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39 Cards in this Set
- Front
- Back
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FTT - ↓wt,N ht, N HC
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caloric insufficiency
↓ intake hypermetabolic state ↑ losses |
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FTT - ↓Wt, ↓Ht, N HC
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structural dystrophies
endocrine disorder familiar short stature constitutional growth delay |
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FTT - ↓Ht, ↓Wt, ↓HC
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intrauterine insult
genetic abnormality |
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Organic FTT causes (broad categories)
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inability to feed
inadequate absorption inappropriate use of nutrients ↑ energy requirements ↓ growth potential |
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Inability to feed causes
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insufficient milk production
poor retention - GERD, V anorexia (e.g. d/t chronic disease) |
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Inadequate absorption
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malabsorption
- celiac - CF - pancreatic insufficiency Loss from GIT chronic D, V |
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inappropriate utilization of nutrients
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renal loss (tubular disorders)
inborn errors of metabolism endocrine - DM - DI - hypopituitism - congenital hypothyroidism |
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Increased energy requirements causing FTT
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pulmonary disease - CF
cardiac disease endocrine - hyperthyroidism, hypopituitism, DI malignancies chronic infection inflammatory - SLE |
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Decreased growth potential causing FTT
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specific syndromes
chromosomal abnormalities GH deficiency intrauterine insults: - FAS - TORCH infections |
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heart murmurs
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50-80% of kids at some point
have audible murmurs most functional audible/accentuated during high output states (fever, anemia) |
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Characteristics of an 'innocent' murmur
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nothing on Hx/PE
SEM (except venous hum - continuous) grade <3/6 physiologically split S2 No extra sounds or clicking murmur varies with change in position |
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Characteristics of pathological murmur
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S/S of cardic dz
- FTT, exercise intolerance diastolic, pansystolic or continuous >3/6 fixed split or single S2 presence of extra sounds/clicks no change in murmur with position change |
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Name 5 innocent heart murmurs
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Still's
pulmonary ejection venous hum supraclavicular arterial bruit peripheral pulmonic stenosis |
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Still's murmur (description and DDx)
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vibratory, LLSB or apex, SEM
DDx subaortic stenosis small VSD |
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Pulmonary ejection murmur (description and DDx)
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soft, blowing, ULSB, SEM
DDx ASD pulmonary stenosis |
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Venous hum (description and DDx)
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infraclavicular hum, continuous, R>L
DDx PDA |
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Supraclavicular arterial bruit (description and DDx)
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low intensity, above clavicles
DDx AS bicuspid AV |
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Peripheral Pulmonic stenosis (description and DDx)
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neonates, low pitched, radiates to axilla and back
DDx PDA pulmonary stenosis |
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cutis marmorata/acrocyanosis
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= vasomotor response
- usually N (especially in premies) |
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vernix caseosa
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soft, creamy white layer
- common in premies - disappears by term - peeling of extremities in post-term babies |
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slate grey nevus of childhood
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= mongolian spots
- bluish-black macules over lower back and buttocks - common in black, asian, aboriginal infants |
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capillary hemangioma
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raised red lesion that increase in size after birth and often involute b/t 1-4yrs
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erythema toxicum
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erythematous vesico-papular rash
- comes in crops - self-limited to 1st 24-48hrs (gone within 1wk) |
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pustular melanosis
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defined by brown macular base with dry vesicles
more common in black infants |
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diaper dermatitis DDx
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irritant contact dermatitis
seborrheic dermatitis candidiasis psoriasis |
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Name 4 common pediatric infections that feature "diffuse erythematous macular eruptions"
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coxsackie
EBV - mononucleosis enteroviruses roseola |
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measles exanthum
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erythematous macular eruption beginning on head and spreading downward
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rubella exanthum
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erythematous macular eruption beginning on face and spreading to rest of body
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scarlet fever exanthum
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erythematous, finely papular eruption first appearing in axilla, groin and neck
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varicella exanthum
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diffuse vesicular pustular eruption beginning on thorax and spreading to extremities
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Itchy eruptions in childhood
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UC-SCAB
Urticaria Contact dermatitis Scabies Chicken pox Atopic dermatitis Bites |
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Causes of Vomiting in the newborn
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TEF
Duodenal atresia pyloric stenosis malrotation of the intestine |
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clinical presentation of TEF
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+/- hx maternal polyhydramnios
vomiting, coughing, gagging (after several mnths if no assoc esophageal atresia) cyanosis with feeds resp distress, recurrent pneumonia frothy bubbles of mucus in mouth and nose that return after suctioning VACTERL associations in 50% |
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clinical presentation of duodenal atresia
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50% premies
assoc w down's +/-hx maternal polyhydramnios bile stained vomiting (of distal to CBD) no abd distension dehydration double bubble sign |
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DDx duodenal atresia
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annular pancreas
aberrant mesenteric vessels pyloric stenosis |
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3 "P's" of pyloric stenosis
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palpable mass
peristalis visible projectile vomiting (age 2-4wks) |
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clinical features of pyloric stenosis
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non-bilious projectile vomiting after feeding
infant hungry & alert - will refeed constipation, FTT dehydration prolonged physiological jaundice gastric peristalsis - LUQ → epigastrium "olive sign" at margin of right rectus abd hypochloremic metabolic alkalosis |
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Malrotation of the intestine clinical features
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80% have symp in first 2 months
3 presentations: 1. recurrent vomiting 2. FTT w vomiting 3. sudden onset abd P then shock - if vomiting bilious = malrotation w volvulus until proven otherwise distended abd |
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Dx of intestinal malrotation
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UGI studies
- duodenum not fixed - spiral jejunum - mobile cecum |
