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247 Cards in this Set
- Front
- Back
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MC soft tissue sarcoma in children
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rhabdomyosarcoma
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what causes breast milk jaundice
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factor in human milk increases bilirubin enterohepatic circulation
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Rx for breast milk jaundice
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switch to formula for a couple days
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time period for breast milk jaundice
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3 weeks and beyond
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what causes breast feeding failure jaundice
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insufficient coloric intake
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time period for breast feeding failure jaundice
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first week
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Rx for breast feeding failure jaundice
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increase breast feeds
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presentation for milk protein intolerance
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vominting and blooding diarrhea that contains RBCs and eosinophils
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milk protein intolerance is a/w
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atopic disorders
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fractures highly suggestive of abuse
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ribs
skull various stages |
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Dx
child who was growing normally suddenly slows growth at 1 year but eventually reaches normal hieght |
constitutional growth delay
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MCC of short stature and pubertal delay
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constitutional growth delay
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Dx
8 yo child wakes up in the middle of the night with pain that resolves in the morning |
growing pains
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Rx for growing pains
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massage
analgesics |
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normal newborn respiratory rate
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40-60
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what is breast milk helps in gastric emptying
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whey protein
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what are the benefits of breast feeding
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less reflux
less colic better absorption |
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what decreases in breast milk with each feed
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protein
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what is the main protein in breast milk
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whey
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what should be down if IV access cannot be obtained in pediatric px
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intraosseous access
can only be used for 24-48 hours |
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what is dacrocystitis
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nasolacrimal duct obstruction
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Dx
chronic tearing and mattering that resolves with massage of lacrimal duct |
dacrocystitis
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when does chemical irritation of the eye occur
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0-2 days
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when does gonorrhea infection of the eye occur
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2-7 days
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when does chlamydia infection of the eye occur
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7-21 days
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when does herpes infection of the eye occur
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over 21 days
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what causes chemical irritation of the eye
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silver nitrate
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Rx for chemical irritation of the eye
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resolve sin 24 hours
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what eye problems are prevented with ointment given at birth
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gonorrhea
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what is put in eye soon after birth
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erythromycon
tetracycline silver nitrate |
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what clotting factor deficiencies commonly cause purpura
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vWD
hemophilia A and B |
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features of cephalohematoma
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doesnt cross suture lines
presents days later subperiosteal hemorrhage |
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features of caput succedaneum
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crosses suture lines
seen immediately after birth echymotic swelling of the scalp |
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what are nuclear remnants within RBC
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howell jolly bodies
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what do howell jolly bodies stain with
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wright stain
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what are oxidized hemoglobin
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heinz bodies
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what do heinz bodies stain with
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crystal violet
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what is deficient in galactosemia
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G1PUT
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features of galactossemia
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cataracts
jaundice hypoglycemia convulsions |
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features of uridyl diphosphate galactose 4 epimerase def
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cataracts
jaundice hypoglycemia convulsions hypotonia nerve deafness |
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what is used to detect Phe products in urine of those with PKU
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gluthrie test
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what causes redness, swelling and fever after a DTaP
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pertussis part
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when should the Hep B vaccine be given
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shortly after birth
except in those that wiegh less than 2kg (4lbs) |
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what newborns should recieve the HBIG
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those with HBaAg positive mothers
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what causes transient polycythemia of newborn
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hypoxia (MCC delayed cord clamping)
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when does transient tachypnea require evaluation
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if more than 4 hours work up for sepsis
blood and urine cultrues |
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MCC of brachial palsy
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macrosomic baby
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when do the sinuses develop
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maxillary and ethmoid are present at birth
sphenoid within first few years frontal by 9-10 yo |
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which brachial palsy is a/w horner syndrome
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klumpke
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MCC of clavicular fracture
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shoulder dystocia
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biggest problem of oligohydramnios
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cord compression
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MCC of induced labor and c section
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cord compression
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until when is bed wetting normal
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5 yo
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what is the first step in management of a hiatal hernia
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intubate
orogastric tube placement |
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where is AFP made
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liver
GI tract |
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what is omphalocele a/w
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trisomy 18
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MCC of elevated AFP
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incorrect dating
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what is the cause of umbilical hernia
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weakness of rectus abdominis
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what is umbilical hernia a/w
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congenit hypothyroidism
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Rx for umbilical hernia
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resolves spontaneously by 3
surgical intervention by 4 |
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MC abdominal mass in children
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wilms
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WAGR is caused by a deletion in
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chromosome 11 PAX6
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MC site of wilms metastasis
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lungs
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wilms tumor arises from
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metanephrose
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what is the best initial test to diagnose wilms
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abdominal US
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what is the most accurate test to diagnose wilms
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CT with contrast
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features of wilms
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hematuria
HTN doesnt cross midline no horners |
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features of neuroblastoma
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no hematuria
no HTN horners syndorme crosses midline |
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what is a/w wilms tumor
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denys drash
beckwith wiedemann |
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features of beckwith weidemenn
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hypoglycemia
macroglossia visceromegaly omphalocele wilms tumor |
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MC cancer of infancy
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neuroblastoma
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MC extracranial solid malignancy
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neuroblastoma
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a/w bag of worms
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varicocele
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what does neuroblastoma prognosis depend on
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N-myc protooncogene and hyperdiploidy
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what causes spermatocele
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dilation of efferent ductules
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Dx
painless fluid filled cyst that transiluminates |
spermatocele
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what causes vericocele
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dilation of pampiniform plexus
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what are hallmark signs of neuroblastoma
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hypsarrythmia (dancing eyes)
opsoclonus (dancing feet) |
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cause of hydrocele
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remnant tunica vaginalis
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how is vesicoureteral reflux diagnosed
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VCUG
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how is posterior urethra valve diagnosed
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VCUG
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what is hypospadias a/w
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cryptorchidism
inguinal hernias 5a reductase def |
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what is epispadias a/w
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urinary incontinence
bladder extrophy |
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which cyanotic heart lesion depend on PDA
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transposition of great vessels
hypoplastic LH |
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what are the cyanotic heart lesions
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Ts
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what are the R-L shunts
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Ts
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what are the acyanotic heart lesions
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3 letters and coarctation
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what are the L-R shunts
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3 letters and coarctation
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MC cyanotic heart lesion in children
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TOF
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what are at increased risk for TOF
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cri du cht
trisomys |
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MCC of cerebral palsy
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cerebral anoxia
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child with trauma to soft palate is at increased risk for
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acute stroke syndrome
due to compression or dissection of carotid |
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a/w boot shaped heart
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TOF
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how are all cyanotic heart lesions Dx
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X ray
most accurate is echocardiogram |
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a/w single S2
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TOGV
TA TOF tricuspid atresia hypoplastic LH |
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MC cyanotic heart lesion in neonates
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TOGV
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a/w egg on string x ray
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TOGV
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a/w pulsus bigeminus
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hypertrophic obstructive cardiomyopathy
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a/w pulsus bisferiens
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aortic regurg
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a/w pulsus tardus et parvus
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aortic stenosis
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a/w pulsus paradoxus
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cardiac tamponade
tension pneumothorax |
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increased risk factor for TOGV
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aperts
cri du chat trisomys |
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features of TOF
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overriding aorta
pulm stenosis right ventricular dilation VSD |
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features of hypoplastic LH
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LV hypoplasia
mitral valve atresia aortic valve lesions |
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presents with gray cyanosis at birth
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hypoplastic LH
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x ray shows globular shaped heart
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hypoplastic LH
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a/w biventricular hypertrophy
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TA
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what is the most severe sequela of TA
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pulmonary HTN
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MC congenital heart lesion
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VSD
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how are acyanotic heart lesions Dx
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best initial is echcardiogram
most diagnostic is cardiac catheterization |
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a/w paradoxical splitting
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LBBB
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how is VSD treated
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75% close by 10yo
surveilence with echocardiogram until then |
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MCC of ASD
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osteum secundum defect
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a/w fixed wide split S2
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ASD
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what is the only congenital heart defect that doesnt develop endocarditis
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ASD
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when is PDA a normal finding
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forst 12 hours
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which heart lesions radiate to the back
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pulmonary and tricuspid
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MCC of secondary HTN in children
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fibromusculr displasia
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Rx for kawasaki
|
aspirin for fever and arthralgia
-if life long, needs influenza vaccine IVIG to prevent coronary aneurysms |
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a/w pear shaped heart
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pericardial effusion
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a/w jug handle appearance
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primary pulmonary artery HTN
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a/w 3 like appearance
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coarctation of aorta
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MC location for coarctation of aorta
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ligamentum arteriosus
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what happens if coarctation is proximal to left subclavian artery
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pressure is higher in the right arm
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when is jaundice pathologic in newborns
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appears in first 24 hours
rises by more than 5mg per day bilirubin rises above 19.5 direct bilirubin rises above 2 hyperbilirubin persist after 2 weeks of life |
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Rx for pathologic jaundice of newborn
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phototherapy
exchage transfusion if rises above 20 |
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Dx
drooling, regurgitation or vomiting during feeds |
esophageal atresia
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best initial test for esophageal atresia
|
coiling NG tube on x ray
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|
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Dx
patient with recent URI follwed by sore throat, hot potatoe voice and neck stiffness |
retropharyngeal abscess
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best initial test for retropharyngeal abscess
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x ray shows widening between trachea and spine
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what confirms a retropharyngeal abscess
|
CT
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best initial test for pyloric stenosis
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abdominal US
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most accurate test for pyloric stenosis
|
GI series
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Dx
palpable olive shaped mass in epigastrium |
pyloric stenosis
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what can be seen in upper GI series of pyloric stenosis
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string sign
shoulder sign mushroom sign railroad track sign |
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a/w doughnut sign
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intussusception
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what is choanal atresia
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membrane between nostrils and pharyngeal space prevents breathing during feeding
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Dx
child turns blue when feeding and pink when crying |
choanal atresia
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best initial test for choanal atresia
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passing NG tube
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confirmation test for choanal atresia
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CT with intranasal contrast shows narrowing of pterygoid plate
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first step in management of choanal atresia
|
secure airway
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a/w explosive stool on rectal exame
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hirschsprung
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what is charge syndrome
|
coloboma of the eye
heart defect atresia of chanae retardation in growth and development genitalurinary defects ear anomolies |
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best initial test for hirschsprung
|
x ray
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best diagnostic test for hirschsprung
|
full thickness biopsy
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what is vecterl syndrome
|
vertebral anomolies
anal atresia cardiovascular anomolies tracheoesophageal fistula esophageal atresia renal anomolies limb anomolies |
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choanal atresia is a/w
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charge syndrome
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imperforate anus is a/w
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vacterl syndrome
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defect in duodenal atresia
|
improper canalization
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what isduodenal atresia a/w
|
annular pancreas
down syndrome |
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what is the best initial test for duodenal atresia
|
x ray
|
|
|
a/w double bubble
|
duodenal atresia
volvulus |
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first step in management of duodenal atresia
|
IVF
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presentation in volvulus
|
vomiting with bile
blood stained stools abdominal distention |
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|
a/w birds beak
|
volvulus
|
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best initial treatment for volvulus
|
endoscopic decompression
|
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most effective therapy for volvulus
|
surgical decompression
(used if endoscopic decompression fails) |
|
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a/w currant jelly stools
|
intussusception
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a/w sausage mass
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intussusception
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MC location for intussusception
|
ileocecal junction
|
|
|
common causes of intussusception
|
polyp
lymphoma hamartoma enlarged mesenteric node enlarged peyer patches meckels diverticulum |
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|
best initial test for intussusception
|
US
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a/w target sign
|
intussusception
|
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most accurate test for intussusception
|
barium/air enema
|
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therapeutic steps in intussusception
|
1- fluid resuscitation
2- NGT decompression 3- barium/air enema 4- surgery |
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what kind of tissue is found in meckels diverticulum
|
gastric or pancreatic
|
|
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what is meckels diverticulum
|
incomplete obliteration of omphalomesenteric duct (viterlline duct)
|
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Dx
1 year old boy with painless rectal bleeding |
meckels diverticulum
|
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what is the most accuarate test for meckels diverticulum
|
technetium 99m scan
|
|
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Dx
infant with excessive crying for more than 3 hours, more than 3 days, for more than 3 months |
infantile colic
|
|
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Rx for infantile colic
|
probiotics
simethicone |
|
|
a/w increased gastric residual volume
|
necrotizing enterocolitis
|
|
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a/w pneumatosis intestinalis
|
necrotizing enterocolitis
|
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how does IDM develop RDS
|
hyperinsulin antagonizes the actions of cortisol on the lungs
|
|
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what pathologies are a/w IDM
|
caudal regression
TOGV duodenal atresia small left colon anencephaly neurotube defects |
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what is increased in 21 hydroxylase def
|
17 a hydroxyprogesterone
|
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how can 21 hydroxylase def be confirmed
|
ACTH stimulation test
|
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|
MCC of congenital hypothyroidism
|
thyroid dysgenesis
|
|
|
a/w palpable step off at lumbosacral area
|
spondyllolisthesis
|
|
|
what is spondylolithessi
|
forward slip of vertebral L5 over S1
slow development of back pain and neurological dysfunction |
|
|
what are some common findings of rickets
|
craniotabes
rachitic rosary (beading of ribs) large anterior fontanelle harrison groove (horizontal depression on lower border of chest) |
|
|
Rx for rickets
|
calcitrol
ergocalciferol |
|
|
MCC of neonatal sepis
|
GBS
|
|
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how can GBS be diagnosed in a mother who has already recieved antibiotics
|
latex agglutination
|
|
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what should be done in a new born suspected of having sepsis
|
lumbar puncture and blood cultures
|
|
|
best initial test to diagnose toxoplasmosis
|
IgM
|
|
|
best initial test to diagnose syphilis
|
VDRL or RPR
|
|
|
best initial test to diagnose CMV
|
urine or saliva viral titers
|
|
|
best initial test to diagnose herpes
|
tzanck smear
|
|
|
best initial test to diagnose varicella
|
tzanck smear
|
|
|
most accurate test to diagnose toxoplasmosis
|
PCR
|
|
|
most accurate test to diagnose syphilis
|
FTA ABS or dark field microscopy
|
|
|
most accurate test to diagnose CMV
|
urine or saliva PCR
|
|
|
most accurate test to diagnose herpes
|
PCR
|
|
|
most accurate test to diagnose varicella
|
viral culture
|
|
|
most accurate test to diagnose measles (rubeola)
|
IgM Ab
|
|
|
MCC of infantile febrile seizures
|
HSV 6 (roseola)
|
|
|
features of measle (rubeola)
|
cough coryza conjunctivitis
rash spreads from head to toe koplik spots |
|
|
what can cause upper airway compression by a vascular ring
|
double aortic arch
right sided aorta pulmonary sling |
|
|
tracheal compression symptoms that are worse when supine and relieved by extending the neck
|
upper airway compression by vascular ring
|
|
|
how is foreign body aspiration treated and diagnosed
|
direct laryngoscopy and rigid bronchoscopy
|
|
|
what causes croup
|
parainfluenza
|
|
|
triad of croup
|
barking cough (horseness)
caryza inspiratory stridor |
|
|
a/w steeple sign
|
croup
|
|
|
a/w narrowing of air column in the trachea on x ray
|
croup
|
|
|
a/w lateral x ray showing subglottic narrowing
|
croup
|
|
|
how is croup Rx
|
mild symptoms = steroids
severe symptoms = racemic epi finally intubate if all fail |
|
|
a/w unilateral tonsilar swelling with uvualr deviation
|
peritonsilar abscess
|
|
|
when is HiB vaccine needed
|
those younger than 5
asplenics |
|
|
MCC of epiglotitis in unvaccinated
|
HiB
|
|
|
MCC of epiglotitis in vaccinated
|
Strep
|
|
|
presentation of epiglotitis
|
hot potatoe voice
drooling in tripod position cherry red epiglotis |
|
|
a/w thumb print sign
|
epiglotitis
|
|
|
Rx for epiglotitis
|
intubate
ceftriaxone |
|
|
prophylaxis for epiglotitis close contacts
|
rifampin
|
|
|
MCC of chronic inspiratory noise in infants
|
laryngomalacia
|
|
|
Rx for laryngomalacia
|
improves slowly
disappears by 2 years |
|
|
how is laryngomalacia diagnosed
|
laryngoscopy
|
|
|
what is seen in laryngoscopy of laryngomalacia
|
rolling in from side to side
|
|
|
what is the most contagious stage of whooping cough
|
catarrhal stage
|
|
|
when does post tussive emesis occur
|
paroxysmal stage
|
|
|
a/w butterfly pattern on xray
|
whooping cough
|
|
|
when should a px with whooping cough be isolated
|
first 5 days of Rx
|
|
|
how is whooping cough diagnosed
|
PCR of nasal secretions
or toxin ELISA |
|
|
pathophys of whooping cough
|
causes ciliary paralysis
|
|
|
prophylaxis to close contacts of whooping cough
|
macrolides
|
|
|
Rx for whooping cough
|
erythromycin or azithromycin
initially decrease infection after 2 weeks they reduce transmission |
|
|
what should never be done in diptheria infection
|
scrape
|
|
|
a/w productive cough lasting 7-10 days with fever
|
bronchitis
|
|
|
MCC of bronchitis in smokers
|
s pneumo
H influ |
|
|
MCC of bronchitis in nonsmokers
|
viral
|
|
|
Rx for diptheria
|
antitoxin
|
|
|
a/w gray pseudomembrane plaques on back of throat
|
diptheria
|
|
|
a/w think greenish amniotic fluid
|
meconium aspiration syndrome
|
|
|
a/w displaced femoral epiphysis in obese adolescents
|
slipped capital femoral epiphysis
|
|
|
a/w a painful limp and an externally rotated leg
|
slipped capital femoral epiphysis
|
|
|
Rx for Slipped capital femoral epiphysis
|
internal fixation with pinning
|
|
|
a/w avascular necrosis of the femoral head
|
legg calve perthes disease
|
|
|
a/w asymmetric hips in a child
|
legg calve perthes disease
|
|
|
a/w proximal thigh atrophy in child
|
legg calve perthes disease
|
|
|
a/w breech infants with difficulty walking
|
congenital hip dysplasia
|
|
|
Rx for congenital hip dysplasia
|
<6m = pavlik harness
6m - 1 y = reduction with spica cast >2y reduction |
|
|
how is congenital hip dysplasia Dx
|
ortolani and Barlow meneuver
causes click or clunk |
|
|
endocrine disfunction in prader willis
|
hypothalamic dysfunction
-GH def -hypogonadism |
|
|
how is SIDS most prevented
|
sleepin in supine position
|
|
|
Rx for reyes syndrome
|
glucose
FFP mannitol |
|
|
pathophys of reyes syndrome
|
diffuse mitochondrial injury
-extensive fatty vacuolization of liver without inflammation |
