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45 Cards in this Set

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Pathophysiology of Reyes syndrome.
Swelling of mitochondria.
DKA Rx.
--IV insulin 0.1 U/kg/hr +/- bolus.
--add dextrose when glucose <250
--if pH<7.2, replace HCO3-
--when ketones get clear or HCO3- >20, stop IV give SQ insulin.
Mediastinal mass: (4T)
Thymona,
Thyroid CA
Teratoma
T cell lymphoma.
Lacunar cells?
Hodgkin's
70-75% kids w/ HTN have renal etiology.
Check BUN and creatinine.
Dx and Rx of Intussuception
Barium enema
Kids w/ known cardiac defect now present w/ fever, seizure, focal neurologic deficit.
Dx: brain abscess. By brain CT.
Rx: surgical drainage and IV antibiotics.
Meconium ileus. Dx and Rx.
Gastrografin enema.
Contact dermatitis covering 15-20% of body surface.
Rx: PO steroids.
Infants w/ sinus tachycardia (QRS complexes w/ no preceding p waves).
Initial best step= bag of ice on face for 5 sec.
Rx of peritonsillar abscess.
IV antibiotics (pnc; if allergic to pnc, try clindamycin and metronidazole).
Needle aspiration in ER setting.
Trisomy 13
Patau syndrome.
Assoc w/ holoprosencephaly.
Infants w/ abd difficulties and CF hint:
think meconium ileus.
Alpha drugs given for nasal congestion can....
have SE of rebound congestion and rhinitis medicamentosa.
William syndrome.
Overfriendly pt w/ supravulvular aortic stenosis.
DiGeorge syndrome
Assoc w/ truncus arteriosus and total anomalous pulmonary venous return.
Rule of 10 of surgery of cleft lip.
Age 10 wks
Wt 10 lb
Hb 10.
Tx for tet spell of TOF
knee chest position
phenylepherine drip
oxygen
TOF pt complication dx.
check O2 oximetry (e.g. pH 7.38 > ok, but if pt has metabolic acidosis> means not enough O2 to tissues)
Normal newborn Hb
50
Polycythemia Hb
>65
Congenital cyanotic disease of polycythemia (twin-twin transfusion, intrauterine hypoxia, DM infants) mostly asx but can get stroke.
Dx: heel stick blood.
Rx: partial exchange transfusion.
Reactive Mantoux and positive CXR in 2 yr old, management (next step)?
Early morning gastric aspiration to ID acid fast bacilli swallowed at night.
General rule: Gram neg rx?
Cover w/ 2 antibiotics.
(e.g. CF pt w/ pneumonia (suspected pseudomona) needs 2 IV drugs w/ anti-pseudomonal activity like ceftazidime and tobramycin; or ticarcillin and tobramycin)
Precocious puberty w/ normal ht and wt, next step?
XR of head and wrist.
Rx of hypophosphatemic rickets
Combined oral phosphate and 1,25-dihydroxyvitamin D3.
EKG characteristics of Wolf-Parkinson-White syndrome?
Short PR interval and delta waves w/ slow QRS upstroke.

Rx: ablation of bypass tract.
Neuroblatoma histology.
small round cell tumor w/ Homer-Wright Rosettes.
Sickle cell pt w/ dilute urine and dehydration.
Think secondary enuresis.
Decrease C3.
SLE, membranoproliferative GN, Post strep GN
Alport syndrome.
--X linked D, AD, mutation
--Biopsy> glomerular sclerosis, lamellation of basement membrane (onion layers w/ breaks).
Most common cause of non-anion acidosis in kids.
Diarrhea.
Bartter syndrome
(opposite of renal tubular acidosis type 4) hyper-renin, hyperaldosteronism, hypokelemia, normal BP, non-function Jexta-glomerular apparatus, hypocholeremic metabolic acidosis.
Most common cause of ARF in kids
Hemolytic-Uremic syndrome.
No stool pass in nursery.
Think CF, kid of DM (microcolon), Hirshsprung.
All kids w/ rectal prolapse.
Get sweat chloride test.
Werdnig Hoffman.
AR,
survival motor neuron gene (SMN) 5q13.
Pes cavum
High arched foot,
peroneal muscle atropphy,
recurrent ankle sprains
Allelic expansion (1 allele has too many copies) in ....
Fragile X syndrome,
myotonic dystrophy,
Huntington's chorea.
Physical examination of infant: continuous murmur heard best at upper left sternal border. Athrill, analogous to a kitten's purring, can be felt over the left side of chest. Dx?
PDA
(ductus arteriosus, connecting pulmonary artery to aorta--to bypass lungs)
Signs and symptoms of PDA.
-tachycardia or arrhythmia
-respiratory problem
-SOB
-systolic ejection murmur
-enlarged heart
-cyanosis
Normal ductus arteriosus.
--when newborn takes its first breath, lungs opened and pulmonary pressure decreases below that of the left heart.
--lung release bradykinin to constrict the smooth muscle wall of DA and reduced bloodflow.
--closes within 15 hours after birth. Completely sealed after 3 weeks.
--becomes ligamentum arteriosum, remains in adult hearts.
PDA
--common in infants w/ persistent respiratory problems (hypoxia). Hypoxic newborns---too little oxygen reach lungs to produce sufficient bradykinin to close DA.
--high occurrence in premature children.
--allows oxygenated blood to flow down its pressure gradient from aorta to pulmonary arteries--> thus oxygenated blood not reach the body, and becomes SOB and cyanotic. Thus, heart rate hastens.
--if left untreated, infants will suffer congestive heart failure (heart unable to meet metabolic demand of body).
Under what circumstances a PDA allow to be opened?
In transposition of great vessels (pulmonary artery and the aorta).
PDA is the only way that oxygenated blood can mix w/ deoxygenated blood.
--prostaglandins are used to keep PDA.
Rx of PDA.
Fluid restriction and prostaglandin inhibitors (indometacin)
Infants w/ petechiae.
Mostly assoc w/ platelet disorder.
(e.g. normal bleeding and count, high PT ---> vit k deficiency).