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561 Cards in this Set
- Front
- Back
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week 1 of gestation
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fertilization
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week 2 of gestation
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implantation complete
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week 3 of gestation
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mesoderm formed (trilaminar embryo)
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week 5 of gestation
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subdivisions of forebrain, midbrain, hindbrain are formed
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week 7 of gestation
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heart formed
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week 8 of gestation
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primary organogenesis complete
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week 9 of gestation
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permanent kidneys begin functioning
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week 10 of gestation
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midgut returns from umbilical cord to abdominal cavity (while undergoing counterclockwise rotation)
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week 24 of gestation
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primitive alveoli are formed, surfactant production begins
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week 26 of gestation
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testicles descend
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main source of energy for growing fetus
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carbohydrates
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most common congenital heart defect
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VSD
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development of heart
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week 3: paired heart tubes begin to work
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sites of fetal erythropoiesis
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yolk sac (3-8 weeks)
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gastroschisis
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full-thickness abdominal wall defect with extruded intestine
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what forms fetal portion of placenta
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chorionic sac
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development of central nervous system
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week 3: neural tube formed on ectodermal surface
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spina bifida
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failure of neural tube to close completely
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what forms maternal portion of placenta?
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endometrium
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what indicates fetal lung maturity?
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lecithin:sphingomyelin ratio > 3
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what does placenta synthesize?
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glycogen
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prenatal toxo infxn
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microcephaly
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prenatal rubella infxn
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meningoencephalitis
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prenatal CMV infxn
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5% have neuro deficits
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fetal alcohol syndrome
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mental retardation
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cocaine during pregnancy causes
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maternal htn, fetal hypoxia
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narcotic use in pregnancy causes
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IUGR
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tobacco use in pregnancy causes
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decreased birth weight
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phenytoin use in pregnancy causes
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fetal hydantoin syndrome:
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use of tetracycline in pregnancy causes
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tooth discoloration
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use of isotretinoin during pregnancy causes
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hydrocephalus
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use of warfarin during pregnancy causes
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abnormal cartilage development
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maternal diabetes causes
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macrosomia, can lead to brith related injury
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head CT consistent with TORCh infection
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marked ventricular dilation
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when is Apgar scoring done?
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1 and 5 minutes
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erythema toxicum
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pustular rash distributed over trunk, face and extremities of newborn
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anterior fontanelle closes at€
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9-12 months
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causes of large fontanelle
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hypothyroidism
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large tongue in newborn seen with
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hypothyroidism
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brushfield spots
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salt and pepper speckling of the iris seen in down's
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caput succedaneum
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area of edema over presenting porton of scalp during vertex delivery
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cephalohematoma
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caused by bleeding that occurs below periosteum of overlying bone
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klumpke's palsy
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7th/8th cervical and first thoracic nerve roots
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erb's palsy
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5-6th cranial roots
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diff between caput succedaneum and cephalohematoma
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caput succedaneum: external to periosteum, crosses midline of skull and suture lines
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treatment of chlamydia in infant
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erythromycin orally, 14 days
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common features of neonatal/congenital syphilis
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intermittent fever
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late manifestations of congenital syphilis
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saddle nose deformity
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treatment of developmental dysplasia of the hip
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Pavlik harness (special brace)
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kernicterus
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bilirubin neurotoxicity
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tests performed on heel puncture
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hypothyroidism
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definition of premature infant
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live born newborn delivored prior to 37 weeks
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define low birth weight infant, very low birth weight infant
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low: <2500g
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CXR findings of respiratory distress syndrome
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diffuse reticulogranular/ground glass pattern
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Wilson-Mikity syndrome
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need for supplemental oxygen beyond 28 days of life
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serious sequelae of necrotizing enterocolitis
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intestinal strictures
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intraventricular hemorrhage
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rupture of germinal matrix blood vessels due to hypoxic or hypotensive injury
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harrison's groove
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indentation of ribs at diaphragmatic level
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name of growth chart for premature baby
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Babson
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order of growth of teeth
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should have all primary teeth by 2.5 years
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define microcephaly, macrocephaly
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head circumference > or < 3 standard deviations below/above the mean
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sotos syndrome
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rare genetic disorder
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signs of failure to thrive
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SMALL KID
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renal causes of failure to thrive
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chronic pyelonephritis
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fanconi syndrome
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disease of proximal renal tubules of kidney
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fanconi anemia
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result of genetic defect in cluster of proteins responsible for DNA repair
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age at which baby reacts to pain
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1 month
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age at which baby responds to noise
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1 month
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age at which baby regards human face
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1 month
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age at which baby establishes eye contact
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1 month
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age at which baby eyes follow object to midline
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2 months
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age at which baby holds head up prone
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2 months
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age at which baby laughs and squeals
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4 months
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age at which baby has social smile
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2 months
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age at which baby recognizes parent
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2 months
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age at which baby eyes follow object past midline
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4 months
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age at which baby rolls over
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4 months
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age at which baby vocalizes
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2 months
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age at which baby regards hand
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4 months
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age at which baby sits well unsupported
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6 months
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age at which baby transfers objects hand to hand
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6 months
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age at which baby rolls prone to supine
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6 months
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age at which baby babbles
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6 months
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age at which baby recognizes strangers
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6 months
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age at which baby has pincer grasp
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10 months
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age at which baby crawls
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9 months
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age at which baby cruises
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9 months
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age at which baby says mama/dada and bye-bye
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9 months
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age at which baby starts to explore
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9 months
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age at which baby walks
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12 months
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age at which baby throws objects
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12 months
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age at which baby says 1-3 words
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12 months
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age at which baby follows 1-step commands
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12 months
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age at which baby has stranger/separation anxiety
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12 months
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age at which baby walks up and down stairs
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2 years
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age at which baby copies a line
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2 years
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age at which baby runs
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2 years
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age at which baby kicks a ball
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2 years
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age at which baby has 2-3 word phrases
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2 years
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age at which baby refers to self by name
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2 years
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age at which baby uses pronouns
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2 years
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age at which baby does parallel play
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2 years
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age at which baby copies a circle
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3 years
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age at which baby peddles a tricycle
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3 years
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age at which baby can build bridge of 3 cubes
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3 years
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age at which baby repeats 3 numbers
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3 years
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age at which baby speaks in sentences
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3 years
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age at which baby recognizes 3 colors
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3 years
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age at which baby engages in group play
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3 years
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age at which baby plays simple games
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3 years
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age at which baby knows gender
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3 years
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age at which baby knows first and last name
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3 years
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age at which baby identifies body parts
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4 years
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age at which baby copies a cross/square
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4 years
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age at which baby hops on one foot
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4 years
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age at which baby throws overhand
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4 years
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age at which baby uses past tense
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4 years
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age at which baby tells a story
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4 years
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age at which baby plays with kids/social interaction
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4 years
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age at which baby copies a triangle
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5 years
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age at which baby catches a ball
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5 years
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age at which baby partially dresses self
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5 years
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age at which baby writes name
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5 years
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age at which baby counts 10 objects
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5 years
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age at which baby draws a person with 6 parts
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6 years
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age at which baby ties shoes
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6 years
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age at which baby skips with alternating feet
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6 years
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age at which baby identifies left and right
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6 years
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developmental assessment test for screening kids
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Denver Developmental Assessment Test (Denver II)
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moro reflex
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birth to 3-6 months
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startle reflex
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when moro disappears to 1 year
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galant reflex
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birth to 2-6 months
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sucking reflex
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becomes voluntary at 3 months
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babinski reflex
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birth to 4 months
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tonic neck
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birth to 4-6 months
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rooting reflex
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birth to 4-6 months
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palmar/plantar grasp reflex
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birth to 4-9 months
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parachute reflex
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appears at 9 months
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associated with down syndrome are€
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50% of DS infants have cardiac defects (endocardial cushion defect, ventricular septal defect, tetralogy of fallot)
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long term consequences/risks of down syndrome
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higher leukemia risk
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special intense exams for DS infants
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thyroid
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Edwards syndrome
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trisomy 18
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physical malformations of Edwards syndrome
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microcephaly, prominent occiput
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holt-oram syndrome
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affects bones in arms and hands, may also cause heart problems
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patau syndrome
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trisomy 13
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musculoskeletal/urogenital malformations in patau syndrome
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polydactyly
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most common signs of Downs in neonates
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hypotonia with poor Moro reflex
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genetic defect with hypersensitivity to atropine and pilocarpine
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patau
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risk of vertical HIV transmission with use of zidovudine
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10%
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DiGeorge syndrome
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22q11 microdeletion
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wiskott aldrich syndrome
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x-linked recessive disease
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SCID
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severe combined immunodeficiency
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fragile X syndrome
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most common single gene cause of autism
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physical phenotype of fragile x
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large protruding ears
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what needs to be supplemented in kids fed only goat's milk?
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folate
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what are infants susceptible to if they drink goat's milk?
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brucellosis
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methylmalonic acidemia
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amino acid metabolism disorder involving defect in conversion of methylmalnyl coenzyme A to succinyl CoA
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deficiency of vitamin A causes
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night blindness
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excess vitamin A causes
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increased ICP
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vitamin D deficiency causes
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rickets
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vitamin D excess causes
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hypercalcemia
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vitamin E deficiency causes
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hemolytic anemia in premature infants
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vitamin c excess causes
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possibly predisposes to kidney stones
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thiamine deficiency causes
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beriberi (neuritis, edema, cardiac failure)
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riboflavin deficiency causes
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photophobia
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niacin deficiency causes
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pellagra (dementia, dermatitis, diarrhea)
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pyridoxine deficiency causes
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irritability
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excess pyridoxine causes
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sensory neuropathy
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deficiency of folate causes
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megaloblastic anemia
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cobalamin deficiency causes
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pernicious anemia
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pantothenic acid deficiency causes
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depression
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biotin deficiency causes
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dermatitis
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vitamin K deficiency causes
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hemorrhagic manifestations
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vitamin K excess causes
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hyperbilirubinemia (water soluble vitamin K, anyway)
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which infant condition would explain multiple vitamin deficiencies?
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cystic fibrosis
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galactosemia
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genetic metabolic disorder: affects individual's ability to metabolize galactose
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maple syrup urine disease
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aka branched chain ketoaciduria
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calories needed by a newborn
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110-115 kcal/kg/day
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maternal benefits of breast feeding
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increased maternal oxytocin levels:
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possible vitamin deficiencies of breast fed babies
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A
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contraindications to breast feeding
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breast cancer
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breast feeding jaundice
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aka "not enough milk jaundice"
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breast milk jaundice
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syndrome of prolonged unconjugated hyperbilirubinemia thought to be due to an inhibitor to bilirubin conjugation in breast milk of some mothers
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when is baby ready for solid food?
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hand to mouth coordination
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why is commercial soy milk bad for baby?
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induces L-thyroxine depletion through fecal waste
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why is goat's milk bad for baby?
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allergen potential
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formula for sodium repletion
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(Na desired - Na observed) * body weight * 0.6
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signs/symptoms of hypokalemia
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decreased peristalsis/ileus
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signs/symptoms of hyperkalemia
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muscle weakness
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excess fluoride causes
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mottling, staining or hypoplasia of enamel
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which vitamin needs to be supplemented at birth?
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vitamin K
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signs of acute hypervitaminosis A
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pseudotumor cerebri (bulging fontanelle, drowsiness, cranial nerve palsies)
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signs of chronic hypervitaminosis A
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poor weight gain
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most common form of nonnutritional rickets
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familial, primary hypophosphatemia
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renal osteodystrophy
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bone mineralization deficiency secondary to electrolyte and endocrine derangements accompanying chronic kidney disease
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schmid metaphyseal dysplasia
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autosomal dominant condition
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anticonvulsive drug effect on bones
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phenobarbital and phenytoin patients have reduced 25(OH)D concentration
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rickets 2/2 renal tubular acidosis type 2
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bicarbonaturia, hyperkaluria, hypercalciuria, hypophosphatemia, phosphaturia
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oncogenic hypophosphatemia
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2/2 tumor secretion of phosphate regulating gene product
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kussmaul breathing
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deep rapid respirations associated with acidosis
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labs on DKA patient
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elevated glucose (400-800)
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treatment of DKA
|
1. initial vascular volume expansion
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Somogyi phenomenon
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patient has nocturnal hypoglycemic episodes
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contraindications to vaccines
|
egg allergy: influenza, yellow fever
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contraindication to hepB vaccine
|
anaphylactic reaction to baker's yeast
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contraindication to MMR vaccine
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known altered immunodeficiency
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contraindication to inactivated poliovirus vaccine
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anaphylactic reaction to streptomycin, polymyxin B, neomycin
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contraindication to varicella vaccine
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anaphylactic reaction to neomycin, gelatin
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Hib vaccine is given to kids under what age?
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5 years
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cause of most pediatric pneumonias
|
60% bacterial (mostly pneumococcus)
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primary bacterial etiologies of peds pneumonia in first few days of life
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enterobacteriaceae and group B strep
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most common peds pneumonia etiologies during first few months of life
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chlamydia trachomatis (infant with staccato cough and tachypnea)
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most common etiology of peds pneumonia from beyond newborn to 5 years
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viral pneumonia: adeno, rhino, RSV, influenza, parainfluenza
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peds pneumonia cause beyond 5 years of age
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mycoplasma mostly
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pneumonia in intubated ICU patient with central lines
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pseudomonas or fungal species (candida)
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treatment for newborn with pneumonia
|
ampicillin + gentamicin/cefotaxime
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treatment for LRTI in peds patient over 5 years
|
azithromycin, ceftriaxone, cefuroxime (cover mycoplasma and pneumococcus)
|
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travel to SW US means€
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coccidioides immitis
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infected sheep or cattle expose patients to€
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coxiella brunetti
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spelunking/working on farm east of rocky mountains exposes to€
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histoplasma capsulatum
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leading cause of death in children <1 year old
|
"perinatal conditions" -->
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anticipatory guidance at first week-1 month
|
place infant on the back to sleep
|
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anticipatory guidance at 2 months - 1 year
|
childproof home!
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anticipatory guidance at 1 to 5 years
|
use toddler seat
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car seat guides
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kids <20 pounds in infant car seat, back seat, rear facing
|
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risk factors for anemia
|
low socioeconomic status
|
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DTaP vs Td
|
DTaP given under 7 years of age
|
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DTaP vs DTP
|
DTaP diphtheria, tetanus toxoids and acellular pertussis
|
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palivizumab
|
RSV monoclonal antibody
|
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antidote for TCA toxicity
|
intubation, activated charcoal if altered sensorium
|
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signs/symptoms of toxicity of sulfonamides
|
kernicterus in infants
|
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signs/symptoms of toxicity of chloramphenicol
|
gray baby syndrome
|
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signs/symptoms of toxicity of quinolones
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may cause cartilage defects in children
|
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signs/symptoms of toxicity of tetracycline
|
gray enamel of permanent teeth
|
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signs/symptoms of toxicity of salicylates
|
Reye's syndrome
|
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signs/symptoms of toxicity of acetaminophen
|
generalized malaise, nausea, vomiting
|
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signs/symptoms of toxicity of TCAs
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anticholinergic
|
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signs/symptoms of toxicity of prednisone
|
growth retardation
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signs/symptoms of toxicity of organophosphates
|
cholinergic effects
|
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treatment of organophosphate toxicity
|
atropine
|
|
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signs/symptoms of toxicity of iron
|
abdominal pain
|
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treatment of heavy metal poisoning
|
dimercaperol
|
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treatment of iron poisoning
|
deferoxamine
|
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signs/symptoms of toxicity of methanol/ethylene glycol
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intoxication
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treatment of methanol/ethylene glycol poisoning
|
ethanol
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signs/symptoms of toxicity of benzos
|
sedation
|
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side effects of oral contraceptives
|
nausea, weight gain
|
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pterygium colli
|
webbed neck
|
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angelman's syndrome
|
maternal deletion 15q11-q13
|
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prader-willi syndrome
|
paternal deletion 15q11-q13
|
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inopathy, mental retardation, hypogonadism, renal failure
|
maps to chromosome 12
|
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alport's syndrome
|
x linked recessive disorder of basement membranes of the kidney, eye, and ear
|
|
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ellis van creveld syndrome
|
polydactyly and congenital heart disease
|
|
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bardet biedl syndrome
|
polydactyly and obesity, pigmentary ret
|
|
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meckel-gruber syndrome
|
triad of occipitial encephalocele, large polycystic kidneys, postaxial polydactyly
|
|
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craniosynostosis
|
premature closing of one or more cranial sutures due to abnormalities of skull development
|
|
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apert's syndrome
|
acrocephalosyndactyly
|
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crouzon syndrome
|
first branchial arch genetic condition
|
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pfeiffer syndrome
|
premature fusion of bones of the skull
|
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pathophys of cleft lip and anterior palate
|
defect in fusing of both maxillary processes with the frontonasal process during weeks 5 and 6
|
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pathophys of posterior cleft palate
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defect in fusion of palatal shelves during weeks 7 and 8
|
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omphalocele
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herniation of abdominal contents through umbilical root, covered only by peritoneum
|
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etiology of oligohydramnios
|
premature rupture of membranes
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how much amniotic fluid is normal at 40 weeks gestation?
|
600ml
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potter's syndrome
|
bilateral renal agenesis
|
|
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pathophys of phenylketonuria
|
deficiency of phenylalanine hydroxylase or cofactor tetrahydrobiopterin
|
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distinctive featues of phenylketonuria
|
fair hair and skin
|
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signs of cholinergic excess
|
DUMBBELS
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damage from inorganic mercury salt exposure
|
GI burns
|
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chronic inorganic mercury intoxication signs/symptoms
|
gingivostomatitis
|
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acute arsenic ingestion signs/symptoms
|
nausea
|
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myringotomy
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treatment for acute otitis media
|
|
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serous otitis media
|
otitis media with effusion
|
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common bacterial pathogens for acute otitis media
|
strep pneumo
|
|
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common organisms for neonate and immune deficient patients with otitis media
|
staph aureus
|
|
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treatment for acute otitis media
|
amoxicillin for 7-10 days
|
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complications of otitis media
|
mastoiditis
|
|
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treatment of otitis externa/swimmer's ear
|
application of topical agent (eg polymyxin and corticosteroids)
|
|
|
cause of swimmer's ear
|
pseudomonas
|
|
|
apgar heart rate
|
0 - absent HR
|
|
|
apgar respiratory effort
|
0 - absent
|
|
|
apgar muscle tone
|
0 - limp
|
|
|
apgar reflex irritability
|
0 - no response
|
|
|
apgar color
|
0 - blue, pale
|
|
|
hartnup's disease
|
deficiency of neutral amino acids (accumulation of tryptophan)
|
|
|
treatment of homocystinuria
|
high dose vitamin B6
|
|
|
tay-sachs disease
|
deficiency of hexoseaminidase A
|
|
|
sandhoff disease
|
defect of hexoseaminidases A+B
|
|
|
niemann-pick disease
|
deficiency of sphingomyelinase
|
|
|
gaucher's disease
|
deficiency of beta-glucosidase
|
|
|
Fabry's disease
|
deficiency of ceramide trihexosidase or alpha-galactosidase A
|
|
|
Krabbe's disease
|
aka globoid cell leukodystrophy
|
|
|
Farber's disease
|
deficiency of ceramidase
|
|
|
hurler's syndrome
|
deficiency of alpha-l-iduronidase
|
|
|
Scheie's syndrome
|
milder form of Hurler's syndrome
|
|
|
Hunter's syndrome
|
iduronate sulfatase deficiency
|
|
|
dysostosis multiplex
|
large dolichocephalic skull
|
|
|
von gierke's disease
|
inherited glycogen metabolism disorder
|
|
|
mcardle's disease
|
deficiency of myophosphorylase
|
|
|
pompe's disease
|
deficiency of alpha-1,4-glucosidase
|
|
|
galactosemia
|
elevated galactose and metabolite levels in blood and urine
|
|
|
fructosuria
|
elevated fructose and metabolite levels
|
|
|
lesch-nyhan
|
disorder of purine metabolism; deficiency of HGPRT
|
|
|
hypercholesterolemia
|
tendinous xanthomata
|
|
|
hyperchylomicronemia
|
eruptive xanthomata
|
|
|
dysbetalipoproteinemia
|
absent chylomicrons
|
|
|
endogenous hypertriglyceridemia
|
increased VLDL
|
|
|
when do kid's antibodies begin developing?
|
between 6 months and 1 year
|
|
|
serum marker of anaphylaxis
|
serum tryptase
|
|
|
serum sickness
|
Type III hypersensitivity reaction
|
|
|
type I hypersensitivity
|
IgE mediated
|
|
|
type II hypersensitivity
|
cytotoxic antibody mediated
|
|
|
type III hypersensitivity
|
immune complex mediated
|
|
|
type IV hypersensitivity
|
cell mediated
|
|
|
erythema multiforme major
|
aka stevens-johnson syndrome
|
|
|
severe combined immunodeficiency
|
abnormalities of both humoral and cellular immunity
|
|
|
letterer-siwe disease
|
acute disseminated form of Langerhans' cell histiocytosis
|
|
|
ataxia-telangiectasia
|
telangiectasia
|
|
|
chronic mucocutaneous candidiasis
|
t-cell disorder
|
|
|
wiskott-aldrich syndrome
|
thrombocytopenia, eczema, increased susceptibility to infection
|
|
|
common variable hypogammaglobulinemia
|
inherited disorder of hypogammaglobulin
|
|
|
bruton's congenital agammaglobulinemia
|
profound defects in B lymphocytes
|
|
|
selective IgA deficiency
|
most common humoral antibody deficiency
|
|
|
DiGeorge's syndrome
|
primary disorder of t cell function
|
|
|
chediak higashi syndrome
|
abnormal neutrophil function -- autosomal recessive
|
|
|
treatment for chediak higashi syndrome
|
high dose ascorbic acid
|
|
|
chronic granulomatous disease
|
neutrophil dysfunction, but chemotaxis and phagocytosis intact (defective killing)
|
|
|
complement deficiency
|
C1q deficiency is systemic lupus erythematosus
|
|
|
howell jolly bodies in erythrocytes indicate
|
asplenia
|
|
|
Job Syndrome
|
hyper IgE
|
|
|
Duncan's Disease
|
x-linked lymphoproliferative disease
|
|
|
most common cause of neonatal septicemia
|
group B strep
|
|
|
waterhouse-friedrichsen syndrome
|
adrenal hemorrhage secondary to bacterial infection (normally n meningitidis)
|
|
|
treatment for meningococcemia
|
IV penicillin
|
|
|
treatment for toxo in the child
|
pyrimethamine and sufadiazine
|
|
|
signs/symptoms of toxo in child
|
mononucleosis syndrome including fever, lymphadenopathy, hepatosplenomegaly
|
|
|
treatment for cryptococcus
|
amphotericin B and flucytosin
|
|
|
diagnosing PCP
|
methenamine silver staining of bronchoalveolar fluid lavage to identify cyst walls
|
|
|
treatment of PCP
|
TMP-SMZ
|
|
|
signs/symptoms of CMV
|
pneumonitis
|
|
|
congenital varicella syndrome
|
maternal varicella infection in first 20 weeks of pregnancy
|
|
|
rubeola
|
aka measles
|
|
|
fifth disease
|
attacks red cell line
|
|
|
complications of fifth disease
|
arthropathy
|
|
|
roseola
|
HHV 6-7
|
|
|
complications of rubella
|
progressive panencephalitis
|
|
|
typhoid fever signs/symptoms
|
diarrhea later changing to constipation
|
|
|
treatment for typhoid fever
|
amoxicillin or bactrim
|
|
|
hand-foot-mouth disease
|
coxsackievirus A16 infection
|
|
|
rocky mountain spotted fever
|
rickettsia rickettsii
|
|
|
toxic shock syndrome
|
high fever, hypotension, erythematous rash
|
|
|
coccidioidomycosis
|
southwestern US
|
|
|
histoplasmosis
|
ohio and mississippi river valleys
|
|
|
schistosoma haematobium
|
fluke that infects bladder
|
|
|
schistosoma interclatum
|
fluke that infects mesenteric vessels
|
|
|
schistosoma mekongi
|
fluke that infects mesenteric vessels
|
|
|
schistosoma mansoni
|
fluke that infects liver
|
|
|
schistosoma japonicum
|
fluke that infects liver
|
|
|
visceral larva migrans
|
ingestion of log or cat tapeworms
|
|
|
pathogens in human bites
|
eikenella corrodens
|
|
|
pathogens in cat bites
|
pastuerella multocida
|
|
|
pathogens in dog bits
|
capnoctophagia canimorsus
|
|
|
kartagener syndrome
|
ciliopathic autosomal recessive genetic disorder
|
|
|
differentiate ITP from ALL
|
ITP commonly has bruising and petechiae BUT
|
|
|
differentiate aplastic anemia from ALL
|
pancytopenia and fever BUT
|
|
|
differentiate infectious mononucleosis from ALL
|
fever, malaise, adenopathy, splenomegaly, lymphocytosis
|
|
|
differentiate leukemoid reaction from ALL
|
resolves when underlying disease is treated
|
|
|
therapy for ALL
|
combination chemo
|
|
|
which diseases carry a high susceptibility to leukemia?
|
klinefelter
|
|
|
bloom syndrome
|
autosomal recessive
|
|
|
what makes you think ITP in a kid?
|
platelets less than 20,000 with a recent viral illness
|
|
|
sandifer's syndrome
|
reflux
|
|
|
treatment for GERD
|
antacids, H2 blockers, PPI
|
|
|
most common cause of esophagitis
|
candida
|
|
|
treatment for ulcers
|
antacids, sucralfate, misoprostol
|
|
|
colic
|
paroxysmal abdominal pain, severe crying, usually in infants <3 months old
|
|
|
pyloric stenosis
|
not usually present at birth; most commonly idiopathic
|
|
|
what maternal condition makes you think atresia?
|
polyhydramnios
|
|
|
duodenal atresia is also associated with which anomalies?
|
malrotation
|
|
|
"lead points" in intussusception
|
meckel's diverticulum
|
|
|
classic triad of intussusception
|
intermittent colicky abdominal pain
|
|
|
contrast enema rules for intussusception
|
barium column should not exceed height of 3 feet
|
|
|
meckel's diverticulum
|
persistence of omphalomesenteric (vitelline) duct -- which normally disappears by 7th week gestation
|
|
|
hirschsprung's megacolon
|
absence of ganglion cells in bowel
|
|
|
signs and symptoms of crohn's
|
perianal fistula
|
|
|
signs and symptoms of ulcerative colitis
|
bloody diarrhea
|
|
|
treatment for crohn's
|
corticosteroids
|
|
|
treatment for ulcerative colitis
|
aminosalicylates
|
|
|
antibiotic for aeromonas
|
bactrim
|
|
|
antibiotic for campylobacter
|
erythromycin
|
|
|
antibiotic for c diff
|
metronidazole or vanco
|
|
|
antibiotic for enterotoxigenic e coli
|
bactrim
|
|
|
antibiotic for salmonella
|
ampicillin or chloramphenicol or bactrim
|
|
|
antibiotic for shigella
|
bactrim or ceftriaxone
|
|
|
antibiotic for vibrio cholera
|
tetra or doxycycline
|
|
|
why isn't e coli 0157:H7 treated with antibiotics?
|
higher incidence of hemolytic uremic syndrome with treatment
|
|
|
enterobius vermicularis
|
pinworm
|
|
|
trichuris trichuria
|
whipworm
|
|
|
ascaris lumbricoides
|
pneumonia, loeffler's pneumonitis, intestinal infection/obstruction, liver failure
|
|
|
necator americanus, ancylostoma duodenale
|
hookworm
|
|
|
strongyloides stercoralis
|
similar to hookworm, plus diarrhea for 3-6 weeks
|
|
|
trichinella spiralis
|
myalgias, facial and periorbital edema, conjunctivitis, pneumonia/myocarditis/encephalitis/nephritis/meningitis
|
|
|
peutz-jeghers syndrome
|
mucosal pigmentation of lips and gums with hamartomas of stomach, small intestine, colon
|
|
|
gardner's syndrome
|
multiple intestinal polyps, tumors of soft tissue and bone
|
|
|
carcinoid tumors
|
tumors of enterochromaffin cells in intestine (usually appendix)
|
|
|
familial polyposis coli
|
autosomal dominant!
|
|
|
juvenile polyposis coli
|
mucus filled cystic glands with no adenomatous changes, no potential for malignancy
|
|
|
tropical sprue
|
generalized malabsorption associated with diffuse lesions of small bowel mucosa
|
|
|
gilbert's syndrome
|
benign condition: missense mutation in transferase gene resulting in low enzyme levels with unconjugated hyperbilirubinemia
|
|
|
crigler-najjar 1
|
autosomal recessive, secondary to mutations in glucuronyl transferase gene
|
|
|
crigler-najjar 2
|
autosomal dominant, variable penetrance
|
|
|
alagille syndrome
|
absence or reduction in number of bile ducts 2/2 progressive destruction of the ducts
|
|
|
zellweger syndrome
|
autosomal recessive progressive degeneration of liver and kidneys
|
|
|
extrahepatic biliary atresia
|
distal segmental bile duct obliteration with patent extrahepatic ducts up to porta hepatis
|
|
|
infants of diabetic mothers are at increased risk for€
|
congenital malformations
|
|
|
erythroblastosis fetalis
|
increased RBC destruction due to transplacental maternal antibody passage active against infant's RBC antigens
|
|
|
findings of jaundice in newborn suggestive of NONphysiologic jaundice
|
1. appearance in first 24-36 hours of life
|
|
|
presentation of gilbert syndrome
|
negative Coombs
|
|
|
mean intubation time of hepA
|
4 weeks
|
|
|
signs and symptoms of hepB
|
increased ALT prior to lethargy, anorexia, malaise (6-7 weeks post exposure)
|
|
|
reye's syndrome
|
acute encephalpathy and fatty degeneration
|
|
|
alpha1-antitrypsin deficiency
|
jaundice!
|
|
|
wilson's disease
|
autosomal recessive, copper deposition in brain and liver
|
|
|
treatment for wilson's
|
zinc!
|
|
|
hepatoblastoma
|
associated with beckwith-wiedemann syndrome
|
|
|
treatment for hepatoblastoma
|
complete resection of tumor
|
|
|
echinococcus
|
causes liver abscess
|
|
|
amebic abscess
|
liver abscess
|
|
|
respiratory rate at age birth - 6 weeks
|
45-60/min
|
|
|
respiratory rate at age 6 weeks - 2 years
|
40/min
|
|
|
respiratory rate at age 2-6 years
|
30/min
|
|
|
respiratory rate at age 6-10 years
|
25/min
|
|
|
most common viruses causing common cold
|
rhinoviruses
|
|
|
drugs for flu
|
amantadine
|
|
|
parainfluenza causes
|
colds
|
|
|
croup
|
mc cause is parainfluenza virus
|
|
|
epiglottitis
|
mc cause s pneumo, h flu
|
|
|
tracheitis
|
mc cause s aureus, h flu
|
|
|
bronchiolitis
|
mc cause RSV
|
|
|
pharyngitis
|
mc viral or group A strep
|
|
|
mc bacteria in pulmonary abscess
|
s aureus
|
|
|
croup
|
aka acute laryngotracheobronchitis
|
|
|
treatment of croup
|
racemic epinephrine, early corticosteroids
|
|
|
admission criteria for croup
|
suspected epiglottitis
|
|
|
spasmodic croup
|
aka laryngismus stridulus, midnight croup
|
|
|
when do you give steroids to a febrile child with stridor?
|
croup
|
|
|
epiglottitis
|
acute life threatening infection of supraglottic tissues
|
|
|
treatment of epiglottitis
|
med emergency!
|
|
|
mc causes of tracheitis/laryngitis
|
s aureus, h flu b
|
|
|
bronchiolitis
|
viral infection of upper and lower respiratory tract
|
|
|
treatment for bronchiolitis
|
humidified oxygen
|
|
|
bronchiectasis
|
abnormal and permanent dilatation of bronchi
|
|
|
bronchitis
|
infection of conductive airways of lung
|
|
|
pharyngitis
|
rhinovirus, adenovirus, coxsackievirus, group A beta hemolytic strep in kids >2, mycoplasma
|
|
|
suppurative complications of group a hemolytic strep
|
peritonsillar abscess
|
|
|
nonsuppurative complications of group a hemolytic strep
|
acute glomerulonephritis
|
|
|
pneumonitis syndrome
|
chlamydia trachomatis
|
|
|
treatment of peds pneumonia
|
1-3 months old: erythromycin or cefuroxime
|
|
|
where do pulmonary abscesses most commonly occur?
|
posterior segment of upper lobe
|
|
|
causes of whooping cough syndrome
|
bordatella pertussis!
|
|
|
stages of whooping cough
|
incubation: 1-2 weeks
|
|
|
diphtheria
|
membranous nasopharyngitis or obstructive laryngotracheitis
|
|
|
treatment of diphtheria
|
antitoxin: dose depends on site of membrane, degree of toxic effects, duration of illness
|
|
|
ppd test for kids
|
>5mm positive for: kids in contact with known/suspected cases of TB
|
|
|
what predisposes to asthma?
|
atopy
|
|
|
cromolyn, nedocromil
|
used to treat asthma
|
|
|
rate of growth in children
|
1st year of life: 23-28 cm/year
|
|
|
constitutional growth delay
|
healthy child's growth slower than expected, but parents were 'late bloomers'
|
|
|
if child with pneumonia has pseudomonas isolated from sputum, think
|
cystic fibrosis
|
|
|
features of CF
|
CF PANCREAS
|
|
|
chronic tonsillitis
|
7 in past year
|
|
|
indications for adenoidectomy
|
persistent mouth breathing
|
|
|
Waldeyer's ring
|
tonsil and adenoids are part of it
|
|
|
peritonsillar abscess
|
occurs in space between superior pharyngeal constrictor muscle and tonsils
|
|
|
retropharyngeal abscess
|
potential space between posterior pharyngeal wall and prevertebral fascia
|
|
|
treatment of peritonsillar abscess
|
antibiotics (penicillin)
|
|
|
treatment of retropharyngeal abscess
|
clindamycin or ampicillin-sulbactam
|
|
|
mild intermittent asthma
|
symptoms up to 2x/week
|
|
|
mild persistent asthma
|
symptoms >2x/week, but <1x/day
|
|
|
moderate persistent asthma
|
daily symptoms
|
|
|
severe persistent asthma
|
continual symptoms
|
|
|
heliox
|
treatment for asthma
|
|
|
indications for mechanical ventilation in asthmatic peds patient
|
failure of maximal pharmacologic therapy
|
|
|
nedocromil
|
NOT approved for kids <12yo
|
|
|
tracheo/laryngomalacia
|
floppy epiglottis and supraglottic aperture
|
|
|
if kid has tracheoesophageal fistulae, think€
|
esophageal atresia
|
|
|
cystic adenomtoid malformation
|
excessive overgrowth of bronchioles
|
|
|
most frequent cause of stridor in infants
|
laryngomalacia
|
|
|
most common congenital lung lesion
|
congenital lobar emphysema
|
|
|
epidemiology of murmur in kids
|
50% of kids have a murmur
|
|
|
accentuation of murmur for PDA
|
increased with supination
|
|
|
accentuation of murmur for atrial septal defect
|
valsalva can cause temporary middiastolic murmur
|
|
|
accentuation of murmur for aortic stenosis
|
increased with valsalva release, sudden squatting, passive leg raising
|
|
|
accentuation of murmur for subaortic stenosis
|
decreased with valsalva maneuver, standing
|
|
|
accentuation of murmur for hypertrophic obstructive cardiomyopathy
|
increased with valsalva maneuver, standing
|
|
|
accentuation of murmur for mitral valve stenosis
|
increased with exercise, left lateral position, isometric handgrip, coughing
|
|
|
accentuation of murmur for tricuspid stenosis
|
increased with inspiration, passive leg raising
|
|
|
pulmonary flow murmur
|
innocent!
|
|
|
still's murmur
|
innocent!
|
|
|
venous hum
|
innocent murmur
|
|
|
normal QTc in kids
|
<0.45 for <6 months
|
|
|
definition of QTc
|
QT interval divided by square root of R-R interval
|
|
|
atrial flutter
|
rapid atrial rate with varying ventricular rate
|
|
|
atrial fib
|
very fast atrial rate (350-600)
|
|
|
ventricular tachycardia
|
series of 3++ PVCs with HR between 120 and 200 bpm
|
|
|
ventricular fibrillation
|
very irregular QRS
|
|
|
causes of right axis deviation
|
severe pulmonary stenosis with right ventricular hypertrophy
|
|
|
causes of left axis deviation
|
with RVH: AV canal, consider with down's
|
|
|
signs of right atrial enlargement on EKG
|
peaked P waves in leads II and V1
|
|
|
signs of left atrial enlargement on EKG
|
wide P wave (notched in II, deep terminal inversion in V1)
|
|
|
signs of right ventricular hypertrophy on EKG
|
r wave >98% in V1 or S wave >98% in I or V6
|
|
|
signs of LVH on EKG
|
R > 98% in V6
|
|
|
causes of increased pulmonary vascular markings in acyanotic child
|
ASD
|
|
|
causes of increased pulmonary vascular markings in cyanotic child
|
transposition of great arteries
|
|
|
boot shaped heart on CXR
|
think tetralogy of fallot
|
|
|
egg shaped heart on CXR
|
think transposition of great arteries
|
|
|
snowman shape heart on CXR
|
think total anomalous pulmonary venous return
|
|
|
risk of rheumatic fever after strep pharyngitis
|
untreated: 1-3%
|
|
|
diagnosis of rheumatic fever
|
Jones Criteria: 2 major or 1 major + 2 minor
|
|
|
diagnostic path of rheumatic fever
|
aschoff bodies in atrial myocardium
|
|
|
arthritis of rheumatic fever
|
migratory
|
|
|
erythema marginatum
|
pink, erythematous macular rash
|
|
|
treatment for rheumatic fever
|
benzathine penicillin G to eradicate strep (IM injection)
|
|
|
most common etiology of endocarditis
|
alpha hemolytic strep (strep viridans 67%)
|
|
|
signs of endocarditis
|
fever, heart murmur
|
|
|
high risk predisposing factors for endocarditis
|
prosthetic cardiac valves
|
|
|
moderate risk predisposing factors for endocarditis
|
acquired valvular dysfunction: rheumatic fever, libman sacks valve, antiphospholipid syndrome associated valve disease, hypertrophic cardiomyopathy
|
|
|
libman sacks endocarditis
|
nonbacterial endocarditis seen in systemic lupus
|
|
|
low risk predisposing conditions for endocarditis
|
isolated ASD, secundum type
|
|
|
difference between janeway lesions and osler's nodes
|
janeway lesions are painless, osler's nodes are painful
|
|
|
when is prophylaxis for endocarditis recommended?
|
most dental and periodontal procedures
|
|
|
most common cause of myocarditis
|
viruses, ie coxsackie and echo
|
|
|
mc causes of pericarditis
|
viruses
|
|
|
signs/symptoms of pericarditis
|
precordial pain with radiation to shoulder and neck
|
|
|
signs of cardiac tamponade
|
distant heart sounds
|
|
|
most common causes of CHF in first 6 months of life
|
VSD
|
|
|
treatment of CHF in kids
|
digitalis: improve ventricular function. Contraindicated in complete heart block, hypertrophic cardiomyopathy
|
|
|
what can precipitate digitalis toxicity?
|
hypokalemia
|
|
|
henoch schonlein purpura
|
immune mediated vasculitis affecting GI tract, joints, kidneys
|
|
|
kawasaki's disease
|
aka mucocutaneous lymph node syndrome
|
|
|
diagnosis of kawasaki's disease
|
need 5+ of:
|
|
|
treatment of kawasaki disease
|
IVIG, usually one dose
|
|
|
polyarteritis nodosa
|
necrotizing inflammation of small and medium sized muscular arteries
|
|
|
treatment of polyarteritis nodosa
|
corticosteroids suppress clinical manifestations
|
|
|
takayasu's arteritis
|
aka aortoarteritis, pulseless disease
|
|
|
wegener's granulomatosis
|
rare vasculitis of arteries and veins leading to widespread necrotizing granulomas
|
|
|
diagnosis of wegner's
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c-ANCA present
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treatment for wegener's
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cyclophosphamide or azathioprine
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4 components of tetralogy of fallot
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right ventricular outflow tract obstruction
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cyanotic heart defects
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truncus arteriosus
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hypoplastic left heart syndrome
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aortic valvue hypoplasia, stenosis, atresia
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subendocardial cushion defect
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ostium primum ASD, VSD
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eisenmenger's syndrome
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left to right shunt caused by congenital heart defect causes increased flow through pulmonary vasculature, causing pulmonary hypertension
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initial management of VSD
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diuretics, digitalis
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ebstein's anomaly
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congenital heart defect: tricuspid valve opening is dispalced towards apex of right ventricle of heart
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treatment for tricuspid atresia
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PGE1 to maintain ductal patency
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characteristic murmur of aortic stenosis
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crescendo-decrescendo systolic murmur
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murmur for aortic insufficiency
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diastolic decrescendo murmur present at left upper sternal border
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murmur for mitral stenosis
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opening snap, presystolic murmur
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murmur for mitral valve prolapse
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midsystolic click, late systolic murmur
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total anomalous pulmonary venous return
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no communication exists between pulmonary veins and left atrium
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