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160 Cards in this Set
- Front
- Back
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What are the criteria for administering intrapartum group B Strep prophylaxis if the GBS status is unknown?
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- gestation of <37 weeks
- membranes have been ruptured 18 hours or longer, or - temperature of 38°C or greater |
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An infant is considered term at how many weeks?
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37 weeks GA
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What are findings seen at birth in infants with congenital CMV?
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Jaundice
Chorioretinitis Hearing loss Hepatosplenomegaly Intracranial calcifications Microcephaly Purpuric rash |
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Absolute contraindications to breastfeeding.
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Maternal HIV infection
Active maternal drug abuse Infants with galactosemia |
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Maternal benefits from breastfeeding.
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Reduced risk of breast and ovarian cancer and osteopororis
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What is considered a normal birth weight?
low weight? very low weight? extremely low weight? |
> 2500 g
1500-2499 1000-1499 < 1000 |
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How much weight should a term infant be gaining per day?
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20-30 grams per day
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How long should it take for an infant to double their birth weight? triple their birth weight?
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2x birth weight by 5 months
3x birth weight by 12 months |
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When do infants develop stranger anxiety?
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9 months
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What are the 5 P's of pyloric stenosis?
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Palpable olive
Peristalsis visible Persistent Projectile Progressive |
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During treatment of DKA, what should be done if there are signs of neurological deficit?
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Elevate head of bed
Decrease fluid rate by 1/3 Mannitol 1g/kg IV Intubate and hyperventilate CT scan when stabilized |
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What should be monitored, and how often during treatment of DKA?
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Plasma glucose by glucometer q30min
Lytes q2-4h Serum β-OH-butyrate q2-4h Neurovital signs q15min until stable, then q1h until order discontinued |
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What investigations should you order in a case where you suspect child physical abuse?
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CBC
Coag screen (PTT, PT) Lytes, LFT, amylase, metabolic studies Skeletal survey if < 2 y.o. or non-verbal Bone scan Retinal exam by ophthalmologist CNS imaging if needed Photographs of surface injuries |
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When is jaundice considered pathological?
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< 24 hours
> 7 days, or starts before day 7 but persists > 2 weeks High rate of rise Conjugated hyperbilirubinemia |
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How high does bilirubin need to be for one to notice jaundice?
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> 100 mmol/L
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What are "hepatic" causes of jaundice?
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Sepsis
Toxins - drugs, TPN Infection - HAV, HBV, CMV, EBV Metabolic - galactosemia |
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Treatment for bacterial tonsillitis in a child.
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Take swab and give Rx at same time. Tell parent to fill Rx only if called with a +ve result.
Penicillin 250 mg po tid x 10 days if < 27 kg 500 mg po tid x 10 days if > 27 kg |
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Antibiotics to use for primary adenitis.
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Cloxacillin
Ancef |
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Complications of post-septal orbital cellulitis.
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Cavernous sinus thrombosis
Meningitis |
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Clinical manifestation of measles.
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Cough, coryza, conjunctivitis.
2-3 days after, get Koplik spots. 5 days after, erythematous maculopapular rash starts on head, spreads caudally, and lasts 4-5 days. |
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Clinical manifestations of rubella.
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Lymphadenopathy (postauricular and occipital), fever, arthritis
Rose pink macules and papules, start on head and spread caudally. Rash lasts 3 days. |
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Clinical manifestations of roseola infantum (HHV-6).
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Begin with abrupt fever for 1-5 days.
Then as the fever resolves, maculopapular rash appears on trunk and spreads peripherally. |
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Clinical manifestations of erythema infectiosum.
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3 stages:
- Begin as slapped cheek appearance. - Reticulate erythematous pruritic rash starts on arms and spreads to trunk and legs. - Rash fluctuates in severity for 2-3 weeks. Other complications: arthritis, hemolytic anemia, encephalopathy. |
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What orthopedic problems is associated with intra-uterine packing syndrome?
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External hip rotation
Internal tibial torsion Metatarsus adductus |
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What are bad prognostic signs in orthopedic abnormalities in lower limbs?
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Rigid position
Varus position Multiple abnormalities |
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How much and when is internal tibial torsion normal?
Treatment for severe cases. |
10-20 degrees at birth, later should become external tibial torsion at ~4-5 years old.
Treatment for severe/persistent cases: Dennis-Brown boot and bar. Tibial osteotomy. |
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Natural history of leg angular alignment.
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At birth, 10-20 degrees genu vara.
At 4-5 years old, peak genu valga of 5-15 degrees. At 6 years old, ~neutral. |
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Natural history of hip rotation.
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At birth, externally rotated.
At 4 years old, peak of internal hip rotation. At ~8 years old, becomes more externally rotated again. |
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What conservative treatments for developmental dysplasia of the hips is there?
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Craig hip abduction splint
Pavlik harness |
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What are the 3 pathologies of the hip most common in age group 0-5? 5-10? 10-15?
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DDH: 0-5
Leg-Calve-Perthes: 5-10 - very active kids - avascular necrosis - minimal pain SCFE: 10-15 - obese children |
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In scoliosis, how large should the Cobb angle be to indicate referral to an orthopedic surgeon?
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> 20 degrees
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What is used for GH stimulation test?
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Arginine
Glucagon Clonidine Dopamine |
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What is the cause of a thickened pituitary stalk?
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Germinoma
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Differential diagnosis of vomiting in infant.
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GER/GERD
Anatomical (HPS, duodenal web/atresia, malrotation, microgastria) Allergic (milk intolerance) ICP raised Infection (UTI, gastroenteritis) Metabolic disease (galactosemia) |
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When does GER tend to peak in infants?
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4-5 months.
However, it is normal to last until 10 months. |
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When does colic tend to peak? When does it tend to resolve?
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Peak at 2-3 months
Resolve at 4 months |
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Treatment of GERD in infants
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Non-pharmacological
- thicken feeds - positioning - 1 week trial of hypoallergenic formula Pharmacological - ranitidine 5-8 mg/kg/day - omeprazole 0.7-3.5 mg/kg/day - lansoprazole 1.4 mg/kg/day |
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Causes of rectal bleeding in neonates
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Anorectal lesions
Swallowed maternal blood Milk allergy NEC Volvulus Hirschsprung's Vascular malformation Coagulopathy Thrombocytopenia |
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What is the diagnostic test of choice when suspecting intussusception in an infant/child?
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Ultrasound.
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What is the test of choice when suspecting swallowed maternal blood in a neonate?
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Apt test.
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What is the difference between a type and screen, vs a type and cross?
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Type and cross - done when there is high risk of need for transfusion (trauma, open heart surgery). The blood ABO type is determined, antibody screen is done, and patient + donors blood are mixed to check for incompatibility.
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What can RDW be used to determine?
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Helps determine thalassemia (low RDW) apart from iron deficiency anemia (high RDW)
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Causes of pancytopenia
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Aplastic anemia
Infection Leukemia |
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Causes of isolated normocytic anemia (no other cell lines down).
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Infection
Diamond-Blackfan anemia (DBA) Acute blood loss Renal disease Transient erythroblastopenia of childhood (TEC) |
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Causes of normocytic anemia with a high retic count.
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Hemolysis
Hemorrhage Hypersplenism |
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Give examples of food allergies that are IgE mediated, mixed IgE/non-IgE mediated, and non-IgE mediated.
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IgE mediated: anaphylaxis, oral allergy syndrome.
Mixed: eosinophilic esophagitis. Non-IgE mediated: protein-induced enterocolitis. |
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When does hypertrophic pyloric stenosis usually present?
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Vomiting starts at 3-6 weeks of life, and progressively worsens.
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What is the name of a posterior hernia? Anterior hernia?
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Bochdalek hernia - posterior
Morgagni hernia - anterior |
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Key physical findings in congenital diaphragmatic hernia.
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Scaphoid abdomen
Bowel sounds in chest Trachea deviation |
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Treatment of congenital diaphragmatic hernia.
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ICU - O2, IV fluids and meds, NG. Wait until pulmonary hypertension settles, then surgery.
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Associated abnormalities with omphalocele.
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Chromosomal abnormalities
Cardiac defects Renal defects Beckwith-Wiedemann Syndrome |
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What are some clinical problems that a SGA infant is at risk for?
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Hypoglycemia
Hypothermia Hypoxia Polycythemia |
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What is lissencephaly?
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AKA agyria-pachygyria
Gyri are too few in number, cortex is thicker than normal. |
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How many calories per day does a term infant need?
How many calories per oz of standard formula is there? |
100-120 kcal/kg/day.
20 kcal/oz |
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What are the most common side effects of immunizations?
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Fussiness and fever x 24 hours.
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When should a child double their birth length?
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4 years old.
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What sort of a lab investigation should be done for neuroblastoma?
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Urine HVA/VMA will be elevated in 90-95% of cases.
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Terminology for eyes turned medially/laterally.
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Medially: esotropia
Laterally: exotropia |
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Questions to ask about exposure risk of TB.
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• Symptoms of TB?
• Abnormal CXR? • Close contact to sick person with active TB? • Born outside NA or traveled outside NA? • Does child have household member who was born outside NA or traveled outside NA? • Is there exposure to person who: currently in jail, or has been in jail for the past 5 years? Has HIV? Is homeless? Lives in group home? Uses illegal drugs? Is a migrant farm worker? • Does the child have HIV, or have risk to contract HIV, or have any other health problem that lowers the immune system? • Is the child/teen in jail or ever been in jail? |
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Diagnostic criteria for Kawasaki disease.
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Fever > 5 days
Plus 4/5 of the follow criteria: 1. Lymphadenopathy 2. Mucositis 3. Extremity changes 4. Rash 5. Conjunctivitis |
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Rocky Mountain Spotted Fever.
Causative agent, and clinical manifestation. |
Vector-borne (tick) disease, Rickettsia rickettsii.
Triad: fever, headache, rash (petechial, starts on wrists/ankles progresses centrally). |
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Describe the rash of Scarlet fever.
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Erythematous, finely maculopapular
Sandpaper texture Begins around neck, axillae, groin, then spreads over trunk and extremities |
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What diseases can cause a strawberry tongue?
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Kawasaki disease
Group A Streptococcal pharyngitis |
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Causes of unilateral lymphadenopathy.
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• Mycobacterial infection
• Cervical adenitis • Pharyngeal infection • Cat scratch disease • Kawasaki disease |
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ADHD - DSM IV criteria.
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6 or more symptoms of inattention
□ Does not pay attention to detail □ Frequently makes careless mistakes in work □ Has difficulty sustaining attention □ Does not seem to listen when spoken to directly □ Does not follow through on instructions □ Has difficulty organizing tasks □ Reluctant to engage in tasks requiring sustained mental effort □ Often loses things □ Easily distracted by extraneous stimuli □ Forgetful in daily activities OR 6 or more symptoms of hyperactivity/impulsivity □ Fidgets □ Squirms in seat/has trouble staying seated □ Runs or climbs excessively in inappropriate settings □ Has difficulty playing quietly □ On the go/driven by a motor □ Talks excessively/blurts out answers before question completed □ Has difficulty awaiting turn □ Interrupts or intrudes on others |
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ADHD - DSM IV criteria.
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6 or more symptoms of inattention
□ Does not pay attention to detail □ Frequently makes careless mistakes in work □ Has difficulty sustaining attention □ Does not seem to listen when spoken to directly □ Does not follow through on instructions □ Has difficulty organizing tasks □ Reluctant to engage in tasks requiring sustained mental effort □ Often loses things □ Easily distracted by extraneous stimuli □ Forgetful in daily activities OR 6 or more symptoms of hyperactivity/impulsivity □ Fidgets □ Squirms in seat/has trouble staying seated □ Runs or climbs excessively in inappropriate settings □ Has difficulty playing quietly □ On the go/driven by a motor □ Talks excessively/blurts out answers before question completed □ Has difficulty awaiting turn □ Interrupts or intrudes on others |
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Side effects of methylphenidate.
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Decreased appetite, decreased growth velocity.
Tics. Insomnia. Sudden death in pt with pre-existing cardiac abnormalities. |
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Staging of hypertension in children.
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Stage 1: 95-99th percentile + 5 mmHg
Stage 2: > 99th percentile + 5 mmHg |
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What is Blount disease?
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Disordered ossification of proximal tibia in physis, epiphysis, and metaphysis. Results in varus angulation and internal rotation of the tibia.
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Normal pubertal developmental timeline for girls
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Breast 10-11
Pubic hair 10-11 Growth spurt 12 Menarche 12-13 Adult height 15 |
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Normal pubertal developmental timeline for boys
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Testicular growth at 12
Pubic hair at 12 Growth of penis, scrotum at 13-14 First ejaculation 13-14 Growth spurt 14 Adult height 17 |
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What is the difference between DTaP and Tdap vaccine?
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DTaP contains 3-5 times more diphtheria toxin than Tdap.
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What causes the murmur of HCM to get louder?
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Standing.
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How do you diagnose perinatal asphyxia?
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Umbilical artery blood gas
- hypoxemia - metabolic acidosis |
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Differential diagnosis of neonatal cyanosis.
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Congenital heart disease
Pulmonary disease CNS anomalies Sepsis/shock Hypothermia Maternal medication |
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Define LGA and SGA
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SGA: < 10th percentile of birth weight for GA
LGA: > 90th percentile of birth weight for GA |
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Risk factors for respiratory distress syndrome.
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Prematurity
IDM (insulin inhibits surfactant production) Sibling with RDS Males C/S without labour Perinatal asphyxia |
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Differential diagnosis for neonatal respiratory distress.
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Respiratory distress syndrome
TTN Meconium aspiration Pneumothorax CHF Sepsis/pneumonia Hypothermia |
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Difference in CXR appearance of TTN, RDS, and meconium aspiration.
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TTN: wet, hyperinflated, no air bronchograms.
RDS: low lung volumes, ground-glass appearance, air bronchograms. Meconium aspiration: diffuse patchy opacities (atelectasis/consolidation), hyperinflation. |
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What are the indications for checking a newborn's blood glucose? When should it be checked? What is normal?
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Check if: SGA, LGA, IDM, preterm.
Check at 2 hours. Normal if ≥ 2 mM. Check again at 6 hours, then q3h ac meals until 3 consecutive readings ≥ 2.6 mM. |
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What is apnea?
What is the differential diagnosis? |
> 20 seconds of no breathing, or other signs of no breathing (cyanosis).
DDx: - apnea of prematurity - reflux - sepsis |
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Risk factors for severe illness in newborn.
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Premature
Ex-preemie with BPD CHD with left to right shunt |
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What is the max bili-total that is still considered reasonable for physiologic jaundice?
What are the causes of physiologic jaundice? |
257 mmol/L.
1. Higher RBC turnover (higher hematocrit, HbF has shorter halflife) 2. Higher enterohepatic circulation 3. Immature liver enzyme (glucuronyl transferase) |
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When does breastfeeding jaundice occur? When does breastmilk jaundice occur?
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Breastfeeding jaundice: first 2-4 days of life.
Breastmilk jaundice: day 4-6 of life, peaks at 2 weeks, and may persist until 12 weeks. |
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When is screening imaging for DDH indicated? What modality of imaging?
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Females born in breech position should be given hip US at 4-6 weeks, or hip/pelvic x-ray at 4 months
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Definition of FTT.
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Weight below 2nd percentile on more than 1 occasion.
Rate of weight gain that causes a decrease in 2 or more percentile lines over time. Failure to regain birth weight by 3 weeks, or continuous weight loss after 10 days of life. |
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Definition of lethargy.
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Poor or absent eye movements.
Failure to recognize parents, interact with persons or objects. |
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What is the normal fontanel size?
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Mean of 2.1 cm +/- 2 SD = 0.6-3.6 cm
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What can cause large fontanel?
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High ICP
Skeletal disorders (Rickets, osteogenesis imperfecta) Chromosomal abnormalities (DS) Hypothyroidism Malnutrition |
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What can cause small fontanel?
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Microcephaly
Craniosynostosis Hyperthyroidism Normal |
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What risk factors increase the probability of umbilical hernia?
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Prematurity
Congenital hypothyroidism |
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How is OTC deficiency inherited?
How is it diagnosed? |
X-linked recessive.
Hyperammonemia and elevated urine orotic acid. |
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How is CAH diagnosed?
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17-OH progesterone elevated in 21 hydroxylase deficiency.
11-deoxycortisol elevated in 11-beta-hydroxylase deficiency. |
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Conditions that can mimic a seizure.
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Motor tics
Myoclonus Sandifer syndrome Pseudoseizures |
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Common causes of fever without source in an infant/child.
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Meningitis
Bacteremia (occult) UTI Roseola Pneumonia |
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What is the best empiric PO antibiotic for pyelonephritis in children?
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Septra.
Give 10 mg/kg/day |
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Follow-up investigations after pyelonephritis in children.
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10 days after, do an abdominal US and voiding cystourethrogram.
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How quickly within the onset of Group A Strep infection do antibiotics need to be started in order to be effective at preventing rheumatic fever?
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Within 9 days of symptom onset.
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Expected lab values in Kawasaki Disease.
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CBC+diff - normocytic anemia, neutrophilia, platelets markedly elevated in 2nd week of illness.
AST and ALT mildly elevated. Serum albumin low. CRP high. U/A - sterile pyuria due to urethritis. |
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Treatment of Kawasaki Disease
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High dose ASA 30-50 mg/kg/day div qid, decrease to 2-5 mg/kg/day when fever settles. Shortens febrile course.
High dose IVIG 2 g/kg over 12 hours - decreases complication of coronary artery aneurysms. |
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Describe the rash of Scarlet Fever.
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Diffuse, erythematous finely maculopapular rash that blanches. Sandpaper texture. Begins around neck, axillae, groin, and spreads over trunk and extremities.
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How long after TB exposure does it take before a skin test will show up as positive?
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8-10 weeks.
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3 stages of pertussis.
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Catarrhal stage (1-2 weeks) - URTI symptoms.
Paroxysmal stage (4-6 weeks) - coughing followed by inspiratory whoop. Convalescent stage |
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Epiglottitis - which age range is affected? underlying organism?
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Age 2-5.
HiB. |
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Ataxia-telangiectasia
Etiology. When does it start? Other clinical manifestations. |
Autosomal recessive disorder.
Ataxia begins in infancy. Immunodeficiency due to hypoplastic thymus. Malignancy predisposition. |
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Name for what looks like neonatal acne.
Etiology. |
Neonatal cephalic pustulosis.
Associated with Malassezia. |
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Erythema toxicum neonatorum
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2-10 days after birth, macular erythema progresses to yellow/white papules-pustules.
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Complications of measles.
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Causes a transient immunodeficiency
□ Pneumonia □ Bronchitis □ Otitis □ Gastroenteritis □ Myocarditis □ Subsclerosing panencephalitis |
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Vesicles and bullae, which turn into verrucous lesions, and then streaks of hyperpigmentation, and then streaks of hypopigmentation/atrophy.
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Incontinentia pigmenti.
X-linked dominant disorder. |
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Neurofibromatosis type 1, cause and diagnostic criteria.
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Autosomal dominant disorder, loss of NF1 gene causes tumors in multiple systems.
1. 6 café-au-lait spots that measure 0.5 cm or more before puberty, or 1.5 cm or more in adults 2. Freckling of axillary and/or inguinal regions 3. ≥ 2 neurofibromas of any type, or 1 plexiform neurofibroma 4. ≥2 iris hamartomas (Lisch nodules) 5. Optic nerve glioma 6. Pathognomonic skeletal dysplasia 7. Affected first-degree relative |
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Circumscribed scaly hypopigmented patch commonly seen in patients with atopic dermatitis.
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Pityriasis alba
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Sturge Weber syndrome.
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Rare congenital vascular disorder of unknown etiology.
Triad: port-wine stain in V1 distribution, seizures, glaucoma. |
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Vesiculopustular lesions on chin, forehead, neck, lower back, shins.
Rupture easily and evolve into hyperpigmented lesions with collarette pattern. |
Transient neonatal pustular melanosis
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Some features of tuberous sclerosis.
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Seizures
Mental retardation Facial angiofibromas Hypopigmented macules Shagreen patches (patch of rough, leathery skin) Brown fibrous plaque on forehead Hamartomas of the skin, brain, eye, heart, lungs, kidneys, bone Retinal hamartomas Ash-leaf spots |
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Disease that causes atopic dermatitis, thrombocytopenia and platelet dysfunction with associated petechial lesions, and immunodeficiency.
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Wiskott-Aldrich syndrome.
X-linked recessive disorder. Diagnose with low IgM levels. |
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Criteria for proteinuria within nephrotic syndrome range in paediatric patients.
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≥ 50 mg/kg/day, or
≥ 40 mg/m²/hour But this requires 24 hour collection of urine, so the easier thing is to use the protein:creatinine ratio in a random urine sample > 300 mg protein/mmol creatinine |
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Types of nephrotic syndrome causes.
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MCD
FSGS Membranous Membranoproliferative |
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Treatment for pneumonia
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Clarithromycin
Alternatively, use Clavulin If IV needed, use Cefuroxime or Clox+Cefotaxime. |
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Treatment for sepsis/meningitis.
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Vancomycin + Cefotaxime.
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Treatment for skin infections.
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Cephalexin
Clinda Pen + Clox |
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Treatment for ruptured appendix.
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Flagyl + Amox + Cefotaxime
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Treatment for UTI/urosepsis.
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Oral: septra
IV: Amp + Gent, or Cefotaxime |
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Treatment for neonatal sepsis.
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Amp + Gent or
Amp + Cefotaxime |
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What are creases under a child's eyes called? What is it indicative of?
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Dennie-Morgan lines.
Sign of allergies. Due to intermittent edema. |
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What are some conditions that mimic seizures?
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Motor tics
Myoclonus Sandifer syndrome - stiffening and opisthotonic posturing due to GER in infants Pseudoseizures |
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Difference between simple and complex febrile seizures.
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Simple febrile seizures
□ Last < 15 minutes □ Occur once in a 24 hour period □ Generalized seizures Complex febrile seizures □ Last > 15 minutes □ Occur more than once in 24 hour period □ Focal seizures |
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Cause of opsoclonus-myoclonus syndrome
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Often caused by neuroblastoma which results in paraneoplastic syndrome.
Manifests as ataxia, opsoclonus and myoclonus. |
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Name the functional disorders that cause chronic abdominal pain.
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Functional dyspepsia
IBS Abdominal migraine Functional abdominal pain |
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Criteria for irritable bowel syndrome diagnosis.
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In last 2 months, at least weekly occurrence of abdominal pain with ≥ 2 of the following:
- Relieved with defecation and/or - Onset with change in frequency or form of stool and - No evidence of organic disease |
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Name some of the multifactorial causes of cerebral palsy.
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Prematurity
Intrauterine growth retardation Intrauterine infection Perinatal asphyxia |
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Important side effects of using topical steroid medication.
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Skin atrophy
Telangiectasia Hypopigmentation Suppression of HP axis |
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Most effective treatment for lice.
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Malathion 0.5% topical (Ovide)
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Recurrent pneumonia that resolves quickly, hemoptysis and anemia.
What disease is the cause? What test should be done? |
Idiopathic pulmonary hemosiderosis. Bronchoalveolar lavage (contains hemosiderin-laden macrophages).
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Treatment of croup.
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Mild: dexamethasone 0.6 mg/kg to max of 10 mg po. Outpatient humidified air.
Moderate/severe: Humidified oxygen. Dex 0.6 mg/kg to max of 10 mg po. Inhaled epinephrine nebulizer. |
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Treatment of bacterial tracheitis.
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Antistaph: Vancomycin or Clinda, PLUS 3rd generation cephalosporin.
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What age group does Mycoplasma pneumoniae affect?
How about S aureus? |
Mycoplasma - older children and young adults.
S. aureus - children under 5 months of age. |
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What is the cause of meconium ileus?
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Cystic fibrosis.
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Antibodies for inflammatory bowel disease.
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ASCA +ve in 40-80% of patients with Crohn disease.
p-ANCA +ve in 60-80% of patients with UC. |
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Typical presentation of visceral larva migrans.
Diagnostic test. |
Toxocara canis, which is a roundworm.
Caused by eating ova, which is usually in dirt. Get dyspnea, wheezing, hepatomegaly, eosinophilia. Dx with ELISA for Toxocara. |
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Which primary teeth erupt first, and at what age?
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Central incisors : 6–12 months
Lateral incisors : 9–16 months Canine teeth : 16–23 months First molars : 13–19 months Second molars : 22–33 months |
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Which drug ingestions can be treated with activated charcoal?
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Carbamazepine, dapsone, phenobarbital, quinine, theophylline, TCAs.
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Diagnostic test for NEC.
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Abdo x-ray, showing pneumatosis intestinalis.
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Most common type of tracheoesophageal fistula.
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Phimosis is normal up to a certain age...
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3 years old.
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Clinical features of prune-belly syndrome.
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Absent abdominal wall muscles.
Urinary tract abnormalities. Cryptorchidism. |
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What kind of imaging can be used to detect acute pyelonephritis and renal scarring?
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DMSA radionuclide scan.
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What is the most common type of hereditary nephritis?
It causes microscopic hematuria, as well as... |
Alport syndrome.
Hearing loss, eventual end-stage renal disease, ocular abnormalities. |
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Clinical features of idiopathic hypercalciuria.
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Intermittent gross hematuria.
Permanent microscopic hematuria. Dysuria, abdominal pain. |
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Clinical features of homocystinuria.
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Poor growth
Arachnodactyly Osteoporosis Lens dislocation Mental retardation Thromboembolism (can cause acute hemiplegia) |
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An immunodeficiency syndrome with petechiae, easy bleeding, eczema, and chronic draining ears
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Wiskott-Aldrich syndrome
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An immunodeficiency syndrome with coarse features, chronic infected eczema, and deep-seated abscesses.
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Hyperimmunoglobin E syndrome
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An immunodeficiency syndrome with short stature, chondrodystrophy and fine hair.
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Cartilage-hair hypoplasia
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An immunodeficiency syndrome with congenital heart disease, developmental delay, and dysmorphic facies with low-set ears, hypertelorism, downturning eyes, and micrognathia.
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DiGeorge syndrome
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An immunodeficiency syndrome with early onset of seborrheic dermatitis and alopecia.
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SCID (severe combined immunodeficiency)
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An immunodeficiency syndrome with oral ulcers, gingivitis, and impetigo.
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Chronic granulomatous disease, or leukocyte adhesion defect.
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Major causes of recurrent infections in a child.
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Normal child with recurrent infections.
Atopic disease mistaken for infections. Chronic disease (CF, GER, CHD, chronic aspiration, anatomic defects, resistant organisms). Immunodeficiency syndrome. |
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Useful physical exam maneuver to test a boy for Duchenne muscular dystrophy.
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Gower sign.
Tell child to lie prone and get up to standing position. They will walk their hands up extremities and trunk to complete the maneuver, a sign of proximal muscle weakness. |
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Which newborns should be screened for neonatal hypoglycemia?
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LGA
IDM (infants of diabetic mothers) SGA Preterm |
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When should at-risk neonates be screened for neonatal hypoglycemia, and for how long?
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2 h of age, then q3-6 h. Discontinue after 12 h in LGA and IDMs if BG ≥ 2.6, and after 36 h in SGA and preterm if feeding established and BG ≥ 2.6.
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Risk factors for developing jaundice, and might make you want to order screening bilirubin levels before discharge.
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Shorter gestation < 38 week
Sibling with jaundice Male Asian/European background Visible bruising Cephalohematoma Maternal age > 25 Dehydration |
