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MED5600 > Pediatri > Flashcards

Pediatri Flashcards

1
Q

Pylorusstenose

A

.

– Olive shape mass in epigaster
– Lab: Hypochloremic metabolic alkalosis!!

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2
Q

Kawasaki

A

.

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3
Q

Major Milestones

A

x

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4
Q

Når får nyfødte tilbake fødselsvekten?

A

Brystfødende: 6,5 dager

formula: 8,3 dager

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5
Q

Vektutvikling:

A 
Vekttap første par dager 5-10%
Tilbake etter 7-10dager (3,5kg)
Dobbel vekt (7kg) 4-5mnd
Trippel vekt (10kg) 1 år
Kvadruppel vekt: 2-3 år

10kg: 1 år
20kg: 5 år
30kg: 10 år

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6
Q

Utvikling lengdevekst

A 
Fødsel: 50cm
1 år: 75cm
90cm: 3 år
100cm: 4 år
økning på 5-7,5 cm/1. år til pubertet
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7
Q

Speech - milestones

A

1 year: 1-3 words
2 years: 2-3 word phrases
3 years: routine use of sentences
4 years: routine use of sentence sequences
5 years: complex sentences, pronouns, prepositions

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8
Q

Normal gråt og kolikk

A
  • Most infants cry little during the first 2 weeks of life. Between 2 and 6 weeks average from 2- 3 hrs per day
  • 12 weeks: 1 hr daily crying
  • Colic: Crying more than 3 hrs per day for more than 3 days a week for more than 3 weeks (”Wessels rule of 3”)
  • < 5% of infants with excessive crying have organic etiology
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9
Q

normal sleep

A
  • Full term infants sleep 2/3 of the day
  • 1 year: 15 hrs (2-3 hrs during the day) • 12 years: 9 hrs
  • Newborns start their sleep cycle (6o min cycle) in active sleep whereas older children and adults (90 min cycle) begin sleep in NREM sleep.
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10
Q

Phenylketonuria PKU

A

x

Screened for at birth

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11
Q

Congenital hypothyroidism (CH)

A

x

Screened for at birth

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12
Q

Vaksinering i Norge

A

6 weeks, 3 months
Rota virus

3 , 5 and 11-12 months:
Diphteria, tetanus and pertussis (DTP), Haemophilus influenzae type B (Hib), Poliomyelitis (IPV)
Pneumococcus (PKV)

15 months and 12-13 years:
Morbilli, Parotitis and Rubella (MMR)

6-7 year:
Diphteria, tetanus and pertussis (DTP) Poliomyelitis (IPV)

13-14 year:
HPV

15-16 year:
Diphteria and tetanus) (DT) Poliomyelitis (IPV)

Girls are offered HPV vaccine at the age of 12
Hepatitt B-vaccine recommended to children of parents from countries where Hepatitis B is common or children who are at risk for hepatitis B. Given in infancy/newborn period . BCG to risk population at 6 weeks

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13
Q

Normal puberty

A

The normal age for onset of puberty is: 9 - 13.5 years for girls,
10 - 14.5 years for boys
The first signs are respectively beginning of breast budding
at an average age of 10-11 yrs.
and testicular enlargement (volume >4 ml), at an
average age of 11 yrs.

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14
Q

Somatic development. Warning signs

A

If the child is not able to:
Reach for objects at latest 5 months
Sit at latest 10 months
Walk at latest 18 months

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15
Q

Språkutvikling

A
  • 1 year 1 word: learn 1 new word per week

* 2 years 2 words together: 1 new word per day • 3 years 3 words together

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16
Q

milestones

A
  • 2 months: response smiling •3 months: good eye contact •5 months: reaches for objects •10 months: sits unsupported •12 months pincer grip
  • 18 months: walks unsupported
  • 18 months : says single words with meaning •20 months: speaks in phrases
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17
Q

Fever, key point:

A

(Bruun Wyller)
• The younger the child, the more concerned!
• Lack of effect of temperature lowering attempts might signal more serious condition
• Temperature values in itself is not very informative

  • Does the baby seem attentive?
  • How is the general condition?
  • Why is the mother so worried?
18
Q

Diffdiagnoser v feber

A 
• A localized infection (common!)
 Upper airway infection, incl. otitis 
 Lower airway infection
 Urinary tract infection
 Gastroenteritis
 Meningitis/encephalitis
 Osteomyelitis/arthritis
 Skin infections
• A generalised infection (possibly dangerous!)
 Generalised viral infection
 Generalised bacterial infection, incl. septicaemia
• Other (rare!)
 Autoimmune disease
 Malignancies
 Immune deficiency
19
Q

Tolkning av syre/ base-prøve

A

x
Se Bruun Wyllers forelesning fra 22/8

Metabolsk acidose
Metabolsk alkalose
Respiratorisk =

20
Q

Apgar Score

A

x

  • Range from 0 to 10. Routinely scored after 1, 5 and 10 minutes.
  • Provides information on asphyxia (general lack of oxygen) during delivery
  • Might be regarded a measure of general condition in the newborn
21
Q

Nutritional deficiencies – key notes

A 
- Affected nutrients
• Proteins (low albumin)
• Lipids (low triglycerides)
• Minerals (calcium, iron)
• Water-soluble vitamins (folic acid)
• Fat-soluble vitamins (Vitamin A)
- Possible diagnosis
• No access to nutrients
• Anorexia nervosa
• General malabsorption, eg. celiac disease
• (Excessive energy and nutrient consumption, eg. heart failure)
- Acid-base balance
• Often slight metabolic acidosis due to increased break-down of ketone bodies
22
Q

Tonsilitt og Centor kriteriene:

A 
4/5 må oppfylles for diagnose i allmenpraksis.
Sår hals (akutt start)
Temp over 38,5
Store innflammerte tonsiller m puss
Såre/ forstørrede lymfeknuter på hals
Fravær av hoste
23
Q

wilms tumor

A

x

24
Q

Ewings sarcoma

A

x

25
Q

Diagnoser viktige hos premature barn

A 
(IVH) Intraventricular hemorrhage 
(BPD) Bronchopulmonary dysplasia 
(NEC) Necrotizing enterocolitis 
(ROP) Retinopathy of prematurity 
(RDS) Respiratory distress syndrome 
(PVL) Periventricular leukomalacia
26
Q

Key notes prolonged jaundice

A 
- Possible diagnoses
• Normal physiology  Gilbert syndrome
 Breast milk jaundice
• Hemolysis
 Rhesus incompatibility
 Other incompatibilities
• Liver disease
 Hepatitis
 Biliary atresia
• Other
 Inborn errrors of metabolism  Hypothyreosis
 Gut obstruction
27
Q

Key Notes rash

A
  • Possible diagnoses
    • Petecchiae/bruises/purpura
     Septicaemia
     Leukemia
     Idiopathic/immune trombocytopenic purpura (ITP)  Henoch-Schönlein purpura
    • «Infectious rash»
     Virus infections (measles, rubella, varicella, herpes simplex, erythema infectiosum, roseola
    infantum, hand-, foot- and mouth disease, warts, molluscum)
     Bacterial infections (scarlatina, borreliosis, impetigo)
     Fungal/parasite infections/infestations (candida, scabies, tropical diseases )
    • Skin inflammations
     Kawasaki syndrome (mucocutaneous lymph node syndrome)  Eczema
     Acne
     Toxic erythema
     Hives
28
Q

Limping key notes

A 
- Possible diagnoses
• Infections
 Osteomyelitis
 Arthritis (bacterial, viral/’reactive’)
• Autoimmunity
 JRA
 Spondyloartheritis  Reumatic fever
• Malignancies  Leukemia
 Primary bone tumor
• Traumas
 Fractures
 Epiphysiolysis
• Neuromuscular disorders
• Congenital malformations/miscellaneous
 Congenital hip dislocation  Calvé-Legg-Perthes disease
- Supplemental investigations
• Lab screening (haematology, infection/inflammation markers)
• Imaging (x-ray, ultrasound, MRI)
29
Q

SMA - spinal muskelatrofi

A

Tre typer:

III: Barn som kan gå og som ser vanlig ut, men kan ikke løpe, hoppe, hinke

30
Q

Fecal Calprotectin

A

x

31
Q

Jern i IBD

A

Gi aldri jern PO.

bare iv.

32
Q

Exclusive Enteral nutrition

A
  • Liquid diet
  • 8 week course
  • ”Liquid bandadge”
  • Mucosal healing
  • No side effects ( except compliance) • Does not work in UC
33
Q

Celiac spesific angibodies

A

• IgA anti- transglutaminase ( tTG) • IgG anti deamidated gliadine

34
Q

Cøliaki tester

A

Immunglobuliner
HLA-typing
biopsi

35
Q

ENCOPRESIS

A

Involuntary passage of stools in children over 4 years of age

36
Q

Kernicterus

A

x

37
Q

Neonatal jaundice

A

• Jaundice is caused by accumulaJon of unconjugated bilirubin in the skin
– In most infants - normal physiology
– In some infants addiJonal factors may increase the degree of jaundice

38
Q

Bilirubin toxicity

A

• Bilirubin encephalopathy - brain funcJon is
affected transitorily (probably): • Lethargy/anorexia • Neurophysiologic changes (ABR, VER)
• Kernicterus - brain damage
• Death in acute phase
– Typically in Rhesus isoimmunizaJon 100+ years ago – And sJll today in LMICs
• In survivors a CP-like condiJon with choreoathetosis, deafness, gaze palsy, ⇓I.Q.

39
Q

”Physiologic” jaundice in neonates is due to the simultaneous occurrence of two phenomena:

A

– High bilirubin production (x2 relative to adults) due to breakdown of fetal erythrocytes
• fetal red cells have shorter survival time • hemoglobin higher in fetal life

– Hepatic excretory capacity for bilirubin is low • low ligandin in liver cells
• low activity of glucuronyl transferase

40
Q

Empiric antibiotic treatment of most respiratory tract infections in Norway

A 
• Drug of choice: Penicillin
– Exceptions:
• Pertussis: Erytromycin
• Mycoplasma: Erytromycin
• Allergy to penicillin: Erytromycin

MED5600 (3 decks)

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