Peds + Derm Stepup2 Step2

Front 1

milestones:
social smile, lifts head to 45 and eyes follow to midline

COOS

Back 1

2 mo

Front 2

milestones:

laughs and aware of parents, localizes sound, lift headto 90 and eyes follow past midline

Back 2

4 mo.

Front 3

milestones:

can tell parents from others, stranger anxiety, rolls over,holds body up w. hands, sits alone, BABBLES

Back 3

6 mo

Front 4

milestones:

paddy cake = interactive games, crawls, grasps w/ thumb, first word

CRAWLING + FIRST WORD!!!

Back 4

9 mo

Front 5

milestones:

separation anxiety, pulls to stand, walks w help, pincer grasp, makes 2 towers blocks. 5-10 word vocab

Back 5

12 mo

Front 6

milestones:

15-18 mo

Back 6

starts walking

Front 7

milestones:

parallel play, w cup or spoon, pulls to stand, walks well, and backward, makes 4 block tower, uses cup or spoon, 10-50 word vocab, 2 word sentences.

Back 7

18mo

Front 8

milestones:

dresses self w help, runs, climbs stairs, makes 6 tower blocks,3 word senstences

Back 8

2yr

Front 9

milestones:

magical thinking, climbs descends stairs, makes 9 block towers, draws circle

Back 9

3 yr

Front 10

milestones:

plays with others,hops on 1 foot,4 sentences, draw closed figures

Back 10

4 yr

Front 11

milestones:

can tell fantasy from reality, skips, draws person, fluent speech

Back 11

6 yr

Front 12

milestones:

ties shoelaces

Back 12

5 yr

Front 13

milestones:

potty training, gender acknowledgement, and wash hands

Back 13

between 2-3 yrs

Front 14

pediatric visit scehdule

Back 14

1 wk post birth and at 1mo.

2 mo visit then q2mo till 6 mo.

from 6-18mo q3mo.

2 yr visit and then annually.

Front 15

initiate solid foods at

initiate whole cow's milk at

SEE THE dentist

Back 15

6mo.

12 mo.

2-3 yo

Front 16

#1 cause of death in adolescence

Back 16

accidents

Front 17

what vaccines are given at the 1-2 mo visit?

Back 17

hepb, rota drops, dtap, hib, pcv (pneumococcal) ipv (polio)

Front 18

total doses of peds vaccines:

hepb
dtap
hib
polio
pneumovaxx
vzv-
mmr-
hepa
hpv
mcv
flu

Back 18

hepb=3
dtap- 5 + TDAP at 11-12yo
hib- 4
polio=4
penumo -4
vzv-2
mmr-2
hepa-2
hpv-3
mcv4 (meningococus)-2
flu-annually after 6mo.

Front 19

tanner stages for male:

prepubertal, small genitals no hair

Back 19

1

Front 20

tanner stages for male:

testicular and scrotal enlg, skin becomes coarser
fine genital and axillary hair

Back 20

2

Front 21

tanner stages for male:

penile enlargement, further testicular growth, further growth of hair = growth phase!!

Back 21

3

Front 22

tanner stages for male:

glans enlargement, darkening of scrotal skin, coarse hair spreads over much of pubic region

Back 22

4

Front 23

tanner stages for male:

adult genitalia, coarse hair extends from pubic region to medial thighs

Back 23

5

Front 24

immune disorders show their faces after

Back 24

3 mo , when maternal immunity wears off

Front 25

CATCH22 deletion, see thymic and pth hypoplasia, congenital and heart disease. tetany and frequent viral and fungal infections common b/c lack T cell function,

ca, vit d replacment necessary

Back 25

digeorge - cxr absence of thymic shadow

lo serum ca

Front 26

persistent mucus membrane infection and of the skin, nails, etc - candida albicans is the agent, a/w t cell def. frequent a/w adrenal pathology. decreased IgG possible, c-albicans anergy test poor rxn

Back 26

chronic mucocutaneous candidiasis

Front 27

x-linked disorder with boys seeing bacterial infections after 6 mo, recurrent infection, b cell def - no b cells in smear, and low ig levels

Back 27

X linked agammaglobulinemia

Front 28

increased incidence of resp and gi tract infections, decreased iga and normal levels of allother ig's

Back 28

iga def

Front 29

defect in t cell cd40, encapsulated bacteria infection common, pulmonary and gi infxns, hi igM and possible decreased hgb,hct plts and neutrophils.

Back 29

hyper IGM

Front 30

common variable immune def

Back 30

autosomal disorder of b cell diff -increased risk of malignant neoplasms and autoimmune disorders, increased resp and gi infections from2nd decade of life, low igG levels, both men and women effected, decreased CD4-Cd8 ratio,lo IG levels, poor response to vaccines

Front 31

this pt cannot be given any live or attenuated vaccines (mmr, vzv, tb), absent t cells and ab function, pts experience significant recurrent infections by all types of pathogens, fatal at early age - need bone marrow transplant

Back 31

scid

Front 32

wiskott aldritch syndrome

Back 32

x-linked - very susceptible to encapsulated bacteria, a/w eczeyma, and thrombocytopenia

prop splenectomy ab prop important

easy bleeding w/ these pts - decreased plts, decreased igM

Front 33

ataxia-talengectasia

Back 33

ar - causing cerebellar dysfunction, cutaneous talngectasias, increased risk of ca, impaired t cells and iga

see after 3 yrs age

Front 34

defect of neutrophils - they cant digest engulfed bacteria, recurrent bacterial and fungal infections

see chronic: cutaneous, pulmonary, perirectal, abscesss, lymphadenopathy

cells lack nadph oxidase

Back 34

cgd

Front 35

neutrophil chemotaxis defect, igE is high, chronic dermatitis, recurrent skin abscess and pulmonary infections, patients commonly have coarse facial features and retained primary teeth, eosionophilia

Back 35

hyper igE - job syndrome

Front 36

ar- dysfunction of neutrophils, recurrent staph, and strep infections, gram- bacteria and fungal infections a/w abnormal plts, albinism, neurologic dysfunction.

Back 36

chediak higashi

Front 37

abnormal facies, uri, skin and short stature inability of neutrophil to leave circ

Back 37

LAD - leuckocyte adhesion def

Front 38

female short sttaure, 45xo, what other defects seen?

Back 38

turners

coarctation of aorts, craniofacial issues, neck webbing, low occiptal hairline, protruding ears, increased incidence of renal and cardiac defect.

Front 39

47xxy- tall thin male

Back 39

kleinfelter's

testicular atrophy, mr, infertile

Front 40

anytime there is an extra x or y increase risk for?

Back 40

mr

Front 41

comorbidities w/ downs?

Back 41

WE ALL GO DOWN TOGETHER

ALL - lymphoma

ANNULAR PANCREAS

alzheimers

CELIACS

DUODENAL ATRESIA

HIRSCHSPRUNG'S

FAILURE TO PASS MECONIUM

FIRST TRIMESTER US - INCREASE IN NUCHAL TRANSLUNCENY

Front 42

wolf-hischorn syndrome

Back 42

a deletion syndrome - 4p16

mr, mutiple craniofacial abnormalities, seizures

Front 43

skinny smiles

Back 43

angelman - 15q from mom

Front 44

fat daddy

Back 44

prader willi -15q from dad

Front 45

a/w digeorge, cleft palate and speech disorders, mild mr, overbite and cardiac complications

Back 45

velocardiofacial -22q11

Front 46

mcc of celulitis and sx

Back 46

staph or gp a strep or mrsa

seen w. ivda and dm

h/p - erythema, swollen and painful skin, myalgias, chills, fever and lymphax, increased wbc, esr and crp

blood culture nescesary but not wound or skin

**can becomes necrotizing

Front 47

subq collection of pus and commonly caused by staph bacteria, occurs as a collection of multiple infected hair follicles...usually mrsa

Back 47

skin abscess

Front 48

apocrine gland inflammation in groin or axilla, or perineum, can lead to scarring..erythematous, fluctuant, and required i and d and abs for tx

Back 48

HIRADENTITIS SUPRATIVA

Front 49

tx regiment for hiradentitis supp

Back 49

tetracycline ++ macrolide (azithro) + steroids intralesional + ocp and or spirinalactone or acutane (severe)

**same as tx for acne vulgaris

Front 50

s pyogenes or gp a strep = infection that crosses fascial planes, leading to extensive soft tissue destruction and you see red, skin w/ loss of sensation, crepitus underneath and purple discoloration and bullae over the infected region

Back 50

necrotizing fasciitis

Front 51

management for nec fasc?

Back 51

surgical debridement, i and d and iv vanc usually

ct shows subq pockets of air

Front 52

dry gangrene mcc

Back 52

necrosis from vasc insuff features hard and dry skin

Front 53

wet gangrene mcc

Back 53

acute vascular obstruction, blistering, swelling and infection, rotten smelling skin, hotn, prior skin infection.

Front 54

impetigo is contagious, h/p? and tx?

Back 54

h/p - kids, staph and gp a strep, yellow crusted lesions, facial itchyness, wash all areas and

tx - eryhtromycin, topical abs, dont share towels

may be caused by mrsa

**if mrsa suspected - tmp-smx +rif or minocin +rif or clind + rif or linezolid + rif

mild - use topical ab

moderate - use oral ab

Front 55

2 - pregnancy test are needd and lft's are montiored before starting on

Back 55

acutane - isotrertnoin

Front 56

contraindicated vaccines for pregnancy

Back 56

vzv, flu, mmr, bcg

Front 57

mode of transmission for vzv

Back 57

resp droplets

Front 58

when is hsv most infectious?

Back 58

when active lesions are present

Front 59

tx for tinea capitis and unguium

Back 59

oral antifungal

Front 60

intertrigo h/p and tx?

Back 60

h/p = skin creases, see itchy painful and red plaques, pustules and a/w candida albicans, koh prep shows pseudohypae

topical antifungal used and nystatin and topical corticosteroid as well,

Front 61

for moluscum what will labs show

Back 61

shiny papules w/ central umblication

geimsa and wright stains show large inclusion bodies

Front 62

diaper dermatitis vs candida caused dermatitis?

Back 62

satellite lesions a/w candida

Front 63

serious cutaneous allergic rxn caused by drugs, infection, or vaccination

vesicles on extremeties, palms and soles and target lesions, erythematous center surrounded by pale inner ring, erythematous outer ring

increased eosinophils,steroids help

Back 63

erythema multiforme rash

Front 64

drugs a/w erythema multiforme target rash

can also incite sjs

Back 64

pens, sulfonamides, nsaids, ocps, anticonvulsants

hsv and mycoplasma too

Front 65

toxic epidermal necrosis (TEN) labs and h/p

Back 65

labs - lo lfts and wbc, lo hgb hct and tx in burn center, ivf and ivig and steroids

see significant skin sloughing and full thickness epidermal necrosis

Front 66

plaques w/ yellow, greasy scales, on infant scalp, itchy and erythemtous, topical steroids and antifungals used

selsun blue also used for tx

Back 66

seborrheic dermatits

Front 67

CHRONIC inflammatory skin rash, you see dry skin patches w/ papules,

risk factrors - asthma, allergic rhnitis and fmhx

vesicles on dorsal surface of hands and feet, flexor surface

Back 67

ATOPIC DERMATITIS AKA - eczyema

Front 68

psoriasis vs eczyema

Back 68

psoriasis - extensor surfaces

eczymea - flexor surfaces

Front 69

psoriasis- h/p

Back 69

knees, elbows see silvery plaques, bleed easily w/ scale removal (auspitz), pitted nails

seronegative for rhemtaoid
bx - thickend epidermis, nucleated cells in corneum, increased esr , arthritis usually follows

Front 70

tx regiment for psoriasis

Back 70

topical steroids, retinoids, tacromilus, antifungals, mtx, cyclosporine, antitnf

Front 71

viral rash in kids and young adults starts as a hearld patch then erupts, itchy and oval, white scaly and on chest, back and extremeties,
rash distributes in a xmas tree like pattern

Back 71

pityriasis rosea

steroids, phototherapy, erythromycin - tx

Front 72

subcutaneous fat septa inflammation resulting in painful red nodules on anterior tibias,on trunk and other extrememties, a/w collagen vasc diseases, ibd -crohns

see pretibial nodules, malaise, arthralgias, fever, +aso if a/w strep

Back 72

erythema nodosum

Front 73

conditions a/w erythema nodosum

Back 73

aso - strp infxn

pregnancy

unkwn

drugs

bhecet's disease

ibd

tb

sarcoid

Front 74

+ nikoslsky sign

Back 74

ten and pemphigus vulgaris

Front 75

ab's to epidermis and +nik sign and painful blisters, middle age, bx - shows acantholysis, fragile blisters,bm intact

tx - steroids, azathioprine, cyclophosphamide

Back 75

pemphigus vulgaris

Front 76

tense bullae, hard to rupture, autoab's to epidermal bm, widespread blistering, 60age gp, and antibm ab's seen on bx

Back 76

bullous pemphigoid

Front 77

def of hepatic urophyrinogen decarboxylase, involved in heme metabolism
increased prophyrins in blood and need periodic phelbtomy, clq-malarial

and h/p= chronic blistering on sun exposed skin, ruptured blisters heal poorly

Back 77

porphyria cutanea tarda

Front 78

risk factors for porphyria cutanea tarda

Back 78

etoh hepc iron od and smoking, estrogen use

Front 79

precA lesions can progress to ____________ and is seen w. sun exposure yellow brown scales seen,
<5mm, tx?

Back 79

sqcellca

tx -5fu

actinic keratosis, imiquimod

Front 80

uvb is main risk factor for this, skin cancer, sun expposure, ak is risk factor, and see painless, red papule w. scaling or keratanizsed growths, may bleed later

mohs or surgery to alleviate this

Back 80

sqqcell ca

Front 81

most common skin ca, risk - sun exposure, pearly papule w/ fine vascular markings and talengectasis,least likeyl to metasitasize

Back 81

bcc ca

Front 82

abcde of melanoma

Back 82

assymetry
border irregular
color is variable
diameter >6mm
enalargement

**depth is really important, never do a shave bx for melanaoma, >.76mm a/w increased risk of mets, and most prognotic impt factor

Front 83

most likely to met skin cancer

Back 83

melanoma >sq >bcc

Front 84

met sites - melanoma

Back 84

lung
brain
gi