Peds Midterm pt4

Question 1

What is a cause of acute life threatening event? (ALTE)?

Answer 1

seizure

Question 2

Findings in SIDS (5)

Answer 2

Petachiae mid-thoracic, resp tract inflammn & congestion, brainstem gliosis, extramedullary hematopoiesis, ↑periadrenal brown fat

Question 3

2 Hypotheses for SIDS

Answer 3

1. Upper airway obstruction, catecholamine excess, ↑ fetal hgb
2. Mal-development or delayed maturity of brainstem

Question 4

What is Hemangioma? Tx (2)

mc in girls

Answer 4

Benign, self-limited tumor of endothelial cells.

Propanolol (tx of choice for infantile capillary hemangioma), Cortisone

Question 5

3 categories of hemangiomas

Answer 5

Superficial - bright red, flat against skin
Deep - therefore have blue/gray color
Mixed

Question 6

If a neural tube defect is anticipated during preg, whaddya do?
How’s it dx?

Answer 6

c-section birth to avoid birth canal

Dx: elevated Mother’s serum-fetoprotein lvl at 16-18 wks

Question 7

What is anecephaly?

Answer 7

absence of large part of brain & skull (neural tube defect)

Question 8

What is Encephalocele

Answer 8

herniation of brain & meninges (neural tube defect)

Question 9

3 types/severities of spina bifida:

Answer 9

1. Spina Bifida Oculta - may go undiagnosed. Missing vertebra, but no open connection to outside.
2. Meningocele - defect of spinal column. OPEN VERTEBRAL ARCHES, OPEN SKIN, underlying soft tissue w/ MENINGES EXPOSED, but SPINAL CORD IS NORMAL
3. Meningimyelocele - everything in 2 + SPINAL CORD is malformed too.

Question 10

MGMT of spina bifida (3)

Answer 10

neuro surgery to correct within 24-48 hours
Shunt placement for hydrocephalus
Anticholinergics/sympathomimetics for neurogenic bladder

Question 11

Spina bifidy patients are more likely to have what allergy?

Answer 11

latex allergy

Question 12

What is Hypersensitivity type I?

Answer 12

igE mediated. Kids with multiple surgeries have ↑ risk of this = ↑ latex allergy

Question 13

Describe scarlet fever (how it looks)

Where on body? (4)

Answer 13

sandpaper rash, diffusely erythematous rough rash

On Axilla, groin, abdomen, trunk.

Question 14

Describe strawberry tongue:

Answer 14

whitish coating then desquamates to red, dotty, irritated.

Question 15

Gold standard tx for Group A Beta Strep
2 others…
Pcn allergy?

Answer 15

PCN V
(amox is grape flavored, or pen G)
pcn allergy: macrolide

Question 16

Dx & ppx of rheumatic fever

Answer 16

Dx: ASO/anti-dnase titers
ppx: Benzathine Pen G

Question 17

at what point would you say epistaxis is due to a bleeding disorder?

Answer 17

> 30 min w/ constant direct pressure

Question 18

Many ulcers on buccal mocosa, anterior tonsillar pillars and inner lips, tongue and gingiva. fever, tender cervical adenopathy, but spares posterior pharynx
Dx & Tx (2)

Answer 18

Herpes Gingivostoma

Acyclovir, Glyoxide (oral care)

Question 19

Mononucleosis stages and antibodies present:

Answer 19

Primary - IgM, IgG
Convalescent (past) - EBNA
Reactivation - IgG, EA

Question 20

Caution against using what meds with mononucleosis? (2)

Answer 20

corticosteroids

acyclovir (or any -cyclovir)

Question 21

Vesicles/ulcerations on tongue, buccal mucosa, POSTERIOR PHARYNX, palate, gingiva

Answer 21

Hand, food, mouth disease.

Question 22

What disorder has similar sx to Hand, foot, mouth ds?

Answer 22

Herpangina, + 106º fever, sore throat, dysphagia, sores in back of throat, h/a, body ache, vomiting, abd pain.

Question 23

Group A infxn and school.

Answer 23

No school until fever’s gone 24 hrs & on antibiotic 24-48 hours

Question 24

Acute unilateral neck swelling, fever, neck pain, URI

Answer 24

Acute Cervical Adenitis

Question 25

demarcated, irregular sm ooth red plaques on drsum of tongue w/ elevated gray margins

Answer 25

geographic tongue

Question 26

Hypernasal speech, constricting movement of nares during speech:

Answer 26

Velopharyngeal dysfunction

Question 27

Micrognathia (small lower jaw), high arched/cleft palate, glossoptosis (downward displacement of tongue when supine can cause difficulty breathing)

Answer 27

Pierrre Robin

tx is corrective surgery - distraction osteogenesis