Peds Flashcards
1
Q
First A in APGAR
A
Appearance, 0 - blue/pale, 1 - pink trunk, 2 - all pink
2
Q
P in APGAR
A
Pulse, 0 - 0, 1 - 100
3
Q
G in APGAR
A
Grimace with stimulation, 0 - None, 1 - Grimace, 2 - grimace and cough
4
Q
Second A in APGAR
A
Activity: 0 - Limp, 1 - Some activity, 2 - Active
5
Q
R in APGAR
A
Respirations: 0 - None, 1 - Irregular, 2 - Regular
6
Q
If a child has mastoiditis, what is the next best step in management?
A
CT head and neck to reveal extent of infection
7
Q
Down Syndrome cancer risks
A
Increase ALL, Decrease solid organ tumors
8
Q
Childhood Disintegrative Disorder
A
Normal development in early childhood then loss of acquired skills. Onset 2-10 yrs. Boys
9
Q
Rett Disorder
A
Normal development until 2 yrs. then loss of acquired skills. Onset 2-10 yrs. Girls. Seizures
10
Q
Pertussis: tx
A
14 Days of Erythromycin (a macrolide) for pt. and close contacts
11
Q
Tx for Kawasaki Dz?
A
IV Ig and ASA
12
Q
Classic signs of peritonsillar abscess
A
Fever, Trismus (can’t open mouth), “Hot potato” voice, Peritonsillar swelling, Uvula deviation
13
Q
Ambiguous genitalia ddx?
A
5-alpha-reductase deficiency, Androgen Insensitivity
14
Q
Bedwetting Tx.
A
Behavior mod, DDAVP, Imipramine (tricyclic)
15
Q
Jejunal atresia keywords
A
bilious, triple bubble, d/t vascular accident in utero causing intestinal necrosis
16
Q
Duodenal atresia keywords
A
bilious 1st day of life, double bubble, d/t failure of duodenum recanalize, assoc. w/ polyhydramnios
17
Q
Hirschprung disease keywords
A
bilious, delayed passage of meconium age >48 hrs, Dx: Rectal biopsy gold standard
18
Q
Necrotizing enterocolitis keywords
A
bilious, bloody stool, thrombocytopenia and unstable vitals, Dx: XRAY showing intramural air
19
Q
Pyloric stenosis
A
NON-bilious, projectile vomiting, 3-6 wks age, olive mass, Dx: US
20
Q
What is the most common nutritional deficiency in children?
A
Iron
21
Q
When can cow’s milk be given?
A
Not until 1 y.o.
22
Q
Infectious mononucleosis keywords
A
EBV, splenomegaly, posterior cervical lymphadenopathy
23
Q
Leukocyte adhesion deficiency
A
recurrent bacterial infections, delayed umbilical cord separation, CD18 deficient, No Neutrophils in infected tissues but levels increased in blood (cause they can’t migrate)
24
Q
Adenosine Deaminase Deficiency
A
Auto Rec, deficient mature B cells and T cells d/t adenosine toxicity
25
Chronic Granulomatous disease
impaired respiratory burst --\> ineffective intracellular killing, Dx: (-) Nitroblue Tetrazolium test --\> yellow is seen (normally should be blue)
26
Cerebral Palsy keywords
equinovarus deformity, clasp knife resistance
27
Galactosemia
galactose-1-p- uridyl transferase deficiency causing: jaundice, hepatomegaly, catarcts, hypoglycemia, Tx: Soy formula
28
Congenital CMV keywords
microcephaly, cataracts/chorioretinitis, periventricular calcifications, sensorineural hearing loss
29
DiGeorge keywords
22q11 microdeletion, decrease T cell production, wide set eyes, small mandible, holosystolic murmur/VSD/Tetralogy of Fallot, neonate with hypocalcemic seizures
30
Klinefelter (47XXY) cancer risk?
breast ca
31
XYY males description
pectus exxcavatum, explosive tempers --\> "Juvenile delinquents"
32
What is the most common form of inherited mental retardation?
Fragile X (CGG repeat), S&S: macrocephaly, long face/forehead, high arched palate, large ears, macro-orchidism after puberty
33
Methylamlonic acidemia keywords
defect of methylmalonyl-CoA --\> Succinyl coA, vegan breast feeding mothers who need B12
34
Who do you avoid HCO3- infusion in DKA?
HypOkalemia, shifts O2 curve left, cerebral acidosis, edema
35
What is the routine care of a child with sickle cell dz?
Daily PCN by 2 mo., Daily Folate by 6 mo., Meningococcal and PPV23 @ 2 y.o., Morphine/Hydromorphone for pain
36
Intussusception keywords, Dx? Tx
Bilious, RUQ Sausage mass, Currant Jelly Heme + stool, Target sign, Cannot give Rotavirus vaccine, Dx AND Tx: Air contrast enema
37
Meckel Diverticulum
remnant of omphalomesenteric (vitelline) duct, 3-6 cm size, 50-75 cm from ileocecal valve in 2 y.o. male, of gastric and pancreatic tissues causing painless hematochezia, Dx: Meckel Radionuclide scan/T-99 pertechnetate
38
choanal atresia
CHARGE syndrome, pink when crying, blue when stops crying/is feeding
39
Tx: Chlamydial conjunctivitis
Erythromycin PO
40
Meconium ileus
failure to pass meconium w/in first 48 hrs, assoc. with Cystic fibrosis. Tx: IVF, NG tube, surgery
41
Electrolyte imbalance in Cystic Fibrosis
hypOnatremic/hypoChloremic met alkalosis
42
Cystic Fibrosis
Auto Rec F508 mutation leading to recurrent sinopulmonary infections, steatorrhea, nasal polyps, Dx: Quantitative Pilocarpine Iontophoresis and Sweat Cl-, Tx: Intranasal glucocorticoids, Vit. ADEK supplementation, Aminoglycosides for Pseudomonas infections
43
Hypothyroidism growth curve in children
normal childhood growth then abrupt falling off growth curve
44
Tetralogy of Fallot keywords
PROV (pulm stenosis, RV hypertrophy, Overriding Aorta, VSD), boot shaped heart, Tet spells (irritable, tachypnea, cyanosis), harsh systolic murmur @ LSB, Tx: Knee-chest which increases SVR, O2, surgical repair before 6 mo.
45
Rheumatic Fever keywords
Strep pyogenes (Group A beta hemolytic), J
46
Henoch-Schonlein purpura (anaphylactoid purpura)
IgA mediated vasculitis post viral URI with mesangium deposition
47
Bruton's (X-linked) Agammaglobulinemia
X-linked recessive defect in B TyKinase, recurrent pyogenic (strep pneumo, H. flu) infections, Dx: Dec. Ig GAME and B cells
48
Common Variable Immunodeficiency (CVID)
acquired hypogammaglobulinemia, older than Bruton's, Dx: Dec Ig GAME but normal B cell count
49
Beckwith-Wiedemann
macroglossia, R sided hemi-hypertrophy, umbilical hernia, 11p15
50
First line tx. for club foot
Stretching and manipulation THEN serial casting between 3-6 mo.
51
Kawasaki Dz (Mucocutaneous Lymph node syndrome)
Fever \>5d, polymorphous rash, cervical lymphadenopathy, bilateral non-exudative conjunctivitis, Inc. ESR, CRP, platelets, Tx: ASA + IVIg
52
Nurse Maid's elbow
Radial head dislocation, Tx: Hyperpronation
53
Lesch-Nyhan
X-Recessive HGPRT deficiency --\> mutilation, gouty arthritis
54
Gilbert Syndrome
Dec UDP glucuronosyl Transferase causing disorder of bilirubin metabolism
55
Criggler Najjar
Dec. UDP transferase., Inc. bili and encephalopathy.
56
What is the most common cause of neonatal sepsis from birth to 3 mo. of age?
Group B. Strep
57
Transient Tachypnea of Newborn
incomplete evacuation of fetal lung fluid in full term infants leading to respiratory condition, assoc. w/ C-sections, Tx: supplemental O2 PRN
58
Atrioventricular Canal Defect
common in Down Syn., systolic and diastolic heart mumur, split loud S2, EKG with RV hypertrophy, Cyanosis when nursing
59
Sturge Weber
seizures + MR + port wine stain along CNV territory, Dx: "tramline" gyriform intracranial calcifications on skull xray, Tx: seizure control, laser therapy for skin lesions
60
Measles "Rubeola"
fever 104, 4 "C"s, Tx: Vit. A will dec. morbidity and mortality
61
Erythema Toxicum Neonatorum
Benign papules/pustules spares palms and soles that shows up first 2 wks of life, Tx: Spontaneous resolution
62
SCID
no lymph nodes, no tonsils, no thymic shadow, Dec. B, T, NK cells, - recurrent sinopulmonary infections, oral candidasis, persistent diarrhea, opportunistic and viral infections
63
Wiskott Aldrich
X-Recessive WASP gene., Classically a young male with eczema, thrombocytopenia, purpura, and encapsulated infections, Dx: Dec. IgM, T, platelets, but Inc. IgA and E
64
Most common cause of 2ndary HTN in children?
Fibromuscular dysplasia, "string of beads" on renal a. angiogram (Right \> Left)
65
Rubella "German Measles" S&S, Tx?
66
Congenital Diaphragmatic Hernia sequelae
pulmonary hypoplasia and HTN, polyhydramnios
67
S&S congenital diaphragmatic hernia
concave scaphoid abdomen, barrel shaped chest, dx: prenatal US, Tx: endotracheal intubation
68
Diamond-blackfan Anemia "Congenital hypoplastic anemia"
progenitor defect causing inc. RBC apoptosis, S&S: pallor, short, web neck, shielded chest, long thumbs, Dx: inc. fetal Hgb, dec. retic., macrocytic anemia, Tx: Corticosteroids
69
Klumpke's Paralysis
C8-T1 injury, Claw hand: wrist extended, MCP jts. hyperextended, interphalangeal jts. flexed, Horner syndrome
70
Erb-Duchenne "Waiter's Tip"
C5-C6 (Tip me "$5"), Dec. moro reflex, Intact grasp reflex
71
Most common primary bone tumor
Osteosarcoma, @ metaphysis of long bones, Dx: spiculated sunburst, periosteal elevation (Codman's Triangle), Inc. AlkPhos, Inc. LDH, Tx: Chemo and Surgical excision
72
Refeeding Syndrome explained
Carbs --\> insulin release --\> intracellular movement of K, phos, Mg --\> arrythmias and cardiopulmonary failure
73
Transposition of Great arteries keywords
Egg on a string, Narrow mediastinum, Cyanosis
74
Parvo B19
targets RBC precursors (dx: 0 Retics), lacy rash
75
Cephalohematoma
sub-periosteal hemorrhage (limited to surface of one cranial bone --\> **does not cross suture lines**), no scalp discoloration
76
Tx. Pinworm
Scotch tape test, Metronidazole
77
Esophageal atresia/Tracheoesophageal fistula
Dx: Polyhydramnios on prenatal US, distended stomach and intestines, choking and regurg with initial feeding immediately after birth, risk for chronic GERD
78
Friedreich ataxia
AutoRec excess trinucleotide repeat sequences, Abnormal Tocopherol transfer protein, S&S: wide-based gait, dec. vibration/proprioception, no DTRs on LE, high plantar arches
79
What is the earliest manifestion of vaso-occlusion in sickle cell anemia?
dactylitis (AKA Hand-foot syndrome)
80
McCune Albright
defect in G-protein cAMP-kinase, 3 P's: precocious puberty, pigmentation (cafe au lait spots), polyostotic fibrous dysplasia
81
Craniopharyngioma keywords
Rathke's pouch, suprasellar and inferior to optic chiasm
82
Myotonic Dystrophy
AutoDom CTG trinucleotide repeat in DMPK gene on Chromosome 19q13.3, Facial weakness, hand grip myotonia, inverted V-shaped lip
83
Duchenne Muscular Dystrophy
X-Rec deletion of Dystrophin gene on chrom Xp21, Dx: DNA blood analysis then mm. biopsy if blood samples not diagnostic, S&S: Trendelenburg waddling gait, progressive proximal mm. weakness (Gower's), calf pseudohypertrophy, death from respiratory failure
84
Becker Muscular dystrophy
X-Rec dystrophin gene deletion from Xp21.
85
IgA Deficiency
recurrent sinopulmonary and GI infections and anaphylactic transfusion reactions (episodic diarrhea secondary to Giardia)
86
Posterior Vermis Syndrome
unbalanced gait, trunk dystaxia, horizontal nystagmus, papilledema, HA/vomiting, d/t Medulloblastoma
87
Fetal Alcohol Syn keywords
small palpebral fissues, smooth philtrum, small gestational age, septal defects
88
Congenital adrenal hyperplasia (CAH)
21-OH-lase deficiency leading to Inc. 17a-OH-progesterone, S&S: ambiguous genitalia in girls, hyponatremia, hypotension
89
Brick Red Urate Crystals in diapers
sign of dehydration
90
Tx. Lead Poisoning
Chelation: EDTA(IM) or DMSA(PO)
91
Berger IgA Nephropathy, Dx?
recurrent painless hematuria preceded by URI, Dx: Immune complex deposition in mesangium
92
Post Strep Glomerulonephritis, d/t, Dx?, Tx?
d/t GABHS (strep throat or impetigo), Dx: Dec. C3, normal C4. ASO +, anti-DNAse Abs, Tx: Fluids, diuretics, CCB for HTN
93
Rapidly Progressive Glomerulonephritis Dx
Crescentic glomeruli
94
Goodpasture Syndrome S&S, d/t?
nephritis + pulm hemorrhage, d/t SLE, HSP
95
What is the most common cause of chronic stridor? S&S? Dx?
Laryngomalacia, inspiratory stridor worse when supine and when crying/feeding, Dx: laryngoscopy showing Omega shaped epiglottis
96
Retropharyngeal abscess, Dx?
fever, drooling, dysphagia, stridor, and muffled voice which is often polymicrobial, Dx: widened pre-vertebral space on lateral neck xrays
97
Croup (laryngotracheobronchitis) keywords
Tx?
Steeple sign ("Up" the steeple"), barking cough, parainfluenzae virus
Tx: Racemic Epinephrine
98
Wilm's tumor arises from? keywords
metanephros, mass that doesn't cross midline
99
What does the mesonephros give rise to?
Guy parts "EVES": Ejaculatory ducts, Vas deferens, Epididydymis, Seminal vesicles
100
What does the paramesonephron give rise to?
Female parts: Fallopian tubes, Uterus, Vagina
101
NF-1 keywords
cafe au lait, MACROcephaly, feeding and learning problems
102
NF-2
bilateral acoustic neuromas, cataracts
103
Osteogenesis imperfecta keywords
COL1A1 mutation, osteopenia, blue sclera, hearing loss
104
If IV access isn't possible in pediatric emergencies what do you do?
Intraosseous access, often proximal tibia
105
Hypertrophic cardiomyopathy keywords
AutoDom, systolic @ LSB, increases with valsalva, decreases with hand grip/passive leg raise, Tx: BB
106
Vesicoureteral Reflux (VUR) Grading
I: undilated ureter, II: into ureter and collecting system, III: dilation of ureter and collecting system, IV: blunted calyces, V: tortuosity of ureter
107
Vesicoureteral reflux (VUR) often leads to? dx? tx?
UTIs, Voiding cystourethrogram showing retrograde flow, Tx. TMP-SMX, Nitrofurantoin
108
Epiglottitis keywords
abrupt stridor, Thumb's sign "(epigloTTiTis Thumb), Haemophilus influenza type B,
Tx: Intubation. Hyperextension of neck, IV PCN, Cephalosporins, Carbapenems
109
Prader Willi keywords
hyperphagia and obesity
110
Chronic Granulomatous Disease, Tx?
-defective NADPH oxidase phagocytosis causing susceptibility to Catalase + organism (staph aureus, serratia, burkholderia, klebsiella, aspergillus), Tx: TMP-SMX and y-IFN 3x/wk
111
Tx. Neonatal meningitis
Ampicillin + Ceftriaxone/3rd gen ceph
112
Salmonella keywords
poultry, eggs, turtles, watery/bloody diarrhea, gastroenteritis
113
Shigella keywords
Gram (-) Motile NON-lactose fermenter, watery diarrea --\> bloody stool
114
Trichuris Trichiura "Whipworms" Dx? Tx?
often found in South East US, whipworms cause rectal prolapse, stool for ova and parasites, Tx: Albendazole
115
Which strains are covered by Gardasil
6, 11 --\> genital warts, 16, 18 --\> cervical ca.
116
Febrile seizure: when does it occur? Different types? Tx?
between 6 mo. and 6 y.o., Simple: 15 minutes with possible lateralizing signs, Tx: Lorazepam (if seizures last \>5 min) and Fosphenytoin if that doesn't work
117
If a child beyond neonatal period (e.g. 5 y.o.) has herpetic lesions, what should you suspect?
Possible sexual abuse
118
Tx: Atopic dermatitis
topical corticosteroids (but not on face, genitalia, intertriginous), oral antihistamines
119
Seborrheic dermatitis ("cradle cap") keywords, tx?
greasy brown scales, Tx: Ketoconazole, low potency steroids
120
Neuroblastoma keywords, Dx?
adrenal gland tumor, raccoon eyes, lymphadenopathy, bluish skin, Dx: CT, MRI, Increased VMA and Homovanillic acid (catecholamines)
121
VATER
Vertebral abnormality, Anus imperforate, Tracheoesophageal fistula, Radial/Renal anomalies
122
Malrotation and volvulus, d/t, Dx? Tx
bilious vomiting, blood per rectum, incomplete intestinal rotation during development, Using upper GI series Contrast: Lig. of Treitz on R side of abdomen (Malrotation), Corkscrew/birds beak of duodenum (Volvulus); Tx: Stop enteral feeds, use NG, LADD procedure
123
Tx. Comedones
1. Topical Benzoyl peroxide or Retin A, 2. Isoretinoin if severe
124
What is the most common cause of UTIs in boys? dx? Tx?
Posterior Urethral valves causing dribbling, poor stream, palpable kidneys, VCUG and postnasal USG, Bladder catheterization then Endoscopic Transurethral valve ablation
125
Tx ADHD. Children with ADHD often have what else?
Methylphenidate, Dextroamphetamine, Atomoxetine (SNRI), Oppositional defiant disorder, conduct disorder, anxiety, and depression
126
Slipped Capital Femoral Epiphysis puts obese children at risk for?
Avascular necrosis
127
Klippel-Feil keywords
torticollis, cervical vertebrae fusion, short neck
128
Waardenburg Syndrome keywords
Think xmen's rogue is deaf: Sensorineural hearing loss, Partial albinism/forelock of gray hair, Heterochromic iris
129
Blount Disease (Idiopathic Tibia Vara) keywords
Abnormal medial Tibial epiphysis, Prominent Beaking and calcification
130
Legg-Calve-Perthes keywords
painless "antalgic" limp gait d/t idiopathic avascular, femoral head necrosis, often boys, limited int. rotation and hip abduction
131
Reye Syndrome S&S, Labs?
encephalopathy and acute liver failure (mitochondrial hepatopathy), Increased AST/ALT, PT/INR, PTT, Ammonia
132
Catarrhal Stage (of Pertussis) S&S
mild cough and rhinitis for 1-2 wks
133
Paroxysmal Stage (of Pertussis) S&S
coughing fits, inspiratory "whoop", "staccato" cough, emesis, apnea, cyanosis. all for 2-6 wks
134
Convalescent Stage (of Pertussis) S&S
resolution of cough and post-tussive emesis that comes after weeks to months
135
Pertussis Tx. and Post-exposure ppx
1 mo: Azithromycin x 7d or Erythromycin x 14d
136
Neimann Pick keywords
AutoRec, sphingomyelinase, no reflexes, hepatomegaly
137
Tay Sachs keywords
AutoRec, Hexoaminidase, hyper-reflexia
138
Krabbe keywords
Autorec, Galacto-cerebrosidase lysosomal storage disorder
139
Gaucher keywords
Gluco-cerebrosidase deficiency, anemia, thrombocytopenia, hepatomegaly
140
Hurler Syndrome keywords
Hydrolase deficiency lysosomal storage disorder, Coarse facies, hernias, cloudy cornea, hepatosplenomegaly
141
Biliary Atresia S&S, Dx, Tx
conjugated hyperbilirubinemia --\> jaundice, dark urine, pale stool, Dx: US, Hepatobiliary Scintigraphy, Liver biopsy, Intraoperative cholangiogram is the Gold standard, Tx: Kasai Hepato-porto-enterostomy procedure
142
Von-Gierkes keywords
Type I Glycogen storage disease, G-6-Phosphatase deficiency, hypoglycemia, lactic acidosis, hyperuricemia, doll-like face
143
Pompe (acid maltase deficiency) Dz. keywords
Type II, Floppy baby, macroglossia, heart failure
144
Tx. Cyanide poisoning
Hydroxycobalamin
145
Adverse effect of Lindane (Gamma-Benzene Hexachloride) lotion for scabies
Neurotoxicity in small infants
146
What is a contraindication for all vaccines?
severe allergic rxn
147
S&S Fetal Dilantin Exposure
midface hypoplasia, low nasal bridge, ocular HyPERtelorism, accentuated Cupid's bow of upper lip
148
S&S Small for Gestational Age baby
hypoglycemia, polycythemia --\> Hyperviscosity syndrome
149
What is the tx. for Hyperviscosity Syndrome in SGA baby
Partial exchange transfusion with saline/LR
150
d/t, Dx, S&S? Tx
d/t surfactant deficiency secondary to prematurity,
151
S&S of Donor Twin in Twin-Twin Transfusion
Oligohydramnios, anemia, hypovolemia, shock
152
S&S of Recipient Twin in Twin-Twin Transfusion
Polyhydramnios, larger size
153
Potter Sequence keywords
pulmonary hypoplasia secondary to oligohydramnios, wide spread eyes, low set ears, broad nose
154
Caput succedaneum keywords
soft tissue swelling often presenting portion, ecchymotic, cross suture lines
155
Atrial Septal Defect (ASD) keywords
wide, fixed split S2 @ LSB, pulmonary stenosis murmur, thrombocytopenia
156
Ventricular Septal Defect (VSD) keywords
harsh, blowing, holosytolic @ LSB, diastolic apical rumble
157
Ebstein anomaly keywords
downward displacement of tricuspid valve causing: quadruple rhythm S3 and S4 (Triscupid Regurg), mid-diastolic murmur @ LSB, R atrial hypertrophy
158
Total Anomalous Pulm. Venous Return (TAPVR) keywords
obstruction to pulm. venous return, snowman venous congestion, fluffy CXR
159
Noonan Syndrome aka Male Turner Syndrome
short, web neck, shield chest, cryoptorchidism, pulm stenosis, pectus excavatum
160
What cardiac defect would you most likely see with Ehlers Danlos, Klinefelter?
Mitral Valve Prolapse, midsystolic click, @ apex
161
Teeth development
1. Mandibular central incisors, 2. Maxillary central incisors
162
Tx. of Phenobarbital OD
activated charcoal
163
Prune Belly Syndrome S&S
pulm. hypoplasia, wrinkly abd wall, oligohydramnios
164
What is the most common hereditary nephritis?
Alport Syndrome (hematuria, hearing loss, ocular anomalies)
165
Homocystinuria keywords
AutoRec, Cystathione B. Synthase deficiency, dislocated lenses, arachnodactyly
166
Werdnig-Hoffman (Spinal mm. atrophy type I) S&S
floppy baby, defective survivor motor neuron gene destroying neurons in brain and spine
167
Tuberous Sclerosis keywords
Ash-leaf hypopigmentation, Shagreen path over sacrum,
168
Prehn Sign, significance?
Lifting of scrotum, Pain gets worse --\> torsion, Pain gets better --\> epididymitis
169
Eisenmenger Syndrome
cyanosis and dyspnea secondary to L to R shunting seen in large VSDs
170
Anemia of Prematurity, d/t
normocytic, normochromic, low retic anemia often seen in hospitalized, premature, LBW infants, d/t transition of erythropoiesis sites of neonate
171
Roseola Infantum (Exanthem subitum) d/t
abrupt high fever THEN centrifugal rash to extremities,
172
Parinaud syndrome, d/t
limited upward gaze, ptosis, Collier's sign of upper eyelid retraction, d/t pinealoma
173
Trachoma conjunctivitis: d/t, Dx:, Tx:
follicular conjunctivitis and neovascularization (pannus formation) in cornea, Dx: giemsa stain of scrapings,
174
Edwards Syndrome keywords
Trisomy "E"ighteen for EDWARDS, LBW, microcephaly
175
Patau Syndrome keywords
Trisomy "ThirTeen" for paTau, cleft lip, polydactyly
176
Developmental Dysplasia of Hip, Dx? Tx?
Normal female baby with abnormal acetabulum resulting in hip instability and uneven leg creases, Ortolani and Barlow tests, Ultrasound to confirm, Tx: Pavlik harness to splint hip in flexion and abduction
177
Pt. with cryptorchidism, hypospadias, aniridia, retardation should raise suspicion for what?
Wilms Tumor. Baby has WAGR (Wilms, Aniridia, GU, Retardation)
178
When is HepB Vaccine given?
Birth, 1-2, 6-18
179
When is Rotavirus vaccine given?
2,4,6
180
When is DTaP vaccine given?
2,4,6, 15-18, 4-6y
181
When is Hib and Pneumoccocal vaccine given?
2,4,6, 12-15
182
When is Inactivated Polio vaccine given?
2,4, 6-18, 4-6y
183
When is influenza vaccine given?
yearly from 6 mo onward
184
When is MMR and Varicella vaccine given?
12-15, 4-6
185
When is Meningococcal Vaccine given?
2-6y
186
When is Tdap given? (Tetanus)
Substitute 1 time dose of Tdap for Td booster, then boost with Td q10y
187
Wilson's Disease inheritance?
pathophys?
S&S?
Tx?
Auto Recessive
_reduced Copper excretion from liver_ leading to:
Kayser-Fleischer rings, parkinsonism, icterus, elevated AST/ALT, neurologic S&S
Tx: Penicillamine, Screen 1st Degree relatives
188
Tx. Lead poisoning
EDTA
189
Tx. Mercury
Dimercaprol
190
Tx. Iron poisoning
Deferoxamine
191
Subgaleal hemorrhage keywords
**crosses suture lines**
grows slowly over first day of life
***Hemorrhagic shock!***
192
Lab abnormalities in baby born to diabetic mother
Hypoglycemia
Hypocalcemia (d/t low PTH)/Hypomagnesemia
Hyp**er**phosphatemia
193
Meconium Aspiration Syndrome
What would you see on CXR?
What complication can arise?
Term Baby with persistent respiratory distress (retractions, grunting, flaring)
CXR with bilateral patchy opacities, possible hyperinflation or pneumothorax
Persistent Pulmonary HTN --\> acidosis and hypoxia and death
194
Posterior Urethral Valves
S&S
Dx
male infant with hydronephrosis/cortical thinning, bilateral flank mass AND an abdominal mass, may also have Potter facies and pulmonary hypoplasia
Dx to confirm: Voiding Cystourethrogram
195
Langerhans Histiocytosis X keywords
solitary, lytic painful long bone lesions in children
eosinophilic
Tx: Resolve spontaneously
196
Precocious Puberty Tx
Leuprolide (GnRH agonist) will negative feedback on GnRH
197
McCune-Albright
S&S
Tx
precocious puberty
Polyostotic fibrous dysplasia
Unilateral café au lait spots "Coast of maine border" that doesn't cross midline
Tx: Ketoconazole (estrogen synthesis blocker), Tamoxifen (anti-estrogen)
198
Henoch-Schonlein Purpura (HSP)
S&S
Tx
Vasculitis affecting children, 50% after URI
IgA and C3 deposition in small vessels
palpable purpura on legs, buttocks, abdominal and joint pain, hematuria
Tx: Supportive care
