Peds Flashcards
(23 cards)
2 month milestone
social smile, lifts head 45d, coos
laughs, lifts head to 90d, eyes follow past midline. Age?
4 months
rolls over, sits without support, grasps-attempts to feed self. Age?
6 month. Also has stranger anxiety
9 month milestone
separation anxiety, crawls, pulls to stand, first words
walks with help, pincer grasp, 5-10 word vocabulary. Age?
12 months- 2 block tower
18 month milestone
parallel play, walks well, uses a cup/spoon, tower of four blocks, 2 word combination, 10-50 word vocab
dresses self, runs, 50-75word vocab, 3 word sentences
2 year- also 6 tower block
3 year milestones
magical thinking, makes tower of nine blocks, draws circle
plays with others, hops on 1 foot, 250 word vocab, 4 word sentence
4 year milestone- draws a line image- draws triangle
able to distinguish fantasy from reality, skips, fluent speech
6 year old- draws a person
Beckwith-Wiedemann syndrome
Macroglossia, anterior abdominal defects, hepatomegaly, pitting of external ear. Concern for MR and Wilms tumor
8yr male. Unsteady gait, B/L LE weakness, dec vibratory and position sense, absent Achilles, hearing/vision problems, diabetes. What are the cardiac concerns?
Arrhythmia or hypertrophic cardiomyopathy. Freidrich Ataxia: Auto recessive with trinucleotide repeats. Neuro involves spinocerebellar, corticospinal and posterior column
5yr male. Single lytic lesion on Xray. Painful
Langerhan Histiocytosis X: eosinophilic type
Differentials for lytic bone lesions
Infectious: Brodie abscess-osteomyelitis
Endocrine: hyperparathyroidism-osteitis fibrosa cystica
Neoplastic: Ewing, Langerhan, met
3 year old presents with oral white plaques that can easily be scraped off for the third time. No other infections. A decrease in what cellular component causes that reaction.
Decrease in IgG. Frequently associated with adrenal pathology.
txt: antifungal- fluconazole
10 year old with frequent strep pneumo, Hib and staph aureus. Increased IgM in serum. Deficiency mechanism
HyperIgM: deficiency in CD40 ligand. Low IgG and IgA. Low Hgb, Hct, platelets
txt: IvIG, prophylactic antibiotic, bone marrow transplant
encapsulated organisms need protein for immunity
9 year old with recurrent strep pneumo infections, eczema.
Definitive treatment?
txt: splenectomy, Abx prophylaxis, IVIG, bone marrow transplant
Wiskott-Aldrich: recurrent infections with encapulated organisms, eczema and thrombocytopenia. decreased IgM
4 year old with abnormal gait, recurrent pneumonia with darkened skin lesions.
Method of inheritance?
Autosomal recessive.
Ataxia-telangiectasia- cerebellar dysfunction, telangiectasia, increased risk of cancer, impaired WBC and IgA development
txt; IVIG prophylaxis and abx
4 year old with recurrent MRSA infection with the recent one located in the perirectal abscess. Deficiency?
Neutrophils cannot digest engulfed bacteria.
Chronic Granulomatous Disease- recurrent S.Aureus and fungal infections.
txt: prophylactic antibiotics, gamma interferon, corticosteriods, bone marrow transplant
5 year with multiple episodes MRSA infections and pneumonia. He also has more than 32 teeth. CBC results?
increased eosinophils and IgE.
HyperIgE - defect in neutrophil chemotaxis, T-cell signalling and overproduction of IgE
txt: prophylactic abx. skin hydration and emollient use
6 year old with albinism and recurrent MRSA infections who presents with numbness and tingling in her feet.
Deficiency?
Lysosomal trafficking disorder.
Chediak-Higashi: Autorecessive: large granules seen on peripheral smear.
txt: prophylactic abx and bone marrow transplant
Newborn born but had a delay in the separation of the umbilical cord.
Type 2 treatment?
Fucose supplementation
LAD- inability of neutrophils to leave circulation. Type 2 has abnormal facial features, short stature. increased serum neutrophils. Defective response of neutrophils to stimulation
13 year old has recurrent infections with niesseria. What is she at risk for in the future?
SLE or other autoimmune disorders.
Complement deficiency.
