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100 Cards in this Set

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Cause of death in Reye's
Cerebral edema and subsequent herniation
What is Ekiri syndrome?
Rare and fatal toxic encephalopathy seen with Shigella infection
Rx for shigellosis
Supportive care and third generation cephalosporin
Major cause of tinea capitis
Tricophyton tonsurans
Rx for trichophyton tonsurans
Oral griseofulvin
Linear hair loss + regional adenopathy
Traction alopecia
Hairs near area of hair loss that can be extracted w/ gentle traction --> attenuated or catagen bulb at termination of hair shaft (exclamation hair)
Alopecia areata
Clinical course of leptospirosis (zoonosis)
Septicemic phase; then most are anicteric and go on to immune phase w/ meningitic symptoms
10% are icteric and can have liver and kidney dysfunction
Rx for leptospirosis
Penicillin and doxycycline
Typical age of Kawasaki disease
<5yo
Rx for newborn baby with pertussis
Erythromycin (mom's Ig is insufficient)
Diffuse adenopathy, tonsillar enlargement, enlarged spleen, small hemorrhages on soft palate, periorbital swelling
EBV
Diff in EBV
Lymphocyte predominance w/ at least 10% atypicals
Rx for mono
Avoid contacts sports b/c of enlarged spleen
When is it not Kawasaki disease?
Teenage pt
What is dacrocystitis?
Infection of nasolacrimal sac
Most common cause of dacrocystitis
Nasolacrimal duct obstruction
Rx for nasolacrimal duct obstruction
Massage and clean w/ warm washcloths; optho referral is not open by 6mo
What is a hyphema
Blood in anterior chamber of eye
Virus causing erythema infectiosum
Parvovirus B19 (Fifth disease)
Other systems involved in mumps
Renal, pancreas, CNS
Common cause of death in Wiskott-Aldrich
Malignancy 2/2 EBV infection in teenage years
Rx for Lyme disease
Penicillin or tetracycline
Family of ticks associated w/ Lyme vs. RMSF
Ixodes vs. Dermacantor
What type of bug is Borrelia?
Spirochete
Pinworm bug
Enterobius vernicularis
Persistent, nonsuppurative diarrhea
Crypto or Giardia
Abdominal pain, N/V; then eyelid edema, myalgia, fever, and eosinophilia
Trichinella spiralis infection from undercooked pork
Close contacts of meningococcemia pt need
Rifampin prophylaxis
Contraindications to LP
Increased ICP WITHOUT open fontanelle; severe thrombocytopenia/ coagulation disorder; CVR distress; skin infection at puncture site
Hypergammaglobulin E, eczema-like rash, and recurrent severe staph infections
Job-Buckley syndrome (disorder of phagocytic chemotaxis)
Rash after administration of amoxicillin
EBV (unknown pathophys, but pathognomonic)
Culture medium for onorrhea
Thayer-Martin media
Lab test suggestive of chlamydia pneumonia
Increased eosinophils in blood
<1yo w/ URI --> severe respiratory distress, pneumatocele, and pneumothorax
Staph pneumonia
Rx-resistant PNA that develops empyema and needs chest tubes placed
Pneumococcal PNA
4 contraindications for contact sports
One eye, hemophilia, single kidney, unexplained syncope
Radionuclide scan results in testicular torsion vs. epididymitis
Decreased uptake in torsion, increased uptake in epididymitis
Test for herpes
Tzanck prep scraping from ulcer w/ multinucleated giant cells and intranuclear inclusions
Unilateral draining lyphadenitis
Lymphogranuloma venereum (caused by subtype of C. trachomatis)
How to distinguish suppurative adenopathy of chancroid from that of LGV?
In chancroid is concurrent; in LGV is after ulcer has healed
Culture medium for Haemophilus ducreyi (chancroid)
Chocolate agar
Most common injuries in swimmers
Shoulder injuries (rotator cuff tendonitis)
Most common injuries in basketball players
Knees (and ankles), esp patellar tendonitis and Osgood-Schlatter
Common skin conditions in wrestlers
Contact dermatitis, fungal infection, HSV, impetigo, staph furunculosis or staph folliculitis
Most common ski injury
Skier's thumb (hyperextension and abduction of thumb)
Jaundice, hepatomegaly, vomiting, seizures on intro of fruit juice
Hereditary fructose intolerance
Children w/ tyrosinemia have problems w/ these 3 organs, one of which is not improved w/ dietary management
Liver (progressive cirrhosis not preventable), kidney, CNS
Storage disease seen in teens + enzyme deficeincy
Gaucher disease, Beta-glucocerebrosidase
Erlenmeyer flask appearance of bone + anemia, leukopenia, and thrombocytopenia
Gaucher disease
Cause of neonatal thyrotoxicosis
Maternally acquired thyrotropin receptor stimulating antibody (which crosses the placenta, unlike TSH)
How to distinguish btwn ovarian tumor/ exogenous estrogen and precocious puberty
Former suppresses pituitary, so no secondary sex characteristics, just isolated premature thelarche or vaginal bleeding w/o pubic hair
White forelock, heterochromia irides, congenital deafness
Waardenburg syndrome (AD)
Most common cause of hypothyroidism (thyromegaly) in kids
Lymphocytic (Hashimoto's) thyroiditis
2 common causes of Cushing's
Glucocorticoid administration and bilateral adrenal hyperplasia
Short, downslanting palpebral fissues, ptosis, low set and malformed ears, broad and webbed neck, shield chest, cryptorchidism, pulmonary stenosis, hearing loss, bleeding diathesis, mental retardation in 25%
Noonan Syndrome
ITP is usually preceded by a?
Viral infection
RX for severe ITP
IVIG, steroids, anti-D Ig, splenectomy if chronic
Levels of free erythrocyte proporphyrin are elevated in these 2 conditions
Iron deficiency and lead poisoning
Most common acquired RBC aplasia in kids
Transient erythroblastopenia of childhood
Congenital anemia with increased RBC ADA levels, short stature, and cranial/ upper extremity abnormalities
Diamond-Blackfan anemia
Increased levels of HbA2 is seen in
Beta-thal train
What is the Kasabach-Merritt phenomenon?
Large vascular anomalies (kaposiform hemangioendothelioma and tufted angioma) sequest platelets and RBCs --> thrombocytopenia, coagulopathy, and microangiopathic hemolytic anemia
Rx for Kasabach-Merritt phenomenon
Steroids, alpha-INF, and vincristine (no surgery! --> excessive bleeding
Another name for port wine stain
Nevus flammeus
Cells seen in G6PD deficiency
Bite cells (RBCs after removal of Heinz bodies)
Retinoblastoma is most commonly (spontaneous vs. hereditary) and (unilateral vs. bilateral)
Spontaneous and unilateral
Cure rate of retinoblastoma
90%, though vision loss is common
Pts w/ hereditary retinoblastoma are at increased risk of
Osteosarcoma
When is physiologic anemia of infancy seen?
Nadir 6-8wks, as erythropoiesis decreases
Anemia in newborn w/ normal retic count and no ABO incompatibility
Fetomaternal transfusion
How to test for fetomaternal transfusion
Keihauer-Betke stain for fetal Hb-containing RBCs in mom's blood
Most common childhood malignancy
Leukemia
Horseshoe kidney and hemihypertrophy are associated w/
Wilms tumor
Wilms associated w/ abnormalities on chromosome
11
Abdominal mass + fever, irritability, bone pain, limp, and diarrhea
Neuroblastoma
Causes of peripheral eosinophilia
Asthma, urticaria, infantile eczema, drug reactions, helminth infections, collagen vascular disease
Allergic rhinitis causes eosinophilia where?
Nasal secretions, not peripheral blood
5 lab findings in DIC
Prolonged PT and PTT, decreased fibrinogen, fibrin split products, increased D-dimer
3 causes of spherocytes other than hereditary spherocytosis
Hyperthermia, G6PD deficiency, ABO incompatibility
Rx for von Willebrand's disease
DDAVP (can also give vWF + Factor VIII if severe)
Sunburst pattern of bone formation
Osteosarcoma
Diffuse LAD, fever, night sweats, malaise, weight loss, pruritis
Hodgkin's
Dx of suspected Hodgkin's
CXR to look for mediastinal mass, then LN biopsy
What are Howell-Jolly bodies and when are they seen?
Small spherical nuclear remnants seen in reticulocytes of pts w/ asplenia or hyposplenia (e.g. in SCA)
Severe anemia requiring transfusions, heart failure, hepatosplenomegaly, weakness
Thalassemia major
Most common finding on peripheral smear in thalassemia
Target cells
What are target cells?
Erythrocyte with membrane too large for its Hb content, seen in alpha-thal, HbC, and liver diseaes
Pregnancy complications more common in teens
Premature delivery, low birth weight, pregnancy-induced HTN, violence risk
Male Tanner Stages
SMR 2: sparse, thin, long pubic hair
SMR 3: darker, curlier pubic hair
SMR 4: adult pubic hair w/o full coverage
SMR 5: pubic hair to inner thigh
(penis lengthening throughout)
Female Tanner Stages
Sparse pubic hair in SMR 2 --> medial thigh by SMR5
SMR 2: breast buds
SMR 3: larger breasts and areola w/o separate areolar contour
SMR 4: elevation of areola
SMR 5: areola part of general breast contour
Rx for suicide attempt w/ nml exam and labs
Hospitalize
Swollen, red, irritated uvula and dental decay
Bulimia
Sport concussion recommendations
LOC --> evaluate at hospital
No LOC, nml w/in 15 min --> return to game
Confusion > 15 min --> out for 1wk
Confusion > 1hr --> hospital
Side effects of isoretinoin
Dry skin/eyes/mucous membranes, MSK pain, IBD, pseudotumor cerebri, corneal opacities, abnormal LFTs, increased TGs and cholesterol
Dehydration, facial and arm hirsutism w/ loss of head hair, bradycardia, amenorrhea
Anorexia
Joint swelling in pt with hemophilia
Hemarthroses (hemophilic arthropathy), w/ iron deposition and synovial thickening + fibrosis
Next option when IV access can't be obtained
Intraosseous access (easier than in adults b/c have less bone density)
Why do we avoid subclavian lines in kids
High incidence of complications (pneumothorax, hemothorax)
Differential for T-wave inversion
MI, myocarditis, old pericarditis, myocardial contusion, dig toxicity