Pediatric Disorders Flashcards Preview

USMLE Step Two > Pediatric Disorders > Flashcards

Flashcards in Pediatric Disorders Deck (98)
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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



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



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



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



urethral opening on ventral surface (under surface), common with other anomalies, no cricumcision



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


meconium ileus

associated with cystic fibrosis, hirschsprung disease

treatment: high gastrografin enema


necrotizing enteroclitis

transmural intestinal necrosis caused by prematurity, introduction of feeds

treatment: cessation of feeds, gut decompression, systemic antibiotics, surgical resection of necrotic bowel if necessary


duodenal atresia

bilious vomiting from first feeding sign, AXR shows double-bubble sign

treatment: surgical correction


imperforate anus

failure to pass stool after birth, no anal opening visible

treatment: surgical correction


breast-feeding jaundice

jaundice that occurs in the first days of life, baby does not nurse adequately, becomes dehydrated, lack of calories causes jaundice

treatment: rehydrate baby


breast-milk jaundice

jaundice occurs in second week of life, occurs due to glucuronidase present in some breast milk

treatment: stop breast feeding for 1-2 days, bilirubin should fall significantly, although it will rise again, it will not rise to previous level, baby may then be safely breast fed