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82 Cards in this Set
- Front
- Back
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Congenital Syphilis symptoms |
Less than 2 -Snuffles -Chorioretinitis -Periosteitis, osteoarthritis -Nephrotic syndrome
More than 2yo - raghades -Saddle nose -Saber shins -Mulberry molars/Hutchinson teeth |
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Becker dystrophy |
X linked dystrophin gene mutation Less severe than Duchenne Adolescence onset |
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Congenital syphilis dx |
Initial: vdrl or rpr Confirm: tpi or fta abs or mha to Most accurate: Dark field microscopy |
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Edwards syndrome |
Physical Rocker bottom feet Micrognatia Low set ears Clenched hands Intellectual disability Congenital heart disease Death within 1year Quadscreen all negative |
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Prophylactic maternal syphilis prior to delivery |
Penicillin 4 weeks prior to delivery |
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Age head lag disappears |
4 months |
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Down syndrome features |
Brushfield spots Flat facies Prominent epicanthal folds Single Palmar crease Gap between 1 and 2nd toes Causes duodenal atresia, hirschprung and congenital heart disease Associated to ALL AML and Alzheimer's |
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Most common cause of stridor in children |
Tracheomalacia 2nd mcc congenital subglotic stenosis |
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Mid Parental height |
Boys: dad height plus mother's height + 13cm/2
Girls: mother's height plus dad's height minus 13/2 |
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Differential dx for macrocytic anemia |
HAD LBS Hypothyroidism Aplastic anemia Diamond blackfan Liver disease Bone marrow infiltration Syndrome of congenital dyserythropietic anemia |
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CHARGE |
Coloboma of eyes Heart defects(tof) Atresia of choanae Retardation of growth and development Genitourinary(hypogonadotropic hypogonadism) Ear |
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VACTERL |
Vertebral Anal anomalies Cardiac TracheoEsophageal fistula Renal Limbs |
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Causes of prolonged QT INTERVAL |
Hypokalemia Hypocalcemia Drugs: TCAs, erythromycin, tmp and Jervel and lange Nielsen Left ventricular hyperthrophy |
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Clindamycin coverage |
Anaerobes, strep and staph Cause of c diff infection |
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Toxic shock syndrome |
Erythroderma Hypotension Fever Diarrhea Hypocalcemia |
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TORCH |
Toxoplasmosis Other: syphilis, varicella zoster, b19, hiv Rubella Dmv Herpes simplex |
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Asthma predictive index |
Major Parent with asthma Dx of eczema Minor Food allergies Eosinophilia Wheezing apart from Colds |
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Causes of stridor in infant |
Intermittent Aspiration Viral croup Electrolyte anomaly Persistent Laryngeal anomalies Mediastinal mass Vascular ring |
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Long term complication of underdiagnosed foreign body |
Recurrent pneumonia Atelectasis Bronchietacsis |
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False positive treponemal tests causes |
Lyme disease Leptospirosis Autoimmune disease Viral infections |
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False positive non treponemal causes |
Lab error Autoimmune disease Tb Lymphoma Virus(ebv, hepatitis,varicella, gov, measles) Malaria Iv drug abuse |
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Differential for congenital and acquired stridor |
Congenital Laryngothracheomalacia Subglotic stenosis Vocal cord paralysis Infections Croup Epiglotitis Bacterial tracheitis Retropharyngeal/peritonsillar abscess Trauma(intubation) Hypocalcemia, hypothermia Allergic reaction |
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Palmar and sole rash differential |
Syphilis Rocky spotted mountain Hand foot mouth Kawasaki Measles Toxic shock syndrome Meningococcemia Bacterial endocarditis Keratoderma blenorhagica(reiters) |
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Age maternal retroviral should brr started |
>12 weeks |
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Quadscreen for downs |
2nd trimester Decreased AFP ESTRIOL increased B hcg, inhibin A |
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Roseola etiology |
Herpes virus 6 or 7 |
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Indications for hospitalization for pneumonia |
<3 mo Hypoxemia Vomiting dehydration Underlying condition Complication Toxic appearance |
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Goats milk anemia type |
Macrocytic anemia Folate deficiency |
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Intubation mnemonics |
DOPE Displacement of tune Obstruction Pneumothorax Equipment failure |
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Intracranial complications of mastoiditis |
. Intracranial complications of mastoiditis (and otitis media) are uncommon and include meningitis, brain abscess, epidural or subdural empyema, and carotid artery and venous sinus thrombosis. |
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Extracranial complications of mastoiditis |
Extracranial complications of mastoiditis (and otitis media) include cholesteatoma, subperiosteal abscess, facial nerve palsy, hearing loss, labyrinthitis, osteomyelitis, and Bezold abscess of the sternocleidomastoid muscle |
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Etiology of mastoiditis |
The bacteria most likely to cause acute mastoiditis in children include Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus. Pseudomonas aeruginosa should be considered as a possible pathogen in children with a history of recurrent otitis media and recent antibiotic use. |
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Most common cause of hemoptysis in children |
Cystic fibrosis |
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Beighton score |
Evaluates joint hypermotility One point for knee or elbow that extends beyond 10 degrees 9 points in total |
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Potter sequence associated condition |
Autosomal recessive polycystic kidney disease |
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Causes of short QT |
Hypercalcemia Digitalis Thyrotoxicosis Increased sympathetic tone |
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Di George syndrome |
Cleft palate Abnormal facies Thymic aplasia Cardiac defects Hypocalcemia Thymus, parathyroid and heart affected |
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Apt test |
Helps differentiate nipple fissure blood from gi tract bleeding Fetal hemoglobin is resistant unlike maternal |
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Brugada syndrome |
Familial syndrome Right bundle branch block St elevation Syncope or death |
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Fragile x syndrome |
Second most common cause of intellectual disability Post pubertal macro orchidism Long face, jaws, ears Autism Mvp |
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Extrapulmonary signs of Mycoplasma |
Erythema multiforme Hemolytic anemia Arthritis Carditis CNS |
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Mc surgical complications of patients with neuromuscular disorders |
Apnea Cardiac Arrythmias Malignant hyperthermia |
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Tumor lysis syndrome electrolyte abnormalities |
Hypocalcemia Hyperkalemia Hyperphosphatemia Hyperuricemia |
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Contraindications to cardiac tamponade |
Furosemide |
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Causes of pericardial efffusions |
metabolic (uremia, hypothyroid states), infectious (viral, bacterial, fungal) with or without myocarditis, and autoimmune (lupus, juvenile rheumatoid arthritis, acute rheumatic fever). |
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“female athlete triad” |
disordered eating, amenorrhea, and osteoporosis |
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McMurray test |
holding the patient’s knee in flexion, then rotating the tibia and extending the knee; pain or a palpable click may indicate the presence of a meniscal tear |
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Valproate side effects |
Valproate can cause hyperammonemic encephalopathy without transaminitis.Valproate can cause neutropenia and thrombocytopenia. |
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Major causes of persistent neonatal Hypoglycemia |
Beckwith wiedeman Nesidioblastosis adenoma Inborn error of metabolism Endocrine, pituitary or adrenal |
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Narrow QRS complex tachycardia causes |
SVT Paroxysmal atrial tachycardia |
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Causes of double bubble sign |
Duodenal Atresia(no distal bowel gas) Annular pancreas Midgut volvulus (distal bowel gas) |
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Influenza complications |
Otitis media(mcc) Staph pneumonia Myositis Encephalitis |
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MC disorders associated to rectal prolapse |
Cystic fibrosis Hirchsprungs Celiac disease Parasites |
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Congenital Rubella infectious for |
1 year |
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Fluconazole indications |
Invasive Candida Inmunocompromised patients Vulvovaginal Candida Cryptococcus meningitis |
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Newborn HIV dx |
PCR at birth, 1 and 4 months. Two positive is hiv positive |
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UTI in patients with indwelling catheters |
Enterococcus Rx ampicillin |
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Drugs that cause early bleeding in infants |
Warfarin Isoniazid Rifampin Phenobarbital |
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Contraindications of tonsilectomy |
Velopharyngeal conditions(cleft palate or cleft uvula) Anemia Disorders with hemostasis Acute airway infection |
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Large Fontanelle or delayed closure |
Congenital HypothyroidismTrisomy 21 (Down Syndrome)Rickets (with Hypophosphatemia)AchondroplasiaIncreased Intracranial Pressure |
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Small Fontanelle or early closure |
Early closure may be normalAlways evaluate for MicrocephalyCraniosynostosis |
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Indications for Tonsillectomy
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recurrent acute or chronic tonsillitis or sinusitis, recurrent acute otitis media or chronic otitis media with effusion, alteration of voice quality because of adenotonsillar hypertrophy, refractory halitosis, peritonsillar abscess, or syndrome of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA syndrome). |
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Exertional chest pain
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Hypertrophic Cardiomyopathy Coronary artery disease |
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Indications for Tonsillectomy |
recurrent acute or chronic tonsillitis or sinusitis, recurrent acute otitis media or chronic otitis media with effusion, alteration of voice quality because of adenotonsillar hypertrophy, refractory halitosis, peritonsillar abscess, or syndrome of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA syndrome). |
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Indications for Patients with strabism
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If constant->referral to ophtalmology If intermittent->no referral unless 4 months old or older |
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Peak growth velocity age for females and males
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Girls achieve an average peak growth velocity of 8 to 9 cm/year by sexual maturity rating 3. Boys’ growth velocity peaks at an average of 10 cm/year by sexual maturity rating 4. |
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Infantile hemangiomas associations
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girls, non-Hispanic whites, premature infants, children who are products of multiple gestation, and children of mothers of advanced age
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High Risk Hemangiomas
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Potentially disguring sites(Nasal tip, perioral, glabela, ear, eyebrow, central facial location >0.5cm, thick or exophytic hemangiomas) Periocular hemangiomas Lumbosacral or perineal hemangiomas Airway hemangioma "beard area" skin hemangioma Multifocal(>5) infantile hemangiomas |
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In patients who have undergone abdominal surgery, the new onset of neurologic symptoms should suggest |
D-lactic acid acidosis related to bacterial overgrowth syndrome.In patients with suspected malabsorption, an acid stool pH suggests carbohydrate excretion. |
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Macrocephaly, learning disorder and cafe au lait spots |
Neurofibromatosis |
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Neurofibromatosis type one dx |
-6 or more cafe au lait spots, 5mm pre pubertal, 15 mm post pubertal -2 or more Neurofibromas -2 or more iris hamartomas -one or more plexiform Neurofibroma -axillary freckling -optic glioma -Oseous lesion:sphenoid dysplasia or tibial pseudo arthritis -first degree relative with nf |
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Leptomeningeal angioma |
Sturge weber syndrome |
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Refeeding syndrome
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muscle weakness and fatigue, along with hypocalcemia, hypokalemia, hypomagnesemia, and hypophosphatemia
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Pathophysiology of Refeeding syndrome
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During periods of starvation, insulin levels fall, promoting release of glucose and free fatty acids for energy. Thyroid hormone levels also are reduced resulting in a lower metabolic rate, and insulin-like growth factor 1 levels fall, reducing protein synthesis. When glycogen stores are exhausted, upregulation of gluconeogenesis from protein catabolism leads to water, vitamin, and mineral depletion. A sudden, marked increase in carbohydrate intake, as with refeeding, will raise serum insulin and lower serum glucagon levels. Increased cellular glucose uptake then promotes intracellular movement of phosphate, potassium, and magnesium, while increased utilization of vitamins (including thiamine) and adenosine triphosphate lead to a deficiency state. Clinically, multiple organ systems may be affected, resulting in muscle weakness, seizures, cardiac arrhythmias, hypotension, and ileus.
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Aspirin triad
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“aspirin triad,” consists of nasal polyps, acetylsalicylic acid intolerance, and asthma, and is identified in 13% to 40% of patients with nasal polyposis
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most common cyanotic congenital heart lesion presenting at birth
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Transposition of great vessels |
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cyanotic congenital heart disease that presents at birth
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Transposition of Great Vessels Pulmonary valve atresia and severe Ebstein malformation Single Ventricle Malformation Hypoplastic heart syndrome |
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Difference between TGA and pulmonary atresia and Ebstein malformation |
Chest radiography can be helpful in distinguishing among these conditions because TGA may show evidence of increased pulmonary blood flow, whereas pulmonary atresia and Ebstein malformation typically show decreased pulmonary blood flow
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Children following a vegan diet require increased what nutrients? |
iron intake and vitamin B12 supplementation |
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Criteria for HSP Dx
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Purpura or petechiae with lower limb predominance and at least 1 of the following: -Arthritis or arthralgia, -Abdominal pain, -histopathology demonstrating immunoglobulin A deposition, or -renal involvement demonstrated by hematuria or proteinuria |
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Allergic rhinitis classification |
It may be classified as seasonal or perennial, intermittent or persistent, and mild or moderate to severe. |
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Allergic Rhinitis physical findings |
“Allergic shiners” is the descriptive term for venous congestion and suborbital edema that appears as dark discoloration under the eyes. Dennie-Morgan lines are accentuated lines or folds below the lower lids. The “allergic salute,” pushing the tip of the nose up repeatedly, may lead to a transverse nasal crease. “Allergic facies” consists of an elongated face, high-arched palate, and open mouth breathing. |
