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20 Cards in this Set
- Front
- Back
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Case 1: What is affected in Failure to Thrive patients?
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Weight, then height, then head circumference.
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What are the tree criterias for Dx of FTT?
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<6mo infant who doesn't gain weight for 2-3 mo, a child's growth under 2-5th percentiles, and a child who crosses more than 2 major growth curve in a short time (catch up).
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Which 5 factors should be considered in a FTT patient?
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Type of milk, frequency/quality of feed, vomiting, voiding/stooling,
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What is the difference b/t breast milk, formula, cow's milk, and goat milk?
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Breast: less iron, but more bioavailable.
Formula: milk protein allergy Cow's: more iron, but less bioavailable. Goat: |
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What are the daily caloric requirement for infant <1yo and those older?
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<1yo: 120kcal/kg/day
>1yo: 100 |
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1.2. 13mo child with developmental delay, 25th% weight, 10th% height, 5th% H.C. with h/o small head (microcephaly) at birth, required cataract surg, and take phenobarb for seizure. What is DX?
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Congenital CMV infection, causing calcified brain density (periventricular pattern).
In toxoplasmosis, they are found scattered throughout cortex. |
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1.4. FTT child has work-up shows Hb 11, Hct 33%, Plt 198, Na 140, K 3.5, Cl 105, HCO3 17, BUN 15, Cr 0.3. LFT normal, urine-pH 8. What is diagnosis
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renal tubular acidosis (RTA)
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Case 2: What are the 3-fold management in a substance-abuse adolescence?
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(1) detox, (2) f/u with psychosocial suport, and (3) long term management service.
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What is the S/Sx and urine retention time for testing for ALCOHOL?
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S/Sx: euphoria, vasodilation (red face), respiratory depression (GABA from acidosis).
7-10h (blood), 10-13h (urine) |
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What is the S/Sx and urine retention time for testing for Marijuana?
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S/Sx: euphoria, distortional of time perception, loss of judgment.
3-10d (occasional), 2mo (chronic) |
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What is the S/Sx and urine retention time for testing for Cocaine?
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S/Sx: increase motor activity (hyperactive), DILATED pupils, tachy, HTN, hyperthermia, paranoia. -- sympathetic response.
2-4 days in urine |
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What is the S/Sx and urine retention time for testing for Meth (methamphetamine) and ecstasy?
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S/Sx: increased sensual awareness, incr psychic and emotional energy, NAUSEA, TEETH grinding, tachy, blurred vision, jaw clenching, anxiety, panic attack, psychosis
2 days in urine |
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What is the S/Sx and urine retention time for testing for OPIATES (heroin, morphine, codeine)?
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S/Sx: decreased pain sensation, PINPOINT pupil, hypothermia, vasodilation, respiratory depression (sedation).
2 days in urine |
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What is the S/Sx and urine retention time for testing for Phencyclidine (PCP)?
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S/Sx: NYSTAGMUS, ataxia, hallucination, disorientation, hypersalivation.
8 days in urine |
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What is the S/Sx and urine retention time for testing for BARB's?
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S/Sx:secation, PINPOINT pupil, hypotension, brady, hypotherm, hyporeflex, CNS/resp depression
1 day (short acting), 2-3wks (long acting) |
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Case 3: patient has Down's syndrome. What are the two screens that could have picked this up?
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Triple screen (AFP, b-HCG, estriol) and quadruple screen (+ inhibin A).
Also acetylcholine-esterase (AchE) |
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What are the VACTER-L association?
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Vertebral
Anal Cardiac Tracheo-esophageal Exomphalos Renal Limbs |
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What are the MCC congenital cardiac anomaly in Down's?
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endocardial cushion defect (60%), VSD (32%), ToF (6%)
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Besides cardiac, what is another VACTER association in Down's?
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Tracheo-esophageal (GI) -- duodenal atresia (12%) with visible DOUBLE_BUBBLE sign on x-ray. Often lead to poly-hydramnios and early vomiting.
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What are other common congenital problems with Down's?
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hearing loss, strabismus, cataracts, nystagmus, congenital HYPOTHYROIDISM (large tongue, small fontanelle), obesity, AML leukemia, Alzheimer.
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