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329 Cards in this Set
- Front
- Back
vaccinations given at birth
|
hep b
|
|
vaccinations given at 1 month
|
hep b, only if not given at birth
|
|
vaccinations given at 2 months
|
Pediarix (HBV, DTaP, IPV)
Prevnar (pneumococc) Rotavirus Hib |
|
what is in pediarix
|
HBV
DTaP IPV |
|
vaccinations given at 4 months
|
Pediarix
Prevnar Hib Rotavirus |
|
vaccinations given at 6 months
|
Pediarix
Prevnar Hib Rotavirus |
|
vaccinations given at 12 months
|
DTaP
Hib MMR VZV Prevnar Influenza Hep A |
|
vaccinations given at 24 months
|
none
|
|
vaccinations given at 4-6 yrs
|
DTaP
IPV MMR Influenza |
|
vaccinations given at 11 yo
|
Tdap
Meningococcus vaccine |
|
what is the schedule for well visits starting from birth
|
1 mo
2 mo 4 mo 6 mo 9 mo 12 mo 15 mo 18 mo 24 mo then annually |
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why shouldn't babies drink water
|
because their kidneys aren't mature enough to handle the extra fluid so the babies will become hyponatremic since they can't excrete the water, and then they can have szs
|
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plagylocephaly
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mishapen head
|
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sunsetting sign
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increased icp, eyes are half closed 2ndary to the increased icp on the cranial nerves
|
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craniosynostosis
|
premature closure of the fontanelles
|
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rash pattern in rmsf
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palms and soles, then spreads to trunk
petechial |
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rash pattern in rubella
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rash on face that spreads to the rest of the body
|
|
rash pattern in measles
|
rash starts at the head and spreads downwards and disappears in the same manner
|
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rash pattern for erythema infectiosum
|
slapped cheek rash; lacy, reticular
|
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vzv rash pattern
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begins on trunk, followed by head, face, and extremities
|
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gross motor skills at 1 mo old
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raises head
|
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gross motor skills at 3 mo
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holds head up
|
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gross motor skills at 4-5 mo
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rolls front to back and back/front
sits supported |
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gross motor skills at 6 mo
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sits unsupported
|
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gross motor skills at 9 mo
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crawls
cruises pulls to stand |
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gross motor skills at 12 mo
|
walks alone
|
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gross motor skills at 15 mo
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walks backwards
|
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gross motor skills at 18 mo
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runs
|
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gross motor skills at 24 mo
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walks well up and down stairs
|
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gross motor skills at 3 yrs
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rides tricycle
throws ball overhand |
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gross motor skills at 4 yo
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alternates feet going down stairs
skips |
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fine motor skills at 1 mo
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follows eyes to midline
|
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fine motor skills at 3 mo
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hands open at rest
|
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fine motor skills at 4-5 mo
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grasps with both hands together
|
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fine motor skills at 6 mo
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transfers hand to hand, reaches with either hand
|
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fine motor skills at 9 mo
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pincher grasp
finger feeds |
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fine motor skills at 12 mo
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throws, releases objects
|
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fine motor skills at 15 mo
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builds 2 block tower
|
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fine motor skills at 18 mo
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feeds self with utensils
|
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fine motor skills at 24 mo
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removes clothing
builds 5 block tower |
|
fine motor skills at 3 yrs
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draws circle
|
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fine motor skills at 4 yrs
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catches ball
dresses alone |
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fine motor skills at 5 yrs
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ties shoes
|
|
Simple febrile sz
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btwn 6mo - 6yr
tonic clonic associated with fever >100.4 sz lasts <15 mins only 1 sz in 24 hrs minimal post-ictal state |
|
complex febrile sz
|
6 mo - 6 yrs
focal sz >15 mins >1 sz/24 hrs |
|
management of simple febrile sz
|
determine the source of the fever, otherwise, no other w/u is needed
|
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management of complex febrile sz
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full w/u should be done, but no anti-epileptics, no eeg needed
if pt is <18 mo, LP |
|
eeg abnormality associated with infantile spasm
|
hypsarrythmia
|
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definition of recurrent abdominal pain
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>3x in 3 mo
|
|
#1 cause of abdominal pain
|
gastroenteritis
|
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mesenteric lymphadenitits
|
persistent pain following an infx
|
|
clinical features of HSP
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condition preceded by uri
non-thrombocytopenic palpable purpura hematuria (good prognosis) proteinuria (poor prognosis) spasmodic abdominal pain ileus, n/v ugi/lgi bleed |
|
tx of hsp
|
steroids
|
|
complication of hsp
|
intussusception
kidney probs |
|
clinical features of kawasaki
|
CRASH and BURN
Conjunctivitis Rash (on trunk mostly) Aneurysm (coronary) Skin peels off, Strawberry tongue Hands/Feet edema BURN = FEVER (x 5d) |
|
phases of kawasaki dz
|
acute
subacute (aneurysm formation) convaslescent takes 2-3 months to resolve |
|
tx of kawasaki
|
ASA
IVIG |
|
when is colicky pain associated with
|
constipation
|
|
what type of stool is seen with bacterial enterocolitis
|
bloody, mucinous stool
|
|
when will an appendix perforate in appendicitis
|
w/i 36 hrs
|
|
which infx can clinically mimic appendicitis
|
yersinia
campylobacter |
|
what imaging study for appendicitis
|
ct
|
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meds used to tx of perforated appendix
|
amp, gent, flagyl
|
|
clinical presentation of intussusception
|
currant jelly stools
lethargy palpable tubular mass paucity of gas on xr or evidence of obx |
|
imaging most specific for intussusception
|
barium (or air) enema
is also therapeutic |
|
most common location for intussusception
|
ileocolic
can also develop at meckel's divertic |
|
major complication of intussusception
|
there is impaired venous return so bowel edema develops --> ischemia, necrosis --> perforation
|
|
etiology of intussusception
|
ileum invaginates into colon at ileocecal valve
a previous viral infx --> hypertrophy of the peyer's patches... this can develop into a lead point hsp can be association with an ileal-ileal intussusception |
|
tx of intussusception
|
must do fluid resusc first, if needed
hydrostatic reduction with air/barium |
|
recurrence rate of intussusception
|
15%
|
|
at what age would a pt present with pyloric stenosis
|
1-3 mo
|
|
which medicaation can be associated with pyloric stenosis
|
erythromycin
|
|
best imaging for pyloric stenosis
|
u/s
will also see a string sign ugi study |
|
tx of pyloric stenoSIS
|
MUST correct fluids and lytes first!
then pyloromyotomy |
|
describe malrotation
|
small intestines rotate abnormally in utero, so there is an abnormal fixation posteriorly to the mesentary
it can twist on its vascular supply --> volvulus |
|
clinical presentation of malrotation
|
bilious emesis
possibly abdominal distention/shock + guiac test = bowel ischemia, poor prognostic sign |
|
tx of malrotation
|
surgery ASAP
|
|
tx for scd induced priapism
|
sedation
|
|
dz that scd can mimic if htere is abdominal pain
|
appendecitis
|
|
when is frontal bossing seen?
|
beta-thal or some other hemolytic process that requires rapid hematopoesis
|
|
tx for beta-thal
|
serial transfusion + chelation therapy (desferoxamine) b/c of fe overload
|
|
consequence of fe overload
|
hemochromatosis
|
|
complications of g6pd deficiency
|
rbcs are destroyed but there is increased amounts of hb liberated in the process --> hb-uria
|
|
findings in classic hemophilia
|
bleeding problems + hemarthrosis
|
|
battle's sign
|
basilar skull fx that leads to bleeding/bruise behind the ear
|
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mechanism behind bell's palsy in neonates
|
forceps deliver... usually resovles
|
|
social milestones at 5 yo
|
competetive games
understands rules and abides by them |
|
social milestones at 4 yo
|
imaginative play
|
|
social milestones at 3 yo
|
group play
shares |
|
social milestones at 2 yo
|
parallel play
|
|
social milestones at 18 mo
|
plays around other children
|
|
social milestones at 12 mo
|
comes when called
cooperates with dressing |
|
social milestones at 9 mo
|
pat-a-cake
|
|
social milestones at 6 mo
|
recognizes strangers
|
|
social milestones at 4-5 mo
|
enjoys observing environment
|
|
social milestones at 3 mo
|
reaches for familiar objects/ppl
|
|
social milestones at 2 mo
|
recognizes parent
|
|
social milestones at 1 mo
|
fixes on face
|
|
developmental dysplasia of the hip
|
abnml relationship between head of femur and acetabulum --> instabilility and dislocation of hip joint
develops 2ndary to lack of contact of acetabulum and femur during intrauterine devevlopment |
|
dx of developmental dysplasia of hip
|
u/s: see "false acetabulum" in lateral ileum
|
|
tx of developmental dysplasia of hip
|
pavick harness (keeps hip abducted and flexed), or body casting on older pts
|
|
complications of developmental dysplasia of hip
|
avn
degen arthritis of hip |
|
metatarsus adductus
|
dorsiflexion and plantarflexion are UNRESTRICTED (diff from clubfoot); heels go out and toes go in
|
|
tx of metatarsus adductus
|
stretching or a brace
surgery not usualy needed |
|
idiopathic talipes equinovarus (aka)
appearance |
congenital clubfoot
medial rotation of tibia, fixed plantar flexion, inversion of foot, forefoot adduction CANNOT DORSIFLEX (unlike metatarsus adductus) |
|
tx of clubfoot
|
bracing
serial casting |
|
legg-calve-perthes dz
|
avn of femoral head
ischemic bone is eventually resolved and re-ossification occurs --> limp, pain referred to thigh/knee |
|
what movt's are restricted in legg-calve-perthes dz
|
abduction
flexion internal rotation |
|
tx of legg-calve-perthes dz
|
bracing
surgery observation |
|
complications of legg-calve-perthes dz
|
collapse of femoral head
|
|
SCFE
|
gradual or acute separation of proximal femoral growth plate
fem head slipps off of femoral neck and rotates inf-post postition |
|
etiology of scfe
|
common during puberty, could be hormonal
|
|
presentation of scfe
|
limp, pain in hip and groin, pain referred to knee
|
|
dx of scfe
|
plain film frog-leg, lateral position
|
|
tx of scfe
|
goal is to prevent further misallignment
pin fixation is done acutely chronic cases require osteotomy |
|
osgood schlatter dz
|
inflammation, swelling and tenderness over tibial tuberosity 2ndary to tendonitis of distal insertion of infrapatellar tendon
|
|
when does osgood schlatter dz occur
|
During growth spurt, in teens
|
|
tx of osgood schlatter
|
conservative, supportive management
|
|
complication related to achondrodysplasia
|
small foramen magnum seen in homozygotes --> brainstem compression
|
|
what is achondrodysplasia
|
d/o of cartilage calcifications and remodeling
|
|
why do childre have an increased risk of fx
|
tendons and ligaments are stronger than bones so in kids injuries often lead to fx when they would only cause sprain in adult
|
|
types of fx
|
spiral (twisting forces on tibia during fall)
epiphyseal fx (use salter classification) stress fx (hairline crack from repeated activity) torus fx (at metaphysis) |
|
nursemaids elbow
|
subluxation of radial head
|
|
define upper airway
|
nose --> carina
|
|
sx of upper airway dz
|
inspiratory stridor
tachypnea respiratory distress |
|
choanal atresia
|
most proximal abnormality of airway
bony or membranous septum btwn 1 or both nasal passages and pharynx, preventing airflow through nose life threatening if b/l (most young infants are obligate nose breathers) can't pass ng tube |
|
complications of long-term intubation
|
subglottal stenosis
|
|
laryngeal or tracheomalacia
|
floppiness that closes off airway
|
|
how to confirm dx of laryngeal or tracheomalacia
|
bronchoscopy
|
|
ddx for wheezing and respiratory distress
|
asthma
bronchiolitis foreign body aspiration gerd te fistula vascular sling |
|
pathophysiology of sx in cf
|
cftr is abnormal --> altered cl channel
cl stays in cells and na/water enter the cell to maintain osmotic balance --> viscous secretions |
|
gi effects in cf
|
pancreatic insufficiency
bowel obx rectal prolapse dm cirrhosis lage bulky smelly stools later in life stools --> distal obx |
|
pathognomonic finding in cf
|
meconium ileus
|
|
tx of cf
|
chest pt
exercise frequent cough recombinant human dnase given through nebs to break down thick mucous complexes |
|
other than respiratory infx, what are some other complications of cf
|
hemoptysis (>500 cc/d = emergency) tx w embolization
spontaneous ptx (1/2 will recur unless sclerosis is performemd, but if that is done then transplant is very difficult) |
|
definition of recurrent abdominal pain
|
>3x in 3 months
|
|
mesenteric lymphadenitis leads to
|
persistent pain after infx
|
|
gi complication from hsp
|
ileal-ileal intussusception
|
|
sx of hsp
|
non thrombocytopenic palpable purpura in dependent areas
an iga mediated vasculitis involving gi, skin, joints, and kidneys |
|
tx of hsp
|
steroids
|
|
what is hsp usually preceded by
|
uri
|
|
gi sx of hsp
|
spasmodic pain, ielus, vomiting, ugi/lgi bleed
|
|
tx of kawasaki dz
|
ivig
asa |
|
3 phases of kawasaki
|
acute
subacute (aneurysms form) convalescent (resolution over 2-3 mo) |
|
which bacterial infx can mimic appendicitis
|
campylobacter
yersinia |
|
sx of intussusception
|
BOWEL OBX
currant jelly stools lethargy palpable tubular mass paucity of gas on xr or evidence of obx |
|
dx of intussusception
|
barium (or air) enema
|
|
progression of complications of intussusception
|
impaired venous return
bowel edema ischemia necrosis perforation |
|
pathophys of intussusception
|
most are ileocecal, and occur when the ileum invaginates into colon at ileocecal valve
|
|
lead points in intussusception
|
hypertrophy in peyer's patches (often p viral infx)
meckel's divertic intestinal polyp lymphoma foreign body hsp |
|
at what age would you expect pyloric stenosis
|
1-3 months
|
|
what medication if given is associated with pyloric stenosis
|
erythromycin
|
|
dx of pyloric stenosis
|
u/s, see hypertrophic pyloris
ugi study shows string sign |
|
embryology behind omphalocele
|
when midgut loop fails to return to abdominal cavity
see light gray shiny sac protruding from base of umbilical cord |
|
embryology behind malrotation of midgut
|
midgut undergoes partial rotation and --> abnormal position fo abdominal viscera, can be assoc with volvulus --> compromised blood flow and gangrene
|
|
gastroschisis
|
weakness in abdominal wall --> herniation of bowel through the rectus muscle, usually to the right of the umbilicus
|
|
clinical features of malrotation
|
bilious emesis
possible abdominal distension xr shows gas in stomach, but no gas in intestines |
|
tx of malrotation
|
surgery stat
|
|
risk factors for deverloping gerd in babies
|
prematurity
esophageal dz obx lung dz overdistension of stomach from overeating meds (theophylline) |
|
dx of gerd
|
pH probe placement in esophagus or ugi endoscopy
barium swallow to confirm nml anatomy |
|
tx of ger/gerd
|
small frequent feedings
keep head up for 20mins p eating thicken feeds with cereal metoclopramide (increases gastric motility) h2 blocker or ppi last resort: nissen fundlopication (fundus of stomach is wrapped around distal esophagus to increase les pressure) |
|
tx of diarrhea in children
|
if no serious complications, feed through the diarrhea --> decreased denudement and faster return to nml stooling patterns
don't give antidiarrheals b/c --> toxic megacolon, unless salmonella, shigella, c diff, or parasites |
|
when to do w/u for diarrhea in a child
|
in infant <3mo, do blood cx
0-12 mo, do stool cx do blood and stool cx if >5d of enterocolitis or salmonella exposure any infant with + stool dx looking toxic or + blood cx should be eval for pyelo, meningiits, pna, osteo |
|
when should a pt with diarrhea be admitted to hospital
|
>5% dehydration and can't rehydrate effectively at home
|
|
obstipation and complications
|
no bm, if after neonatal pd, #1 cause is voluntary witholding
can be caused by pain, on defacation --> fear fo defecation --> further retention voluntary holding increaess distension of rectum, decreases rectal sensation, requiring increaesed amounts needed to receive urge |
|
sx of hirschprung's
|
h/o diarrhea, fecal spotting alternating with constipation
|
|
effect on incresaed bll on bm
|
--> constipation
|
|
how to tx functional constipation
|
incresae fluid, decrease junk food, increase fiber, increase ingestion of undiluted juice
|
|
pathophys of hirschsprung's
|
failure of ganglion cells of myenteric plexus to migrate down colon in utero
therefore distal colon is tonically contracted and there is obx usually limited to rectosigmoid colon |
|
when to suspect hirschsprung's
|
in any infant who doesn't pass meconium, then --> bilious vomiting, abdominal distension, and poor feeding
|
|
tx of hirschsprung's
|
diverting colostomy with bowel that contains ganglion cells
aganglionic segment is removed by pulling ganglionic segment through rectum |
|
sx of meckel's diverticulum
|
remnant of vitilline duct w/i 2 inches of ileocecal valve
bleeding from divertic melena, obx (from intussusception), diverticulitis |
|
tx of meckel's diverticulum
|
surgical resection
|
|
dx of meckel's divertic
|
technetium-99 scan p h2 antagonist to locate hemorrhagic cells
|
|
encephalocele
|
projection of cranial content through bony skull defect in occiput --> severe mr, sz, mov't do
|
|
myelomeningocele
|
protrusion of neural and meningeal tissue
|
|
meningocele
|
meninges protrude
|
|
spina bifida II is associated with
|
chiari II malformation
|
|
complications of spinal bifida
|
caudal end of cord is tehtered to distal spine and can't ascend to adult position --> scoliosis, sphincter dysfxn, LE deformities
|
|
non-communicating hydrocephalus
|
block in exiting ventricles; above blockage, ventricles are big
|
|
causes of non-communicating hydrocephalus
|
secondary to narrowing at 4th ventricle/aqueduct or malformation at posterior fossa
chiari II malformation spina bifida occulta |
|
communicating hydrocephalus
|
subarachnoid villi are dysfunctional/obliterated
|
|
sx of motor cp
|
fixed lesion in immature brain -> nonprogressive d/o of mov't and posture
spasticity is #1 type from injury to motor tracts in brain pts are hypotonic in early months then later become spastic CONDITION IS NOT PROGRESSIVE |
|
sx of extrapyramidal cp
etiology |
from basal ganglia damage --> choreoathetoid mov't, postural ataxia, spasticity
kernicterus, there is usually some sort of brain insult |
|
what gcs is required for a head ct to be obtained
|
<12
|
|
#1 cause of ich in kids
|
avm
|
|
what meds are associated with pseudotumor cerebri
|
tetracyclines
corticosteroids |
|
define encephalopathy
|
generalized cerebral dysfxn, ms change, disorientation
|
|
risk factors for developing retinopathy of prematurity
|
bw <1250 g
age <32 weeks mechanical ventilation need for supplemental o2 |
|
causes of leukocoria
|
retinoblastoma (--> death and visceral mets in all cases)
cataracts (most common cause) retinopathy of prematurity |
|
amblyopia
|
visual impairment not corrected by glasses and not due to an ocular lesion
often from strabismus |
|
tx of amblyopia
|
occlusion of better seeing eye forces development of affected eye and visual cortex of affected eye
|
|
at what age will tx not be successful in ambylopia
|
after 8yo
|
|
tx of retinoblastoma
|
enucleation (removal of the affected eye)
radiation tx chemo |
|
complications of neonatal cataracts
|
if not remoed by 3-4 months, there is irreversible amblyopia
|
|
course of retinopathy of prematurity
|
most regress spontaneously
if not, cryotherapy can be performed to reduce progression are still at risk for amblyopia even if treated |
|
dacryostenosis
|
congenital nasolacrimal duct obstruction
causes overflow tearing - 6% of neonates 2ndary to failrue of distal membranous end of nasolacrimal duct to open |
|
tx of dacryostenosis
|
probing of nasolacrimal dut at 12-15 mo
although most resolve spontaneously by 1 yo (in 96% of infants) |
|
ophthalmia neonatorum
|
conjunctivitis occurring in first month of life
p/w eyelid edema, conjunctival hyperemia and ocular d/c |
|
when is it normal for there not to be tears
|
in the first few weeks of life
|
|
age of onset of gonococcal ophthalmia neonatorum
|
2-4 days
|
|
age of onset of chlamydia ophthalmia neonatorum
|
4-10 days
|
|
clinical features of gonococcal ophthalmia neonatorum
|
eyelid edema
chemosis purulent d/c |
|
complications of gonococcal ophthalmia neonatorum
|
sepsis
meningitis arthritis corneal ulceration blindness |
|
complications of chlamydia ophthalmia neonatorum
|
corneal scarring
PNA |
|
tx of chlamydia ophthalmia neonatorum
|
oral and topical erythromycin
tx parents tx with erythromycin despite the risk of developing pyloric stenosis |
|
tx of gonococcal ophthalmia neonatorum
|
topical erythromycin
IV cefotaxime tx parents |
|
when should steroid containing eye drops not be given in conjunctivitis
|
if hsv-1 is suspected etiology
can make dz worse |
|
hordeolum
|
acute infection of sebacous tarsal glands
staph aureus is usually cause |
|
tx of hordeolum
|
warm compresses
|
|
chalazion
|
area of sterile lipogranulomatous reaction within meibomian glands that can enlarge
can be chronic and recurrent |
|
is periorbital or orbital cellulitis an emergency
|
orbital cellulitis
|
|
sx of periorbital cellulitis
|
skin around eye is indurated, warm, and tender
no eye pain may have si/sx of sinus infx |
|
sx of orbital cellulitis
|
severe pain with eye movement
proptosis vision changes decreased ocular mobility |
|
dx of orbital cellulitis
|
ct scan
|
|
organisms to cover with orbital cellulitis
|
strep
h. flu m. cat |
|
tx of periorbital cellulitis
|
iv abx
can --> meningitis, tx agressively with vanco, pcn, 1st gen cephalosporin |
|
orgs to tx in periorbital cellulitis
|
strep
h flu m cat |
|
features of fragile x syndrome
|
hyperactive
mr large body long face prominent jaw and ears thickened nasal bridge large testes +/- autism |
|
facial features of xyy
|
long asymmetric ears
incresaed length: breadth in hands, feet, and cranium |
|
nutritional deficiencies in goat's milk
|
decreased vit d, iron, folate, b12
|
|
infectious dz associated with drinking raw cow's milk
|
brucellosis
|
|
what supplements should moms receive if they are vegan
|
b12 to prevent buildup of mma
|
|
effects of excess vit d
|
hypercalcemia
azotemia poor growth n/v/d |
|
vit e deficiency in premies -->
|
hemolytic anemia
|
|
b1 defic -->
|
beriberi
(neuritis, edema, chf) hoarseness anorexia |
|
b2 deficiency -->
|
photophobia
cheilosis glossitis corneal vascularity |
|
b3 deficiency -->
|
pellagra (dermatitis, dementia, diarrhea)
|
|
pathophys of primary hypophosphatemia
|
defective po4 resorption
no conversion of 25-vit D --> 1,25-vit D in proximal tubules |
|
lab studies in primary hypophosphatemia
ca po4 alk phos |
low/nml
low high |
|
clinical findings in primary hypophosphatemia
|
smooth LE bowing (not angular, as is seen in ca defic)
intraglobulin dentin deformities (ca deficiency --> enamel defects) coarse trabecular bone and fraying |
|
somogyi phenomenon
|
nocturnal hypoglycemia manifested as night terrors, early am sweating, then later has hyperglycemia, ketonuria, glucosuria (sugars increase because of glucagon release)
|
|
what is an absolute contraindication for DTaP
|
if first dose --> encephalophaty or encephalitis
|
|
clinical presentation of pb poisoning
|
emotional lability
abdominal pain achy bones intermittent vomiting and constipation |
|
at what BLL should tx be initiated
|
>45
|
|
clinical presentation of acute hg poisoning
|
gi pain
fever chills HA visual changes cough cp |
|
clnical presentation of chronic hg poisoning
|
gingivostomatitis
tremor neuropsych features |
|
clinical presentation of acute arsenic poisoning
|
n/v/d, abdominal pain
3rd spacing hemorrhage hypovolemic shock vtach qt prolongation |
|
narcosis
|
deep stupor, unconsciousness
|
|
clinical presentation of cerebral palsy
|
postural hypotonia
failure ot reach for toys gross and fine motor delay cognitive and sensory deficits |
|
complications of cp
|
sz
mr |
|
differences in etiology for quadriplegia and paraplegia
|
quadriplegia results from umn damage
paraplegia results from lmn or spinal cord damage |
|
most likely organisms ot --> pna in cf
|
staph or pseudomonas
|
|
clinical presentation of meconium ileus
|
vomiting
abdominal distension distended bowel loops "soap bubble" on axr |
|
pathophys of meconium ileus
|
obx begins in utero --> underdeveloped distal lumen
|
|
tx of meconium ileus
|
surgical emergency
gastrograffin enema |
|
vitamin a deficiency -->
|
pseudotumor cerebri (among other things)
will see bulging fontanelles, ha, n/v may be seen as first presenting sign in a pt with cf |
|
what effect does phenobarb have on jaundice
|
it improves it by increaseing gluocoronyl transferase
|
|
cancer that is associated with (germline) retinoblastoma
|
osteosarcoma is most common
melanoma squamous cell ca |
|
conditions associated with aniridia
|
congenital glaucoma
surge-weber marfan neurofibromatosis |
|
presentation of malrotation
|
obx
typically normal for first few days of life than malrotation worsens --> abdominal fullness, especially in ruq --> bilious vomiting --> ischemia and necrosis |
|
#1 malrotation
|
volvulus
|
|
pathophys of volvulus
|
cecum fails to move to rlq and never adheres to abdominal wall
mesentary and sma are tethered to narrow stalk and twist about itself band of adhesive tissue can extend from cecum to ruq -> duodenal obx |
|
presentation of children with 2ndary htn
|
ha
epistaxis visual sx easy fatiguability |
|
describe how biliary atresia can occur post-natally
|
from scarrin gan dinflammation of intrahepatic or extrahepatic biliary ducts
etiology is unclear |
|
describe findings of prenatal biliary atresia
|
gb is absent
|
|
sx of congenital toxo
|
chorioretinitis
hydrocephalus intracranial calcifications |
|
complement levels in post-strep gn
|
decreased c3
|
|
what are "currant jelly stools"
|
bloody stools
indicative of intussusception |
|
tx of intussusception
|
barium/air enema
|
|
germinal matrix
|
embryonic tissue present near caudate nucleus, often gets damaged by hypoxia/ischemia
#1 place for intraparenchymal bleed |
|
progression of intraparenchymal bleed in a newborn
|
blood can flow into ventricles w/i 3 days of life
|
|
what bvs are damaged in shaken baby syndroem
|
bridging veins
|
|
what bvs are involved in sah
|
circle of willis
|
|
signs of svt
|
hr 220-270
no p waves |
|
pathophys of strawberry hemangioma
|
vascular tissue fails to communicate with adjoining tissue
enlarges --> raised tumor |
|
most common causes for pna in a child > 6 yo
|
mycoplasm
strep pneumo |
|
cardiac complications in marfan syndrome
|
aortic root dilatation, aortic dissection
mvp |
|
most common orgs in peritonsillar abscess
|
anaerobes
GAS |
|
physical findings of patau syndrome
|
forebrain fails to develop (holoprosenceph)
midface developmental abnormalities abnml genitalia severe mr |
|
which chromosomes are associated with
1. edwards 2. patau |
Edwards = Election age (18)
Patau = Puberty age (13) |
|
porencephaly
|
cyst/cavity in brain that communicates with ventricles
|
|
causes of euvolemic hyponatremia
|
siadh
glucocorticoid deficiency hypothyroid water intoxication |
|
vacterl
|
vertebral
anal cardiac trach esophageal renal limb |
|
gastrografin
|
way to dx meconium ileus
is demonstates unused microcolon and pellets of meconium higher up can draws water into lumen and meconium gets unplugged (dx and tx) |
|
features of neonatal listerosis
|
respiratoyr distress at 5 days
meningitis |
|
clinical presentation of congenital hypothyroid
|
constipation
jaundice ftt enlarged fontanelle umbilical hernia |
|
presentation of neuroblastoma
|
asx abdominal mass
horner's dancing eyes dancing feet blueberry muffin lesions htn |
|
patau's or edwards syndrome:
microcephaly |
patau
|
|
patau's or edwards syndrome
prominent occiput |
edwards
|
|
patau's or edwards syndrome
narrow forehead |
edwards
|
|
patau's or edwards syndrome
microphthalmia |
patau
|
|
patau's or edwards syndrome
cutis aplasia |
patau
|
|
patau's or edwards syndrome
micrognathia |
edwards
|
|
patau's or edwards syndrome
low-set malformed ears |
edwards
|
|
patau's or edwards syndrome
cleft lip |
patau
|
|
patau's or edwards syndrome
congenital heart dz |
both
|
|
patau's or edwards syndrome
omphalocele |
patau
|
|
patau's or edwards syndrome
clenched hands with overlapping fingers |
both
|
|
patau's or edwards syndrome
rocker bottom feet |
edwards
|
|
patau's or edwards syndrome
polydactyly |
patau
|
|
patau's or edwards syndrome
polycystic kidney dz |
patau
|
|
patau's or edwards syndrome
horseshoe kidney |
edwards
|
|
patau's or edwards syndrome
crytorchidism |
patau
|
|
patau's or edwards syndrome
agenesis of corpus callosum |
patau
|
|
genetic changes in prader willi
|
paternal deletion, 2 defective maternal chromosomes
|
|
physical appearance of pts with prader willi
|
obese
almond shaped eyes downturned mouth small hands and feet |
|
genetic changes in angelman's
|
maternal deletion, 2 deffective paternal chromosomes
|
|
physical appearance of angelman's
|
large mouth
short stature tiptoe walk szs |
|
galactosemia
|
galactose 1-p builds up and accumulates in liver and brain
|
|
complications of galactosemia
|
increased risk of e coli sepsis
LD premature ovarian failure |
|
tx of galactosemia
|
eliminate galactose containing foods from diet
|
|
complications of pku during pregnancy
|
if diet not followed, baby can develop microcephaly, mr, and congenital heart dz
|
|
physical features of homocystinemia
|
marfan like appearance
dislocaed lens |
|
what effect does sepsis have on bilirubin
|
disrupts the bbb so it can cause diffusion of bili into the brain
|
|
what effect does temp have on bili
|
cold temperature can --> bili dissociation from albumin
|
|
protocol for neonates whose mom developed varicella infection just after delivery
|
if mom develops sx w/i 2 days of delivery or during end of pregnancy, treat baby wiht ivig and acyclovir. if greater amt of time is lapsed, no tx needed
|
|
consequences of neonatal asphyxia
|
cerebral edema
irritability sz cardiomegaly renal and heart failure DIC RDS |
|
what is the apt test
|
used to differentiae fetal from maternal blood
|
|
which drugs are contraindicated for breastfeeding
|
lithium
cyclosporin antineoplastic drugs ergots bromocriptine tetracyclines |
|
classic finding on xr for nec
|
pneumanitis intestinalis
|
|
consequences of cold temparature in a premie
|
increased metabolic rate in order to raise body temp, but their ventilation rate increased as well
but, b/c of respiratory problems in premies they can't oxygenate enough so lactic acide accumulates --> metabolic acidosis |
|
which is worse:
ABO incompat or Rh incompat |
Rh incompat
|
|
lab findings in abo incompat
|
increased retic count
weakly + coomb's |
|
lab findings in rh incompat
|
strongly + coombs
|
|
pathophys of transient apnea of the newborn
|
immature respiratory centers, esp in premies
|
|
how to id the underlying cause of congenital hypothyroid
|
iodine uptake scan
|
|
late development of clavicle fx during delivery... when does this occur?
|
callous formation in anterior shoulder
1 week |
|
physical findings of subgaleal hemorrhage
|
feels like cephalohematoma that crosses midline
can lose 1/3 of |
|
onset of gonococcal conjunctivitis in a newborn
|
DOL 2-5
|
|
onset of chlamydia conjunctivitis
|
DOL 5-14
|
|
what effects does surfactant deficiency have on lung compliance and lung volume
cardiac effecT |
decreases both
R-->L shunt |
|
what should be given to newborns whose moms are infected with Hep B
|
Hep B Ig and HBV
|
|
effect of propanolol in utero
|
iugr
decreased ability of asphyxiated nb to incresae hr and co associated with hypoglycemia and apnea |
|
when is surgery for cleft lip done
|
3 mo
|
|
when does transient tachypnea of nb resolve
|
DOL #3
|
|
significance of 5th finger polydactyly
|
in black infants, no consequence
in white infants, can be associated with cardiac abnormalities, must do an echo |
|
twin twin transfusion
|
donor twin --> oligohydramnios, anemia, ypovolemia
recipient twin --> polyhydramnios, larger size (20% difference in body weight), hyperviscocity, respiratory distress, hyperbili, hypocalcemia, renal vein thrombosis |
|
when does serum bili peak
|
DOL 3-5
|