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peds23 Flashcards

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1
Q

management for NLD obstruction

A

observation for most kids (half resolve), nasolacrimal massage, topical antibiotics if infected; NLD probing through hasner’s valve into nose

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2
Q

amniotocele (dacryocele)

A

swelling of the nasolacrimal sac

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3
Q

cause of amniotocele

A

accum of fluid due to NLD obstruction

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4
Q

clinical features of amniotocele

A

blusih swelling in the medial canthal area may be apparent and represents fluid sequestered withn the nasolacrimal sac; infection may occur

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5
Q

management of amniotocele

A

local massage if no evidence of infection; IV antibiotics and urgent NLD probing if infections

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6
Q

retinal hemorrhages

A

highly suggestive of child abuse! Nonabuse causes include birth trauma, leukemia, incr ICP, malignant htn, bacterial endocarditis, immune thrombocytopenia purpura, and, rarely, cardiopulm resuscitation

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7
Q

clincal features of retinal hemorrhage

A

hemorrhagic dots and blots, or hemorrhage within the preretinal vitreous on a dilated fundoscopic exam

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8
Q

corneal abrasion

A

cause is traum, incl injury from contact lens; pain, tearing, and photophobia. Also foreign body sensation

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9
Q

diagnosis of corneal abrasion

A

identification on fluorescein staining of the cornea

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10
Q

management of corneal abrasion

A

ealing usually in 24-48 hours; placement of patch for that time is recommended in severe cases; topical antibiotic to prevent bacterial superinfection; optho consult if abrasion associated with contact lense

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11
Q

hyphema

A

blood within the anterior chamber

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12
Q

causes of hyphema

A

blunt trauma is most frequent cause; other causes are iris neovascularization and iris tumors

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13
Q

iris tumor

A

juvenile xanthogranuloma

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14
Q

clinical features of hyphema

A

impaired vision, blood-aquoeous fluid level

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15
Q

complications of hyphema

A

rebleeding 3-5 days after initial injury; glaucoma; staining of the cornea with blood; optic nerve damage in kids with sickle cell disease

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16
Q

management of hyphema

A

optho consult and bed rest for at least 5 days

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17
Q

orbital floor fracture due to what?

A

blunt trauma

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18
Q

clinical features of orbital floor fracture

A

orbital fat and inferior rectus muscl can become trapped in the fracture and lead to diplopia due to restricted vertical eye movement, to strabismus, and to enophthalmos

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19
Q

enophthalmos

A

backward displacement of the eye

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20
Q

why would numbness of the cheek and upper teeth below the orbital fracture occur?

A

infraorbital nerve injury

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21
Q

management of orbital floor fracture

A

empiral oral antibiotics to prevent max sinus organisms from getting to the orbit; also surgical repair if diplopia persists 2-4 wks after injury or if enophthalmos is signif

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22
Q

congenital glaucoma

A

incr intraocular pressure occuring at or soon after birth

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23
Q

adult glaucoma

A

pressure damages the optic nerve but does not change the size of the eye

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24
Q

congenital glaucoma

A

not only results in optic nerve injury but also expands the size of the eye; results in corneal edema, corneal clouding, and amblyopia

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25
cause of congenital glaucoma
outflow of acqueous humor is reduced bc of maldevelopment of the trabecular meshwork (aut dom); other causes are infection or genetic syndromes
26
clinical features of glaucoma
tearing, photophobia, enlarged cornea, corneal clouding, and dull red reflex
27
glaucoma is often misdiagnosed as what?
NLD obstruction
28
bilateral glaucoma?
seen bilaterally in congenital glaucoma in 70% of patients
29
management of glaucoma
surgery to open outflow channels is almos always required; topical or systemic b-ags and carbonic anhydrase inhib, may help lower pressure
30
prognosis for congenital glaucoma
if not detected and surgically treated early, leads to blindness
31
retinopathy of prematurity
proliferation of vessels in premature infants exposed to oxygen
32
late complications of ROP
myopia, astigatism, amblyopia, strabismus, and blindness
33
management of ROP
optho exams every 1-2 weeks to monitor prgoress; if disease is severe, retinal cryotherapy and laser therapy may be effective
34
two most impt ways to prevent ROP
limit oxygen delivered and effective treatment of hyaline membrane disease
35
who should get a dilated optho exam at 4-6 weeks of age
infants born at less than 28 weeks or less than 1500 g
36
leukocoria
white pupil; refers to opacity at or behind the pupil; can be caused by cataract, opacity within the vitreous, or retinal disease like retinoblastoma
37
congenital cataract
crystalline opacity of the lens present at birth
38
most common cause of cataract?
idiopathic
39
genetic syndromes that can cause cataracts
down, noonan, marfan, alport, and smith-lemli-opitz syndrome
40
what metabolic derangements can cause cataracts
hypoglycemia, galactosemia, and DM
41
what intrauterine infections can cuase cataracts?
CMV and rubella
42
can trauma cause cataracts?
yes
43
management of cataracts
early surgery to prevent amblyopia
44
prognosis for congenital cataract
treated within the first few weeks of life- good prognosis; but surery performed later is associated with poor visual outcome
45
most common ocular malignancy in childhood
retinoblastoma
46
average age of presentation of retinoblastoma
13-18 months. More than 90% of cases dx before 5 years of age
47
genetics of retnoblastoma
mutation or deletion of growth supp gene on both alleles on the long arm of chrom 13; two hit model
48
two most common presenting signs of retinoblastoma
leukocoria and strabismus
49
hallmark of retinoblastoma?
calcification within the tumor identified on imaging studes of the eye
50
management of retinoblastoma
large tumors involving the macula are treated by removing the eye; smaller tumors may be treated with external beam radiation (which may induce secondary tumors); very small peripheral tumors can be treated with cryotherapy or laser photocoagulation
51
starbismus
misalignment of the eyes
52
esotropia
eye turned nasally
53
exotropia
eye turned laterally
54
vertical strabismus
eye turned up or down
55
pseudostabismus
prominence of the epicanthal folds that results the false appearance of stabismus
56
if strabismus occurs before age 6
child suppresses the image in the deviated eye and amblyopia may result
57
if strabismus occurs after age 6
the mature visual system can't suppress the image and diplopia develops
58
management
ocular patching to prevent amblyopia; corrective lenses if farsighted; surgery if misalignment does not respond to patch or glasses
59
when is fifth disease no longer contagious?
when facial rash appears
60
management of fifth disease
supportive. IV IG can be used to treat chronic anemia in immunosupp patients
61
roseola infantum
aka exanthem subitum
62
roseloa most common in what agr
under 2
63
what causes roseola?
HHV 6 and 7; other causes ar adenovirus, parvi, b19, and echovirus 16
64
clinical features of roseola
begins with 3-5 days of high fever; once the fever resolves, a pink papular eruption occurs in the trunk and fades in 24-48 hrs
65
management of roseola infantum
supportive
66
gianotti-crosti syndrome
papular acrodermatitis; associated with hep B infection, EBV, CMV, and coxsackievirus
67
clinical features of gianotti-crosti syndrome
red or flescolored papules in acral areas; URI symptoms may precede the eruption; treatment is supportive
68
clinical features of varicella
intensely pruriti erythematous macules develop after a 7 to 21 day incubation period; looks like a dew drop on a rose petal (vesicle on a red background)
69
management of varicella
antipyretics, cleansing with antibacterial soaps; antihistamines for itching; acyclovir for varicella pneumonia and encephalitisi or in eyes for eye involvement
70
most common HSV infection during infancy
gingiostomatitis, almost always caused by hsv 1
71
characteristic lesions for hsv
grouped vesicles on an erythematous base
72
hsv gingivostamatitis
young infants with grouped vesicles and ulcers on the lips, mouth, tongue
73
neonatal hsv
first week of life; may have just a few vesicles; serious sequelae include meningoencephalitis, hepatitis, sepsis, shock and death; hsv2 more common than hsv1
74
herpetic whitlow
hsv-1 infection; of the thumb or fingers (usually 2/2 thumb sucking by kid with oral hsv lesion)
75
where does hsv reside?
dorsal root ganglion; can reactivate
76
recurrent hsv lesions?
more mild and less symptomatic; generally occur on lip
77
how to diagnose hsv?
tzanck preparation, by detection of hsv antigen on fluorescent antibody testing, or culture of base of lesion; pcr of cerebrospinal fluid
78
management of hsv
neonatal hsv is medical emergency! Iv acyclovir; cutaneous and oral hsv may be treated with oral acyclovir promptly
79
hand-foot-mouth disease
coxsackievirus
80
clinical features of hand-foot-mouth diseae
vesicles, papules, or pustules on the palms, soles, fingers, and shallow ulcer on the soft palate or tongue
81
if only oral lesions are present in hand-foot-mouth disease, what do you call it?
herpangina
82
management of herpangina or hand foot mouth
supportive
83
what causes warts?
hpv
84
condylomata acuminata
term to describe multiple external warts in the genital area
85
management of warts
resolve spontaneously in 1-2 years; can treat but recurrance after treatment is high
86
molloscum cantagiosum is caused by what?
pox virus
87
molloscum features
flesh-olored papules with central umbilication
88
what disease is associated with eruption of molluscum
hiv infection
89
management of molluscum
just watchful waiting; can remove like wart
90
louse infestation
pediculus humanus (head and body lice) and phthirus pubis (pubic lice)
91
louse associated with what?
crowded living conditions, sharing hats, clothes, combs
92
body lice
papules and pustules on the trunk with excoriations
93
pubic lice
lice or nits in the groin and blackcrusted papules or blue macules (macula cerulea)
94
management of head lice
permethrin shampoo and comb
95
management of body and pubic lice
12 hours application of hexachloride lotion
96
scabies caused by what?
mite named sarcoptes scabei
97
clinical features of scabies
pruritic papules or vesicles all over body; severe itchign and S shaped burrows
98
management of scabies
overnight applic of permethrin lotion or lindane (adults only); highly contagious so treat all household contacts; wash all sheet and clothes
99
causes of hypopigmentation
postinflamm; pityriasis alba; vitiligo; oculocutaneous albinism
100
postinflamm hypopigmentation caused by what and resolves in how long?
may follow any skin inflamm (like atopic dermatitis) and resolves in months to years

Peds (99 decks)

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