Peds 13 Flashcards by Giselle McIntyre

Treatment of abnormal uterine bleeding

Iron supplements + OCP (3-6 months then mat attempt to be weaned)

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What types (#) of HPV are associated with cancer?

16 and 18

6 and 11 are associated with warts

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Diagnostic criteria of Kawasaki

♣ Fever lasting > 5 days with at least 4 out of five of the following:
• Bilateral bulbar conjunctival injection
• Oral mucous membrane changes, including injected or fissured lips, injected pharynx, or strawberry tongue
• Peripheral extremity changes, including erythema or palms or soles, edema of hands or feet, and periungual desquamation
• Polymorphous rash
• Cervical lymphadenopathy

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Describe Niacin deficiency

Vitamin B3 deficiency = pellagra = diarrhea, dermatitis, dementia

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Describe pathophysiology of breast milk failure jaundice

Decreased intake causes decreased stooling and therefore decreased bilirubin elimination and increased intrahepatic circulation

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Tx of battery in the esophagus

Immediate endoscopic removal

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Tx of ingested battery distal to the esophagus

Observation - 90% of these are excreted uneventfully

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Most common complication of mumps

Aseptic meningitis

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What is the problem in Osgood-Schlatter

Traction apophysitis of the tibial tubercle where the patellar tendon inserts

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Describe splenic sequestration crisis

♣ Will have increased reticulocytes
♣ Splenic vaso-occlusion leads to rapidly enlarging spleen due to pooling or red blood cells
♣ Occurs in children prior to autosplenectomy

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Common complication of JIA

chronic uveitis

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Tx for scabies in kids

Permethrin cream (Elimite)

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Tx of orbital cellulitis

IV abx

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Tx of periorbital cellulitis

oral abx

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What is a cholesteatoma

It is a small epithelium-lined sac containing debris in the ear

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Describe Kallman syndrome

o Defective migration of GnRH-releasing neuron

o Leads to hypogonadism and anosmia (lack of smell)

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Describe cause of respiratory distress in infants of diabetic mother

Polycythemia leads to viscous blood which impairs blood flow to various organs

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What are infectious contraindications to breast feeding?

Active pulmonary TB, HIV, malaria, typhoid fever, septicemia

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Is mastitis a contraindication for breast feeding?

No - frequent feeding may help by preventing engorgement

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What is the first diagnostic test that should be done in a newborn with bloody meconium

Apt-Downey test which can differentiate fetal from adult hemoglobin

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Tx of necrotizing enterocolitis

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If no evidence of perforation - bowel rest with nasogastric decompression and systemic abx

If evidence of perforation - surgical exploratory laparotomy

Describe laryngomalacia and it’s presentation

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Due to collapse of supraglottic structures during inspiration
Inspiratory stridor most prominent in infants
Stridor worse when supine, improves when prone

Describe vascular ring and its presentation

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Results from abnormal development of aortic arch, such that arch encircles and compresses the trachea, bronchus, and/or esophagus
Presents in infants
Biphasic stridor that improves with neck extension
May also present with esophageal (e.g. dysphagia, vomiting, difficulty feeding) symptoms

Next step in acute asthma exacerbation after BiPAP

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Intubation (not epi)

What should you do if pt is bitten by a bat

Postexposure prophylaxis - rabies immunoglobulun + rabies vaccine

Describe post-exposure managment of pertussis

Macrolide abx prophylaxis is recommended for all close contacts despite vaccination status (Azithromycin or Erythromycin)

Next step if peripheral IV fails in infant requiring emergency fluid rescuscitation

Interosseous cannulation

What is the cause of "pink stains" or "brick dust" in neonatal diaper

Uric acid crystals - normal

Tx of iron poisoning

Deferoxamine (binds ferric iron, allowing urinary excretion)

Sx of DiGeorge

♣ C – Cleft palate ♣ A – Abnormal facies ♣ T – Thymic aplasia (T-cell deficiency – poor development of lymph node paracortex) ♣ C – Cardiac defects (tetralogy of Fallot, truncus arteriosus) ♣ H – Hypocalcemia (due parathyroid aplasia)

What clinical features help to distinguish Preseptal from orbital (post-septal) cellutits

o Orbital cellulitis ♣ Occurs posterior to orbital septum ♣ Clinical features • Symptoms of preseptal cellulitis (eyelid swelling, chemosis) PLUS • Pain with EOM, proptosis, and/or ophthalmalgia with diplopia

Tx of preseptal vs. orbital cellulitis

Preseptal = oral abx Orbital = IV abx +'/- surgery

Describe nursemaids elbow

♣ Annular ligament is torn at the attachment site to the radius bone when sudden traction is placed on the child’s arm ♣ The radial head slips through the tear, and when the pulling motion has ceased, the radial head recoils with a small portion of the annular ligament trapped between the radius and humerus

Diagnosis of nursemaids elbow

♣ Clinical diagnosis – X-ray not necessary

Tx of nursemaids elbow

♣ Supinate the forearm with the elbow in in flexed position while applying pressure over the radial head – a click may be felt when the annular ligament is freed from the joint or hyperpronation of forearm

Common empiric tx of meningitis

Ceftriaxone + Vancomycin

What disease presents with herald patch followed by "christmas tree" rash

Pityriasis rosea

Tx of pityriasis rosea

♣ Reassurance (spontaneous resolution) | ♣ Treatment of pruritis (e.g. antihistamines)

Desribe McCune Albright syndrome

o Precocious puberty o Café-au-lait spots o Polyostotic fibrous dysplasia (leads to recurrent bone fractures)

Describe problem in severe combined immunodeficiency (SCID)

♣ Defect in early stem cell differentiation • Leads to failure of T-cell development • B-cell dysfunction due to absent T cells

Presentation of SCID

* Failure to thrive * Chronic diarrhea * Recurrent infections * Absence of thymic shadow and lymphoid tissue

Tx of SCID

• Stem cell transplant

Describe difference between CVID and Brutons

Bruton = defect in B-cell maturation (will have decreased B-cell and immunoglobulin levels) CVID = less severe; defect in B-cell differentiation (will have normal B-cell and decreased immunoglobulins)

Tx of scabies

Topical Permethrin or Oral Ivermectin

At what age should pts transfer objects hand to hand

6 months

At what age should pts have 2 finger pincer grasp

12 months

Describe Chediak Higashi syndrome

♣ Defect in protein trafficking ♣ Presentation: • Recurrent infections – impaired phagolysosome formation • Giant granules in leukocytes – granules have no cytoskeleton to follow to distribute • Partial albinism – melanocytes cannot pass pigment to keratinocytes • Peripheral neuropathy

Most common cause of nephrotic syndrome in children

Minimal change disease

Tx of minimal change disease

Steroids

Features specific to congenital syphilis

Rhinorrhea (snuffles), desquamating or bullous rash, abnormal long-bone radiographs

Tx of SCFE

surgical pinning of femoral head

Which HPV strains cause common warts, genital warts, and cancer

1-4 = common 6 and 11 = genital 16 and 18 = cancer

Peds 13 Flashcards

(52 cards)