Flashcards in peds101 Deck (195):
1
antibiotic activity against pseudomonas for Cf patients
ceftazadime(or penicillin deriv) plus aminoglycoside like amikacin or gentamycin
2
digeorge syndrome
catch22- conotruncal cardiac defects; abnormal facies; thymic aplasia, cleft palate; hypocalcemia
3
2 year old vocab
150-300 words
4
micrognathia, microcephaly, overlapping fingers, rocker bottom feet, VSD, absent palmar creases
edwards syndrome, trisomy 18
5
heart defect in trisomy 21
ASD or endocardial cushion defect
6
william's syndrome heart defect
supravalvular aortic stenosis, pulm stenosis, or septal defects
7
what are the CATCH-22 syndromes
digeorge and velocardiofacial
8
what cardiac abnormality is assoc with the catch-22 syndromes
conotruncal abnormalities (truncus, tet of fallot, interupted aortic arch)
9
interupted aortic arch
almost always assoc with VSD
10
congenital heart block assoc with what?
neonatal lupus
11
PDA assoc with what?
congenital rubella
12
coronary artery aneurysms
kawasaki disease
13
treatement of pertussis
macrolides in catarrhal stage; less effective later on
14
macrolide abx
azithromycin, clarithromycin
15
post-tussive emesis
think pertusis
16
hemophilic arthropathy
late complic of hemophilia and caused by hemosidern/iron dep leading to synovitis and fibrosis within the joint
17
patient with alkali ingestion
upper GI endoscopy
18
whenever IV access cannot be obtained, what do you try next?
intraosseus cannulation; osteomyelitis is a rare complication
19
vitD supplementation in breast fed babies
400 IU daily
20
treatment of rickets
1000-2000 IU daily of vit D
21
congenital syphilis
frontal bossing, anterior bowing of the shins (saber shins); saddle nose deformity; notch-gapped teeth (Hutchinson teeth)
22
cupping and fraying of the metaphyses of the lung bones
sign of rickets on xray
23
postpericardiotomy syndrome
pleuropericardial disease that occurs days to months after cardiac surgery; inflamm from surgery leads to pericardial effusion;
24
CHF on chest xray
pulm vascular congestion and interstitial edema
25
treatment for OCD
fluoxetine or other high dose SSRI
26
dermatitis herpetiformis
itchy blistering rash assoc with celiac disease
27
prolonged PR interval on EKG
think rheumatic fever
28
therapy in pericarditis
salicylates
29
paramyxo virus
measles and mumps
30
most common organism responsible for pericarditis
coxsackie virus
31
leukocyte def type 1
deficiency in ability of neutrophils to migrate; absence of pus with infection; delayed umbilical cord separation; poor wound healing; recurrent skin and mucosal bacterial infections; periodontiti, often necrotizine
32
leukocyte def type 1 on lab
leukocytosis with neutrophil predominance; bx shows inflamm infiltrate devoid of neutrophils
33
adenosine deaminase def
AR form of SCID; toxic accum of adenosine leads to def in mature B and T cell formation
34
nitroblue tetrazolium test
neg (abnormal) in chronic granulomatous disease
35
chronic granulomatous disease pathophy
defective intracellular killing due to impaired respiratory burst from activated phagocytes; nitroblue tetrazolium test is neg; dihydrohodamine 123 test is more sens and quantify the severity of illness
36
developmental defects in the pharyngeal arch system
digeoge
37
digeorge immune def
T cell def; also thymic hypoplasia
38
opsonization defects result from what
asplenia because spleen produces opsonizing antibody, which is required for clearance of encapsulated organisms
39
preseptal cellulitis
aka periorbital cellulitis
40
proptosis
eyes popping out
41
murmur in coarctation of the aorta
heard all over the chest due to collaterals developing
42
rib notching
caused by dilation of the collateral chest wall vessels in coarctation of the aorta
43
pericardial calcification
constrictive pericarditis
44
how to diagnose absence seizure
ask patient to hyperventilate; it should mimic the seizure
45
no post-ictal state in absence seizures
right
46
differentiating between typical and atypical absence seizure
atypical is slower (freq 2.5 hz as opposed to 3 hz)
47
iron poisoning tx
deferoxamine
48
TCA and aspirin overdose antidote
sodium bicarb
49
prolonged QT and torsade des pointes- what med to give patien?
mag sulfate
50
severe lithium toxicity
hemodialysis because lithium is very dializable
51
hyperkalemia- give what to protect the heart
calcium gluconate
52
oral succimer
lead poisoning chelating agent
53
pediatric viral myocarditis caused by what
coxsackie or adenovirus
54
why would heart failure due to myocarditis give you a holosystolic murmur
the heart dilates because it is filled with blood it cannot pump and then you get mitral regurg during systole
55
myocarditis on echo
global hypokinesis
56
why is strep pharyngitis (and rheumatic fever) uncommon in kids less than 3
they have fewer epithelial cells in the throat for the strep to infect
57
can you see wheezing in a patient with pulm edema?
yes
58
blue sclerae and hearing loss
osteogenesis imperfecta; defect in type 1 collagen
59
fibrillin-1 defect
marfans
60
the most common predisposing factor for bacterial sinusitis
viral URI
61
treatment for bacterial sinusitis
amox plus clavulonic acid
62
kid with uti less than 24 mos
treat and then do renal and bladder u/s to see if there is anatomic reason exposed to UTI
63
koplik's spots
red spots with bluish specks over the buccal mucosa seen in measles; fade once the rash appears
64
rash in measles
starts on face and spreads to trunk and extremities
65
herpes virus 6 causes what rash
roseola infantum
66
croup aka
laryngotracheobronchitis
67
laryngeal diptheria
can present like croup; in an unvaccin kid
68
hypointense center with ring enhancement on brain CT
brain abscess
69
bullous myringitis
seen in patients with acute otitis media; bullous on the TM; more severe ear pain than normal OM; assoc with mycoplasma pneumoniae
70
cholesteatoma
growth of squamous epithelium in the middle ear
71
what condition is assoc with false pos RPR test results
lupus
72
cystic hygroma
lymphangioma; dilated lymphatic spacies lined by endothelium; commonly occur on the neck
73
clubfoot management
stretching, manipulation of the foot, and serial casting
74
terbinafine
a topical antifungal
75
mongolian spot
congenital dermal melanocytosis; fades spontaneously during the first decade of life
76
babinski reflex
normal (adult) is to have a plantar response; up to 2 year olds, an extensor response is normal
77
acute unilateral lymphadenitis
bacterial infection, usually staph aureus, next most common is group a strep
78
difference between craniopharyngioma and pituitary tumor
craniopharyngioma has calcifications; pit tumor secretes prolactin in addition
79
adolescent with nosebleeds, nasal mass, and nasal obstruction
think juvenile angiofibroma until proven otherwise
80
treatment of juvenile angiofibroma
if asymp, no tx; if symp, surgical removal but recurrance is common
81
what is an endocardial cushion defect?
AV septal defect; assoc with Down syndrome
82
midsystolic click with late systolic murmur
mitral valve prolapse
83
transposition of the great vessels often seen in what patients
infants of diabetic mothers; and males
84
larygoscopy shows collapse of supraglottic structures with inspiration and omega shaped epiglottis
laryngomalacia
85
management of laryngomalacia
reassurance; usually resolve by 18 mos; for some, surgery supraglotoplasty is indicated
86
stridor ddx
croup, laryngomalacia, foreign body,
87
stridor that is worse in the supine pos and exacerbated by crying or wheezing
laryngomalacia
88
when does laryngomalacia present
4-8 months, resolves by 18 mos
89
most common cause of chronic stridor in infants
laryngomalacia
90
vomitting, arching of the back with feeds, and poor weight gain
GER
91
vascular rings, biphasic stridor, and feeding difficulties
anomalous branch of the aortic arch encircles the trache and esophagus; confirm w MRI and angiography
92
toddler with fever, drooling, dysphagia, neck pain, and stridor
retropharygeal abscess
93
prevertebral soft tissue thickening
retropharyngeal abscess
94
pain with eye movements, proptosis, opthalmoplegia, and diplopia
orbital cellulitis; bacterial sinusitis is the most common predisposing factor
95
beckwith-weidemann genetics
11p15 mutation
96
beckwith-weidemann physical exam
fetal macosomia, rapid growth, oomphalocele or umbilical hernia, macroglossia, hemihyperplasia
97
complications of b-w
wilms tumor, hepatoblastoma
98
surveillance in w-d syndrome
serum alpha protein, abdominal/renal ultrasound
99
why do babies with B-W syndrome need to be monitored for hypoglycemia>
they produce excess insulin like growth factor
100
most common complication in patients with sickle cell trait
painless hematuria
101
hep B assoc with what renal disease?
membraneous nephritis
102
most common cause of nephrotic syndrome in kids
minimal change disease
103
classic triad of congenital rubella syndrome
deafness, cataracts, cardiac defects (PDA, ASDs)
104
eczema herpeticum
form of primary HSV that is associated with atopic dermatitis; superimposed on healing eczema lesions after exposure to herpes; umbilicated vesicles on an erythematous base; can be life threatening in infants
105
HSP
leukocytoclastic (destroy WBC) vasculitis; palpable purpura on LE with normal platelet count; can present with scrotal pain/swelling; igA dep; renal disease, abdom pain
106
complications of HSP
GI hemorrhage and intussusception
107
intussusceptions in HSP
more likely to be small bowel or ileo-ileal (as opposed to ileo-colic like in other cases)
108
small bowel intussusception on u/s
target sign; unlike ileocolic intuss, which can be seen on contrast enema
109
serum sickness like reaction occurs when
like 1-2 weeks after you have taking an antibiotic
110
how does maternal diabetes lead to RDS?
fetal hyperinsulinism antagonizes corticoids, which mature the lung; interestingly, intrauterine stress decr the risk of RDS
111
how to treat cervical lymphadenopathy
usually caused by staph and strep; use dicloxacillin
112
difference between simple partial seizures, partial seizures with generalization, and complex partial seizures
no loss of conciousness in simple only; the other two have loss of consciousness; partial generalized has tonic-clonic activity
113
diffuse muscle aches and elevated cpk in a seizure
indicates tonic-clonic
114
Lennox-gaustat syndrome
mental retardation, seizures,
115
cri-du-chat sndrome
cat like cry, hypotonia, short stature, microcephaly with protruding metopic suture, moonlike facies, hypertelorism, epicanthal folds, high arched palate, wide and flat nasal bridge, mental retardation
116
5p deletion
cru-di-chat
117
4 p deletion
wolf-hirschorn
118
wolf-hirschorn syndrome
microcephaly, epicanthal folds, greek helmet facies, ocular hypertelorism,
119
viruses that cause viral meningitis
enteroviruses like cocksackie and echovirus
120
myotonic muscular distrophy (aka steinert diseae)
autosomal dominant; second most common muscular dystophy; all types of muscles (striated, smooth, card) are involved; progressive weakness; delayed muscle relaxation
121
conjucntivitis first 24 hours of life
chemical
122
conjucntivitis days 2-5 of life
gonococcal; treat with IV or IM cef
123
conjunctivitis on day 5-14 of life
chlamydia, treat with oral erythromycin
124
blood stained eye discharge
chlamydial conjunctivitis
125
prophylaxis against gonoccocal conjunctivitis
topical erythromycin or topical silver nitrate (not available in the US)
126
treatment for absence seizures
ethosuximide or valproic acid
127
Reye syndrome
fatty liver with encephalopathy; URI with varicella or influenza PLUS aspirin
128
def of niacin (vit B3)
leads to pellagra (diarrhea, dermatitis, dementia, and death), glossitis, sunburn rash
129
def of thiamine (vit b1)
causes beriberi or wernicke-korsakoff; neuro sx; often seen in alcoholics and patients with recent weight loss surgery
130
supracondylar fracture associated with what other injury
brachial artery injury leading to decr radial pulse so always check radial pulse
131
most common fracture in kids
supracondylar fracture
132
technetium-99m pertechnetate scan
meckle's diverticulum; painless hematochezia; technetium stains the ectopic gastric tissue in meckel'ss
133
hematochezia
bright red stools
134
WPW on ECG
shortened PR interval, delta waves, and widening of QRS
135
continuous antibiotic prophylaxis in rheumatic heart disease- why?
patients with a history of rheumatic fever are at high risk for recurrent GABHS pharyngitis; preferred regimen is IM penicillin every 4 weeks
136
muscle spasms
think tetanus; neonatal tetanus is fatal if left untreated; neonatal tetanus often follows umbilical stump infection
137
Wiskott-Aldrich syndrome
thrombocytopenia with skin lesions characteristic of eczema and a hx of multiple bacterial infections; decreased platelet production is the cause; x-linked
138
why howell jolly bodies in sickle cell diseae
these patients often have infarcted spleens that
139
heinz bodies and bite cells
g6pd def
140
basophillic stippling
thalasemmias or lead poisoning
141
freidrich ataxia
most common type of spinocerebellar ataxia; degeneration of the spinal tract; also causes concentric hypertrophic cardiomyopathy, diabetes, skeletal deformities, cardiomyopathy is most common cause of death; absent ankle jerks
142
allergic contact dermatitis
CELL-mediated hypersens; not igeE mediated
143
developmental dysplasia of the hip
dislocation of the femoral head from the acetabulum; in kids 2 wks- 6 mos, get a hip u/s. in kids more than 6 mos get a hip xray bc by now the femoral head and acet are ossified
144
DDH suspected less than 2 weejs
no imaging, may resolve on its own
145
functional asplenia puts you at risk for infection w what organisms
pneumococcus, h influenza,
146
intestinal obstruction in a neonate management
abdominal xray for pneumoperitoneum for a perforated bowel; next step is contrast enema, which will differentiate between meconium ileus and hirschsprung
147
microcolon on contrast enema
meconium ileus; underused contracted colon as a result of viscous meconium
148
treatment for meconium ileus
hyperosmolar enema to dissolve the meconium
149
when is sweat chloride testing indicated for suspected CF?
greater than 2 weeks old because they do not make sweat before then
150
contrast enema demonstrates transition zone between sigmoid colon and dilated megacolon
hirschsprung
151
Jervell-Lange-Nielson syndrome
long QT and congenital deafness;
152
nursemaid's elbow
radial head slips through part of the annular ligament; child keeps arm pronated and refuses forearm supination
153
3 pathognomonic facial dysmorphisms for fetal alc poisoning
thin vermillion border; smooth filtrim; small palpebral fissues
154
fragile x syndrome face
long narrow face, prominent forehead and chin, large ears, macrocephaly
155
macroorchidism
fragile x syndrome
156
Werdnig-hoffman syndrome
AR disorder involving degeneration of anterior horns and CN motor nuclei
157
trachoma
caused by chlamydia trachomatis. Major cause of blindess, follicular conjunctivitis and pannus (neovascularization) formation in the cornea. Concurrent nasopharynx infxn.
158
treatment for trachoma
topical tetracycline or oral erythromycin
159
mild vit k def
prolonged PT and normal PTT; severe would be prolonged both
160
murmur with hypertrophic myopathy
increases with standing, which decr venous return
161
freidrich taxia
aut recess; excessive trinuc repeats; progressive; necrosis of cardiac muscle and myocarditis,
162
differential for t wave inversion
MI, myocarditis, old pericarditis, myocardial contusion and digoxin toxicity
163
copies a cross and circle
three years
164
copies a rectangle
four years
165
copies a triangle
five years
166
copies a diamond
six years
167
osteogenesis imperfecta type II
fractures, blue sclerae and short, ben extremities; aut dom; typically die in utero for type 2
168
lisch nodules of the iris
associated with neurofibromatosis type 1
169
tuberous sclerosis
ash leaf hypopigmentation, cardiac rhabdomyomas, kidney angioleiomyomas, mental retardatio, seizures
170
sturge weber syndrome
a neurocutaneous syndrome
171
cholesteatoma
growth of squamous epithelium in the middle ear; they are destructive; can lead to infection
172
meniere's diseae
vertigo, tinnitus, hearing loss; more common in adults
173
otosclerosis
abnormal bone growth in the middle ear that causes hearing loss
174
osteoma
benign bony overgrowth that can form in the outer ear and lead to hearing loss
175
nonpitting vs pitting lymphedema
pitting is CHF, liver failure, nephrotic syndrome;
176
measles is more severe than rubella in what way?
higher fever, darker rash
177
erythema multiforme
target lesions; usually follows herpes simplex infection
178
choledochal cyst
cystic dilation of the bile duct
179
acholic stools
clay colored or pale; due to problems in biliary system
180
waterhouse-friderichson syndrome
seen w meningococcemia; adrenal gland failure causes death
181
pseudomonas
gram neg rod
182
gram pos diplococci
strep pneumo
183
gram pos cocci in clusters
staph
184
gram neg cocci
neisseria
185
gram pos rods
listeria and bacillus
186
GNRs
pseudomonase, h. flu, klebsiella, legionella
187
todd's paralysis
post-ictal paralysis
188
treatment for minimal change disease
steroids
189
iron poisoning
anion gap met acidosis
190
TCA antidepressant intox
sodium bicarb
191
HUS preceded by what?
diarrheal illness like EHEC, shigella, salmonella, yersinia, and campylobacter; causes microangiopathic hemolytic anemia
192
diff between DIC and microangioathic hemolytic anemia
PTT and PT are prolonged in DIC
193
hepatosplenomegaly, target cells, microcytosis, hypochromia, and anisopoikilocytosis
thalasemmias
194
macrocytosis and hypersegmented neutrophils
B12 def or folate def
195