Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/74

Click to flip

74 Cards in this Set

  • Front
  • Back
12 y/o w/high BMI and hip pain/limp, no other problems, no fever, no joint swelling
-tests
-Dx
Xray pelvis
slipped femoral capital epiphysis
Possible ADHD in patient who can't sit still in class - next step?
Rating scales to parents and teachers
Pain + anemia + thrombocytopenia + fever --> want to r/o
(why not toxic synovitis?)
ALL
(TS has normal platelet count)
Test for Henoch-Schonlain purpura
Labs will be normal
Use pressure cuff --> petechiae --> capillary fragility test
Jones Criteria
MAJOR
J = joints (arthralgias)
O = heart (carditis)
N = nodules (osler's)
E = erythema marginatum (pink rings on the trunk and inner surfaces of the limbs which come and go)
S = syndhams chorea

MINOR
Fever
Arthritis
Acute phase reactants increased
Prolonged PR interval (1st degree heart block)
olioarthritic vs poly" JIA - size of joint
oligo = big
poly = small
2-5 y/o
URI, then limp
low grade fever
CBC, ESP, Xray normal
-Dx?
-Tx?
transient synovitis of hip
(but r/o septic arthritis)
resolves w/o Tx
SCFE (Slipped Capital Femoral Epiphysis)
vs
Legg-Calve-Perthe disease
=
age ranges
10-20 y/o
vs
5-10 y/o
Toddler
Fever
Low Hct/Hb
High WBC/Bands
High EST
-Dx?
-next?
septic arthritis
joint aspiration, xray, antibiotics
violaceous heliotropic rash
Gottron papules
serum CK, ANA, AST, LDH elevated
tirednesss, weakness, anorexia and low grade fever for few weeks
juvenile dermatomyositis
Gottron papules
skin over prox phalangeal joints and metacarpals hypertrophic and pink (indicative of juvenile dermatomyositis)
college student
swelling of metacarpal and interphalangeal jts for week
red rash on face, lacy rash on trunk and extrem
5th disease (parvovirus B19)
child w/pain in R knee on and off for 2 mo
knee normal
has limp
CBC, EST, ANA, RF and lyme serology normal
Dx?
Tx?
hip dysplasia
crutches
in infants, chlamydia trachomatis causes:
To Dx:
to Tx:
pneumonia
eosinophilia
macrolides
herald patch
cluster of small oval red spots --> first step of pityriasis rosea
Fitz-Hugh-Curtis syndrome
violen string adhesions to w/inflamed Glisson's (liver) capsule,
ascending from PID
--> presents w/RUQ pain
best bedside test of testicular torsion
lack of cremasteric reflex
best bedside test of epididymus torsion
blue dot sign
Tx of bacterial vaginosis
metronidazole, clindamycin
Tx of trichomoniasis
oral metronidazole, topical nystatin
shock by age
age systolic BP of shock
1 mo - 1 y/o <70
1y-10 y/o <70 + (2xage)
>10 y/o <90
Na+ = 120-130
Na+ <120
apathy, somnolence, irritability, hypotonia
seizure
serum osmolality
2(Na+) + (BUN/3) + (Glu/18)

(Na has 2 letters, BUN has 3)
Reye syndrome preceded by
varicella, influenza
Reye-like syndromes
FA oxidation defects, UC defects, organic acidemia
cardiomyopathies
Hypertrophic
Arrythmogenic
Restricted
Dilated
If an infant loses >10% of their weight, suspect
lactation failure
In hypertonic dehydration, skin feels
doughy
repeated emesis tinged w/birght red blood
-Dx
-to test
-intervention
Mallory-Weis tear
Drop NG tube - if any doubt, endoscopy
No intervention (suuportive)
Shigatoxin hits --- then ---
GI, then GU (small blood vessels)
3 warning signs of hemorrhagic disease
-prolonged bleed after trauma or surgery
-spontaneous bleeding into skin (petechiae), mucous membranes (swollen gums), internal organs
-bleeding from >1 site
Strep pneumo is the MCC of:
1 - OM
2 - sinusitis
3 - meningitis in adults
4 - bacteremia
5 - pneumonia in adults
sudden onset of abd distension in infants
(where?)
volvulus
(midgut)
EMERGENCY
Increased reticulocytes from
Hemolysis
Hemorrhage
Hematinic (things that increase Hb, like FA/B12/Fe++) deficiency
Henoch-Schonlein Purpura effects:
GI
GU
Skin
Joints
HSP vs ITP
normal labs vs low platelet count
If infant vomits blood, first check
If mom's nipple is cracking
Premie w/abd distension, single yellow emesis, occult blood in stool
-Dx
-test
-Tx
necrotizing enterocolitis
Xray
NPO, NG tube, IVF
mucosal pigmentation of lips and gums + new-onset rectal bleed
Peutz-Jeghers syndrome
(intestinal polyps and pigmented macules)
patient who comes in unconscious/semiconscious/confused

S Stroke

E Epilepsy/seizures

M Meningitis/encephalitis/sepsis

I Injury (head injury)

-------------------------------------------------------------

M Metabolic/medications

A Alcohol

I Insulin

D Diabetes

----------------------------------------------------------------

U Uremia

P Poisons and drugs
S Stroke
E Epilepsy/seizures
M Meningitis/encephalitis/sepsis
I Injury (head injury)
-------------------------------------------------------------
M Metabolic/medications
A Alcohol
I Insulin
D Diabetes
----------------------------------------------------------------
U Uremia
P Poisons and drugs
Wheezing child
asthma
if has CF - nasal polyps
aspiration syndromes
-GERD, TEF, foreign body
bronchiolitis
pneumonia
CF
CHF/HD
bronchopulmonary dysplasia
extrinsic AW compression
defects in host defenses
-immunodeficiency, bronchiectasis, immotile cilia syndrome
Blood in stool
YESS-C!

Yesinia enterocolitica
E.coli (EIEC)
Shigella
Salmonella

Campylobacter jejuni
9 month old w/fever, vomiting and fever lethargy, irritable
No other findings on PE
DD? tests?
infectious processes like meningitis, sepsis, pneumonia, UTI

CBC w/diff and blood cultures
4 y/o w/several emesis in last 6h, then lethargy
dehydrated
normal CBC
ALT = 375 U/L
DD?
intrahepatic cholestasis, viral hepatitis, nonspecific granulomatous hepatitis, autoimmune hepatitis, acetaminophen poisoning, mononucleosis, Reye syndrome
differential diagnosis of incessant crying
would include GI problems (intussusception, appendicitis, pancreatitis, presenting sign of pneumonia, GERD, functional abdominal pain, acute diarrhea and excessive flatulence), sepsis, meningitis, trauma, respiratory problems (acute nasopharyngitis, acute pharyngitis, acute tonsillitis, acute otitis media, peritonsilar abscess), a UTI, bacteremia, roseola infantum, hair tourniquet syndrome, strangulated hernia, torsion of the testicle/ovary
What does teething cause?
More teeth
Drooling
NOT fever
NOT incessant crying
Sudden onset seizure
Irritable for several days
No trauma
Unsure if fever
Failure of R lateral gaze on PE
-suspect? why?
-next?
Be suspicious of an increased ICP, especially a space occupying lesion (tumor, abscess, hematoma) as indicated by the CN VI palsy demonstrated
-obtain a head CT with no contrast.
hierarchy of infant resuscitation
If crying and pink --> wipe dry,
warm towels

If crying/blue - hold O2 to baby’s face

If not crying, blue and HR>100 - suction baby

If not crying, blue and HR<100 - use mask and bag for positive pressure ventilation
- intubate

If not crying, blue and HR<60 (or NONE) -use crash cart medications like epinephrine
6 - CPR
Materials needed for infant resuscitation
warmer, blankets, DeLee suction device, O2 source, tubing, bag w/at least 3 sizes of mask, straight laryngoscope, uncuffed ET tube, meconium aspirator, crash cart with medications
MMR and Varivax are CI in pts who
-have had a live vac in preceding 6 wks
-are preggers
Is rotavirus assoc w/intussesception?
Nope! fixed it
We now regularly use __ Ags to immunize against __ diseases
130, 11
Which live vac is okay for chemo pts?
MMR
why not vaccinate vs the common cold?
>100 viruses cause it
too many Ag serotypes
no cross-conferred immunity
MC deaths due to sequelae of Hep B
cirrhosis
hepatocellular carcinoma
Hep B seronegative patient should get
1 booster shot
ZOSTER vac should be give to all adults > __ y/o
65
Get ZOSTER vac even if had shingles?
YES
DIDMOAD syndrome
(wolfram)
DI
DM
optic atrophy
deafness
Delayed fontanelle closure can be caused by
Cretonism
Hydrocephalus
Acondroplasia
Rickets
Downs
Low Na+
High K+
Increased plasma renin
-what syndrome?
Addisons
primary hyperPTism usually caused by
gland hyperplasia
hyperPTism - primary or secondary MC?
secondary
congenital hypothyroidism
dry skin, large fontanelles
mostly asymp at birth --> DD if unTxed
-test for it
MCC = thyroid dysgensis
Soto syndrome
cerebral gigantism
(increased growth in 1st 2-3 yrs w/mild MR, other DDs, hypotonia and speech problems)
SIADH signs and Sx
HAs, impaired consciousness, hyponatremia, high urine osmolality (very concentrated), low plasma osmolality
mucopolysaccharidoses stature
normal to short w/hunchback
type of tremor in hyperthyroid
resting
rickets - clinical signs
craniotabes (abn thick skull), enlargement of bone at wrists/ankles, beading of rins, pectus carinatus, Harrison's sulci (diaphragm pulls bone down to cause horizontal line at thoracic region), hypotonia, deformed/delayed dentition
Harrison's sulci
diaphragm pulls bone down to cause horizontal line at thoracic region
-rickets
-chronic asthmatics
MC thyroid carcinoma and Px
papillary (75%), good
Cushing's __ is caused by a pituitary tumor
disease
CAH HTN usually occurs w/the
11 beta-hydroxylase deficiency form
CAH MCC
21 hydroxylase deficiency