Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
101 Cards in this Set
- Front
- Back
|
Definitive evidence of sexual abuse in children
|
N. gonorrhea culture
|
|
|
Definitive signs of shaken baby syndrome
|
Retinal hemorrhage, subdural hemorrhage
|
|
|
VSD associations
|
Apert's, Down's, FAS, TORCH, cri-du-chat, trisomy 13 and 18
|
|
|
Small VSD presentation
|
Harsh holosystolic murmur at lower left border; asymptomatic
|
|
|
Large VSD - presentation
|
Softer holosystolic murmur with thrill, narrow S2; resp infections, dyspnea, FTT, CHF
|
|
|
CXR findings in VSD
|
Cardiomegaly, increased pulmonary vascular markings
|
|
|
Down syndrome - heart defect association
|
ASD and endocardial cushion defects; VSD
|
|
|
Congenital rubella - heart defect association
|
PDA
|
|
|
Turner's syndrome - associated heart defect
|
Coarctation of aorta, bicuspid aortic valve
|
|
|
Kawasaki disease - associated heart defect
|
Coronary artery aneurysms
|
|
|
Neonatal lupus - associated heart defect
|
Congenital heart block
|
|
|
Williams syndrome - associated heart defect
|
Supravalvular aortic stenosis
|
|
|
Lithium use - associated heart defect
|
Ebstein's (tricuspid valve leaflets displaced towards apex)
|
|
|
Neonatal thyrotoxicosis - associated heart condition
|
Heart failure
|
|
|
Maternal diabetes - associated heart defect
|
Transposition of great vessels; asymmetric septal hypertrophy
|
|
|
Indications for VSD repair
|
Pts who fail medical rx
Pts <1yo with pulm HTN Older pts with patent VSDs |
|
|
ASD associations
|
Down's, FAS, Holt-Oram syndrome (absent radii, ASD, heart block)
|
|
|
Difference in presentation of ostium primum and secondum defects
|
Primum - early childhood
Secondum - late childhood |
|
|
ASD presentation
|
Asymptomatic, or fatigue, resp infections, FTT; systolic ejection murmur at upper left sternal border
|
|
|
ASD cardiac exam findings
|
Systolic ejection murmur at upper left sternal border; *wide and fixed, split S2*
|
|
|
ECG findings in ASD
|
RVH, RA enlargement, PR prolongation
|
|
|
Indications for ASD surgical/catheter closure
|
Infants with CHF
Ps with >2:1 ratio of pulm-to-systemic blood flow |
|
|
PDA cardiac exam
|
Continuous machine-like murmur at 2nd IC space of sternal border; wide pulse pressure, bounding peripheral pulses
|
|
|
PDA
|
Patency of ductus arteriosus to remain open after birth, causing blood from aorta to travel to pulm artery
|
|
|
Tx for PDA
|
Indomethacin unless PDA is needed for survival
Surgery if child is >6-8months, or if indo fails |
|
|
Common location of coarctation
|
Below lt subclavian artery, above DA
|
|
|
Common exam findings of coarctation
|
Upper limb HTN, weak femoral pulses, systolic murmur in back, lt axilla
|
|
|
Compensatory findings in older children with coarctation
|
LVH on ECG, "3 sign" and "rib notching" on CXR
|
|
|
Transposition of great vessels
|
Aorta is connected to RV, pulmonary artery is connected to LV
|
|
|
Compensatory defects needed for life in TGV
|
ASD/VSD and PDA
|
|
|
Risk factors for developing TGV
|
Diabetic mothers, DiGeorge
|
|
|
Classic presentation of TGV
|
Cyanosis within first 24 hours of life; reverse differential cyanosis if coarctation is present
|
|
|
Examination findings of TGV
|
Tachypnea, hypoxemia, cyanosis; loud, single S2, VSD murmur if present
|
|
|
CXR findings of TGV
|
"Egg-shaped" silhouette, increased pul vascular markings
|
|
|
Management of TGV
|
IV PGE1 (to keep DA patent); balloon atrial septostomy to create ASD until surgery (definitive)
|
|
|
DiGeorge - associated heart defect
|
Transposition of great vessels
|
|
|
Tetralogy of Fallot
|
Overriding aorta
VSD Pulm stenosis RVH |
|
|
Severity of ToF depends on?
|
Pulmonary stenosis
|
|
|
ToF presentation
|
Cyanosis after 2yo (due to pulm. stenosis), dyspnea, diaphoresis with feeding; "tet spells"
|
|
|
Cardiac exam findings in ToF
|
Systolic ejection murmur at upper left sternal border, rt ventricular heave, single S2
|
|
|
CXR findings in ToF
|
"Boot-shaped" heart with decreased pulm vascular markings
|
|
|
ECG findings in ToF
|
Rt axis deviation, RVH
|
|
|
Management of hypercyanotic "tet spells"
|
O2, propranolol, phenylephrine, knee-chest position
|
|
|
Management of tetralogy of fallot
|
Manage tet spells
Balloon atrial septostomy to stabilize pt before Blalock-Taussig shunt |
|
|
Language development milestones from 0-5yrs
|
Babbles @ 6m
1 word @ 1 yr 2 word phrases @ 2 yrs 3-word phrases @ 3 yrs Proficient @ 5 yrs |
|
|
Gross motor milestones from 0-1 yr
|
Lifts head @ 2m
Rolls @ 4m Sits @ 6m Crawls @ 9m Walks @ 1yr |
|
|
Gross motor development from 1-5 yrs
|
Walks @ 1yr
Up/down steps @ 2yrs Rides tricycle, climb stairs @ 3yrs Proficient @ 5yrs |
|
|
Fine motor milestones from 1-5 yrs
|
2-finger grasp @ 1yr
Builds tower of 6 blocks @ 2yrs Circle @ 3yrs Cross/square @ 4yrs Triangle @ 5yrs |
|
|
Social/cognitive milestones from 0-5yrs
|
Social smile @ 2m
Stranger danger @ 6m Follows 1-step commands @12m Follows 2-step commands @ 2yrs |
|
|
Average age of puberty and menarche in girls
|
Puberty - 10.5yo
Menarche - 12.5yo |
|
|
Average age of puberty in boys
|
11.5
|
|
|
Precocious puberty
|
Secondary sexual maturation in girls <8yo and boys <9yo
|
|
|
Constitutional growth delay
|
Normal variant of growth - consistent growth curve lags; children catch up eventually; positive fhx
|
|
|
Delayed puberty
|
No puberty in girls >13yo and in boys >14yo
|
|
|
Lesch-Nyhan syndrome
|
X-linked HGPRT deficiency, hyperuricemia; mental retardation, spasticity, dystonia, self-mutilation, gout
|
|
|
Homocystinuria
|
Cystathionine beta synthase deficiency; increased methionine, homocysteine; mental retardation, seizures, Marfinoid, ectopic lens, thromboemboli
|
|
|
Down's syndrome associated conditions
|
Duodenal atresia, Hirschprung's disease, congenital HD (ASV, VSD); ALL, hypothyroidism, Alzheimer's
|
|
|
Edward's syndrome
|
Trisomy 18; rocker-bottom feet, micrognathia, clenched hands; death before 1yo
|
|
|
Patau's syndrome
|
Trisomy 13; microphthalmia, microcephaly, cleft lip/Palate, holoprosencephaly, Polydactyly; death before 1yo
|
|
|
Klinefelter's syndrome
|
47XXY; primary testicular hypogonadism; testicular atrophy, eunuchoid, tall, gynecomastia, female hair distribution
|
|
|
Presentation of Turner's syndrome in newborns
|
Lymphedema of hands/feet, widely spaced nipples, webbed neck, decreased femoral pulses
|
|
|
PKU
|
AR-phenylalanine hydroxylase (or tetrahydrobiopterin cofactor) deficiency; fair hair/skin, mousy odour, increased risk of heart disease
|
|
|
Fragile X syndrome
|
X-linked dominant FMR1 gene mutation; CGG repeats; large jaw, testes, and ears with ASD behaviours
|
|
|
Respiratory presentation of CF
|
Chronic cough, recurrent S. aureus + Pseudomonas infections, digital clubbing, nasal polyposis; common in children
|
|
|
Abd presentation of CF
|
*Meconium ileus*, pancreatitis, steatorrhea, rectal prolapse, jaundice, fat-sol vit deficiency; common in infancy
|
|
|
Non-resp/abd signs/symptoms of CF
|
Type II DM, *salty skin*, male infertility (vas def agenesis), hyponatremia
|
|
|
Screening and confirmatory test for CF
|
Screening: sweat chloride test >60mEq/L in peds, >80mEq/L in adults
Confirmatory: genetic testing |
|
|
Acid-based disorder common in CF
|
Hypochloremic alkalosis
|
|
|
Most common cause of bowel obstruction in under 2yos
|
Intussusception
|
|
|
Risk factors for developing intussusception
|
Meckel's diverticulum, intestinal lymphoma, Henoch-Schonlein purpura
|
|
|
Presentation of intussusception
|
Sudden-onset colicky abd pain, vomiting, bloody mucus in stool (current jelly)
|
|
|
Exam finding in intussusception
|
"Sausage-shaped" RUP abd tenderness, absence of bowel in RLQ
|
|
|
Test of choice and finding for intussusception
|
US - shows "target" sign
|
|
|
Diagnostic and therapeutic test for intussusception
|
Air-contrast barium enema
|
|
|
Contraindications for air-contrast barium enema in intussusception
|
Shock, peritoneal perforation/peritonitis
|
|
|
Pyloric stenosis
|
Pyloric sphincter hypertrophy leading to gastric outlet obstruction
|
|
|
Presentation and exam findings in pyloric stenosis
|
Projective, nonbilious emesis @ 3wks; palpable olive-shaped epigastric mass
|
|
|
Diagnostic test of choice for pyloric stenosis
|
US
|
|
|
Acid-base disorder in pyloric stenosis
|
Hypochloremic, hypokalemic metabolic alkalosis
|
|
|
Tx of pyloric stenosis
|
Pyloromyotomy
|
|
|
Meckel's diverticulum
|
Failure of omphalomesenteric duct to obliterate
Ectopic gastric, pancreatic tissue Ulcers and bleeding |
|
|
Meckel's rule of 2s
|
Most common in <2yos
2x more common in males 2 tissue types (gastric, pancreatic) 2 inches long Within 2 ft of ileocecal valve 2% of population |
|
|
Classic presentation of Meckel's
|
Sudden, intermittent, painless rectal bleeding
|
|
|
Diagnostic test for Meckel's
|
Tchnetium-99m tertechnetate - scintigraphy scan (detects ectopic gastric tissue)
|
|
|
Tx of Meckel's
|
Excision of diverticulum with adjacent ileal segment
|
|
|
Hirschprung's disease
|
Congenital lack of ganglionic cells in colon leading to decreased peristalsis
|
|
|
Presentation of Hirschprung's in neonates
|
Failure to pass meconium within 48 hrs of birth, with bilious vomiting and FTT
|
|
|
Exam findings in Hirschprung's
|
Abd distention, *POS squirt sign* (explosive stool discharge with DRE)
|
|
|
Diagnostic test of choice and finding in Hirschprung's
|
Barium enema - narrowed distal colon with proximal distention
|
|
|
Confirmatory test and findings in Hirschprung's
|
Rectal biopsy - absence of myenteric/Auerbach) and submucosal (Meissner) plexi; hypertrophied nerve trunks seen with AchE stain
|
|
|
Tx of Hirschprung's
|
2 stages: diverting colostomy followed by definitive "pull-through" of remaining colon to rectum
|
|
|
Malrotation with volvulus
|
Congenital abnormal positioning of midgut - cecum in Rt hypochondrium; Ladd's bands (fibrous bands) predispose to obstruction, constriction
|
|
|
Presentation of malrotation with volvulus
|
Bilious emesis in first month of life, crampy abd pain, distention, passage of blood in stool
|
|
|
Characteristic AXR finding
|
"Bird-beak" appearance and air-fluid levels
|
|
|
Study of choice in malrotation with volvulus
|
Upper GI endoscopy showing abnormal ligament of Treitz
|
|
|
Tx of malrotation with volvulus
|
Emergency surgical repair if volvulus is gastric; surgery or endoscopy if volvulus is intestinal
|
|
|
Necrotizing enterocolitis presentation
|
Nonspecific - formula intolerance, delayed gastric emptying, abd distention, bloody stools, fever/vomit
|
|
|
Complications of necrotizing enterocolitis
|
Intestinal perforation, peritonitis, abd erythema, shock
|
|
|
Pathognomonic finding on AXR for NEC
|
Pneumatosis intestinalis (intramural air bubbles)
|
|
|
Complications of NEC
|
Intestinal strictures, short-bowel syndrome
|
|
|
Tx of NEC
|
Supportive (NPO, orogastric tube, TPN, IV fluids, electrolyte correction); ileostomy with mucous fistula for perforation or worsening serial plain films
|
