Term
| What is the MCC of testicular pain in boys > 12y/o? |
|
Definition
|
|
Term
| In what age-group is torsion of the appendix of the testis the MCC of pain? |
|
Definition
|
|
Term
| What deformity is described as an abnormal attachment of the testis within the scrotum? |
|
Definition
| Bell-and-clapper deformity |
|
|
Term
| Pt presents with acute testicular pain and swelling, cremasters reflex is absent and testicle feels firm. What is you dx? What sign on PE is indicative of this condition? How can you confirm? What is the treatment? |
|
Definition
| Testicular Torsion; Blue Dot Sign; Color Doppler Sonography; STAT urology surgery |
|
|
Term
| What radiologic imaging test should be done on all children 2mo-2yo after 1st UTI? |
|
Definition
|
|
Term
| What radiologic studies should ALL children <6 years with a UTI undergo? |
|
Definition
Renal Ultrasound
Voiding cystourethrogram (VCUG) |
|
|
Term
| In young boys, what surgical procedure can be done to help prevent UTIs? |
|
Definition
|
|
Term
| What is the MC pathogen causing a UTI? What is the 2nd MC? |
|
Definition
#1 - E Coli
#2 - Klebsiella |
|
|
Term
| Pt presents with dysuria, increased urgency and frequency. Labs show WBC of 12 and nitrites. What condition do you suspect? |
|
Definition
|
|
Term
| What lab tests should be done if a UTI is suspected? |
|
Definition
| U/A and culture (clean catch) |
|
|
Term
| Pt presents with fever, abdominal pain, flank pain as well as vomiting and diarrhea. There is an elevated WBC count on U/A. What condition do you suspect? |
|
Definition
|
|
Term
| What is the WBC count indicative of a UTI in a clean catch specimen for boys? for girls? |
|
Definition
|
|
Term
| What is the WBC count indicative of a UTI in an I/O cath urine specimen? |
|
Definition
|
|
Term
| What results are indicative of a UTI in a suprapubic aspiration specimen? |
|
Definition
Any gram negative rods
>1000 gram pos cocci |
|
|
Term
| What is the least invasive test after U/A used in the evaluation of a UTI in kids? |
|
Definition
| U/S to view the structures (esp the kidney) |
|
|
Term
| What condition is described as abnormal mvmt of urine from bladder to ureters to kidney? |
|
Definition
| Vesicoureteral reflux (VUR) |
|
|
Term
| A young child presents with dysuria, freq.urination, and GI symptoms, what underlying condition might you suspect? |
|
Definition
| Vesicoureteral reflux (VUR) |
|
|
Term
| What bacterial organism can lead to kidney stones? |
|
Definition
|
|
Term
| In in-utero infants, in which sex does Vesicoureteral reflux (VUR) occur? |
|
Definition
|
|
Term
| In infants, which sex is more commonly affected by Vesicoureteral reflux (VUR) occur? |
|
Definition
|
|
Term
| In which sex are UTIs more common? Why? |
|
Definition
| Females; More common due to the anatomy (females have shorter urethra, while males have a longer urethra) |
|
|
Term
| How does the occurrence of UTIs change with age? |
|
Definition
| UTI occurrence in males decreases, while it increases in females |
|
|
Term
| How is Vesicoureteral Reflux differentiated from pyelonephritis? |
|
Definition
| In VUR the VCUG will show a abnormality of structure. |
|
|
Term
| What are the two structural abnormalities shown on VUCG that are present in Vesicoureteral reflux? |
|
Definition
1 - Insufficient submucosal length of the ureter related to its diameter
2 - An obstruction distorting the UVJ |
|
|
Term
| What is the treatment for Vesicoureteral Reflux in an infant < 6 w/o? ... in an infant 6w - 2m? ... in an infant >2mo? |
|
Definition
<6wk=Amoxil
6w-2m=Bactrim
>2mo=Nitrofurantoin, Cephalosporin, Bactrim |
|
|
Term
| When is surgery used to treat Vesicourethral Reflux? |
|
Definition
Used in older children (2 y.o.)
If abx prophylaxis has failed |
|
|
Term
| If a 3 y/o pt with an UTI is non-toxic in appearance, well hydrated and can take medicine by mouth, what is the treatment for their UTI? |
|
Definition
| Outpatient Treatment - Antibiotics (Amoxil, Rocephin, Cefotaxime, Ampicillin, Gentamycin or Gantrisin) |
|
|
Term
| 18 m/o Pt presents and you diagnose them with a UTI. They patient is toxic appearing and dehydrated. What is your treatment plan? |
|
Definition
| Inpatient Treatment - Antibiotics (Amoxil, Rocephin, Cefotaxime, Ampicillin, Gentamycin or Gantrisin) |
|
|
Term
| What is the pharmacological treatment for nocturnal enuresis? |
|
Definition
DDAVP (Desmopressin)
Imipramine (Tofranil) |
|
|
Term
| 5 y/o male pt presents with an abrupt onset of fever, chills, nausea and abdominal and testicular pain. On exam you note the testis are swollen and tender. His history is + for an illness approximately 8 days ago that made his cheeks swell. What is you dx? |
|
Definition
|
|
Term
| What are the 3 causes of orchitis? |
|
Definition
Mumps (MCC)
Coxsackie B virus
Trauma |
|
|
Term
| What is the treatment for orchitis? |
|
Definition
|
|
Term
| Which type of PCKD is often fatal in the first month of life? What is the MC COD in these infants with this type of PKD? |
|
Definition
| Autosomal Recessive PCKD; 50% die of pulmonary hypoplasia - other complications include Hepatic fibrosis |
|
|
Term
| What is the MC type of PCKD? |
|
Definition
|
|
Term
| Pt presents with abdominal discomfort, polyuria and nocturia as well as blood in his urine. He also has a history of UTIs. On U/A there is mild proteinuria and hematuria. On PE you note HTN and an abdominal mass. What condition do you suspect? What imaging would you use to diagnose this condition? |
|
Definition
Polycycstic Kidney Disease
Renal U/S |
|
|
Term
| What is the treatment for AD Polycystic Kidney Disease? |
|
Definition
|
|
Term
| What MUST be present on renal U/S to diagnose AD PCKD? |
|
Definition
| 2 cysts in 1 kidney and 1 cyst in the other one |
|
|
Term
| What is the MCC of proteinuria? |
|
Definition
|
|
Term
| What disease conditions can cause nocturia? (5) |
|
Definition
UTI
DM or DI
Sleep Apnea
Chronic Constipation |
|
|
Term
| What anatomical defects or body physiology can lead to nocturia? (3) |
|
Definition
Small bladder
Inability to recognize a full bladder
Hormonal Imbalance - Dec in ADH |
|
|
Term
| What outside stressors can lead to nocturia? |
|
Definition
Divorce
Life Changes
School stress
Munchausen's syndrome |
|
|
Term
| What is a sign of renal damage caused by insufficient absorption or impaired filtration? |
|
Definition
|
|
Term
| What is the MC type of glomerulonephritis in the world? What is a common clinical sign for this disease? |
|
Definition
| Berger’s Disease (IgA Nephropathy
); Proteinuria and Hematuria |
|
|
Term
| What are the 5 causes of glomerulonephritis? (G.L.I.P.P) |
|
Definition
Goodpasture’s Syndrome
Lupus Nephritis
IgA Nephropathy (Berger’s Disease)
Postinfectious glomerulonephritis
Pauci-immune GN |
|
|
Term
| What is the treatment for the various types of glomerulonephritis? |
|
Definition
Corticosteroids
Correct HTN
Diuretics and fluid restriction |
|
|
Term
| Pt presents with edema in the periorbital and scrotal regions, U/A shows mild proteinuria. Also present are anti-glomerular basement membrane autoantibodies. What condition do you suspect? |
|
Definition
|
|
Term
| Pt presents with peripheral edema, dyspnea, and ascites. On PE you note rales bilaterally. Labs reveal heavy proteinuria, decreased serum albumin, and hyperlipidemia. What is your suspicion? |
|
Definition
|
|
Term
| What is the MC type of Acute Renal Failure in PEDs pts? What is the hallmark of ARF? |
|
Definition
| Prerenal Failure (MC caused by dehydration); Oliguria |
|
|
Term
| What condition is described as a malignant tumor compresses normal kidney parenchyma? |
|
Definition
| Wilm's Tumor (Nephroblastoma) |
|
|
Term
| A 4 y/o AA pt presents for a check-up. On PE you note a unilateral abdominal mass on the L side. His mom says he has had a decreased appetite lately, some Nausea and stomach pain. He also has HTN that is new onset within the last year. U/A reveals Hematuria. What is the MC renal tumor in children? |
|
Definition
| Wilm's Tumor (Nephroblastoma) |
|
|
Term
| What is the treatment for a Wilm's tumor? |
|
Definition
|
|
Term
| What is the MCC of nocturnal eneuresis? |
|
Definition
|
|
Term
| What is the MC type of stone in Nephrolithiasis? |
|
Definition
|
|
Term
| What is the MCC of chronic HTN in infants and neonates? |
|
Definition
| Renal artery thrombosis after umbilical artery catherization |
|
|
Term
| What is the MCC of chronic HTN in 1y/o to 10y/o? |
|
Definition
Renal parenchymal dz
Coarctation of the aorta |
|
|
Term
| What is the MCC of chronic HTN in 11y/o to adolescents? |
|
Definition
Renal parenchymal dz
Essential HTN |
|
|
Term
| What is the MCC of nephrotic syndrome in children <10y/o? |
|
Definition
| Minimal Change Disease
(Lipoid Nephrosis or Nil Disease) |
|
|
Term
| 8y/o male pt presents with facial edema that occurred first then the mom notice bilateral edema of his legs. He had a URI 1 week prior and has had a loss of energy since. On PE you note dependent edema of both LE as well as . U/A reveals heavy proteinuria. Serum lipid levels are high. What is your diagnosis? What is your treatment? |
|
Definition
| Minimal Change Disease; Prednisolone and BP meds as well as statins |
|
|
Term
| What is the MC urethral anomaly? |
|
Definition
|
|
Term
| What is the #1 birth defect in males? What is the 2nd MC birth defect in males? |
|
Definition
#1 - cryptorchidism
#2 - hypospadiasis |
|
|
Term
| What are the complications of cryptorchidism? |
|
Definition
| Infertility and higher risk for testicular CA |
|
|
Term
| When do most cases of cryptorchidism descend by? When is surgery necessary is descention does not occur? |
|
Definition
| 3 mo; Surgery by 1 y/o if still undescended |
|
|
Term
| Which type of testicular CA does cryptorchidism increase the pts risk for? |
|
Definition
|
|
Term
| An 8y/o Female presents with a deepening voice, and early hair growth under the armpits and on the pubis as well as excessive hair growth on the face. You begin you PE and on genital exam you note hyperpigmentation of labioscrotal folds and clitoromegaly. What condition do you suspect? |
|
Definition
| Congenital Adrenal Hyperplasia (CAH) |
|
|
Term
| A 3y/o boy presents with signs of puberty including a deepening voice, appearence of hair in the armpits and pubic area. On PE you note an enlarged penis and smaller testes. He is also in the 100% percentile for height in his age. What condition do you suspect? |
|
Definition
| Congenital Adrenal Hyperplasia (CAH) |
|
|
Term
| What condition is described as ambiguous genitalia due to a chromosomal abnormality in which there is a presence of both male and female parts? |
|
Definition
|
|
Term
| What condition is described as painful swelling of the foreskin distal to the phimotic ring? |
|
Definition
|
|
Term
| What is the largest neonatal group with ambiguous genitalia? |
|
Definition
| Female pseudohermaphroditism: 46, XX karyotype; Caused by CAH |
|
|
Term
| What is the genetics for most cases of True hermaphroditism? |
|
Definition
|
|
Term
| What is the 'cause' of paraphimosis? |
|
Definition
| Occurs if the foreskin remains retracted for a prolonged period of time |
|
|
Term
| Pt presents with N/V and fever. C/o dysuria, low back pain and fatigue. U/A shows proteinuria. Labs show hyperkalemia and metabolic acidosis as well as kidney failure. What condition do you suspect? |
|
Definition
| Acute Interstitial Nephritis |
|
|
Term
| Pt presents with weakness, lethargy and V/D. Had a history of recent bout of gastroenteritis. Pt has also been urinating less than usual. Pt is pale and has bruising and petechiae present. On labs pt is uremic and anemic. What condition do you suspect? |
|
Definition
| Hemolytic Uremic Syndrome |
|
|
Term
| What are the 3 phases of acute tubular necrosis? |
|
Definition
OLIGURIC - (for 10 days)
DIURETIC - (Increased urine output)
RECOVERY phase - s&s rapid resolve |
|
|
Term
| A pre-pubescent female pt presents with dysuria, vulvar pain, and itching as well as vaginal discharge.What condition do you suspect? |
|
Definition
|
|
Term
| What condition accounts for the majority of vaginal complaints before menarche? |
|
Definition
|
|
Term
| What condition is described as an inflammatory process of the vulva and the vagina? |
|
Definition
|
|
Term
| In which categories of pts is urethral prolapse MC seen? |
|
Definition
| AA and obese school-aged girls |
|
|
Term
| Pt presents with vulvovaginal irritation, and dysuria. On PE you note precipitation of prolapse with valsalva. What condition do you suspect? |
|
Definition
|
|
Term
| Pt presents with c/o itching and water d/c for 1 week and now describes that lesions are present in her vaginal area. On PE you note small pink, flat-topped papular lesions appearing on both cutaneous and mucosal surfaces of her vaginal region. What is your diagnosis? What is your next step in treatment? |
|
Definition
| Lichen planus; Refer to derm for biopsy |
|
|
Term
| What can lichen planus raise concern for? |
|
Definition
| Can raise concern for sexual abuse |
|
|
Term
| Pt presents with c/o of vaginal pruritis. On PE you note an intensely hyperemic vulva, and a thick, cheesy white d/c covering the urethra, introitus and hymenal area. What condition do you suspect? |
|
Definition
|
|
Term
| What change in the vaginal pH is noted with a candidal infection?... with BV? |
|
Definition
decreased vaginal pH with candidal infection
increased vaginal pH with bacterial vaginosis |
|
|
Term
| Pt presents with acute vulvar pain, dysuria, and vaginal d/c. On PE there is an area of inflammation that is sharply circumscribed extending from the vulva to the peritoneal area. Some desquamation is present. What condition might you suspect? |
|
Definition
| Streptococcal Vulvovaginalis |
|
|
Term
| When do the ovaries descend into the pelvis? |
|
Definition
|
|
Term
| Which speculum is ideal for use in virginal adolescents? |
|
Definition
|
|
Term
| Which speculums are used for examining sexually active pts? |
|
Definition
|
|
Term
| When does the American College of Gynecology recommend a first Papanicolaou (Pap) smear in healthy adolescents? |
|
Definition
| 3 years after the initiation of vaginal intercourse, or by age 21, whichever is sooner |
|
|
Term
| Virilization noted in the newborn, especially when accompanied by hyperpigmentation, should prompt what action? |
|
Definition
| IMMEDIATE laboratory investigation for evidence of salt-losing adrenal hyperplasia and URGENT endocrinology referral. |
|
|
Term
| In which pts should a rectal bimanual examination be performed? |
|
Definition
Precocious puberty,
suspected abdominal masses,
suspected vaginal foreign body,
abdominal pain |
|
|
Term
| Is an ectropion (or eversion) of the endocervical columnar epithelium onto the cervical surface in adolescents worrisome or normal? |
|
Definition
|
|
Term
| What is urethral prolapse often mistaken for? |
|
Definition
|
|
Term
| What is the treatment for urethral prolapse? |
|
Definition
| topical estrogen and topical antibiotic |
|
|
Term
| What is the treatment for a labial adhesion? |
|
Definition
| topical estrogen and topical antibiotic |
|
|
Term
| What does gardasil protect against? |
|
Definition
4 types of human papillomavirus (HPV):
- 2 types that cause 70% of cervical cancer cases
- 2 more types that cause 90% of genital warts cases |
|
|
Term
| What can cause false positive pregnancy test results? (4) |
|
Definition
Hydatidiform mole,
malignancy,
post abortion,
LH surge/elevations |
|
|
Term
| What is the MC form of genital tract obstruction in females? |
|
Definition
|
|
Term
|
Definition
Inspection for warts
Acetic Acid staining for lesions
Colposcopy
HPV typing |
|
|
Term
| Which types of HPV cause genital warts? |
|
Definition
|
|
Term
| Which two types of HPV account for 70% of all cervical CA? |
|
Definition
|
|
Term
| Which type of genital warts is caused by HPV? |
|
Definition
|
|
Term
| What is characteristic of primary syphillis? |
|
Definition
| Painless chancre that is indurated on palpation (base is smooth and margins are rolled) |
|
|
Term
| What is characteristic of secondary syphillis? |
|
Definition
- rash consisting of reddish, brown small solid flat/raised skin sores that are less than 2cm across. - small open sores may be present on mm
- Other symptoms include fever, sore throat, feeling of weakness or all over discomfort, swelling of lymphnodes, patchy hair loss |
|
|
Term
| What common childhood rash is commonly confused with the rash found in secondary syphillis? How can you differentiate between the two? |
|
Definition
| Pityriasis rosea - rash in syphillis is present on soles of feet and palms of hands |
|
|
Term
| Pt presents with a solid, round breast mass that is rubbery in consistency. What is your diagnosis? What would you use to confirm your diagnosis? |
|
Definition
| Fibroadenoma - confirmed with FNA or excisional biopsy |
|
|
Term
| In adolescents, what breast imaging study is most commonly used? |
|
Definition
|
|
Term
| Pt presents with bilateral masses that are tender. She notices that the masses tend to wax and wane in size and tenderness with her cycle. What do you suspect? |
|
Definition
|
|
Term
| What are the signs of sexual abuse? |
|
Definition
Lichen Sclerosis
Abrasions (healing abrasions)
STI = Sexual Abuse until proven otherwise
Multiple Others! |
|
|
Term
| What are the risks for infants born to adolescent mothers? |
|
Definition
- LBW
- Pregnancy-induced HTN and pre-eclampsia
- Poorer developmental outcomes
- STIs (through vertical transmission) |
|
|
Term
| What does risk does maternal tobacco use cause to the fetus? |
|
Definition
|
|
Term
| What can Maternal Alcohol use cause in the fetus? |
|
Definition
| Fetal Alcohol Syndrome = facial abnormalities (fish mouth), growth deficiency, and CNS dysfunction |
|
|
Term
| What are the distinctive effects of maternal marijuana use? |
|
Definition
| infants may experience w/drawal like sx (high pitched cry and tremulousness) |
|
|
Term
| For how long in newborns is vaginal discharge common? |
|
Definition
|
|
Term
| What should the vaginal pH in a newborn be? (acidic or basic) |
|
Definition
|
|
Term
| What is the appearance of a newborn's genitalia affected by? |
|
Definition
|
|
Term
| Describe the appearance of the labia majora and minora in a newborn? |
|
Definition
Labia majora is puffy
Labia minora is enlarged and protrudes |
|
|
Term
| How does the appearance of the labia majora and minora in prepubertal female compare to a newborn? |
|
Definition
Labia majora loses its fullness
Labia minora and hymen b/c thinner and flatter |
|
|
Term
| What is the appearance of the mucosa in a newborn? |
|
Definition
|
|
Term
| What is the appearance of the mucosa in a prepubertal female? |
|
Definition
| Mucosa is thin and atrophic with a reddish-pink hue |
|
|
Term
| What is the vaginal pH is a prepubertal female? |
|
Definition
| Vaginal pH is neutral or alkaline |
|
|
Term
| During the 6 - 8 wks prior to puberty what changes occur? What do these changes put the pt at risk for? |
|
Definition
| perineum, perivaginal tissues are rigid making them more predisposed to tear easily |
|
|
Term
| What are the three types of vaginal orifices? |
|
Definition
Annular
Crescentic
Fimbriated |
|
|
Term
| During peripuberty, what change occurs to the mons pubis? |
|
Definition
|
|
Term
| Describe the appearance of the labia majora and minora in a peripubertal female? |
|
Definition
Fat deposition in labia majora
Labia minora thicker, softer, more rounded & asymmetries are more apparent |
|
|
Term
| What is the appearance of the mucosa in a peripubertal female? |
|
Definition
Vaginal mucosa thickens and softens
Vaginal discharge is more profuse |
|
|
Term
| When is a pelvic exam indicated? |
|
Definition
Sexually active, suspected STD orAbnormal vaginal d/c
Pelvic, abdominal, perianal pain
ABNORMAL Menstruation (Painful or bleeding irregularities)
Suspected Sexual abuse |
|
|
Term
| Should labial adhesions be manually separated? |
|
Definition
| NO... manual separation is painful and traumatic |
|
|
Term
| When can an imperforate hymen be seen in infancy? |
|
Definition
|
|
Term
| What type of imperforate hymen develops in infants with copious vaginal fluid? |
|
Definition
|
|
Term
| What type of imperforate hymen develops in infants with neonatal withdrawal bleed or trauma? |
|
Definition
|
|
Term
| Which imaging tools are helpful in diagnosing genital tract obstructions? |
|
Definition
|
|
Term
| What is the treatment for Imperforate hymen? |
|
Definition
Incision of membrane to allow for drainage
Excision of redundant tissue |
|
|
Term
| Pt presents with malodorous homogenous vaginal discharge. On wet-mount, "clue" cells are present. Vaginal pH is basic. What condition do you suspect? |
|
Definition
|
|
Term
| Pt presents with prurulent vaginal discharge and vulvar inflammation. Gram stain reveals sheets of leukocytes with gram-negative intracellular diplococci. What condition do you suspect? |
|
Definition
|
|
Term
| By what age is breast development usually complete? |
|
Definition
|
|
Term
| What is considered premature thelarche? |
|
Definition
| breast development before age 8 |
|
|
Term
| What is considered delayed thelarche? |
|
Definition
| absence of breast development after age 13 |
|
|
Term
| What is the general prognosis for MOST breast masses found in adolescence? |
|
Definition
|
|
Term
| Where are the most obvious signs of abuse seen? What are some examples of these? |
|
Definition
| On the skin - bruises, welts, scars, abrasions, lacerations, tourniquet and bite marks |
|
|
Term
| How should all signs of abuse be documented? |
|
Definition
| on body diagrams and with photographs |
|
|
Term
| What is the MC finding seen in children of abuse? |
|
Definition
|
|
Term
| If a fingerprint or grab marks are located on the medial thighs, what should this prompt? |
|
Definition
| Suspicion of concurrent sexual abuse and should prompt searching for signs of this abuse |
|
|
Term
| What type of injuries to the head or face are highly suspicious for abuse? |
|
Definition
Trauma to more than one plane
Round impression of thumb and forefinger seen on cheeks, sides of forehead or sides of chin in infants |
|
|
Term
| What type of burns are characteristically signs of abuse? |
|
Definition
|
|
Term
| Which types of immersion burns are MC in abuse? |
|
Definition
| immersion scalds, dip burns |
|
|
Term
| Mom brings child to ER explaining that the child fell off of the top of the bunk- bed while playing. After x-rays, you find the pt suffered from a transverse mid-shaft femur fracture, what is your next step? |
|
Definition
| Suspect abuse (suspect abuse with any long bone fracture) |
|
|
Term
| Which type of fracture in the wrist is more suspect for abuse? |
|
Definition
| distal or radius fracture with VOLAR ANGULATION is MC in inflicted fractures |
|
|
Term
| When working up an abuse pt, what may need to be ordered in a child who has multiple bruises or signs of CNS damages, and no signs of fractures on film? |
|
Definition
|
|
Term
| When working up an abuse pt, what should all children under the age of 3 undergo due to fractures usually being occult? |
|
Definition
|
|
Term
| When working up a child who has been abused, if they have multiple fx of their extremities and ribs, what else should you order? Why? |
|
Definition
| Head CT - approx 70% will have closed-head trauma |
|
|
Term
| What should be considered in cases of abuse when an infant has unexplained irritability or grunting respirations and no other findings? |
|
Definition
|
|
Term
| Which type of fracture is due to a caregiver forcefully grabbing a child's arm and twisting it? |
|
Definition
|
|
Term
| Which type of fracture can be caused by a torsional force or slowly applied bending force? |
|
Definition
|
|
Term
| Which types of fractures are the results of mild-to-moderate compression forces delivered in direction parallel or nearly parallel to the axis of a bone? |
|
Definition
|
|
Term
| Which type of fracture is described as "high-energy injury" that are likely to be accompanied by acute soft tissue swelling and deformity? |
|
Definition
| Transverse and three-point bending |
|
|
Term
| What mode of imaging is best for detecting skull fractures? |
|
Definition
|
|
Term
| Which mode of imaging is especially good at revealing interhemispheric subdural hematomas along the falx and in the parietaloccipital area? In which type of victims are these particular injuries commonly seen in? |
|
Definition
|
|
Term
| What imaging test is good for detecting edema? |
|
Definition
|
|
Term
| Which imaging test is 50% more accurate at detecting small subdural hematomas over the convexities? |
|
Definition
|
|
Term
| What mode of imaging is BEST for detecting subtle contusions and small parenchymal hemorrhages? |
|
Definition
|
|
Term
| What is the most typical pattern of oral/mucosal injuries in infants of abuse? What is this injury caused by? |
|
Definition
bruising of the mucosa or the upper lip or the maxillary gingiva
Covering a child’s mouth or force feeding with bottle or spoon |
|
|
Term
| What are the parental risk factors of abuse? |
|
Definition
Past hx of being abused
Domestic Violence in the home
Alcoholism or Substance abuse
Mental Illness
Poor socialization
Limited ability to deal with stress or emotions
Member of certain cults or sects |
|
|
Term
| What are the risk factors of abuse associated with the child? |
|
Definition
Age < 3y/o
Being separated from mother at birth b/c of illness
Being unexpected child
Small for gestational age, born with chronic illness or congenital abnormality
Perception of child as difficult or different
Having ADHD or ODD
Being a foster child or adopted child |
|
|
Term
| What is the most typical pattern of oral/mucosal injuries in children of abuse? |
|
Definition
| punches; forceful slaps, especially with the back of a hand; or kicks can cause lip lacerations and contusions, frenulum, gingival tears, dental fractures, chin lacerations, and mandibular fractures. |
|
|
Term
| What is the abused child with a septal hematoma especially vulnerable to developing? |
|
Definition
| a septal abscess due to delay in presentation |
|
|
Term
| In what aged children are Metaphyseal and periosteal stripping injuries more common signs of abuse? |
|
Definition
|
|
Term
| In what aged children are shaft fractures more common signs of abuse? |
|
Definition
| older infants and toddlers |
|
|
Term
| In which age group of children are symmetrical thin rims of subperiosteal new bone (<2 cm in width) a NORMAL and COMMON finding, and not a sign of abuse? |
|
Definition
| infants younger than 3 to 6 months of age. |
|
|
Term
| What are the findings on PE indicative of shaken baby syndrome? |
|
Definition
Retinal hemorrhages
Subdural hematomas
Metaphyseal Fractures
Rib fractures (posterior) |
|
|
Term
| What are the MC COD in children? |
|
Definition
| head trauma, abdominal trauma, or suffocations |
|
|
Term
| When are the vast majority of inflicted fractures seen? |
|
Definition
| before age 3 years (60% of those seen before 18m/o) |
|
|
Term
| In what population do the majority of shaken baby instances occur? |
|
Definition
| 80% of victims with are less than 1 yo |
|
|
Term
| What condition is described as alterations in spinal alignment in the AP or frontal plane? |
|
Definition
|
|
Term
| Which type of scoliosis is caused by an underlying neuromuscular d/o? |
|
Definition
|
|
Term
| Which type of scoliosis is caused by CP, DMD, Spinal Muscular atrophy or Myelodysplasia? |
|
Definition
|
|
Term
| Which type of scoliosis is caused by Leg length discrepancy? |
|
Definition
|
|
Term
| Is scoliosis MC in females or Males? |
|
Definition
|
|
Term
| What is the MC pattern of curvature in scoliosis? |
|
Definition
|
|
Term
| What do Left Thoracic curvature of Scoliosis with back pain have an increased incidence of? |
|
Definition
| intraspinal pathology (syrinx or tumor):MRI |
|
|
Term
| If congenital scoliosis is identified, what other investigation should be done? |
|
Definition
|
|
Term
| When do the scoliosis abnormalities in congenital scoliosis first appear? |
|
Definition
|
|
Term
| What is the MC abnormality, found in conjunction with congenital scoliosis? |
|
Definition
| Unilateral Renal Agenesis |
|
|
Term
| What age group classification is idiopathic scoliosis MC? |
|
Definition
|
|
Term
| What is the tx for Idiopathic Scoliosis? |
|
Definition
Physical Therapy
Orthopedic Referral
Orthosis/Bracing
Surgery (>40 degrees) |
|
|
Term
| What is the treatment for congenital scoliosis? |
|
Definition
Early diagnosis/Prompt tx
Orthotic tx is limited b/c curves are rigid |
|
|
Term
| What is the tx for neuromuscular scoliosis? |
|
Definition
Tx goal is to prevent progression and loss of funx.
Surgery is necessary in most cases
Orthotics/bracing not usually effective |
|
|
Term
| Which type of neuromuscular scoliosis have a lower incidence of spinal deformity? Which have a higher incidence? |
|
Definition
Lower = Ambulatory Pts
Higher = Non-ambulatory |
|
|
Term
| Which type of scoliosis is described as curves are long and sweeping, producing pelvic obliquity,cervical spine curves and pulmonary funx involvement? |
|
Definition
| Nonambulatory Neuromuscular Scoliosis patients |
|
|
Term
| What condition is described as an increased angulation in the thoracic or thoracolumbar spine in the sagittal plane? |
|
Definition
|
|
Term
| Which type of kyphosis is described as "bad posture"? How is it treated? |
|
Definition
| Postural Kyphosis; Treated by voluntary correction |
|
|
Term
| What condition is described as congenital failure of formation of all or part of a vertebral body, but preservation of the posterior elements, and failure of anterior segmentation of the spine? |
|
Definition
|
|
Term
| On x-ray you see a narrowing of the disc space, loss of normal anterior height, wedging of 5 degrees in 3 or more vertebrae, irregularities at end plates and Schmorl nodes. What condition are these findings consistent with? |
|
Definition
|
|
Term
| What is the 2nd MC spinal deformity? |
|
Definition
|
|
Term
| What are described as are protrusions of the cartilage of the intervertebral disc through the vertebral body endplate and into the adjacent vertebra? What condition are they seen in? |
|
Definition
| Schmorl's nodes or Schmorl's nodules; Scheuermann Disease |
|
|
Term
| What is the Most Important maneuver in examining the newborn hip? |
|
Definition
|
|
Term
| Which condition is described as impairment of the blood supply to the developing femoral head results in avascular necrosis? |
|
Definition
| Legg-Calve-Perthes Disease (aka Aseptic Hip Necrosis) |
|
|
Term
| A 9 y/o male pt presents to you with c/o a painless limp. There is a flexion contracture of the the affected hip and well as a + Trendelenburg sign. There are no significant findings on x-ray. What condition do you suspect? |
|
Definition
| Legg-Calve-Perthes Disease (aka Aseptic Hip Necrosis) |
|
|
Term
| When does Legg-Calve-Perthes Disease (aka Aseptic Hip Necrosis) manifest itself (what age)? |
|
Definition
| Between the ages of 4y/o and 11y/o |
|
|
Term
| What is the tx for Legg-Calve-Perthes Disease? |
|
Definition
Self-Limited (lasts 1-2yrs)
Causes permanent degenerative changes - Surgery |
|
|
Term
| What condition is caused by a microfracture of the tibial tuberosity where the patellar tendon inserts? |
|
Definition
|
|
Term
| Is Osgood-Schlatter's MC in females or males? |
|
Definition
|
|
Term
| Pt presents with anterior knee pain when going up and down stairs. On PE there is swelling, tenderness and increased prominence of the tibia tubercle. What condition do you suspect? |
|
Definition
|
|
Term
| What is the treatment for Osgood-Schlatter's dz? |
|
Definition
Rest, Restriction of Activities, Brace (Immobilizer)
- Requires 1 - 2 yrs to heal |
|
|
Term
| What is the MC pediatric foot deformity? |
|
Definition
| Calcaneovalgus Foot Deformity |
|
|
Term
| What condition is described as displacement of the femoral head from the femoral neck thru the epiphyseal plate? |
|
Definition
| SCFE - Slipped Capital Femoral Epiphysis |
|
|
Term
| IS Legg-Calve-Perthes unilateral or bilateral? |
|
Definition
|
|
Term
| Is SCFE unilateral of bilateral? |
|
Definition
|
|
Term
| Pt presents with a painful limp, without hx of trauma. Pain is in the thigh and knee. On PE the LE is in external rotation. Pt has an antalgic gait with abductor lurchgait, flexion contracture, limited ROM and shortening of affected LE. On x-ray a widened and radiolucency of physis is seen as well as a displacement of the femoral head. What condition do you suspect? |
|
Definition
| SCFE - Slipped Capital Femoral Epiphysis |
|
|
Term
| What is the tx for mild to moderate SCFE? |
|
Definition
|
|
Term
| What is the tx for Severe SCFE? What are the complications? |
|
Definition
| Pin fixation but may have complications of avascular necrosis |
|
|
Term
| What conditions pathology is described as hormonal changes result in the loss of mechanical integrity of the growth plate causing increased shearing and stress and slippage occurs? |
|
Definition
| SCFE - Slipped Capital Femoral Epiphysis |
|
|
Term
| What is the medical term for "knock-knees"? |
|
Definition
|
|
Term
| What is the medical term for "bow-legged"? |
|
Definition
|
|
Term
| When does bilateral congenital genu varum resolve? By what age should it have corrected itself? |
|
Definition
| 6 - 12 mo after independent ambulation begins - should correct itself by 2 y/o |
|
|
Term
| When is genu varum seen first? |
|
Definition
|
|
Term
| When is genu valgus seen first? |
|
Definition
|
|
Term
| When does genu valgus resolve? |
|
Definition
| Resolves with growth between 5 and 8 y/o |
|
|
Term
| What are associated conditions with genu valgus? |
|
Definition
| Ligamentous laxity and mild pes planus |
|
|
Term
| Should genu varum be unilateral or bilateral at presentation? |
|
Definition
| bilateral - if unilateral suspect underlying pathology |
|
|
Term
| Is congenital hip dysplasia MC in males or females? |
|
Definition
| 9:1 more common in females |
|
|
Term
| What condition's pathology is described as maternal estrogens and other hormones associated with pelvic relaxation result in temporary relaxation of the newborn hip joint? |
|
Definition
| Congenital Hip Dislocation (aka DDH - Developmental Dysplasia of the hip) |
|
|
Term
| What is the birth position associated with the highest risk of Congenital Hip Dislocation or DDH? |
|
Definition
| frank breech (bottom first) position with the hips flexed and the knees extended is the position of highest risk |
|
|
Term
| What maneuver is used to reduce a recently dislocated hip in a newborn? |
|
Definition
|
|
Term
| How can hip stability as well as acetabular development be assessed accurately in neonates and young infants (less than 6 mo old)? |
|
Definition
|
|
Term
| What imaging study can be used to evaluate hip stability and acetabular development in older infants and children (greater than 6 mo of age)? |
|
Definition
| Radiographic evaluation including anteroposterior and Lauenstein (frog) lateral radiographs of the pelvis |
|
|
Term
| Newborn pt has limitation of hip abduction. What condition might you suspect? |
|
Definition
| Ipsilateral soft tissue contractures caused by CHD or DDH |
|
|
Term
| Newborn pt has hip abduction contractures. What condition might you suspect? |
|
Definition
| may indicate dysplasia of the contralateral hip |
|
|
Term
| In older or walking children, complaints of limping, waddling, increased lumbar lordosis, toe walking, and leg length discrepancy may indicate what condition? |
|
Definition
| may indicate an unrecognized DDH. |
|
|
Term
| When should a case of scoliosis be referred to an orthopedic physician? |
|
Definition
Skeletally immature with a curve of >20 degrees
Skeletally mature with a curve of >40 degrees
Presence of suspicious pain or neurologic symptoms |
|
|
Term
| What is the description of a grade 1 sponylolisthesis? What treatment is indicated for Grade 1 spondylolisthesis? |
|
Definition
Grade 1 = <25%
Tx - No treatment, conservative management or surgery |
|
|
Term
| What is the description of a grade 2 sponylolisthesis? What treatment is indicated for Grade 2 spondylolisthesis? |
|
Definition
Grade 2 = 25% - 50%
Tx - spinal fusion |
|
|
Term
| What is the description of a grade 3 sponylolisthesis? What treatment is indicated for Grade 3 spondylolisthesis? |
|
Definition
Grade 3 = 50% - 75%
Tx - Spinal Fusion |
|
|
Term
| What is the description of a grade 4 sponylolisthesis? What treatment is indicated for Grade 4 spondylolisthesis? |
|
Definition
Grade 4 = 75% - 100%
Tx - Spinal fusion |
|
|
Term
| What is the description of a grade 5 sponylolisthesis? What treatment is indicated for Grade 5 spondylolisthesis? |
|
Definition
Grade 5 = Complete
Tx - spinal fusion |
|
|
Term
| If spondylolithesis or spondylosis is asymptomatic, what is the treatment? |
|
Definition
|
|
Term
| If spondylolithesis or spondylosis is painful, what is the treatment? |
|
Definition
|
|
Term
| What back condition is common in gymnasts? |
|
Definition
| Spondylosis and Spondylolisthesis |
|
|
Term
| Which condition is described as a defect of the pars interarticularis without forward slippage of the involved vertebra on to the one below? |
|
Definition
|
|
Term
| Which condition is described as forward slippage or displacement of the involved vertebra? |
|
Definition
|
|
Term
| Pt presents with back pain. On PE you note a palpable “step-off” at the lumbosacral area with a vertically oriented sacrum. What condition do you suspect? What imaging studies should you order to confirm your dx? |
|
Definition
| standing PA and Lateral views of the entire spine with an oblique radiograph of the lumbar spine |
|
|
Term
| What can a progressive kyphosis deformity result in? |
|
Definition
|
|
Term
| What is the treatment for torticollis? |
|
Definition
| Increase ROM - Correcting the cosmetic deformity |
|
|
Term
| How is patellar chondromalacia treated? |
|
Definition
Anti-inflammatories
Strengthening exercises of the Vastus medialis mm |
|
|
Term
| How is patellar subluxation or dislocation treated? |
|
Definition
Nonoperative- Physical Therapy
Surgical Correction |
|
|
Term
| How is nursemaid's elbow treated? |
|
Definition
| closed-reduction = supinate forearm while pressing down on radial head |
|
|
Term
| What treatment option for CHD or DDH is 95% successful? |
|
Definition
|
|
Term
| What is the treatment of choice in older infants (1 - 6 m/o) with true dislocation of the hips? |
|
Definition
| Pavlik Harness - Usually, spontaneous relocation of the femoral head occurs within 3-4 wk |
|
|
Term
| What is the MAJOR method of treatment for CHD or DDH in infants 6 mo - 18 mo? |
|
Definition
| surgical closed reduction is the major method of treatment |
|
|
Term
| What is the MAJOR method of treatment for CHD or DDH in babies > 18 mo? |
|
Definition
| deformities are so severe that open reduction is necessary to realign the hip |
|
|
Term
| What is the treatment for a Grade 1 ankle sprain? |
|
Definition
|
|
Term
| What is the treatment for a Grade 2 ankle sprain? |
|
Definition
| splinting or casting for a few weeks |
|
|
Term
| What is the treatment for a Grade 3 ankle sprain? |
|
Definition
|
|
Term
| What is the treatment for femoral anteversion? |
|
Definition
| NO treatment is indicated - condition will resolve with growth |
|
|
Term
| What is the treatment for internal tibial rotation? |
|
Definition
| Treatment is seldom indicated |
|
|
Term
| Are anti-inflammatories beneficial in the treatment of Osgood Schlatters? |
|
Definition
|
|
Term
| What is the treatment for congenital clubfoot? |
|
Definition
Manipulation
Serial Casting
Open Reduction - Surgical release of soft tissue |
|
|
Term
| What is the treatment for MILD metatarsus adductus? |
|
Definition
|
|
Term
| What is the treatment for MODERATE metatarsus adductus? |
|
Definition
| Manipulation, stretching and reverse or straight-last shoes |
|
|
Term
| What is the treatment for SEVERE metatarsus adductus? |
|
Definition
Serial manipulation
Casting for 6-8 weeks
Surgery |
|
|
Term
| What is the treatment for calcaneovalgus foot deformity? |
|
Definition
Non-operative; serial casting
Later - wearing shoes with inner heel wedges and longitudinal arch support |
|
|
Term
| If pes planus is asymptomatic, what is the treatment? |
|
Definition
|
|
Term
| For symptomatic pes planus, what is the treatment? |
|
Definition
| Corrective shoes with arch supports |
|
|
Term
| What is the MC genetic cause of osteoporosis? |
|
Definition
| Osteogenesis imperfecta (OI) (brittle bone disease) |
|
|
Term
| Pt presents with hx of 4 breaks, blue sclera and some hearing deficits. What condition do you suspect? |
|
Definition
|
|
Term
| Which type of OI is lethal in infants, usually resulting in still births? |
|
Definition
|
|
Term
| What can be given to OI pts that has been shown to improve bone density and decrease bone turnover and fractures? |
|
Definition
|
|
Term
| Fracture described as bone bending and buckles rather than breaks? |
|
Definition
|
|
Term
| Fracture line is perpendicular to the long axis of the bone? |
|
Definition
|
|
Term
| Fracture line is at an angle relative to the long axis of the bone? |
|
Definition
|
|
Term
| Which SALTER Harris is described as epiphyseal separation through the physis? |
|
Definition
|
|
Term
| Which SALTER Harris is described as fracture through a portion of the physis and metaphysis? |
|
Definition
|
|
Term
| Which SALTER Harris is described as fx through the physis and epiphysis? |
|
Definition
|
|
Term
| Which SALTER Harris is described as fxc extending through the entire joint including metaphysis, physis and epiphysis? |
|
Definition
|
|
Term
| Which SALTER Harris is described as a crush injury to the physis? |
|
Definition
|
|
Term
| When is the age of onset of JRA? |
|
Definition
|
|
Term
| 14y/o pt presents with swelling, tenderness and pain in her knees and ankles that has lasted for at least 2 months. She has trouble in the morning with her knees as they are really stiff. On presentation her knees and ankles are warm and swollen and lack full ROM. What condition do you suspect? |
|
Definition
|
|
Term
| Which joints are characteristically affected by JRA oligoarthritis? |
|
Definition
|
|
Term
| Pt presents with swelling, pain and tenderness in her hands, elbows, knees and ankles. She is febrile and has felt that way for a long time, approximately 6 weeks. What condition do you suspect? |
|
Definition
|
|
Term
| What pupil irregularity may be found in a pt with JRA? |
|
Definition
|
|
Term
| How is the diagnosis of JRA confirmed? |
|
Definition
|
|
Term
|
Definition
| combination therapy should begin with the least toxic medications, usually NSAIDs, and proceed through hydroxychloroquine, methotrexate, or possibly immunosuppressive or experimental drugs |
|
|
Term
| Pt presents with nonthrombocytopenic palpalpable purpura, arthritis, bowel angina, and renal abnormalities. Rash is on the hips and LE. Labs show clotting factors, and platelets are WNL. On skin biopsy of the rash, your dx is confirmed. What is your dx? What was found on biopsy to confirm your dx? |
|
Definition
Henoch Sholein Purpura (HSP)
IgA found in skin (also would be found in glomeruli and serum) |
|
|
Term
| When do over 90% of cases of HSP occur? |
|
Definition
|
|
Term
| What is the most SERIOUS complication of Kawasaki's disease? |
|
Definition
|
|
Term
| Pt presents with fever x 4days, irritability, oropharyngeal erythema (some present with a strawberry tongue), redness in the whites of the eyes (spares the limbus), rash on chest, LAD and extremity edema. What condition do you suspect? |
|
Definition
|
|
Term
| What further study is warranted in pts < 10y/o that present with scoliosis but "opposite" curves are present? |
|
Definition
|
|
Term
| What is the treatment for scoliosis that is greater than forty degrees of curvature? |
|
Definition
|
|
Term
| After 2y/o what is the normal rate of linear growth? |
|
Definition
|
|
Term
| What is premature thelarche in boys or girls age 0-2 considered? |
|
Definition
| Normal due to maternal estrogen |
|
|
Term
| What ages for boys and girls are the cut-offs for precocious puberty? |
|
Definition
boys < 9 y/o
girls < 8 y/o |
|
|
Term
| Which type of precocious puberty is described as GnRH-DEPENDANT puberty and involves the activation of the Hypothalamic-Pituitary-Gonadal axis? |
|
Definition
| Complete or True Precocious Puberty |
|
|
Term
| Which type of pre-cocious puberty is described as GnRH-INDEPENDANT puberty that involves the adrenal, gonadal, ectopic or exogenous sources of hormone production? |
|
Definition
|
|
Term
| What is the MCC of complete or true precocious puberty? |
|
Definition
|
|
Term
| What is the MCC of psuedoprecocious puberty? What are some other causes? |
|
Definition
CAH is MCC
Other causes include:
TUMORS (adrenal, gonadal and hCG-producing)
Use of EXOGENOUS SEX HORMONES |
|
|
Term
| In males on PE, what is a characteristic sign of pseudoprecocious puberty? |
|
Definition
| Penile length is disproportionately greater than testicular size |
|
|
Term
| If a pt presents after swallowing a button battery, what are the initial steps? |
|
Definition
Obtain an x-ray
Call the National Button Battery Ingestion Hotline
MEDICAL EMERGENCY |
|
|
Term
| If a pt has swallowed a button battery and it is lodged in their esophagus, what must you do for tx? Why? |
|
Definition
| REMOVAL; Button batteries in the esophagus can cause severe burns in just 2 hours |
|
|
Term
| If a pt has swallowed a button battery and it has passed beyond the esophagus, what is your next action if the pt is asymptomatic? |
|
Definition
| Removal is not indicated unless symptomatic - Watch and wait for button to pass or symptoms requiring removal (fever, abdominal pain, vomiting or blood in the stools) |
|
|
Term
| What types of foreign bodies lodged in the esophagus require EMERGENT Endoscopy? |
|
Definition
Button Batteries
Sharp Objects |
|
|
Term
| In the first mo of life, which two organisms are the MCC of sepsis? |
|
Definition
|
|
Term
| In infancy and early childhood, what organism is the MCC of sepsis? |
|
Definition
|
|
Term
| What is the treatment for sepsis? |
|
Definition
| stabilization and antibiotic tx (VANC) |
|
|
Term
| When should you consider admission for pneumonia? |
|
Definition
Pulse ox < 93%
O2 desaturation with crying, feeding or exercise
Age < 3mo
Toxic Appearance
Grunting with respiration
Comorbidities |
|
|
Term
| What is the treatment for MOST viral pneumonias? |
|
Definition
|
|
Term
| If pt is admitted for pneumonia based on criteria, what is the treatment? |
|
Definition
| IV Antibiotics started in the ER (ROCEPHIN) |
|
|
Term
| Which treatment drug is given to pneumonia pts if they are high risk? |
|
Definition
| Ribavirin for HIGH-risk pts |
|
|
Term
| Antidote for Acetaminophen poisoning? |
|
Definition
|
|
Term
| Antidote for Iron poisoning? |
|
Definition
|
|
Term
| Antidote for pesticide poisoning? |
|
Definition
|
|
Term
| Antidote for narcotic poisoning? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Antidote for Carbon Monoxide poisoning? |
|
Definition
|
|
Term
| Antidote for Cyanide poisoning? |
|
Definition
|
|
Term
| Antidote for Benzo overdose? |
|
Definition
|
|
Term
| Which type of burn is painful, erythematous and only involves the epidermis? |
|
Definition
|
|
Term
| Which type of burn involves both the epidermis and dermis, results in painful blisters? |
|
Definition
| Second Degree (Superficial) |
|
|
Term
| Which type of burn involves the dermis and epidermis and results in white lesions and decreased pain? |
|
Definition
|
|
Term
| Which type of burn involves the epidermis and ALL of the dermis, includes the dermal appendages is described as a leathery and painless lesion? |
|
Definition
|
|
Term
| What is the MCC of osteomyelitis? |
|
Definition
|
|
Term
| What is the first symptom of osteomyelitis? What other symptoms may also be present? |
|
Definition
| PAIN; fever, limp, abscess |
|
|
Term
| What is the MCC of bronchiolitis? |
|
Definition
|
|
Term
| What is the MC pathogen causing pneumonia in school aged children and adolescents? |
|
Definition
| S. pneumonia, C pneumonia and S aureus |
|
|
Term
| In a hospitalized pt, what is the MC type of nosocomial cause of pneumonia? |
|
Definition
|
|
Term
| Pt presents with severe pain in their R knee. They have had the pain for 3 days and are now beginning to limp. The parent reports no trauma preceding the pain, but does indicate that 1 week prior to the pain beginning that the toddler had scraped his knee at church while playing on the playground. On PE his knee is swollen, tender and he is febrile. What condition do you suspect? What will you use to confirm your diagnosis? |
|
Definition
Osteomyelitis
X-ray may show abscess formation, Blood culture to confirm and to identify pathigen |
|
|
Term
| 4 y/o girl presents with refusal to use her L arm. Her mother explains she was playing ring-around-the-rosie in the yard with her older siblings and they brought her inside when she stopped using her L arm. She was never was distressed, but since she hasn't used her arm for the last 5 hrs, the mom got worried and brought her in. What condition do you suspect? What techniques can you use to treat it? |
|
Definition
Nursemaid's Elbow
Tx using supination reduction technique or the hyperpronation technique |
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Term
| What is the MC type of presentation of bacterial meningitis? |
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Definition
| A SLOW progression of febrile illness (generally over several days) |
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Term
| Pt presents after a fever for 2 days that has progressively worsened. Now the pt appears toxic and has stopped feeding, is lethargic and decreased responsiveness and has vomited 3 times. What condition might you suspect? |
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Definition
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Term
| Pt presents to ER and has hands on knees and is bent over. The pt has accessory muscle use with respiration. SubQ Epi is given with no improvement. What condition do you suspect? |
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Definition
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Term
| Pt has wheezes on inspiration on expiration, respiratory stridor, chest pain, hemoptysis, and cough. What condition might you suspect in this child? |
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Definition
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Term
| Newborn pt presents with jaundice, decreased alertness, hypotonia, and poor feeding in the first few days of life. Then hypertonia of the extensor muscles develops and pt begins to have retrocolis (backward arching of the back). What condition do you suspect? |
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Definition
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Term
| What condition is caused by hyperbilirubinemia leading to CNS deficits? |
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Definition
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Term
| What organs are MOST affected by Reye syndrome? What occurs in those organs? |
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Definition
| Liver (accumulation of fat) and Brain (increased pressure) |
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Term
| Pt presents with persistent vomiting, listlessness, irritability, disorientation and confusion as well as combativeness. Mom explains the child had a fever and cough and she gave him ASA to bring down the fever. What condition do you suspect? |
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Definition
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Term
| What condition is described as a seizure associated with fever, without evidence of intracranial infection or other defined cause? |
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Definition
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Term
| When do febrile seizures usually occur? |
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Definition
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Term
| What is the treatment for a febrile seizure? |
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Definition
| treat the fever! - Acetaminophen or Ibuprofen |
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Term
| What condition is described as congenital hypothyroidism? |
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Definition
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Term
| Pt has broad nasal bridge, thick lips, umbilical hernia, puffy-looking face, dull look, thick protruding tongue, dry brittle hair, low hairline, jaundice, poor feeding, lack of muscle tone, and short stature. What condition do you suspect? |
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Definition
| Cretinism - Congenital Hypothyroidism |
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Term
| What are the 2 major categories of delayed puberty? |
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Definition
Hypergonadotropic hypogonadism
Hypogonadotrophic hypogonadism |
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Term
| What is the difference between hypergonadotropic hypogonadism and hypogonadotropic hypogonadism? |
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Definition
Hyper= HIGH LH and FSH
Hypo = Low or Normal LH and FSH |
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Term
| What are the ONLY appropriate times for rapid growth? |
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Definition
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Term
| What is an early sign of B12 deficiency? |
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Definition
| hypersegmented neutrophils |
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Term
| What condition has a smooth beefy red tongue? |
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Definition
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Term
| What is the difference btwn B12 and folate def in the later stages? |
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Definition
| B12 causes neurological deficits wheres are folate does not |
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Term
| What are the serum and urine findings indicative of B12 deficiency? |
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Definition
Serum = low B12
Urine = Methylmalonic acid |
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Term
| When in young pts should folate deficiency be expected? |
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Definition
| In VLBW babies and newborns (they need as much as 10x the normal adult amt of folate) |
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