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1
Q

Common Etiologies of Secondary Lactase Deficiency

A

Small intestinal epithelial damage after infection

Symptoms due to malabsorption of CHO

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2
Q

Secondary Lactase Deficiency Clinical Presentation

A

Symptoms after reintroducing dietary dairy
-abdominal pain
-bloating and flatulence
-watery diarrhea

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3
Q

Secondary lactase deficiency management and prognosis

A

Temporary dairy restriction

Typically transient and resolves in weeks to months

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4
Q

What is Primary Nocturnal Enuresis

A

Nighttime urinary incontinence beyond age 5

No hx of prolonged periods of nighttime dryness

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5
Q

Etiologies if Primary Nighttime Enuresis

A

Delayed maturation of bladder control

Decreased bladder capacity

Increased nocturnal urine output

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6
Q

Risk Factors of Primary Nocturnal Enuresis

A

Males aged 5-8

Family hx is the greatest risk factor

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7
Q

Evaluation of Primary Nocturnal Enuresis

A

Urinalysis to rule out UTI, DM, and DI

Voiding diary

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8
Q

Management of Primary Nocturnal Enuresis

A

Treat any Comorbid conditions

Restrict evening fluids

Enuresis alarm

Pharmacotherapy (desmopressin)

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9
Q

Etiology of Craniopharyngioma

A

From Remnants of Rathke’s Pouch

Bimodal age: 5-14 and 50-75

Benign and slow growing

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10
Q

Craniopharyngioma Clinical Manifestations

A

Compress optic chiasm: bitemporal hemianopsia

Compress pituitary stalk: endocrine dysfunction
-dec ADH = diabetes insipidus
-dec LH and FSH = pubertal delay
-dec TSH and GH = growth failure

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11
Q

Craniopharyngioma Brain Imaging

A

Calcified and/or cystic suprasellar mass

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12
Q

Craniopharyngioma Management

A

Surgical resection

Radiation treatment

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13
Q

Trisomy 18 etiology

A

Increased risk with maternal age

Trisomy 18 = “Edward’s”

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14
Q

Trisomy 18 MSK Defecects

A

FGR and small for gestational age

Microcephaly, micrognathia, low-set ears, prominent occiput

Clenched hands with overlapping fingers

Limited hip abduction

Rocker-bottom feet

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15
Q

Trisomy 18 additional physical findings

A

Cardiac VSD

hypotonia

Hypoventilation; inc risk of aspiration

Renal defects

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16
Q

Prognosis in Trisomy 18

A

95% of patients die in 1st year

Causes of Death: heart failure, respiratory failure

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17
Q

HSV Encephalitis Etiology

A

Primary infection with HSV or reactivation of latent infection

Typically affects Temporal Lobes

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18
Q

HSV Encephalitis Clinical Presentation

A

Altered mental status

Fever

Headache

Seizure

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19
Q

HSV Encephalitis CSF Findings

A

Lymphocytosis

Normal glucose

Increased protein

Increased RBC

HSV DNA on PCR

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20
Q

HSV Encephalitis Brain MRI

A

Temporal lobe hemorrhage/edema

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21
Q

HSV Encephalitis Treatment

A

IV Acyclovir

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22
Q

12 Months Language Markers

A

1st words

Point to desired object

Use several gestures with vocalizing

Recognize names of 2 objects
-look when objects are named

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23
Q

15 Months Language Markers

A

3 to 5 words

Points to 1 body part

mature Jargoning

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24
Q

18 Month language Markers

A

Use 10 to 25 words

Point to self

Imitate environmental sounds

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25
24 Month Language markers
50+ words Use 2 word sentences 50% intelligibility Follow 2 step commands
26
36 Month Language markers
200+ words Use 3 word sentences 75% Intelligibility Use Pronouns correctly
27
Vit A Deficiency
Night blindness Dry Conjunctiva/Cornea Follicular Hyperkeratosis Growth Retardation
28
Vit D Deficiency
Craniotabes Frontal Skull Bossing Bowlegs Beading of ribs
29
Vit E Deficiency
Sensory and motor neuropathy Ataxia Hemolytic Anemia
30
Vit K Deficiency
Bleeding: Gums, Skin, Joints
31
Etiology of Congenital Dacryostenosis
Incomplete Canalization of Distal Nasolacrimal Duct
32
Clinical Presentation of Congenital Dacryostenosis
Increased Tearing and discharge Eyelash Crusting Clear Conjunctivae on exam
33
Management of Congenital Dacryostenosis
Observation and lacrimal skin massages Probe duct if >6 months
34
Complications of Congenital Dacryostenosis
Dacryocystitis Dacryostocele
35
Poor Prognostic Signs in Drowning
Arterial blood pH < 7.1 Delayed initiation of CPR Prolonged CPR efforts Submerged > 5 minutes
35
Complications of Drowning
ARDS -fluid washes out surfactant Arrhythmia Cerebral Edema
36
Etiology of Diamond-Blackfan Anemia
Congenital defect of erythroid progenitor cells apoptosis of RBC
37
Diamond-Blackfan Anemia Clinical Presentation
Craniofacial Abnormalities Triphalangeal Thumbs Macrocytic Anemia Reticulocytopenia
38
Treatment of Diamond-Blackfan Anemia
Corticosteroids RBC Transfusions
39
Complications of Diamond-Blackfan Anemia
Increased risk of malignancy
40
Etiology of Wiskott-Aldrich Syndrome
XLR defect in WAS protein Gene -impaired cytoskeleton remodeling in WBC and platelets: Immune dysfunction
41
Wiskott-Aldrich Syndrome Clinical Presentation
Early in life: infants/toddlers Eczema Recurrent infections: Bacterial, viral, fungal Thrombocytopenia -Petechiae, hematemesis, hematochezia
42
Diagnosing Wiskott-Aldrich Syndrome
Microthrombocytopenia -decreased platelet # and size Confirm with genetic testing
43
Treatment for Wiskott-Aldrich Syndrome
Stem Cell Transplant
44
Causes of Osteomyelitis in Children
Staph Aureus: most common Neonates: E. Coli and Group B Strep Puncture wounds: Pseudomonas Aeruginosa Sickle Cell Patients: Salmonella
45
Causes of Septic Arthritis in Children
Staph Aureus Group A Strep: >3 months of age Group B strep: < 3 months of age Gram (-) Bacilli: < 3 months of age
46
Acute Presentation of Mumps
Unvaccinated patient Acute Parotitis preceded by viral prodrome
47
Complications of Mumps
Acute Pancreatitis Aseptic Meningitis Orchitis and Infertility Sensorineural Hearing loss
48
Acute Lymphoblastic Leukemia Clinical
Peak age 2-5 years Nonspecific: fever, fatigue, wt loss Anemia: pallor, fatigue Thrombocytopenia: bruise, petechiae Neutropenia: recurrent infection Lymphadenopathy Hepatosplenomegaly Bone pain Mediastinal Mass -airway compression -dysphagia -SVC syndroem Leptomeningeal spread -Neuro S/S Testicular enlargement
49
Acute Complications of Meningococcal Meningitis
Adrenal Hemorrhage -primary adrenal insufficiency Death DIC Multiorgan Failure Shock SIADH
50
Delayed Complications of Meningococcal Meningitis
Central DI Cranial Nerve Defecits Hearing Dysfunction of deafness Normal Pressure Hydrocephalus Seizure Disorders
51
Celiac Disease Pathophysiology
Immune-mediated inflammation of small intestine --chronic malabsorption Inflammation triggered by Gliadin
52
Celiac Disease Clinical
GI S/S: Abd pain, bloat, diarrhea Wt loss Iron Deficiency Anemia Vit D Deficiency Dermatitis Herpetiformis
53
Celiac Disease Diagnosis
Screen: Tissue Transglutaminase IgG Confirm: duodenal Biopsy -Crypt Hyperplasia -villous atrophy
54
Celiac Disease Management
Gluten-free diet
55
Oligoarticular Juvenile Idiopathic Arthritis
age 2-4 years Arthritis in <5 Joints
56
Polyarticular Juvenile Idiopathic Arthritis
Age 2-5 or 10-14 years Arthritis in >5 Joints
57
Systemic Juvenile Idiopathic Arthritis
Arthritis in >1 joint for >6 weeks
58
Other features of Oligo/Polyarticular Juvenile Idiopathic Arthritis
Females > Males Uveitis
59
Other Features of Systemic Juvenile Idiopathic Arthritis
Females = Males Fever > 2 weeks Evanescent Rash Anemia Hepatosplenomegaly Leukocytosis Lymphadenopahy Inc. Inflammatory Markers
60
Etiology of Inhibitor Development
seen in 25% of patients with Severe Factor VIII Deficiency Ab formation against infused Factor VIII --leads to decreased Factor Function
61
Clinical Manifestations of Inhibitor Development
Increased Bleeding Frequency Refractory Hemorrhage Prolonged pTT with normal PT
62
Management of Inhibitor Development
Regular screening Treat acute bleeds with bypass products -recombinant activated factor VII
63
Etiology of Measles (Rubeola)
Airborn transmission of Rubeola Virus Prevented by Live-Attenuated Vaccine Symptoms 1-3 weeks after inhalation of infectious particles
64
Measles (Rubeola) Clinical Presentation
Prodromal: Cough, Coryza, Conjunctivitis, Koplik Spots Fever Maculopapular Rash -Cephalocaudal: Starts on face centrifugal spread -spares palmes and soles
65
Complications of Measles (Rubeola)
Blindness Encephalitis Pneumonia -most common in infants/immunocompromised
66
Treatment of Measles
Supportive Care Vit A for hospitalized patients

Pediatrics Rotation (1 decks)

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