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19 Cards in this Set
- Front
- Back
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Failure to thrive |
physical sign not a final diagnosis suspected if a child's growth below 3rd or 5th percentile in child less than 6 months old who does not gain weight for 2-3 months or in a child whose growth cross more than 2 major growth percentiles in a short time frame usually in children less than 5 who are significantly smaller than their peers |
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Major causes of inadequate weight gain |
p.20 Case files inadequate caloric intake altered growth potential caloric wasting increased caloric requirements |
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Healthy infants require how many calories per day in first year? For FTT? |
120kcal/kg/day
and 100 kcal/kg/day thereafter FTT require 50-100 percent more |
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congenital CMV |
developmental delay, IUGR (microcephaly), cataracts, seizures, HSM, prolonged neonatal jaundice, purura periventricular calcified brain densities toxo - scattered throughout cortex |
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premies |
use appropriate growth chart |
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picky eaters |
18-30 months growth rates can plateau counsel parents to avoid force feeding and snacks |
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renal tubular acidosis |
low bicarb, low K, elevated chloride levels type 2 - proximal - impaired tubular absorption of bicarb distal - type 1 - impaired hydrogen ion secretion |
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substance abuse in adolescents |
new-onset truant behavior, depression or euphoria, declining grades |
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Clinical features of substance abuse: alcohol, marijuana, cocaine, meth and ecstasy, heroin, PCP, and barbituates |
case files p.30 |
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trisomy 18 |
clenched hands with overlapping digits, small palebral fissures, prominent occiput, short sternum, and cardiac defects (VSD, ASD, PDA, and coarct) |
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AV canal defect |
slight cyanosis since mixing of deoxygenated with oxygenated complete - ASD, VSD, common AV valve partial - defects of the atrial septum, and separate and mitral and tricuspid orifices |
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trisomy 13 |
cutis aplasia, polydactyly, holoprosencephaly, cleft lip or palate, postaxial polydactyly, flexed and overlapping fingers, colobroma, cardiac defects (VSD, ASD, PDA, dextrocardia) |
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HIV infection |
vertical transmission dx in younger patients made by PCR >18 months ELISA PCP prophylaxis - TMP-SMX exposed - receive 6 weeks of antiretroviral zidovudine immunizations kept current |
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3 major categories of anti-retrovirals |
NRTIs (didanosine, stavudine, zidovudine) nonNRTIs (efavirenz, nevirapine) protease inhibitors (indinavir, nelfinavir) current pediatric (2 NRTIs, and 1 protease inhibitor) |
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immunosuppression |
difficult to eradicate infections FTT |
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Diabetes Mellitus -> immunosuppression |
hyperglycemia -> neutrophil dysfunction -> ineffective neutrophil chemotaxis |
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leukocyte adhesion deficiency |
inheritable disorder of leukocyte chemotaxis and adherence recurrent sinopulmonary, oropharyngeal, and cutaneous infections with delayed wound healing neutrophilia with WBCs greater 50,000 Stap, Enterobacteriaceae, and Candida |
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SCID |
AR and X linked of both humoral and cellular immunity IgG and T cells are diminished thymic dysgenesis recurrent cutaneous, GI, or pulmonary infections with CMV and Pneumocystis death occurs in first 12-24 months of life if bone marrow transplantation not performed |
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DiGeorge Syndrome |
22q11 microdeletion decreased T cell production and recurring infection VSD, tetralogy of fallot, thymic or parathyroid dysgenesis hypocalcemia and seizures developmental and speech delay are common in patients |
