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Clinical Medicine - Pediatrics
n/a
162
Medical
Graduate
09/24/2011

Additional Medical Flashcards

 


 

Cards

Term
examiner grasps the thigh & lifts the greater trochanter while abducting the hip -- attemps to relocate a dislocated hip


flex hips to 90 deg and pushes down while abducting the hip -- attempts to dislocate the hip
Definition

ortolani test

 

barlow

Term
represents a generic group of infections that produce congenital or perinatally acquired infections
Definition

TORCH infections

 

toxoplasmosis

other

rubella

cytomegalovirus

HSV

Term
most common brachial plexus injury - involves C5&6. results from excessive traction on the neck. unable to abduct, externally rotate or supinate arm
Definition
erb palsy
Term
separation of R and L rectus abdominis in infants -- can be seen in umbilical hernia.
Definition
diastasis recti
Term
boggy, fluctuant pustule mass that forms on the scalp as an exaggerated response to tinea capitis
Definition
kerion
Term
complete twisting of a loop of intestine around its mesenteric attachment site. very serious.
Definition
volvulus
Term
birth trauma resulting in injury to C8-T1 nerves. decreased or absent hand function. 90% resolve by 1 year
Definition
klumpke palsy
Term
1.edema over presenting part of that crosses suture lines
2. pinpoint white papules on nose and cheeks due to blocked sebaceous glands
Definition

1. caput succedaneum

2. milia

Term
<10th percentile weight
AKA intrauterine growth retardation

most commonly due to maternal tobacco use

asymmetric:
length > weight, head circumference = length
occurs after 24 weeks gestation

symmetric: length = weight = head circumference
occurs in early gestation
associated with neuro sequelae
Definition
small for gestational age
Term
>90th percentile weight

often infants of DM mom
Definition
large for gestational age
Term
collection of blood under periosteum of skull
Definition
cephalohematoma
Term
ellis-van crevald syndrome
carpenter syndrome
meckel-gruber syndrome
polysundactyly
trisomy 13
orofaciodigital syndrome
rubinstein-taybi syndrome


all are associated wtih?
Definition
polydactyly
Term
hold baby supine, and abruptly lower entire body about 2 feet - arms extend and legs flex
Definition
moro/startle reflex
Term
1. defect where the urethra opens on the ventral side of the penis
2. earliest stools of the infant
3. Rounded or oval dark-blue pigmentation over butt and lower back due to melanoctes in dermis
4. anterior abd wall defect usually with protrusion of abd viscera
Definition

1. hypospadias

2. meconium

3. mongolian spots

4. gastroschisis

Term
1. a hemolytic disesase of the fetuss and newborn that is characterized by an increase in circulating erythroblasts and by jaundice that occur when the system of an RH- mom produces abs in an rh+ fetus
2. defect in umbilical area where the abdominal contents come out of the belly buttom
Definition

1. fetal erythroblastosis

2. omphalocele

Term
diagnostic criteria for rheumatic fever.
can improve but not confirm diagnosis

need one major and two minor or two major criteria

Major: carditis, polyarthritis, syndenham chorea, erythema marginatum, subcu nodules

Minor: previous RF, labs consisitent with infection, evidence of previous strep infection
Definition
jone's criteria
Term
TESTS:

1. used to dx autoimmune hemolytic anemia & mycoplasma pneumonia
2. an oncofetal protein produced by liver and yolk sac. serum marker for fetal body wall defects. women screened at 16-18 weeks. high levels = neural tube or abdominal wall deformity. low levels: down's.
3. used to determine whether a previous strep infection has caused a poststreptococcal disease
4. used to test for HSV or VZV
Definition

1. cold agglutinin

2. alpha fetoprotein (AFP)

3. antistreptolysin O titer (ASO titer)

Term
taken at 1 min, 5 min, and every 5 min until score >7

Components?
Definition

APGAR score

 

HR: absent, <100, >100

Resp effort: absent, slow and irregular, good and strong

Muscle tone

reflex irritability

color

Term
Components of the newborn exam
Definition

General: posture/tone/alertness

CN and reflexes

HEENT

Skin

Abdominal exam

chest

cardiac

ortho

GU

Term
a common newborn problem where excess accumulation of bilirubin causes jaundice and other problems.

Defined when total bilirubin is >95% for age

from increased production or slow rate of excretion of bilirubin

TSB >17 mg/dL

jaundice extends out of "normal" range into lower body and feet

tx
Definition

hyperbilirubinemia

 

tx: LED light (phototherapy) -- NOT sunlight

Immediate transfusion if >25 mg/dl

Term
1. jaundice that appears 24 hours after birth and resolves within 1-2 weeks

2. jaundice due to bilirubin >20 mg/dl. causes injury to brainstem and basal ganglia. commonly due to rh incompatibility, early discharge from hospitla, and breast feeding. Effects = choreoathetoid cerebral palsy and hearing impairment. dental enamel dysplasia, paralysis of upward gaze, intellectual impairemnt.

3. sign of kernicterus is severely jaundiced babies (25 mg/dl) who appear lethargic and uninterested in feeding. CNS damage
Definition

1. physiologic jaundice

2. kernicterus

3. acute bilirubin encephalopathy

Term
Signs & Symptoms of prematurity
Definition

small plantar creases, thin skin with prominent vessels, no lanugo, imperceptible breasts, lids fused, scrotum flat/smooth, clitoris prominent, labia flat, neuromuscular immaturity (straight posture, legs bent to head), lower apgar score

 

delayed stooling, lack of coordinated reflexes/sucking, increased enterohepatic circulation, hyperbilirubinemia, retinopathy, resp distress, apnea, bradycardia, increased SIDS rate, increased CVA rate, immature kidneys, increased susceptibility to infection, hypoglycemia, hypocalcemia

Term
reduced erythropoietin, decreased RBC life, frequent blood sampling, and rapid growth that can't be compensated bc bone marrow is immature

causes?
Definition
anemia of prematurity
Term
clinical manifestations of meconium aspiration

cxr
tx
Definition

small airway obstruction --> resp distress

tachypnea, retractions, grunting, cyanosis

 

cxr: patchy infiltrates, coarse streaking of both lung fields, increased AP diameter, flattening of diaphragm

 

tx: suction, admit to NICU, resuscitaiton

 

 

 

 

Term
IF a child is obese, they have a __% chance of being obese in adulthood. If an adolescent is, they have a __% chance.
Definition
20, 80
Term
normal wieght gain for babies
Definition

normal to lose a little after birth but gain it back by 2 weeks or so

0.5-1oz per day

 

after age 2: gain 5 lbs per year until adolescence

Term
Babies' gross motor skills develop in what fashion?
Definition
head to toe  -- head coordination first
Term
simian lines, clinodactyly, and brushfield's spots are all associatd with?
Definition
Down's
Term
comorbidities with down's
Definition

sleep apnea

hirschprung's disease

chronic nonspecific diarrhea

congenital heart problems --> most common cause is down's

 

Term
Triad of symptoms with ADHD

3 subtypes

tx
Definition

Triad: impulsivity, inattention, hyperactivity

 

3 subtypes: inattentive, hyperactive, combined

 

tx: counseling, stimulant meds (methylphenidate or atomoxetine

Term
MR

diagnostic criteria
Definition
diagnostic: IQ <70 AND adaptive skills more than 2 sd below mean
Term
pruritic, exudative or lichenified eruption of face, neck, upper trunk, wrists, hands, antecubital and popliteal folds

35% of these pts will develop asthma

Severe and prolonged itching which leads to lichenification (itch-scratch cycle). Rough, red plaques without thick scales effect face, neck and upper trunk
Definition
atopic dermatitis
Term
mild, acute, inflammatory eruption of unknown etiology

herald patch followed by christmas tree distribution
Definition
pityriasis rosea
Term
contagious and autoinnoculable infection of the skin caused by staph or strep

tx?
Definition

impetigo

 

tx: topical antibiotics

systemic: cephalexin or doxy

Term
1. white, adherent painless, discrete or confluent pathces in mouth tongue or esophagus
2. erythematous irritation with redness and pustules in skin folds
3. common erythematous putular perineal infection in infants
Definition

thrush

intertrigo

diaper rash

 

all caused by candida

 

tx: topical azoles

Term
cradle cap in infants
Definition

seborrheic dermatitis

 

tx: steroid shampoos - zinc pyrthione, selenium sulfid, coal tar

2% ketoconazole shampoo

Term
pharyngitis without rhinorrhea, cough, diarrhea, or conjunctivits is most likely?

may have fevr, HA, GI sx

tx?
Definition

bacterial -- strep

 

tx: penicillin, erythromycin, azithromycin

Term
punctate, erythematous, blanchable, sandpaper like exanthem rash in neck, groin, axilla, and in body folds (pastia's lines)

pharynx and tonsils are erythmeatous and covered with exudates

strawberry tongue
Definition
scarlet fever -- GABHS
Term
Otitis Media:

risk factors,

acute, subacute, and chronic

tx
Definition

URI, group daycare, siblings, passive smoking, supine feeding, not breastfeeding

 

acute: < 3 weeks

Subacute: 3 weeks - 3 mos

chronic: >3 mos

 

tx: Ibuprofen, amoxicillin or augmentin, ear tubes

Term
dx?

causes: parainfluenzal viruses, RSV, rubeola, adenovirus
more common in late fall and early winter
infection and swelling in larynx

s/s: barking cough + stridor. low grade fever

tx?
Definition

croup

 

tx: none if mild

O2, dexamethasone (steroids), racemic epinephrine for severe

Term
dx?

severe ear pain. increases with movement of pinna. often disproportionate to degree of inflammation

itching, hearing loss, edema, white cerumen

tx?
Definition

otitis externa -- swimmer's ear

 

cipro/dexamethasone ear drops

 

oral abx if signs of systemic infection (fever)

 

analgesics

Term
permenant dilation of bronchi resulting from airway obstruction by retained mucus secretions or inflammation

sx: chronic cough, purulent sputum, fever, weight loss, URI, DOE, hemoptysis

confirm dx with CT

tx?
Definition

bronchiectasis

 

aggressive abx during pulmonary exacerbation

 

Term
dx?

congenital metabolic disorder inherited as an autosomal trait in which secretions of exocrine glands are abnormal and excessively viscous mucus causes obstruction of passageways

caused by a mutation in the ____ gene on chrom 7

sx: meconium ileus, chronic cough, recurrent bronchitis, Salty forehead, pancreatic insufficiency, azospermia (absence of vas)

labs: sweat chloride >60mEg/L, IRT positive,

tx?
Definition

CF

 

CFTR gene

 

tx: promote clearance of secretions and control infection

Term
Ethmoid sinusitis can lead to ___ if left untreated
Definition
periorbital cellulitis (blindness)
Term
dx?

premature child with immature lungs

sx: rapid shallow respirations >60/min, tachypnea, grunting, cyanosis

CXR: glass-like appearance of lungs

prevention? tx?
Definition

Hyaline membrane disease (HMD)

 

prevention: give mom betamethasone 48 hours before delivery if <34 weeks

 

tx: monitoring in NICU, oxygen, ventilator, endotracheal surfactant

Term
90% are on superior pole of tonsil

from tonsillar infecetion that penetrates the tonsillar capsule. most commonly gabhs

ss: sore throat, high fever, tonsil bulging medially, edematous on affected side. ear pain, dysphagia, drooling. "hot potato voice"
Definition

peritonsilar abscess

 

tx: I&D, IV abx

 

Term
dx?

usually caused by h. influenza and thus is preventable

s/s: odonyphagia, dysphagia, drooling, voice change, resp distress

SITS ERECT, LEANS FORWARD, DROOLS


DO NOT TOUCH THE PT
Definition
epiglottitis/supraglottitis
Term
dx?

1st episode of wheezing in a kid <2 years
due to primary infection or reinfection resulting in inflammation of smaller airways

often due to RSV

S/S:
1. sx of viral infection
2. 1-2 days later: tachypnea, retractions, wheezing, hypoxia, cough, nasal flaring

tx?
Definition

bronchiolitis

tx: adequate hydration, O2 if needed

Term
caused by sinusitis or OM

s/s:
tonsillar pain, swelling in neck, trismus (jaw spasm), edema of pterygoids, dyspnea, dysphagia, palpable mass

dx via CT

treatment?
Definition

pharyngeal abscess

 

tx:

retropharyngeal: IV abx, external drainage

parapharyngeal: ssurgery

Term
inflammation of airway cuased by viruses usually

s/s: cough (nonproductive at first, may become productive), fever uncommon, vomitting from swallowing mucus

ronchi possibly heard on auscultation

tx?
Definition

acute bronchitis

 

paliative tx

Term
inflammation of the lungs

80% are caused by viruses

s/s: nasal flaring, grunting, tachypnea, dyspnea, retractions, decreased breath sounds in areas of consolidation, rhonchi, dullness to percussion, absent freitus

dx via xray

tx?
Definition

pneumonia

 

tx: based on pathogen. amoxicillin

 

mycoplasma/chlamydia/pertussis - macrolides

Term
occurs in 3-5 year cycles

catarrhal stage: mild URI sx
paroxysmal stage: prolonged coughing attacks with inspiratory whoop, posttussive emesis, and lyphocytosis

can last up to 10 weeks

dx: nasopharyngeal mucus culture is gold standard

tx?
Definition

pertussis

 

tx: -mycins, hospitalize if <3 mo

 

close contacts should have booster + 14 days of -mycins

Term
wheezing, coughing, nighttime cough, feeling of chest tightness, SOB

brought on by triggers

dx via spirometry

mild: FEV1 > 80%
moderate: 60-80%
severe: <60%

tx?
Definition

asthma

 

tx allergies

1. SABA

2. low dose ICS

3. Medium dose ICS
4. Medium dose ICS + LABA
5. high dose ICS + LABA

Term
leading cause of death 1 mo - 1 year
Definition
SIDS
Term
leading cause of preventable MR
Definition
FAS
Term
craniofacial dysmorphology: smooth philtrum, thin upper lip, small palpebral fissures
growth retardation: often <10th %
neuro damage & MR

dx by having facial abnormalities + growth deficits + CNS deficits
Definition
Term
growth failure: child < 2 whose weight curve has falllen by 2 major percentiles from a previously established rate of growth. Weight <3rd percentile for age

associated wtih inadequate social or developmental acheivement

short stature, microcephaly are possible
Definition
failure to thrive
Term
- An unusual condition where the formation of the heart is flawed and the aorta and pulmonary artery never separate, resulting in a single arterial trunk and one semilunar valve which may be stenotic, regurgitant, or both
- Large VSD is also present, so all blood leaving the heart is partially oxygenated


Sx: cyanosis, pulmonary HTN, bounding pulses, wide pulse pressures, loud systolic murmur at base

xray: large heart with increased pulmonary vasculature

tx?
Definition

truncus arteriosus

tx: surgery by 4-8 weeks of age
- close VSD

- separate pulmonary arteries from truncus and connect to RV via a conduit (must be replaced later in life)






Term
- Secundum is the most common type of this- it causes a left to right shunt
- sx: systolic ejection murmur and widely split S2 at LUSB, diastolic murmur at LLSB
- CXR: heart enlargement

tx?
complications
Definition

atrial septal defect

 

tx: surgery if >3mm by age 2-5 years

 

complication: pulmonary HTN if not caught early

 

 

Term
- persistence of the normal fetal vessel that joins the pulmonary artery to the aorta
- should close spontaneously at day 3-5
- creates L-R shunt with oxygenated blood from aorta going back into lungs

sx: >20 mmg difference between upper and lower BP
- bounding pules with wide pulse pressure
- rough murmur at second left intercostal space, radiates through lungs
- large: failure to thrive, tachypnea, diaphoresis with feeding

- associated with prematurity and rubella in mom

tx?
Definition

patent ductus arteriosus

 

tx: surgical closure for large shunts

- indomethacin for small ones

Term
- inflammation of the parietal and visceral surfaces of the pericardium which leads to an accumulation of serous, fibrinous, hemorrhage or purulent exudate in pericardial space
- most common causes are inflammatory - viral infection

s/s: pt presents leaning forward and does not want to lay down
- dypnea, malaise, fever, tachycardia, friction rub

diagnostic studies?

tx?'
Definition

pericarditis

 

- CXR: enlarged heart

- Echo: fluid

- ECG: reduced QRS, diffused ST segment elevation, electrical alternans

- fluid analysis

 

tx: treat underlying condition

- removal of fluid

- may need surgical removal of pericaridum

 

Meds: indomethacin, colchicine

Term
- aorta arises from RV and pulmonary artery from the LV
- AKA "ventriculoarterial discordance"
- with or without VSD
- cannot survive without ASD or patent foramen ovale to allow mixing of blood

s/s: large profoundly cyanotic without resp distress or signficiant murmur

tx?
Definition

transposition of great arteries

 

tx: arterial switch operation at age 4-7 days

-95% survival

Term
- For this disease, 2 substrates are necessary:
- substrate: foreign body (prosthetic valves)
- agent: bacteria
- presents in low pressure regions or defects
- body attempts to close off with thrombus and bacteria adhere to and proliferate in thrombus - reducing the availability of abx access

commonly strep viridans and staph aureus

sx: fever, chills, nightsweats, anorexia, weight loss, fatigue, malaise, chest pain, petechiae
- new or changing murmur, splenomegaly
- Janeway lesions, osler nodes, emboli on soles and toes, splinter hemorrhages, roth spots

Labs?
tx?
Definition

infectious endocarditis

 

labs: anemia, leukocytosis w/ left shift, hematuria, proteinuria, elevated ESR, CRP, RF

 

tx: IV abx 4-8 weeks

surgical: valve replacement

Term
- Most common CHD in kids
- involves 4 heart defects... which are?
- results in a l-r shunt

s/s: squatting to raise intraabdominal pressure, cyanosis, easy fatiguability, DOE, audible S2 at LLSB, hypoxemic spells,

CXR: BOOT SHAPED HEART
EKG: Right axis deviation, RVH


tx?
Definition

tetralogy of fallot

 

 

1. RV valve outflow obstruction

2. Large VSD

3. RVH

4. Overriding aorta

 

tx:

- surgery from birth - 2 y/o - close VSD

- palliative if surgery is too risky. B blockers + shunt to replace ductus

Term
- Narrowing of aortic arch in the proximal descending aorta near the L subclavian and the ductus arteriosus
- thought to be caused by ductual tissue closing off the aorta when the ductus closes

Common presentation:
- Young person with HTN and difference between BP in arms and legs. Decreased or absent femoral pulses + UE hypertension and LE hypotension.

Echo is diagnostic

tx?
Definition

coarctation of aorta

 

tx: surgery in kids <10 y/o

- stenting >10 y/o

Term
Incomplete ventricular septum that allows L-R shunting of blood
- most common CHD

s/s: dyspnea, poor growth, sweating, feeding trouble, LOUD high pitched systolic murmur at LLSB with thrill

normal EKG & CXR

tx?
Definition

VSD

 

tx: surgical repair of septum

Term
mulit-system inflammatory disease involving the heart, joints, CNS, skin, and subcu tissue
- most common in 5-15 y/o
- triggered by ___ infection

s/s: JONES CRITERIA
- Major critera: polyarthritis, carditis, chorea, erythema marginatum, subcu nodules
- Minor criteria: arthralgia, leukocytosis, elevated ESR or CRP, prolonged PR, previous disease

Must have 1 major and 2 minor criteria or 2 major criteria

heart murmurs associated with this?
tx?
Definition

Rheumatic fever/haert disease

- GABHS infection

 

murmurs: mitral regurg, aortic regurg, carey-coombs murmur (mid-diastolic rumbling at apex)

 

tx: bed rest, pcn, aspirin, steroids

Term
1. non-tender, red macules in palms and soles
2. small red or purple nodules. mild to moderately painful, usually present at fingertips
3. linear dark red or brown subungual streaks
4. small bright red oval retinal hemorrhages with clear pale centers
Definition

1. janeway lesions

2. osler node

3. splinter hemorrhages

4. roth spots

Term
mid-diastolic rumbling murmur at apex, probably due to mitral valve edema
Definition

carey-coombs murmur

 

assocaited with rheumatic heart disease

Term
One of the most common rheumatic diseases in kids
- characterized by idiopathic synovitis in peripheral joints, associated with soft tissue swelling and effusion, may be triggered by preceding infection

Criteria for dx:
- polyarthritis of 5 or more joints
- Oligoarthritis <5 inflamed joints
- systemic arthritis wtih characteristic fever
- age at onset <16 years
- duration >6 weeks


s/s: morning stiffness, fatiguability, joint pain & swelling, daily fever, pericardial effusion/serositis, faint erythmatous macular rash

Labs?
tx?
Definition

juvenile RA

 

labs; elevated ESR, CRP, leukocytosis, thrombocytosis, anemia of chronic disease, elevated ANA

 

tx: NSAIDs, sulfas, methotrexate, etanercept, maybe glucocorticoids

 

Term
- most common systemic vasculitis in kids - unknown cause
AKA anaphylactoid purpura
- distinct systemic vasculitis characterized by palpable purpura over buttocks and lower extermities + abd pain, arthritis, and hematuria (renal problems)

- immune complex deposition with IgA
- usually seen in kids 4-7 y/o

skin biopsy to confirm dx

tx?
Definition

henoch-schoenlein purpura

 

tx: prednisone

Term
AKA mucocutaneous lymph node syndrome
- acute febrile multisystem disease of kids ages 3 mos to 5 years and occassionally seen in adults
- vasculitis characterized by infiltration of vessel walsl with mononuclear cells and later by IgA secreting plasma cells which results in destruction of media and aneurysm formation

dx - 4 criteria for 5 days:
- bilateral conjunctivitis
- mucus membrane changes
- peripheral extremity changes
- polymorphous rash
- cervical lymphadenopathy

+ irritability, vomiting, anorexia, cough, diarrhea

complication: arteritis --> MI

labs?
tx?
Definition

Kawaksaki Disease

 

Labs: elevated ESR and CRP

 

tx: IVIG w/in first 10 days

- high dose aspirin until afebrile for 48 hours

 

Term
bacteria in joint - usually single joint

s/s: joint pain, decreased ROM, effusion, fever, renal or hepatic insufficiency

XR: bony erosion, joint space narrowing
Joint aspiration: 100,000 WBC/uL with >90% neutrophils

tx?
Definition

bacterial (septic) arthritis

 

IV abx and drainage of joint

Term
infection caused by entamoeba histolytica, a protozoa that exists as a resistant infectious cyst or as a motile, invasive trophozoite
- transmitter via contaminated food or water and by person-person contact


s/s: may be asymptomatic. may have acute cramping diarrhea, extraintestinal lesions, perforations, and hemorrhages

dx: stool culture (may be neg), biopsy of ulcers or abscesses, antibody testing, US or CT will show liver abscess if present

tx?
Definition

Amebiasis

 

tx: metronidazole - tissues

iodoquinol - intraluminal

Term
- flagellated protozoan ingested via water then live in duodenum

s/s: acute illness with sudden onset explosive watery diarrhea, foul-smelling stools, flatulence, abd distention, nausea, anorexia can last for months

dx: stool culture

tx?
Definition

giardiasis

 

tx: metronidazole, tinidazole, or furazolidine

Term
Signs of dehydration
Definition

Mild (3-5%): none except for thirst/dry mucus membranes

 

Moderate (6-9%): Rapid pulse, dry mucus membranes, sunken fontaneles & eyes, cool skin, irritability, decreased urine

 

Severe (>10%): rapid/weak pulse, shock, deep/increased respirations, parched mucus membranes, markedly sunken eyes and fontanelles, cool skin w/ acrocyanosis and tenting, anuria, grunting, lethargy

Term
Dehydration management
Definition

mild (3-5%): 50 ml/kg/hr PO for 4 hours

 

Moderate (6-9%): 100 ml/kg PO or IV for 4 hours

 

Severe (>10%): 20 ml/kg bolus

 

 

Maintenance - 4:2:1 rule per hour, 100:50:20 rule per day -->

first 10 kgs: 4 ml/kg/hour (100 ml/kg/24 hours)

Next 10 kgs: 2 ml/kg/hr (50 ml/kg/24 hours)

Remainder: 1 ml/kg/hr (20 ml/kg/24 hours)

Term
What is maintenance fluid managment for a 35 kg child?
Definition

Hourly:

4 ml x 10 kg = 40 ml/hr

2 ml x 10 kg = 20 ml/hr

1 ml x 15 kg = 15 ml/hr

___________________

75 ml/hr

 

 

Daily:

100 ml x 10 kg = 1000 ml/day

50 ml x 10 kg = 500 ml/day

20 ml x 15 kg = 300 ml/day

_____________________

1800 ml/day

Term
acute v. chronic diarrhea in kids

time frame and possible causes
Definition

Acute: <2 weeks

1. Non-inflammatory : watery, non-bloody, mild - virus or noninvasive bacteria

2. inflammatory - blood or pus, fever. Usually caused by invasive or toxin-producing bacterial -- indicates mucosal irritation. Needs lab work

 

Chronic: >2 weeks - consider meds, chronic infection, and autoimmune disease

Term
types of diarrhea:

1. persists during fasting, watery, normal osmolality. Common causes - cholera, neuroblastoma, E. coli

2. slows or stops during fasting, transport defect, high osmolality, water, acidic, + reducing substances. usually due to lactase deficiency or laxative abuse

3. greasy or malodorous

4. contains blood or pus
Definition

1. secretory

2. osmotic

3. malabsorption

4. inflammatory

Term
Diarrhea-causing organisms:
1. School aged kids in winter. watery to loose stools. rarely fever.
2. summer time. watery stools. kids <2
3. gram neg rods. watery, self limiting
4. gram neg rodes. invasive wtih mucus and blood in stool. tenesmus, malaise, fever. +/- seizure. Need Ceph or azithro
5. varies in severity. can lead to bacteremia/enteric fever. commonly spread by zoonosis.
6. gram neg spiral rods. from water. abd cramps then diarrhea. flu-like prodrome. diarrhea may be bloody. can cause guillain-barre, reactive arthritis, urticaria, and erythema nodosum.
7. attained from swimming in lakes/rivers. giardia and crypto
Definition

1. norwalk-like virus

2. intestinal adenovirus

3. e. coli

4. shigella

5. salmonella

6. campylobacter

7. parasites

Term
Common in winter mos and in kids <3 y/o

Classic triad: fever, vomiting, diarrhea (pale yellow, malodorous, frequent, large, watery)
- 5-7 days duration
- Loss of brush border and microvilli


tx?
Definition

rotavirus

 

tx: supportive - NO ANTIMOTILITY DRUGS

fluids

tylenol for cramping

probiotics may shorten course

Term
Terminal ileum telescopes into colon. Upper portion into lower portion. may involve mesentery and vessels
- most often ileocolic or ileoileocolic

s/s: Sudden onset. paroxysms of abdominal pain - screaming, dropping to knees. vomitting and diarrhea, bloody stools, lethargy, +/- fever. weak, thready pulse. shallow respirations/grunting

CURRENT JELLY STOOLS

DRE: blood

Barium enema: COILED SPRING SIGN

US: TARGET or DONUT

tx?
Definition

intussusception

 

tx: enema

surgery (bowel perforation, unsuccessful enema)

 

if untreated - most likely death

Term
AKA congenital aganglionic megacolon
- abnormal innervation of the bowel beginning at the anus and extending proximally. bowel is in constant state of contraction

s/s: THIN, RIBBONY STOOLS, progressive dilation of proximal bowel and abd distention, EMPTY RECTAL VAULT

dx: barium enema -- transition zone (dilated bowel proximal to contracted bowel)
Rectal suction biopsy - high AChE at transition zone

tx?
Definition

hirschprung's disease

 

tx: surgery (Swenson approach, Duhamel approach, Boley approach)

Term
Most common birth abnormality in males, esp premies
- usually spontaneously resolves in 3 mos
- may be associated wwtih infertility or malignancy


labs: LH, FSH, testosterone, ultrasound

tx?
Definition

cryptorchidism

 

tx: surgery before 15 mos

Term
Twisting of ____ which cuts off blood supply to affected testicle

often caused by "BELL CLAPPER DEFORMITY" - loss of gubernaculum causes the tunica vaginalis to go all the way around the testicle and thus the testicle is not anchored to the scrotum and is free to twist.

s/s: red, swollen, lifted, horizontal-lying testicle on one side. Severe acute pain. absent creamsteric reflex.

tx: needs to be treated w/in ____ to avoid loss of testicle. how is this done?
Definition

spermatic cord

 

4-6 hours

- manually untwist - outward

- surgery

Term
What does the "blue dot sign" on the scrotum indicate?
Definition
torsion of a testicular appendix
Term
obstruction of the appendix by a fecolith (most commonly), parasite, or unknown cause
- most common indication for emergency surgery in kids
- frequency peaks between 15-30 y/o

s/s: fever, periumbilical pain that localizes to RLQ, signs of peritonitis, anorexia, vomiting, constipation, diarrhea

PE: rectal exam may clarify site of tenderness

tx?
Definition

appendicitis

 

 

tx: appendectomy

Term
s/s: PROJECTILE VOMITING (non-bilius) after every feeding, starts in first 3 weeks of life - not present at birth, hungry infant, wants to eat all the time, palpable olive in abdomen

BMP: hypochloremic, hypokalemic metabolic alkalosis

tx?
Definition

pyloric stenosis

 

surgery: pyloromyotomy

correct dehydration and electrolytes

Term
Eneuresis

- most common form?
- what should you suspect if secondary develops?
- dx?
Definition

- primary nocturnal - most common

- secondary - suspect abuse, diabetes, UTI

- dx: wetting the bed 2x/week  for 3 consecutive mos or when there is significant stress from bed wetting

 

tx: r/o UTI, reassurance, go to bathroom before bed, limit water 90 min before bed, wake up child 90 min after bed to go to the bathroom

Term
- Recent hx of GABHS infection

s/s: gross hematuria (RBCs too numerous to count), RBC cases, edema, HTN, HA

labs: elevated antistrptolysin O titer, elevated antistrep antibodies

tx?
Definition

poststreptococal glomerulonephritis

 

tx: no specific tx. erythromycin, reduce salt intake, diuretics

Term
75% are from E. coli
- Females >> males after age 1
- 3 diff types

s/s dependent on type

labs:
UA: leukocyte esterase, wbc, nitrate pos, bacteria

positive if >100,000 cfu/ml
likely if >50,000 cfu/ml
maybe if >10,000 cfu/ml + classic sx
Definition
UTI
Term
3 types of UTI & tx for each:

1. dysuria, frequency, small voids, abd/back pain

2. fever over 101.3 (newborns may be hypOthermic), abd/flank pain, vomiting

3. no sx. seen in kids with intermittent catheterizations
Definition

1. cystitis

tx: amoxicillin, bactrim

in teens: fluroquinolones

2. pyelonephritis

tx: parenteral 3rd gen ceph or aminoglycoside

 

may need VCUG or DMSA scan to ID bladder reflux or kidney scarring, respectively

3. asymptomatic bacturia

Term
most common cause of nephrotic syndrome in kids
Definition

minimal change disease

 

UA: large amounts of protein

Term
Highly contagious disease that causes necrosis of resp tract epithelium and an accompanying lymphocytic infiltrate. Small vasculitis of skin and oral mucus membranes.

WARTHIN-FINKELDEY GIANT CELLS and KOPLIK'S SPOTS - pathognomic

4 phases: incubation, prodromal illness, exanthemous phase, recovery

s/s: high fever, exanthem, cough, coryza, conjunctivitis, mild fever after 8-12 days

rash begins on forehead then spreads downward

tx?
Definition

Rubeola - MEASLES

 

tx: supportive - hydration, O2, comfort. Antipyretics for fever.

Term
a painful viral infection that leads to painful swelling of salivary glands.

s/s: face pain, fever, HA, swelling of parotid glands, and swelling of temples or jaw

tx?
Definition

mumps

 

tx: tylenol (NOT aspirin)

 

complication: orchitis

Term
Healthcare associated and community acquired
- not a matter of hygiene

s/s: skin infections & soft tissue abscesses

tx?
Definition

MRSA

 

tx: drain abscess, bactrium, clindamycin, doxy (not kids under 8)

 

 

Term
Fever >100.4 lasting for more than 14 days with no obvious cause despite a complete hx, PE, and routine labs
Definition
fever of unknown origin
Term
a condition in which the pt has bacteria in the blood stream leading to inflammation and immune overload

s/s: fever, malaise, shock, tachy

from trauma, dental work, severe UTI, untreated infection

labs: blood culture, CBC
Definition

bacteremia

 

tx: IV abx - ADMIT

Term
infection localized to subarachnoid space

s/s: fever, anorexia, poor feeding, HA, URI sx, Myalgia, arthrlagia, tachy, hypotension, petechia, seizure, DIC, LOC

+ brudzinski's and kernig's

tx?
Definition

meningitis

 

tx:

<3 mos: ampicillin + 3rd gen ceph

>3 mos: 3rd gen ceph + amp + gent

Dexamethasone

Term
causes of meningitis by age

0-28 days
>28 days
2 mos - 12 years
Definition

0-28 days: Group B strep

28 days - 2 mos: Strep pneumo, neisseria meningitidis

2 mos-12 years: Neisseria meningitidis, strep pneumo

Term
cause by clostridium tentani
- caused by contamination of wound wtih the toxin -- causes CNS sx

s/s: mild pain at wound site, hypertonicity, spasms in jaw (trismus), irritability, inability to nurse, neck/back/abd stiffness
2-4th day: elevated BP, increased CO, tachy, arrhythmia

tx?
Definition

tetanus

 

tx: Human TIG, IVIG, surgical debridement, abx

- anxiolytic, kept in quite room

- may need mechanical ventilation or muscle paralysis, nasogastric or IV feedings

 

Term
viral infection of mucosa of URT and conjunctiva
- airborn transmission or contact with lesions

- late winter/early spring
- <10 y/o usually

- contagious 1-2 dyas before rash onset until crusting phase
- incubation: 2 weeks

s/s: mild fever, systemic sx --> dew drop on a rose petal lesions that eventually get crusty

Pathognomonic: all 3 stages of rash are visible on a pt at once
Definition
varicella
Term
Rash over single dermatome that doesn't cross midline
- if in kids - usually immunocompromised

dx: clinical

tx?
Definition

zoster

 

tx:

supportive: hydration, tylenol or ibuprofen (NOT aspirin) , cool soaks, antihistamines

oral acyclovir: if really sick and within 24 hours of rash

 

can be fatal in pregnant women

Term
an enteroviral infection spread by fecal-oral or resp or placental routes

- most are asymptomatic and resolve in 2-6 days
- mild illnes = fever, malaise, sore throat, myalgia, HA
- severe illness = fever/severe myalgia/anxiety -- progress to loss of reflexes/paralysis asymmetrically, loss of cardiorespiratory function and bladder control

labs: leukocytes in CSF

tx?
Definition

poliovirus

 

tx: supportive, bed rest, fever and pain control, iron lung

Term
common enteroviral infection - second only to the common cold
- mostly asymptomatic
- mild URI sx, fever/chills, muscle ache, petechial rash, vomiting, abd pain, diarrhea

labs: throat, stool cultures is gold standard
Definition

nonpolio virus

 

tx: supportive

Term
aka: exanthem subitum, Sixth disease

- primary infection caused by HHV6 or 7

s/s:
- prodrome: mild URI, rhinorrhea, mild pharyngeal sx, mild conjunctival redness, cervical and post occipital lymphadenopathy, GI signs, inflamed TMs
- High Fever for 3-8 days, resolves abruptly
- Rose colored maculopapular rash lasting hours to days

tx?
Definition

roseola

 

tx: usually none

- ganiclovir and cidofovir for 2-3 weeks in severely immunocompromised

Term
pharyngitis + fever + rash --> caused by group A strep infection

s/s:
- diffusely erythematou and appears sunburned and roughened - sandpaper rash. most intense in axillae, groin, abd, and trunk
- Pastia sign: rash blanches except in skin folds where it will appear pigmented
- fever
- desquamation - end of first week - 3rd week
- White-Strawberry Tongue
- mucosal petechiae

labs? tx?
Definition

scarlet fever

* severe strep throat with a rash *

 

usually no labs

- throat culture, rapid strep test

- cbc - leukocytosis

 

tx: Abx - PCN

 

can turn into acute rheumatic fever

Term
infection caused by epstein barr virus (HHV4)
- >90% of pop is infected between 10-35 y/o
- spread through genital and saliva secretions

s/s: fever, HA, sore throat, fatigue, malaise, anorexia, abd pain, myalgia, lymphadenopathy, splenomegaly, hepatomegaly, maculopapular or petechial rash, exudative pharyngitis, tonsillitis, gingivitis.

labs: granulocytopenia, lymphocytic leukocytosis with atypical lymphocytes

tx?
Definition

mono

 

monospot

 

tx: supportive, tylenol, no contact sports, steroids if needed to prevent airway obstruction

acyclovir only if infection is chronic

Term
antigenic ___ occurs annually
antigenic ___ occurs every 7-10 years
Definition
shift, drift
Term
spread person-person via aerosols

s/s: sudden onset fever, chills, malaise, HA, myalgia, cough, coryza, pharyngitis

kids: fever, vomiting, diarrhea, abd pain

infants: sepsis, apnea

CBC: leukopenia
Definition

flu

 

tx: supportive

antivirals must be given w/in first 48 hours of onset - amantadine

 

major complications: Reye syndrome

Term
major
Definition
Term
Most severe form of rickettsia infection
- transmitted via tick bite, which must be attached for at least 6 hours

s/s:
CLINICAL TRIAD: HA, Fever, Rash
- after 3-12 days: abrupt onset high fever, myalgia, severe and persistent HA, toxicity, photophobia, vomiting, diarrhea.
- Rash on PALMS and SOLES

Primarily on eastern seaboard, southeast from april to september.

tx?
Definition

Rocky Mtn Spotted Fever

 

tx: doxy for 2-3 days after fever is gone. at least 10 days

Term
benign exanthematous illness of school aged kids caused by human parvovirus B19.

s/s: rash and joint sx
- prodrome: mild URI sx, fever, HA
- 3 phase rash: slapped cheek, symmetric maculopapular pruritic, central clearing of rash giving classic lacy appearance
- rash fluctuates with temp changes and sunlight

tx?
Definition

erythemat infectiosum -- 5th disease

 

tx: supportive, IV immunoglobulin for immunocompromised

 

Term
subcutaneous tissue infection that involves necrosis of deep layer of superficial fascia but largely spares the adjacent epidermis, deep fascia, and muscle.
- complication of varicella infection (most commonly), group a strep, staph aureus

s/s: skin is pale, red, tender w/o borders. Resembles cellulitis initially
- blisters or bullae may appear
- collar deepds to purple
- tenderness out of proportion to clinical appearance
- "woody induration" - skin anesthesia due to infarct of superficial nerves
- mild to severe edema
- can become septic

dx: surgical exploration, MRI

tx?
Definition

necrotizing fasciitis

 

tx: supprotive, surgical debridement, broad spectrum abx, meticulous wound care

Term
common tick disease in midwest/south east/mid atlantic
- march-october

s/s: fever, HA, abd pain, anorexia, N/v/d, edema, chills, photophobia, conjunctivitis, myalgia

PE: rash (erythematous, macular, papular, petechial, scariantiniform, or vasculitic) - SPARES PALMS AND SOLES. mild adenopathy/hepatomegaly

labs: leukopenia w/ left shift, lymphopenia, thrombocytopenia, elevated aminotransferase

tx?
Definition

erlichiosis

 

tx: doxy ASAP

 

risk: minigoencephalitis and neuro defects

Term
CNS infection caused by a gram neg intracellular diplocci
- most common cause of bacterial meningitis 2mo-12 years

s/s: fever, anorexia, poor feeding, HA, URI sx, myalgia, arthralgia, tachy, hypotension, PETECHIAE/PURPURA, seizure, + brudzinski's/kernig's (18 mos)

labs: LP, CBC

tx?
Definition


meningicoccal meningitis

 


tx: must be immediate

<1 mo-3 mos: ampicillin + cef

>3 mos: cef or amp + gentamycin

 

Dexamethasone to limit inflammation







Term
bacterial infection (corynebacterium) characterized by nasopharyngeal/laryngitis with fever that is spread through eyes, nose, throat, skin
- bacteria produces toxins that destroy epithelium
- 2-7 day incubation

s/s: GRAY membrane over back of throat, tonsillitis/pharyngitis, low grade fever w/ resp symptoms for 1-2 dyas

possible airway obstruction, myocarditis, peripheral neuropathies

tx?
Definition

diphtheria

 

tx: penicillin + antitoxin for 10 days

 

pt is cleared when 2 cultures are neg

Term
teratogenic disease - only a big deal if pt is pregnant.
80% of infections are subclinical
- transmitted via aerosol secretion in late winter/early spring

s/s: rash w/discrete macupapules begin on face and spreads to trunk and extremities for 4 days. red eyes, fever, HA, slapped cheek appearance
- Forchheimer spots in throat

CONGENITAL: 80% of infected women in first 4 mos of pregnancy deliver infected infants.
- growth retardation, cardaic and vascular anomalies, ocular anomalies, deafness, retardatoin, blood problems

labs: IgM assay - may need to terminate pregnancy

tx?
Definition

rubella

 

tx: symptomatic therapy

- Keep out of school 7 days after rash onset

 

congenital defects are irreversible

- should be considered contagious until 1 y/o

Term
an entrovirus that causes acute hepatic injury. spread through FECAL-ORAL rought

incubation: 15-30 days

s/s:
- prodrome: 1 week. HA, anorexia, malaise, nausea, vomiting
PE: jaundice and large tender liver

labs: high IgM, low IgG

tx?
Definition

hep A

 

tx: supportive.

 

give IG in institutes of high risk spread

Term
Most common genetic condition
1/700 births - increases wtih maternal age'

what are some physical characteristics? associated health problems?
Definition

Down's

 

physical: small flat head, up-slanting palpebral fissures, epicanthal folds, brushfield spots, midface hypoplasia, small lowset ears, small mouth big tongue

 

Health problems: CHD, leukemia, GI atresia, hirschprung disease, hearing loss, OSA, ear infections, cataracts, hypothyroid, AD, celiac, atlanto-occipital instability

Term
genetic condition in a female w/ 1 X chrom. 45X is most common

s/s: webbed neck, edema of hands & feet, coarctation of aorta, triangular facies, short stature, shield chest, wide set nipples, horseshoe kidney, amenorrhea, absence of secondary sex characteristics, infertility, LD

tx?
Definition

turner syndrome

 

tx: estrogen to produce secondary sex characteristics

growth hormone

Term
genetic abnormality in boys with extra X chrom. dx rarely made before puberty
- from nondisjunction

s/s: microorchidism, lack of libido, minimal facial hair, TALL, eunochoid build (long arms and legs), Low IQ, infertility, gynecomastia

risk factors: advanced maternal age

karyotype of peripheral blood --> gold standard
high fsh, lh and estrodiol, low testosterone
tx?
Definition

Klinefelter's

 

tx: testosterone replacement

 

prognosis: higher risk of breast cancer, DM, hypothyroid/parathyroid, SLE, sjogrens, RA

Term
s/s: open lesion with skin-covered lesion
clubfeet, dislocated hips, flaccid paralysis below lesion
associated: hydrocephalus, neurogenic bladder/bowel, congenital paralysis in lower extremities, CNS heart and kidney anomalies

labs: MRI

tx?
Definition

spina bifida (myelomeningocele)

 

tx: closure in first 24-48 hours after birth

address orthopedic problems

attain continence - anticholinergics

genetic counseling

 

prophylactic: folic acid

Term
Chronic, static impairment of muscle tone, strength, coordination, or movement
- NONPROGRESSIVE, originates from some type of cerebral injury before, during, or soon after birth

risks: SGA, intrauterine hypoxia/bleeding/infection
-50% have no identifiable cause

PE: spasticity, hyperreflexia, ataxia, involuntary movements, microcephaly

TX?
Definition

cerebral palsy

 

tx: PT, OT, SLP,

botox for spasticity, baclofen pump

Term
Types of CP:

1. most common form of CP
- due to injury of upper motor neurons of pyrimidal tract
- truncal hypotonia in first year
- spasticity, hyperreflexia, clonus in 2nd year

2. 2nd most common
- due to cerebellar injury
- affects fine coordinated movements. mainly UE
- wide unsteady gait

3. due to injury to basal ganglia. associatd with kernicterus (hyperbilirubinemia)
- variable tonal abnormalities - athetosis & chorea
- greater cognitive fxn than other forms

4. more than one motor pattern
- typicaly associated with more complications
Definition

1. spastic

2. ataxia

3. dyskinetic

4. mixed

Term
transient occurrence of signs and sx resulting from abnormal excessive synchronous neuronal activity in the brain
Definition
seizure
Term
most common seizure disorder in kdis.

do LP <1 y/o

find source
Definition
febrile seizure
Term
2 kinds:
1. simple: sudden cessation of motor activity or speech with a blank facial expression and flickering of lids. <30 sec.
2. complex: myoclonic face, finger, and extermity movment. possible loss of muscle tone.

tx?
Definition

absence seizures

 

tx: valproic acid or ethosuximide

Term
seizure resulting from metabolic derangement
- stiffening of muscles. arms up, legs out.
- initiead by loud "ictal cry", impaired respirations, biting of tongue, increased HR, BP, pupil size
- progrressive relaxation, unresponsiveness, flacidity
- prone to anterior shoulder dislocation

tx?
Definition

tonic clonic seizure

 

tx: valproic acid or lamotrigine

Term
Signs of abuse vs. normal accidental injury:
burns, spanking

red flags of abuse
Definition

burns:

abuse - soles and palms. no splash marks

"comet sign" - cigarette burns

 

spanking:

SHOULD NOT CAUSE BRUISING

abuse: upper arms, anterior thigh, trunk, genitals, buttocks, face, ears, neck

- in kid <6 mos -- those who cruise rarely bruise

 

should be signs of behavioral change

- anger, depression, withdrawal

- overtly sexual behaviors

- knowledge/language beond developmental expectations

 

Red Flags:

- hx does not make sense, history changes, vague hx, frequent accidents, multiple injuries at different stages of healing, perp is unable to defend self

Term
every infant requires between __ & __ doses of vaccine by 18 mos to protect against 14 diseases.

contraindications to childhood vaccines
Definition

25-26

 

contraindictations: severe febrile illness,

HIV or cancer - let ped onc do the vaccines

Term
Adolescents:

- at what age should kids start being seen w/o their parents? Same age for having an annual exam
- History - HHEADSSSFFIRST
- leading cause of death for kids 15-24 is ____, ___, ___. Alcohol is a major factor in all three.
- sexual activity in HS is __%
- __ % of HSers are obese, ___% are overweight
- gardasil is recommended in girls ages __-__
Definition

- 11-12

- Hx:

home, health, eaducation, abuse, drugs, safety, sexuality, selfcare, family, friends, image, recreation, spirituality, threats/violence

- MVA, homicide, suicide

- 46%

-12%, 15.8%

- 9-26

Term
Types of scoliosis:

1. failure of formation causing a hemivertebrae that results in failure of segmentation and a unilateral bar
- often associated with renal and cardiac sx
2. causes flaccid weakness or spasticity, loss of sitting balance, impaired resp function, adn typically long thoracolumbar or lumbar curves due to CP, spina bifida, etc
3. onset after age 10. most common kind


how do you evaluate scoliosis?
tx?
Definition

1. congenital

2. neuromuscular

3. adolescent

 

 

evaluation: cobb angle

risser sign: 0-5. 0 being no apophysis. 5 being complite fusion

-MRI for any curve to the left

 

tx:

- surgery - >40deg (immature) or >50 deg (mature) or for congenital or neuromuscular

- brace 25-40 deg

- observe 0-25 deg

Term
Due to shallow acetabulum, instability of femoral head, frank dislocation, or birth defect
- common in breech presentaiton
- girls:boys 4:1
- + galeazzi, barlow, or ortolani signs

tx?
Definition

congenital hip dysplasia

 

tx: pavlic splint - 90% effective if less than 6 mos. typically worn 6-12 weeks

Term
progressive displacement of the upper portion of the femur that occurs in relation to the capital femoral epiphysis
- pain in groin/anterior thigh, decreased abduction, abductor lurch gait
PE: loss of internal rotation

- boys 13-15, girls 11-13

xray of both hips: check by drawing a "klein" line along superior femoral neck

tx?
Definition

slipped capital femoral epiphysis

 

tx: refer for surgery

Term
salter-harris classification
Definition

S: separate - needs closed reduction if displaced

A: above

L: lower (below)

T: through

R: ram

Term
subluxation of radial head as a result of being lifted or pulled by the hand

s/s: painful, fully pronated elbow that won't bend

PE: point tenderness over radial head

tx?
Definition

nurse maid's elbow - subluxation of radial head

 

tx: immobilize elbow w/ sling

Term
elevation of tibial tubercle caused by the recurrent traction of the muscle-tendon unit that occurs in jumpin and running sports. fragmentation and microfractures may occur

- preteens and adolescents

s/s: pain at tibial tubercle. aggrevated by activities using quads.

xray: fragmentation or irregular ossification at tibial tubercle

tx?
Definition

osgood-schlatter disease (tibial tubercle apophysitis)

 

tx: NSAIDS, hamstring stretches, ice after workout

Term
knock-kneed appearance of legs during development

normal in girls around 8 y/o
Definition
gen valgum
Term
due to blood supply being cut off to head of femur

s/s: 4-8 y/o. persistant pain with limping or limitation of motion

labs: normal

xray: effusion around joint, decreased bone density, center of bone appears denser than surrounding bone, widening of femoral head w/ coxa plana

tx?
Definition

avascular necrosis of proximal femur

(Legg-calve-perthes disease)

 

tx: protect joint, complete replacement of femoral head

Term
injury to lower trunk (C7-T1) from difficult childbirth with shoulder dystocia. small mom, big baby

- good shoulder fxn, decreased hand fxn = "claw hand"
- horner syndrome may be present

tx?
Definition

Klumpke's palsy

 

tx: surgery to nerves in kids w/ no spontaneous recovery by 6-9 mos, PT

Term
aka compression fracture. typically in distal radius of young kids. heal in 2-3 weeks with immobilization
Definition
torus fx
Term
most common birth fracture
- associated with high birth weight and shoulder dystocia
tx?
Definition

clavicle fx

 

tx: pinning sleeve for 10-14 days

 

 

Term
gaits:

1. shortened stance phase characterized by pain in the extremity or spine
2. shifting the trunk or shoulders toward the affected side to compensate for weakness of abductor muscles
3. foot contact wtih floor by the front of the foot may be due to heel cord contracture or to compensate for a limb length discrepency
4. characterized by swinging of entire leg out ot the side in a circle during the swing phase, such as to allow clearance of a longer leg
Definition

1. antalgic

2. abductor

3. equinus

4. circumduction

Term
aka clubfoot
- hindfoot equinus + forefoot adduction + varus + midfoot cavus (high arch)

r/o hip dysplasia and torticollis

commonly assocaited with spina bifida, arthrogryposis, and myelodysplasia
Definition
talipes equinovarus
Term
increased internal or external rotation of tibia. can cause gait abnormalities and genu varum. internal usually fixes itself. external unlikely to resolve spontaneously. some cases require surgery
Definition
tibial torsion
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