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42 Cards in this Set
- Front
- Back
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kid found unconscious, wakes up -> hemiplegia -> resolves?
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- todd's paralysis: seizure => post icatla paralysis => resolves in 24 hrs
- most likely 2/2 underlying structural abnormality - unlikely thromboembolic event b/c of the resolution of sx |
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fragile x syndrome
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- FMR1 mutation => increased CGG repeats
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VSD
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- harsh holosystolic LLSB
- increased risk endocarditits => give abx ppx with dental work - observe - tx if sx e.g. growth failure, resp infx, CHF |
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viral meningitis?
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- 90% enterovirus = echovirus, coxsackie
- CSF: normal glucose, normal to high protein - supportive tx |
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brain abscess
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- always suspect wtih fever, focal neuro changes
- esp if hx of heart defect (cyanosis, poor growth, low energy) |
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leukocyte adhesion defect?
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- delayed separation of umbilical cord, recurrent bacterial and necrotic peridontal infx
- nl lymphocyte, gamma globulin |
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delayed separation of umbilical cord
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- leukocyte adhesion defect
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opsonization defect? complement defect?
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- 2/2 asplenia => encapsulated organisms
- infx from encapsulated organsisms e.g N meningities |
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nitroblue tetrazolin?
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- impaired oxidative burst w/in phags
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brain abscess, when to suspect?
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- HA, neuro findings s/p otitis media, don't need to have fever (50%)
- key finding = papilledema |
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cellulitis near eye?
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- need to ddx preseptal vs orbital cellulitis
1. PS = infx eyelid anterior to orbital septum = eyelid sx e.g. discoloration; tx outpatient abx 2. OC = posterior to orbital septum = decreased eye mvmt, vision decline, proptosis, sicker looking = IV abx |
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abd mass that crosses midline?
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- neuroblastoma, not WILMs tumor
- < 1y.o. |
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screening for vesicoureteral reflux?
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- UTI between 2-24mo in all kids
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infantile colic?
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- crying 3hrs/ day, 3d/wk, 3wk/mo starting at 3 wks, ends 4 mo
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turner syndrome complications?
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- osteoporosis due to low E fron bad gonads
- normal cognition |
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other than prematurity what causes RDS? what decreases risk?
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- DM, delayed lung maturation 2/2 hyperinsulin => decrease cortisol
- prlonged memebrane rupture, IGUR, maternal HTN |
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dx of hemophilia?
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- factor VIII level
- if mild tx with DDAVP |
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CF child with lung dz?
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- pseudo
- empiric tx: ceftazadine + aminoglycoside (gentamicin or amikecan) |
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indications for neonatal jaundice evaluation even if baby looks ok?
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- jaundice in 24-36 hrs of life
- bili rising >5/24 hrs - >12 mg/dL in full term, 10-14 in perterm - jaundice after 10-14days |
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conjugated bili jaundice? unconjugated?
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- biliary atresia, hepatitis
- breast milk, physiologic, crigler-Najjar, gilbert |
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prader willi
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- chr 15 long arm deletion
- 2/2 genomic imprinting (from mom or dad) - obese, MR, hypothalmaic dysfx, responds to GH |
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rapidly enlarging fluctuant cervical lymph node?
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- 2/2 staph or strep
- tx: incision, abx = dicloxacillin, cephalexin or clinda - doesn't work on s. auerus: PCN, amox, erythromycin |
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MCC hemolysis and hemoltyic anemia of newborn?
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- hereditary spherocytosis, northern europena descent
- coombs - |
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Neimann Pick's disease
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- milestone regression, cherry red spot, hepatosplenomegaly
- 2/2 sphingolipidosis 2/2 sphingomyelinase def => accumulates in liver, spleen, bone marrow |
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ddx Neimann Pick, Tay Sachs, Gaucher
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- Neimann pick: hepatosplenomegaly, cherry red macula
- Tay Sachs: cherry red macula, no HSM - Gauchers: no cherry red macula, +HSM |
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blue sclera
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- osteogenesis imperfecta = type I collagen defect
- fibrillin = marfan |
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tx of lyme dz?
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- < 9 y.o. - amox
- > 9 y.o. - doxy - stage 3 = ctx, pcn g |
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increased gastric residue in preterm neonate?
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- nec 2/2 bowel injury from asphxia
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gbs
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- peripheral neuropahty no corticospinal tract
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jejujunal atresia
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- biliuos vomiting, 2/2 ascular accident => necrosis in uterus
- axr: triple bubble sign => surgery |
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ertyehma marginatum
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- rash on trunk
- seen in rheumatic fever - s/p sore throat, now with arthalgia, fever, rash on trunk = rheumatic fever! |
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tx intussusception
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- barium enema, dx and tx!
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VSD vs ASD
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- VSD = pansystolic; LLSB, diastolic murmur at apex b/c increase flow across mitral valve
- ASD - widely split, fixed S2, systolic EJ murmurin LUSB, if large shunt = diastolic murmur LLSB |
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duchenne muscular dystrophy
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- difficulty walking, walks on toes, hypertrophied calf
- increased aldolase and CK; dx by muscle biopsy, geentic study - x linked |
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hyper IgM syndrome
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- high IgM, low IgG, IgA, increased infx, PCP
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metatarsus adductus
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- congenital foot abnormality 2/2 uterus, increased in first born
- type I: overcorrects with mvmt => spontaneously corrects - type II: corrects to neutral: orthosis or corrective shoes - type III: doesn't correct; serial casts |
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slipped capital femoral epiphyses
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- femoral epiphysis displaces from acetabulum, occurs in endocrine d/o, obese
- pt holds hip in external rotation - tx: ortho surgery |
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leg length discrepancy
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- developmental hip dysplasia = poor formed fem head
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clubfoot
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- equinus, varus of calcaneum and tarus etc
- tx: stretching, manipulation followed by serial casting IMMEDIATELY |
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tx of impetigo?
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- topical mupirocin or oral (not topical) erythromycin
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torticollis
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twisting of neck 2/2 uri, trauma, lymphadenitis, retropharyngeal abscess
- do cervical spine radiograph to check for spine injury first! |
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febrile seizure
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- 2/2 rapid rsie in in temp >102.2, either simple or complex
-associated wtih viral illness or otitis media - r/o intracranial infx with enuro exam, ex -no imaging, no LP, send home - increased risk future seizure, epilepsy |
