Pediatric Disorders Flashcards
(98 cards)
cutis marmorata
lacy, reticulated vascular pattern over most of body when baby is cooled, improves after first month, can be associated with some syndromes, non-concerning
milia
firm, white papules, inclusion cyst, on palate midline; epstein pearls, spontaneous resolution
caused by accumulation of sweat beneath eccrine sweat ducts
salmon patch (nevus simplex)
pale, pink vascular macules found in nuchal area, glabella, eyelids, usually symmetric, facial ones disappear, posterior ones persist
mongolian spots
blue or slate-gray macules, seen on presacral, back, posterior thighs, arrest melanocytes, usually fade over first few years
differential: child abuse
erythema toxicum
firm, yellow-white papules/pustules with erythematous base, peaks on second day of life, contain eosinophils, self-limited
differential: staphylococcal scalded skin syndrome
port wine stain (nevus flammeus)
vascular malformation, permanent defect, unilateral, most on head and neck, rule out sturge-weber syndrome
treat with pulsed laser
hemangioma
superficial: bright red, protuberant, appear in first 2 months, involution by 5-9 years of age
deeper: bluish hue, firm, less likely to regress, treat with steroids or pulsed laser if huge and interfering with function
neonatal acne
erythematous papules on face, caused by maternal androgens, no treatment
preauricular tags/pits
look for hearing loss and genitourinary anomalies
nevus sebaceous
alopecia of orange-colored, nodular skin, possible malignant degeneration, remove before adolescence
coloboma of iris
cleft at “6 o’ clock” position, associated with CHARGE syndrome
aniridia
hypoplasia of iris, defect usually through to retina, associated with wilms tumor
branchial clef cyst
mass arising laterally, infections common, requires surgical removal
thyroglossal duct cyst
mass arising midline, moves with swallowing
hypospadias
urethral opening on ventral surface (under surface), common with other anomalies, no cricumcision
epispadias
urethral opening on dorsal surface (top surface)
phenylketonuria diagnosis and management
phenylalanine hydroxylase accumulation
mental retardation, vomiting, growth retardation, hyperactive, purposeless movements, athetosis, seizures
fair hair, fair skin, blue eyes, tooth abnormalities, microcephaly
MR occurs gradually over first few months
treatment: low phenylalanine diet for life
classic galactosemia diagnosis and management
G-1-P uridylyltransferase deficiency, accumulation of G-1-P with injury to kidney, liver, and brain
jaundice, hepatomegaly, hypoglycemia, cataracts, seizures, MR
predisposition to e. coli sepsis
may begin prenatally
treatment: no lactose reverses growth failure and cataracts but not neurodevelopmental problems
symmetric IUGR
early, in utero insult
genetic syndromes, chromosomal abnormalities, congenital infections, teratogens, toxins
asymmetric IUGR (head bigger than body)
relatively late onset after fetal organ development, abnormal delivery of nutritional substances and oxygen to the fetus
uteroplacental insufficiency secondary to maternal diseases, risk of neurologic asphyxia
characteristics of post-term infants
increased birth weight absence of lanugo decreased/absent vermix desquamating, pale, loose skin abundant hair, long nails meconium staining
transient tachypnea of the newborn
slow absorption of fetal lung fluid, decreased pulmonary compliance
tachypnea after birth, common in term infant delivered by c-section or rapid second stage of labor
rapid improvemen within hours or days
meconium aspiration
meconium passed from hypoxia or fetal distress can be aspirated, causing respiratory distress and hypoxemia, overdistention of chest, patchy infiltrates, increased AP diameter
treatment: positive pressure ventilation, nitric oxide, ECMO
diaphragmaic hernia
failure of diaphragm to develop, abdominal contents enter chest causing pulmonary hypoplasia
bowel sounds easily heard in chest
treatment: immediate intubation, ECMO, followed by surgical correction
