . male

8

3 genetic factors

1. cardiac ion channel defects
2. neurotransmitter assoc. defects
3. complement C4 defects

9

5 common path findings in SIDS

1. thoracic petechiae
2. pulm congestion and edema
3. mild resp inflammation
4. mild brain swelling
5. empty bladder

10

what is ontario system for investigation

MD coroner system

11

3 parts to pre-autopsy

1. scene investigation
2. circ. of death
3. infant and fam. medical Hx

12

steps to autopsy (7)

1. external exam
2. photograph
3. diagnostic imaging
4. complete internal exam
5. detailed neuro exam
6. microscopic exam
7. microbio/chemical tests

13

6 other causes of SUID

1. infection
2. CNS disorder
3. asthma
4. CV
5. metabolic
6. GI

14

def. cholestasis

reduction in bile formation or bile flow resulting in accumulation of bile - bilirubin - jaundice

15

features of infant jaundice

- yellow discoloration in sclera, skin, internal
- pale stool
- dark urine

16

what level is needed to cause jaundice

2-3 in adults, over 5 in infants

17

what is physiologic jaundice

unconjugated bulirubinemia in infacnts - up to 15%

18

def. kernicterus

deposition of bilirubin in basal ganglia - neuro impariment

19

*** top 3 causes of early infant cholestais

1. biliary atresia
2. idiopathic neonatal hepatitis
3. A1-antitrypsiin def.

20

3 steps to investigate

1. biochem - unconjugated?
2. diagnotic imaging
3. liver biopsy

21

def. biliary atresia

pregressive necrotizing infalmmatory process affecting the extrahepatic biliary system
- loss of bile duct patency

22

2 main forms of atresia

1. perinatal form (80%) - forms later
2. fetal form (20%) - from birth

23

causes of two forms

perinatal - progressive destruction of bilairy system
fetal - abnormal dev. of biliary system

24

3 patho types of biliary atresia

type 1 and 2 - limited to ductal system below porta hepatis
type 3 (90%) - involves porta hepatis and ducts

25

what happens to liver in atresia

damage due to bile backup

26

3 types of imaging for atresia

1. ultrasound
2. HIDA scan
3 operative cholangiogram

27

what is needed for atresia diagnosis

liver biopsy

28

3 treatments of atresia

1. resection and reconstruction of part involved
2. kasai procedure
3. liver transplant

29

what is kasai

loops of bowel anastamosed to porta hepatis
- high failure rate after 1 year

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