Exam I Flashcards
(250 cards)
1
Q
What are the 2 types of circumcision?
A
Gomco
Plastibell
2
Q
What are 2 contraindications to circumcision?
A
Unstable infant
Congenital penile anomalies
3
Q
Circumcision decreases the rate/risk of? (4)
A
↓ rate of: UTI, HPV, penile inflammation/ dermatoses, some STI’s
4
Q
What is the difference b/w pathologic and physiologic phimosis
A
Pathologic is caused by scaring, early forcible retraction, infection, inflammation.
Physiologic = normal foreskin adhesion to glans of penis
5
Q
Where is the urethral opening displaced with congenital epispadias?
A
Dorsal displacement of urethral opening
6
Q
What classifies microscopic hematuria?
A
> 5 RBCs/hpf
7
Q
What is the TX plan for asymptomatic microscopic hematuria?
A
Watchful waiting. Repeat UA weekly x 2 weeks until resolved
8
Q
What is a DDX for proteinuria?
A
Nephrotic syndrome
9
Q
What are the 4 characteristics of nephrotic syndrome?
A
- Nephrotic range proteinuria
- Hypoalbuminemia
- Facial edema (round O face)
- Hyperlipidemia
10
Q
What is 1st line imaging for UTI?
A
RBUS
11
Q
2 y/o presents with first febrile UTI what DX test should you order?
A
RBUS
12
Q
VCUG evaluates for?
A
ABN urine flow
13
Q
What is the test of choice for VUR?
A
VCUG
14
Q
VCUG is used for UTI f/u if? (4)
A
- ≥ 2 febrile UTIs
- 1st febrile UTI + RBUS anomaly
- temp ≥ 102.2 w/ pathogen other than E.coli
- Poor growth or HTN
15
Q
What is indicated by decreased DMSA uptake on renal scintigraphy?
A
Scarring/ inflammation
16
Q
Pathologic phimosis is secondary to what most commonly?
A
Early forcible retraction
17
Q
If a patient presents with painful erections, irritation/ bleeding, dysuria/ urinary retention, and recurrent infections, what should you be concerned about?
A
Pathologic phimosis
18
Q
What is 1st line treatment for pathologic phimosis?
A
Gentle stretching
also corticosteroids
19
Q
How does paraphimosis occur? (5 steps)
A
- Entrapment
- Impaired venous flow
- Engorgement
- Arterial compromise
- Ischemia
20
Q
In what populations is irritability concerning for paraphimosis?
A
Nonverbal
21
Q
What condition is considered a urologic emergency due to risk of ischemia?
A
Paraphimosis
22
Q
What surgical intervention is used in the treatment of paraphimosis?
A
Dorsal slit procedure
23
Q
If cryptorchidism is noted on PE of a patient diagnosed with hypospadias, what should you consider?
A
DSD (disorder of sexual development)
24
Q
What should be avoided in a patient diagnosed with hypospadias?
A
No circumcision during newborn period
25
What is the most common GU congenital abn?
Cryptorchidism
26
If you note a uni or bilateral absent testicle and a flat, underdeveloped scrotum on PE, what should you be concerned about?
Cryptorchidism
27
What is 1st line tx for cryptorchidism?
Orchiopexy (from 4 mos- 2 yrs)
28
What patient education should you provide with early cryptorchidism?
70% descend spontaneously by 4 mos
29
What is the test of choice for dx of testicular torsion?
Doppler US (blood flow and position of testes)
30
What sign will be negative on PE for testicular torsion?
Prehn sign
31
What concerning risk should you be concerned about with testicular torsion?
Risk of vascular compromise
32
If testicular torsion is treated within 4-6 hours, what is the prognosis? 12+ hours? >24 hours?
100%
20%
0% viable
33
What is the most common etiology of a UTI?
E. coli (ascending bacteria)
34
What is 1st line tx for a UTI?
Cephalosporin
| begin with empiric then adjust per C&S
35
How long should you treat with abx for UTI if the pt is febrile? Afebrile?
```
Febrile = 10 days
Afebrile = 3-5 days
```
36
What is vesicoureteral reflux (VUR)?
Retrograde urine flow
37
What is the most common type of renal fusion?
Horseshoe kidney
38
A patient diagnosed with a horseshoe kidney is at increased risk for what malignancy?
Wilms tumor (most common renal malignancy in kids?
39
Is a patient with a horseshoe kidney usually sx or asx?
Asx (excellent prognosis w/o any intervention in most its)
40
What is 1st line tx for nocturnal enuresis?
Reassurance/ education/ motivation therapy
41
What is 1st line pharmacologic tx for nocturnal enuresis?
DDAVP/ desmopressin (synthetic ADH)- use if > 6 yo
42
If a patient presents to your office 7-14 days post group A beta-hemolytic strep infection and has symptoms associated what glomerular specific disease should you be concerned about?
Poststreptococcal glomerulonephritis
43
What does throat, bloat, coke mean in regards to poststreptococcal glomerulonephritis?
Throat- post strep infection
Bloat- edema
Coke- cola colored/ dark urine
44
What labs are diagnostic for poststreptococcal glomerulonephritis?
Urine microscopy w/ RBC casts
45
What is the tetrad on PE for IGA vasculitis HSP?
1. Palpable purpura (LEs)
2. Arthritis/ arthralgia
3. Abd pain
4. Renal disease
46
What is the triad for HUS?
1. Hemolytic anemia
2. Thrombocytopenia
3. AKI
47
What is the most common acquired cause of HUS?
Shiga toxin- producing E. coli
48
If a patient presents to your office reports a previous illness (5-10 days) with abd pain, vomiting, and diarrhea, what condition should you be concerned about?
HUS
49
When does vomiting require an urgent eval?
If bilious (indicates obstruction)
50
What is the difference between GER and GERD?
```
GER= happy spitter, no complications, no tx required
GERD= unhappy spitter, complications
```
51
What is 1st line tx for GERD?
Lifestyle modification
52
If a patient with GERD has refractory sxs or an underlying medical condition, what meds should be used for tx?
1. PPI (omeprazole)
| 2. H2 blocker (ranitidine)
53
If a patient presents with a hx of macrolide abx use in the first few weeks of life, what condition should you be concerned about?
Pyloric stenosis
54
An "olive-like" mass in the RUQ is indicative of what?
Pyloric stenosis
55
What is the imaging test of choice for pyloric stenosis?
US
56
What is used for definitive management of pyloric stenosis?
Surgery (pyloromyotomy)
57
What is the most commonly affected site for congenital intestinal atresia?
Duodenum
58
If on imaging, you note a "double bubble" sign, what condition should you be concerned about?
Congenital intestinal atresia
59
What is the concern/ disease process with midgut malrotation?
Increased risk of volvulus which can lead to small bowel ischemia/ necrosis
60
What is the gold standard imaging for midgut malrotation, and what might you see?
UGI fluoroscopy/ x-ray
| "Corkscrew appearance"
61
What is the tx for midgut malrotation?
Surgery- Ladd procedure
62
What is the most common abd emergency in kids <2 yo?
Intussusception
63
Abdominal pain, sausage shaped mass and current jelly are sx of what disease?
Intussusception
64
What is the 1st line tx for intussusception if no evidence of perforation or shock?
Hydrostatic/Pneumatic enema
65
What is the most common cause of obstruction 6 mos - 3 yrs?
Intussusception
66
What is the most common pediatric surgical emergency?
Appendicitis
67
Radiation pain from the periumbilical area to the RLQ is concerning for?
Appendicitis
68
Vomiting and fever secondary to onset of pain is concerning for?
Appendicitis
69
What is the TX of choice for classically presenting appendicitis?
Surgery
70
What # of loose stools/day is indicative of diarrhea?
≥ 3
71
What are the 3 most common viral causes of diarrhea?
1. Norovirus
2. Rotavirus
3. Adenovirus
72
FTT, anemia, +/- foul smelling stools are concerning for?
Chronic Diarrhea from celiac disease
73
What are 4 causes of chronic diarrhea?
1. Malabsorption (CF)
2. Functional toddler's diarrhea
3. Celiac disease
4. Allergic enteropathy (food allergy)
74
Are routine stool cultures recommended for acute diarrhea?
No
75
What is 1st line tx for diarrhea?
Hydration
76
Why are ABX used routinely for the tx of well appearing children w/ diarrhea?
↑ risk of HUS
77
What are the two main subtypes of inflammatory bowel disease?
1. Crohn's disease
| 2. Ulcerative colitis
78
Mouth to anus GI involvement, skip lesions and cobblestones ulcerations, and transmural inflammation are sx of what disease?
Crohn's Disease
79
Rectum and colon GI involvement, continuous/diffuse ulcerations, and inflammation of the superficial/mucosal layer are sx of what disease?
Ulcerative collits
80
What is the tx progression for the majority of pt's dx w/ inflammatory bowel disease?
Step-up (most pts)
1. Aminosalicylates
2. Immunomodulating agents
3. Steroids (acute flares)
4. +/- ABX, surgery (refractory cases)
81
If pt w/ high risk inflammatory bowel disease, what is the tx progression?
Top Down
1. ABX, surgery (refractory cases)
2. Steroids (acute flares)
3. Immunomodulating agents
4. Aminosalicylates
82
Tx of inflammatory bowel disease is multidisciplinary, what are the 5 principle tx components?
1. Meds
2. Surgery
3. Nutritional rehab
4. Behavioral health support
5. Colorectal cancer screening (older pts)
83
What is the most common congenital anomaly of the GI tract?
Meckel's Diverticulum
84
Painless rectal bleeding, obstruction, and diverticulitis are sx of what disease?
Meckel's Diverticulum
85
What is Meckel's Diverticulum's "Rule of 2's"?
2% population
2:1 M:F
2% develop complications (usu. Before age 2),
2’ from ileocecal valve
86
What imaging will identify ectopic gastric mucosa?
Mekel's Scan
| Meckel's Diverticulum
87
What is 1st line tx for Meckel's Diverticulum?
Surgical ressection
88
Leakage of retained stool commonly seen in kids w/ chronic constipation
Encopresis
89
Is constipation more likely to be caused by functional or organic causes?
Functional
90
What is the recommended daily dose of fiber for children > 2y/o
Age + 5-10 g/day
91
What is the recommended daily dose of fiber for children < 2y/o
5 g/day
92
Anal tissues and fecal leakage are sx of what disease?
constipation
93
Constipation red flags? (5)
1. Weight changes
2. FTT
3. Hx of delayed meconium
4. Acute onset
5. Failure to respond to conservative tx.
94
Diarrhea red flags? (8)
1. Fever
2. Severe abd pain
3. Blood in stool
4. Recent ABX use
5. Persistent sx
6. Dehydration
7. Leukocytosis
8. FTT/developmental delays
95
Findings suggesting an organic cause of constipation? (7)
1. Failure to pass meconium
2. FTT
3. Abd distention/ obstructive sx
4. Lumbosacral problems
5. Neurologic abn
6. Anterior placed anus
7. occult blood in stool
96
What labs and imaging for are ordered for constipation when red flags are present?
Labs: CBC, CMP, TSH, celiac testing, chloride sweat
Imaging: Abd XR (r/o impaction)
97
What are the conservative txs for constipation? (5)
1. Hydration
2. Increase daily fiber
3. Limits cow's milk
4. Fruit juice (apple, pear, prune)
5. Counseling/positive reinforcement
98
When is a child w/ constipation referred to Gi?
If not improving with conservative measures or + red flag
99
Colon failure +/- obstruction (due to the absence of the ganglion cells in mucosal and muscular layers of the colon causing spasm abnormal motility) is what disease?
Hirschsprung disease
100
Failure to pass meconium w/in first 48 hrs of life is concerning for?
Hirschsprung disease
101
Bilious vomit, abd distention, + squirt sign are sx of what disease?
Hirschsprung disease
102
Older children w/ chronic constipation and FTT w/ + hx for passing meconium are concerning for what disease?
Hirschsprung disease
103
Rectal biopsy is gold standard for what disease?
Hirschsprung disease
104
Why is a contrast enema is useful in the dx of Hirschsprung disease?
Localizes the "transition zone"
105
What is the tx of choice for Hirschsprung disease?
Surgical resection of aganglionic segment of colon
106
What is the prognosis for Hischsprung disease?
Good, +/- abnormal bowel function
107
Embryonic remnant of the viteline duct that can cause GI bleed
Meckel's diverticulum
108
Abnormal positioning of the intestines in the abdomen with an increased risk of volvulus?
Midgut malrotation
109
One+ segment of the bowel that may be absent and/or obstruction at birth (duodenal, jejunoileal, colonic)
Congenital Intestinal Atresia
110
5 wk old hungry infant w/ projectile vomit, this is concerning for?
Pyloric stenosis
111
6 mos old w/ abd pain and current jelly stool, this is concerning for?
Intussusception
112
Congenital aganglioic megacolon (rectal biopsy is gold standard) is concerning for?
Hirschsprung disease
113
Chronic diarrhea, gluten sensitivity, FFT is concerning for?
Celiac disease
114
Transmural inflammation from mouth to anus, + skip lesions is concerning for?
Crohn's disease
115
Continuous, red, friability in rectum, + large colon is concerning for?
Ulcerative colitis
116
Periumbilical pain, + Rovsings, obturator, psoas, McBurney's point tenderness is concerning for?
Appendicits
117
Healthy 7y/o F present with painless dark urine. What is best screening test to assess for hematuria?
a. VCUG
b. Urine dipstick
c. Urine C&S
d. RBUS
b. Urine dipstick
| best screening test for hematuria
118
Foamy urine is indicative of what?
a. hematuria
b. UTI
c. proteinuria
d. HUS
c. Proteinuria
119
Retracted foreskin in an uncircumcised M that can't be return to natural position is concerning for?
Paraphimosis
120
Inability to retract the foreskin is concerning for?
Phimosis
121
What the tx options for pathologic phimosis?(3)
stretching, topical steroids, circumcision
122
Causes of paraphimosis? (5)
Forceful retraction, infection, inflammation, procedures, trauma
123
Does phimosis or paraphimosis require emergent tx?
Paraphimosis (risk of ischemia)
124
Ventral displacement of the urethra is concerning for?
Hypospadias
125
Abnormal penile curvature is concerning for?
Chordee
126
Dorsal displacement of the urethra is concerning for?
Epispadias
127
Cryptorchids may increase risk for what?
Testicular torsion, sub-fertility, testicular CA
128
Confirmatory test of choice for testicular torsion
Testicular US/doppler
129
Surgical correction of testicular torsion
Orchiopexy (detorsion and fixation)
130
Retrograde flow of urine from bladder into upper respiratory tract
Vesicoureteral Reflux
131
Management options for VUR
Surveillance, prophylactic ABX, surgical options
132
What are the warning signs for childhood cancer? (11)
1. weight loss
2. HA/ vomiting
3. swelling
4. lump/ mass
5. bruising/ bleeding rash
6. infections
7. white-is color behind pupil
8. persisting nausea/ vomiting without nausea
9. tiredness/ paleness
10. vision changes
11. recurrent fevers (unknown origin)
133
What oncology syndrome is considered an emergency?
tumor lysis syndrome (anticipated w/ start of cancer tx)
134
>10 yo, splenomegaly, mediastinal mass, and initial WBC > 20,000 are independent predictors of what?
tumor lysis syndrome
135
What are the cardinal signs of a bone tumor?
1. bone pain @ tumor site
2. mass formation
3. fracture through area of cortical destruction
136
What is the most common malignancy of childhood? (2-5 yo)
ALL
| *ALL children get sick*
137
What cancer is defined by uncontrolled proliferation of immature lymphocytes?
ALL (mostly B cells)
138
What will be seen on a peripheral smear for ALL?
lymphoblasts
139
What is 1st line treatment for ALL?
chemotherapy (multi drug regimen)
140
What cancer is defined by decreased differentiation of precursor cells committed to myeloid line?
AML
141
What is diagnostic in a BM bx for AML?
20%+ blasts AND leukemic cells of myeloid origin
142
If WBC > 100,000 and peripheral smear shows Auer rods with circulating myeloblasts, what cancer should you be concerned about?
AML
| *AML = Auer rods, malaise, leukocytosis*
143
What is the tx for AML?
chemo followed by consolidation chemo or HSCT
144
What cancer is defined by myeloproliferative disorder or mature/ maturing granulocytes?
CML
145
If you see a Philadelphia chromosome on peripheral smear, what cancer should you be concerned about?
CML
| *BrC-ABL1 CML*
146
What is considered a blast crisis in CML?
Blast cells > 20%
147
How is CML controlled? Cured?
```
Control = TKIs
Cure = HSCT
```
148
Which cancer is associated with previous EBV?
Hodgkin lymphoma
149
If a patient presents with painless cervical and supraclavicular adenopathy, mediastinal mass, and Reed Sternberg cells on peripheral smear, what cancer should you be concerned about?
Hodgkin lymphoma
150
What is the treatment for Hodgkin lymphoma?
chemo + radiation, autologous HSCT
151
What cancer is defined by rapidly proliferating, high grade, diffuse malignancies?
Non- hodgkin lymphoma
152
What should you watch for when treating non- hodgkin lymphoma?
Tumor lysis syndrome
153
What is the most common solid tumor of childhood and the leading cause of death from childhood cancer?
brain tumors
154
What is the triad commonly associated with brain tumors?
a.m. HA, vomiting, papilledema
155
If a younger child presents with FTT, delayed development, and macrocephaly, what should you be concerned about?
brain tumor
156
If an older child presents with hx of school failure, personality changes, or focal neurological deficits, what should you be concerned about?
brain tumor
157
What is the tx for brain tumors?
Surgical removal and radiation/ chemo when indicated
158
What is the most common solid neoplasm outside of the CNS (typically seen as abd mass)?
Neuroblastoma
159
If upon PE, you note an abd mass that crosses midline, what should you be concerned about?
Neuroblastoma
160
If upon PE, you note a smooth, firm, well demarcated abd mass that does not cross midline, what should you be concerned about?
Nephroblastoma
161
What is the treatment for neuroblastoma?
surgical resection + chemo +/- radiation
162
What is a nephroblastoma aka?
Wilms tumor
163
What is 2nd most common abd tumor?
Nephroblastoma
164
Is a solitary tumor or bilateral kidney involvement more common with regards to nephroblastoma?
Solitary tumor
165
What is the preferred dx study for brain tumors?
MRI (but 30 min, so sometimes use CT bc shorter ~ 10 min)
166
What imaging is used for nephroblastoma?
US > CT abd/ chest
167
What is the treatment for nephroblastoma?
surgical exploration, chemo, radiation
168
What is the most common primary malignancy of bones and which type of bones is it more common in?
osteosarcoma, long bones
169
If upon x-ray imaging you note destruction of trabecular pattern and irregular margins, what cancer should you be concerned about?
osteosarcoma
170
What is the tx for osteosarcoma?
surgery/ chemo
171
What is the 2nd most common primary bone tumor and what type of bones is it more common in?
Ewing, long bones
172
If a pt presents with hx of nighttime bone, worsening localized pain +/- swelling, what type of cancer should you be concerned about?
Ewing sarcoma
173
What is the treatment for Ewing sarcoma?
chemo, surgery, radiation (or combo)
174
What is the most common intraocular tumor and what role do parents play in this type of cancer?
retinoblastoma, parent may be silent carrier
175
What is leukocoria and what type of tumor will this be seen with?
White pupillary reflex (< 3 yo), seen w retinoblastoma
176
If you note chalky, off-white retinal mass with soft, friable consistency, what should you be concerned about?
retinoblastoma
177
What is the treatment for retinoblastoma?
vision sparing therapies, external beam irradiation, chemo if confined to globe
178
What is the most common soft tissue sarcoma?
rhabdomyosarcoma
179
Although any body part can be affected by rhabdomyosarcoma, what is most common in infants? young children? adolescents?
infants= GU tract
young children= head and neck
adolescents= extremity tumors
180
What might be noted on PE of a patient with rhabdomyosarcoma if it is orbital?
proptosis/ exophthalmos
181
What is the treatment for rhabdomyosarcoma?
surgery, chemo, radiation (in any combo)
182
How prevalent are hepatic tumors?
2/3 of liver masses
| hepatoblastoma = most common
183
What is a marker for response to treatment of hepatic tumors?
elevated AFP
184
What is the treatment for hepatic tumors?
surgery and chemo (complete resection essential for survival)
185
How is anemia defined?
- reduction in RBC 2 SD below normal for age/ sex
| - [Hgb] < 11 for 6 mos- 5 yrs
186
What reticulocyte count levels are concerning?
Low
187
Normocytic and normochromic anemia is considered anemia of what?
chronic disease
188
What are the types of microcytic, hypochromic anemia?
IDA, thalassemia, lead intoxication
189
What are the types of macrocytic anemia?
vit B12 and folate def
190
What is fanconi anemia often misdiagnosed as?
ITP
191
What condition is an inherited BM failure syndrome?
Fanconi anemia
192
What condition is defined by progressive pancytopenia, severe congenital malformations, and increased malignancy incidence?
Fanconi anemia
193
Fanconi anemia is associated with a high risk of what 2 conditions?
MDS, AML
194
What condition is peripheral pancytopenia with hypo cellular BM?
acquired aplastic anemia
195
What complications are associated with acquired aplastic anemia?
overwhelming infection and severe hemorrhage (can lead to death)
196
What is the most common nutritional deficiency in children?
iron
197
When is screening performed to check for iron deficiency (anemia)?
12 months- check Hb conc and RF's
198
Microcytic anemia have an MCV < what?
78
199
If a patient presents with a hx of delayed motor development and pica, what should you be concerned about?
IDA
200
What is the treatment for IDA?
Iron 6mg/kg/day divided into 3 doses
201
If when screening for ID/ IDA you note a Hgb value of 10-11, what should you do next?
Close monitoring/ empiric tx and re-check Hgb in 1 month
202
Microcytic anemia have an MCV > what?
100
203
Pallor and glossitis may be noted upon PE for what 2 conditions?
vit B 12 and folate def
204
Are neurologic signs noted with vit B12 or folate def?
vit B12
205
Labs will show hyperhsegmented nuclei and only elevated homocysteine acid with B12 or folate def?
folate
206
Labs will show hyperhsegmented nuclei and elevated methylmalonic acid AND elevated homocysteine with B12 or folate def?
vit B12
207
Although treated with folate will fix anemia in vitB12 def patients, why must you still treat with vitB12?
to avoid permanent neurological deficits
208
What condition is associated with a RBC membrane defect?
hereditary spherocytosis (HS)
209
Hemolytic anemia leading to jaundice, splenomegaly, and gallstones + spherocytes + increased osmotic fragility are indicative of what?
HS
210
What is the treatment for HS?
supportive +/- RBC transfusion, possible splenectomy
211
How is thalassemia diagnosed?
Hgb electrophoresis
212
What disease is associated with vast-occlusion/ pain?
sickle cell disease
213
How is sickle cell disease diagnosed?
Hgb electrophoresis
214
What is the treatment for sickle cell disease?
hydroxyurea, tx for painful vaso-occlusive episodes?
215
What condition is associated with episodic hemolysis w/ oxidant stress of infection/ drugs/ food?
G6PD
216
What will be seen on peripheral smear of a patient with G6PD?
bite-like deformity, Heinz bodies
217
If on peripheral smear you note basophilic stippling, what should you be concerned about?
lead poisoning
218
What is the treatment for lead poisoning?
chelation
219
Increased RBCs (Hgb up to 27 g/dL) +/- plethora and splenomegaly is indicative of what condition?
polycythemia
220
What levels of platelets place someone at risk for spontaneous bleeding?
< 20,000
221
What measures extrinsic & common pathways (VII, tissue factor)?
PT, PTT/aPTT, INR, or bleeding time?
PT
222
What measures intrinsic pathways (VIII, XI, XII)?
PT, PTT/aPTT, INR, or bleeding time?
PTT/aPTT
223
What provides a more accurate PT reflection and is used for Warfarin monitoring?
PT, PTT/aPTT, INR, or bleeding time?
INR
224
What measures hemostasis time and screens for platelet dysfunction?
PT, PTT/aPTT, INR, or bleeding time?
Bleeding time
225
What is the most common bleeding disorder of childhood?
Acute ITP
226
If a patient presents with hx of viral infection, petechiae, eccymosis/ epistaxis, what should you be concerned about?
ITP
227
What will PT and aPTT values look like in a pt with ITP?
normal
228
How common is spontaneous remission in a patient with ITP?
90%
229
What is the most common inherited bleeding disorder?
Von Willebrand disease
230
What disorder is associated with prolonged bleeding time from mucosal surfaces and easy bruising?
Von Willebrand disease
231
What is the treatment for Von Willebrand disease?
Desmopressin + vWF replacement therapy
232
Is hemophilia A or B more common? Which is the Christmas disease?
```
A= most common
B= Christmas disease
```
233
What are the common sites of bleeding in patients with hemophilia?
into joints/ muscles
234
What are patients diagnosed with hemophilia at risk of?
spontaneous hemarthrosis (severe disease, if recurrent, can cause joint destruction)
235
What is the treatment for hemophilia?
Desmopressin + factor replacement therapy
236
What are the 3 types of acquired bleeding disorders?
DIC, liver/ kidney disease, vit K def
237
Sepsis, trauma/ tissue injury, and malignancies can be triggers for what disease?
DIC
238
What can shock with DIC lead to?
end organ dysfunction
239
Evidence of thrombotic lesions (major vessel thrombosis and purport fulminans) can be seen with what disease?
DIC
240
Increased D-dimer and fibrin depredation products can be noted on labs for what disease?
DIC
241
What is the most common type of small vessel vasculitis?
Henoch-Schonlein purpurn (HSP)?
242
What disorder is caused by deposition of IgA immune complexes in small vessels of skin, GI tract, and kidneys?
HSP
243
Palpable, non-blanching purpura is noted on PE of what disease?
HSP
244
What is inactivated with a protein C def?
factors V and VIII
245
What facilitates action of activated protein C?
protein S
246
What condition may diminish efficiency of Heparin?
antithrombin def
247
Factor V Leiden mutations is associated with increased risk of what?
VTE (esp if use of oral contraceptives, or homozygous for factor V leiden)
248
What is the treatment for inherited thrombotic disorders?
anticoagulation prophylaxis/ agents
249
What are the inherited thrombotic disorders?
protein C def
protein S def
antithrombin def
factor V leiden mutations
250
What is 1st line tx for VTE?
anticoagulation 3+ mos
