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comp 3 - Peds
Nova Orlando
258
Health Care
Graduate
05/07/2011

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Cards

Term
delay in obtaining milestones suggests what?
Definition
mentl retardation
Term
gross motor involvement at 2 months old
Definition
cradled in parent's arm
Term
gross motor involvement at 6 months old
Definition
sitting on the parent's lap or on the exam table requiring minimal trunk support
Term
gross motor involvement at 12 months old
Definition
cruising or toddling through the room
Term
what is an abormality of gross motor involvement?
Definition
at 6m old shows poor head control with pull to sit maneuver
Term
sits alone momentarily
Definition
4-8m
Term
rolls back to stomach
Definition
4-10m
Term
sits steadily
Definition
5-9m
Term
gets to sitting
Definition
6-11m
Term
pulls to standing
Definition
9-12m
Term
stands alone
Definition
9-16m
Term
walks three steps alone
Definition
9-17m
Term
moro reflex
Definition
birth - 4m
Term
palmar grasp reflex
Definition
birth - 3m
Term
crossed adductor reflex
Definition
birth - 7m
Term
toe (plantar) reflex
Definition
birth - 8-15m
Term
asymmetric tonic neck reflex
Definition
2wks - 6m
Term
head righting reflex
Definition
4-6m - persists
Term
protective equilibrium
Definition
4-6m - persists
Term
parachute reflex
Definition
8-9m - persists
Term
crawl reflex
Definition
4 - 6m
Term
platar reflex (babinski)
Definition
birth until 12m
Term
what reflexes persist through adulthood?
Definition
head righting, protective equilibrium, parachute
Term
absent moro reflex is what kind of injury?
Definition
upper motor neuron lesion
Term
incomplete moro reflex may indicate a
Definition
brachial plexus injury
Term
this reflex occurs when the infants body is turned to the side, he assumes the "fencer's" position
Definition
tonic neck reflex
Term
this reflex is performed by placing the child's head and neck off of a flat surface with his arms folded at the chest, the examiner suddenly lets go of the head, neck, and hand. The pt brings his arms back towards his chest with the hands in a "C" shape
Definition
moro reflex
Term
this reflex occurs when pressure is applied to the palm or plantar aspect of the child's hand or foot
Definition
grasp reflex
Term
this reflex occurs when pressure is applied to the palm or plantar aspect of the child's hand or foot
Definition
grasp reflex
Term
this reflex occurs when a child's foot feels a hard surface
Definition
step reflex
Term
this reflex occurs when a child is placed prone after 4-6m of age
Definition
crawl reflex
Term
this reflex occurs when the pt is placed in ventral suspension position and one side of the trunk is stimulated. The child's trunk and hips swing towards the side of the stimulus.
Definition
galant reflex (trunk incurvation)
Term
child has a strong sucking sensation, what reflex?
Definition
suck reflex
Term
child opens his mouth once it is stimulated on the corner of the mouth of cheek, what reflex?
Definition
rooting reflex
Term
this reflex involves extension of the head, then trunk, then legs when held prone. seen between 2-3m
Definition
landau response
Term
this reflex involves stroking the lateral aspect of the infants foot causing an extension of the big toe and fanning out of the little toes. This response is normal until 12m of age, due to incomplete myelination of the corticospinal tracts.
Definition
plantar reflex (Babinski)
Term
reflex involves child adducting legs across midline
Definition
crossed adduction
Term
this reflex involves the child keeping his head vertical despite a tilt of the body
Definition
head righting
Term
as the child is pushed laterally by the examiner, he flexes his trunk toward the force to regain his center of gravity, what reflex?
Definition
protective equilibrium
Term
examiner allows the child to free fall in ventral suspension, the child's extremities extend symmetrically to distribute his weight over a broader and more stable base on landing, what reflex?
Definition
parachute
Term
when does head righting take place?
Definition
6w - 3m
Term
when does the landua reponse take place?
Definition
2-3m
Term
when does derotational righting take place?
Definition
4-5m
Term
when does anterior propping take place?
Definition
4-5m
Term
when does the parachute reflex take place?
Definition
5-6m
Term
when does lateral propping take place?
Definition
6-7m
Term
when does posterior propping take place?
Definition
8-10m
Term
child focuses on face, tracts vertically and horizontally, turns towards light, widens eyes at 8-12 inches
Definition
term
Term
child blinks at approaching objects, tracks 60 degrees horizontally and 30 degrees vertically
Definition
1m
Term
child tracks across midline, follows movement, raises head to 30 degrees from prone position
Definition
2m
Term
child's eyes and head track to 180 degrees, looks at hands
Definition
3m
Term
child reaches for objects, notices raisens 1ft away, smiles at a familiar adult
Definition
4-5m
Term
child smiles in mirror
Definition
5-6m
Term
child rakes at a raisen
Definition
7-8m
Term
child notes visual details, pokes at holes in a pegboard
Definition
8-9m
Term
child has a neat pincer grasp
Definition
9m
Term
child stacks blocks, places peg in round hole
Definition
12-14m
Term
what age?
holds head up and turns head to side while prone, flexes in ventral suspension, moves in response to sound, primitive reflexes present
Definition
neonatal 0-1m
Term
what age?
doll's eye movement, visually fixes, regards face, tight grasp, follows object to midline
Definition
neonatal 0-1m
Term
what age?
lifts head to 45 degrees while prone, head and trunk level in vental suspension, head lags on pull to sitting, holds head in midline, lefts chest off table
Definition
2m
Term
what age?
child visually tracks moving objects 180 degrees, smiles on social contact, responds to voice:coos, recognizes parent
Definition
2m
Term
what age?
child lifts head up to 90 degrees, supports self on forearms in prone position, holds head up steadly while in prone, fingers and toes make pre-reach movements
Definition
3m
Term
what age?
holds hands open at rest, looks at hands, coos:produces long vowel sounds, reaches for familiar people, anticipates feeding
Definition
3m
Term
what age?
raises head vertically when prone, sits with truncal support, head tipped forward, no head lag, rolls over, supports on wrists and shifts weight, grasps objects and brings to mouth
Definition
4m
Term
what age?
active at site of food, laughs/orients to voice, displeased when social contact is broken, enjoys looking around
Definition
4m
Term
what age?
lifts head while supine, rolls front to back and back to front, sits with pelvic support, rounded back, grasps and transfers objects, rakes at pellet
Definition
6m
Term
what age?
puts feet in mouth in supine position, turns body to extend reach (unilateral), raking grasp: transfers objects, makes repetitive vowel sounds: babbles, discriminates social smile, prefers mother, recognizes strangers
Definition
6m
Term
what age?
sits alone with back straight, pivots when sitting, pulls to stand, creeps or crawls: walks with hands held
Definition
9m
Term
what age?
find pincer grasp, alert to sound of name, understands "no", waves "bye-bye", uncovers hidden objects, plays peek-a-boo, repeats consonant sounds, says mama, dada
Definition
9m
Term
what age?
stands without help, walks with one hand held, cruises, releases on request and gesture
Definition
12m
Term
what age?
neat pincer grasp (unassisted), puts 2 cubes in a cup and pellets in a bottle, uses 2 words other than mama/dada, throws a ball, imitates actions, comes when called, cooperates with dressing
Definition
12m
Term
what age?
walks alone, can walk backwards, crawls up stairs, scribbles in imitation, makes tower of 2 cubes
Definition
15m
Term
what age?
indicates wishes by pointing, uses 4-6 words, follows one step command with gesture, can use a spoon (spills a little) and a cup
Definition
15m
Term
what age?
walks downstairs assisted, runs stiffly, sits on small chair, feeds self, kisses parents with pucker, says "no", knows 7-20 words
Definition
18m
Term
what age?
makes tower of 3 cubes, scribbles spontaneously, turns 2-3 pages at a time, mature jargoning, copies parents in tasks (sweeping/dusting), identifies 5 body parts, names pictures, explores drawers and waste baskets
Definition
18m
Term
what age?
walks step wise up and down stairs without help, jumps in place with both feet off, uses "i" and "you", 3 word phrases and 50 vocab words, understands 2 step commands
Definition
24m
Term
what age?
listens to stories with pictures, makes tower of 7 cubes, circular scribble, opens doors, handles spoon, turns pages one at a time, removes shoes, pants, etc, parallel play
Definition
24m
Term
what age?
throws ball overhand, unbuttons, holds pencil in adult fashion, differentiates horizontal and vertical line
Definition
30m
Term
what age?
uses pronouns appropriately, understands concept of "1", repeats 2 digits forward, repeats 2 digits forward, tells first and last name when asked
Definition
30m
Term
what age?
can alternate feet when goes up steps, pedals tricycle, copies circle, undresses completely, dresses partially, unbuttons
Definition
3yrs
Term
what age?
dries hands if reminded, uses min of 250 words, 3 word phrases, uses pleural, past tense, knows all pronouns, understands concept of "2", group play, shares toys, takes turns, plays well with others, knows full name, age, gender
Definition
3yrs
Term
what age?
hops skips, alternates feet going down steps, copies a square, buttons clothing, dresses self completely, catches a ball
Definition
4yrs
Term
what age?
knows colors, says song or poem from memory, asks questions, tells "tall tales", plays cooperatively with group of children
Definition
4yrs
Term
what age?
skips alternating feet, jumps over low obstacle, copies triangle, ties shoes, spreads with knife
Definition
5yrs
Term
what age?
prints first name, asks what word means, plays competitive games, abides by rules, likes to help in household tasks
Definition
5yrs
Term
what is the gold standard for dx of ADHD?
Definition
Connor's scale
Term
what are the types of ADHD?
Definition
inattentive, hyperactive-impulsive, combined
Term
what is the best tx for ADHD?
Definition
medication
Term
what resources are available for ADHD at the different ages?
Definition
age 0-3 = early intervention services
3-21yrs = special education and individual education plan
Term
meds used in the tx of ADHD
Definition
stimulants:ritalin, concerta, daytrana, focalin, dexedrine, vivanse, adderall
nonstimulants: stattera
antidepressants
Term
mental retardation is defined as an IQ below
Definition
70-75
Term
what dietary changes should be made in an ADHD child?
Definition
elimination diet: cut sugar, dairy, food colorings, artifical sweeteners, fried foods, MSG, processed meats and foods
avoid aluminum and heavy metals
try high protein, low carb, mineral supplements, omega oils
more water, fruits, veggies
Term
groups of disorders characterized by delays in social and communication skills
Definition
pervasive developmental disorder
Term
when is the onset of pervasive developmental disorder?
Definition
< 3 yo
Term
impairment of social interactions and communication
repetitive, restrictive, or stereotyped behavior
Definition
Autism
Term
who is Asperger's syndrome most common in?
Definition
males
Term
impairment of social interaction and restricted repetitive patterns of behavior,
fail to develop peer relationships and display an inability to express pleasure in happiness of others,
delay in language, cognition, or attainment of self-help skills
Definition
Asperger's syndrome
Term
who is Rett's syndrome more common in?
Definition
females
Term
child is normal for the first 6m then exhibits sxs of autism, receptive and expressive language delay, psychomotor retardation, decreased head growth, breathing abnormalities, seizurse, poor coordination of gait and trunk movements
Definition
Rett's syndrome
Term
tx of Rett's syndrome
Definition
no cure, meds to tx specific sxs.
benefit from specialized classrooms where the class size is small and instructions are given on a one to one basis.
Intense early intervention services - educational and behavioral
Term
when does conduct disorder usually present?
Definition
in early or middle childhood as ODD
Term
defiance of rules and argumentative verbal interactions
Definition
Oppositional Defiant Disorder (ODD)
Term
criteris for dx of ODD
Definition
aggression towards people and animals
nonaggessive destruction of property
deceitfulness
lying and theft
serious violations of the rules
Term
how does a child with ODD present: <10yo, >10yo
Definition
< 10yo = deomstrat
Term
how can you diagnose ODD: <10yo, >10yo
Definition
< 10yo = deomstrate even one of the criterion for antisocial behavior
> 10yo: requires 3 criteria
Term
when is tx for ODD most successful?
Definition
when started early
need medical, mental health, and educational components as well as family support.
Term
loss of appetite
Definition
anorexia
Term
hungry but restricts food intake
Definition
anorexia nervosa
Term
vomits usually within 2 hours of overeating due to over-concern of weight gain
Definition
bulimia
Term
binging without purging
Definition
binge eating disorder
Term
overeating
Definition
binge
Term
elimination of food by vomiting of laxative use
Definition
purging
Term
criteria for dx of anorexia nervosa
Definition
BMI < 17.5
loses > 25% of ideal body weight
Term
when s psychotherapy most effective for anorexia nervosa?
Definition
if initiated within 6m or less
Term
meds used to treat anorexia nervosa
Definition
antipsychotic (olanzapine)
antidepression (SSRI - fluoxetine)
Term
swollen salivary glands, scars on knuckles, erosion of tooth enamel, low potassium on blood test, dx?
Definition
bulimia
Term
tx of bulimia?
Definition
psychotherapy, SSRI
Term
inflated self esteen, delusions of grandeur, talks constantly and rapidly, easily distracted, depression (anorexia, overeating, oversleeping)
Definition
bipolar disorder
Term
tx of bipolar disorder
Definition
psychiatrist/psychotherapy
meds:lithium, tegretol, depakene
hospitalization
Term
who is often the perpetrator in Munchausen by Proxy?
Definition
mother, sxs are often present only in the presence of the mother, and subside in her absence. The mother's partner is often disengaged.
Term
what is the normal time frame for colic?
Definition
3wks - 3m
Term
criteria for dx of colic
Definition
lasts >3hrs, >3d/wk, >3wks/m
Term
what are the 5 "S's" in the tx of colic
Definition
swaddling
side/stomach
swinging
shhhh
sucking
Term
tx of colic
Definition
meds: simethicone, dicyclomine
if breast feeding: have mom stop dairy, whey, or casein x 1 wk
probiotics
chamomille, anis, fennel, dill tea
gripe water
tummy massage
Term
criteria to dx chronic abdominal pain
Definition
3+ episodes of pain over a 3m period severe enough to affect activities
Term
sxs of lactose intolerance (3)
Definition
bloating, gassy, diarrhea
Term
sxs of irritable bowel syndrome (5)
Definition
pallor
nausea
vomiting
headache
diarrhea
Term
usual timeframe for GER
Definition
common in infancy and disappears by 1-2 years of age
Term
sandifer syndrome
Definition
abnormal posturing due to reflux
Term
how do you dx severe GER?
Definition
pH studies, scope, barium xrays
Term
tx of GER
Definition
left recumbant/prone position
elevating head of crib
smaller more frequent feedings
keep upright after feedings
thicken with rice cereal
antacids, H2RA, PPI
pro-motility agents (controversial)
Term
tx for GERD unresponsive to medical therapy
Definition
Nissen Fundoplication
Term
what increases the risk of pyloric stenosis in neonates?
Definition
erythromycin
Term
narrowing of the pyloric channel due to hypertrophy of the pyloric musculature, etiology = unknown
Definition
pyloric stenosis
Term
persistent hunger, constipation, dehydration, unconjugated hyperbilirubinemia, peristalic waves, firm pyloric olive, prejectile, nonbilious emesis
Definition
pyloric stenosis
Term
how do you confirm the dx of pyloric stenosis?
Definition
ultrasound, if still questionable use GI barium study which will demonstrate a "string sign"
Term
normal pyloris size
Definition
<15cm long, <3mm wide
Term
sudden onset bilious vomiting and abdominal pain
Definition
volvulus
Term
common presentation of volvulus
Definition
SI is rotated to the right side of the abdomen and the narrowing site has a corkscrew appearance
Term
MC type of constipation
Definition
functional
Term
what's the definition of constipation?
Definition
delay or difficulty passing a bowel movement for 2+ wks that results in pain and discomfort
Term
what is diagnostic for constipation?
Definition
unprepped barium enema radiographic study
Term
what is necessary to confirm constipation?
Definition
rectal biopsy for ganglion cells and acetylchoinesterase stain
Term
what helps differentiate organic from functional constipation in older children?
Definition
rectal manometric studies
Term
developmental disorder of the enteric nervous system = absence of ganglion cells in the distal colon
Definition
Hirschsprung disease
Term
what is missing in Hirschsprung disease?
Definition
the Auerbach and Meissner's plexus = increase extrinsic intestinal innervation and unopposed intrinsic muscle tone leading to an imbalance in smooth muscle contractility, uncoordinated peristalsis, and functional constipation
Term
what should be considered in any newborn who doesn't pass meconium in the first 24-48 hrs after birth
Definition
Hirschsprung disease
Term
barium enema denomstrates a tapered transition zone to a normal caliber colon
the increased number and size of cholinergic nerves in the lamina propia and muscularis mucosae stains black.
Definition
Hirschsprung disease
Term
tx of Hirschsprung disease
Definition
reestablish fluid/electrolyte balance
prevent bowel distention
colonic lavage
NG decompression
surgery
IV antibiotics to prevent enterocolitis after surgery
botox injections to the internal sphincter for post op pts with enterocolitis
Term
causes of diarrhea (3)
Definition
infectious: blood/mucous, fecal leukocytes, stool culture, O&P to look for giardia lamblia
dietary: lactose intolerance, malabsorption
congenital: early onset, poor growth, malnourished
Term
chronic intolerance of dietary gluten that results in malabsorption
Definition
celiac disease
Term
chronic diarrhea, abdominal distention, wt loss, FTT, short stature, abd pain, constipation, arthritis, delayed puberty, anemia, osteoperosis, vomiting, weight loss, protruding abdomen, wasted buttocks
Definition
malabsorption - celiac
Term
gold standard for the dx of malabsorption (celiac)
Definition
small bowel biopsy = villous atrophy, crypt hyperplasia, abnormal surface epithelium
Term
tx of celiac disease
Definition
elimination of gluten (wheat, rye, barley, oats)
serologic testing is used to monitor adherence to the gluten-free diet
Term
GI bleeding proximal to the liagement of Treitz
Definition
upper GI
Term
common causes of UGI bleeding in children < 1 yo
Definition
esophageal varices, pill esophagitis, gastric ulcer, H pylori, duodenal ulcer, IBD
Term
iron deficiency anemia, guaiac positive stools on exam, melanotic stools, coffee ground emesis, hematemesis
Definition
UGI bleed
Term
common causes of LGI bleeding in children < 1 yo
Definition
colonic polyps, anal fissure, intussusception, Meckel diverticulum, IBD, infectious colitis, hemorrhoids
Term
diagnostic exam to determine UGI bleed
Definition
endoscopic examination
Term
how is Meckel's diverticulum diagnosed?
Definition
nuclear scintigraphy
Term
painless maroon or melanotic stool
Definition
Meckel's diverticulum
Term
perianal disease: fistulas/fissures
perianal skin tags
abscesses
transmural inflammation with granuloma formation and skip areas
affect anywhere in the GI tract
Definition
Crohn's disease
Term
rectal disease, mucosal inflammation confied to the large bowel, "lead pipe" appearance
Definition
ulcerative colitis
Term
most common inherited lethal disorder in whites
Definition
cystic fibrosis
Term
all neonates diagnosed wtih meconium ileus must be evaluated for what?
Definition
cystic fibrosis
Term
MC GI abnormality associated with CF?
Definition
involves the pancreas --> steatorhhea
Term
MC finding of liver disease associated with CF
Definition
elevated liver transaminases
Term
pt presents with hx of meconium ileus, FTT, rectal prolapse, steatorrhea and elevated liver transaminases
Definition
cystic fibrosis
Term
definitive dx of eosinophilic esophagitis
Definition
biopsy obtained through upper endoscopy
linear furrowing of the esophagus, esophageal ring formation, and granularity
Term
dysphagia, vomiting, feeding refusal, heartburn, chest pain, abdominal pain
Definition
eosinophilic esophagitis
Term
tx of eosinophilic esophagitis
Definition
diet modifications, corticosteroids
Term
blockage of the intestine where the small intestine invaginates into another section of small bowel and telescopes
Definition
intussesception
Term
early sxs = n/v (bile/green color)
late sxs = rectal bleeding (currant jelly stool mixed with mucous)
Definition
intussesception
Term
retraction of right iliac fossa where the child brings his knees to his chest in pain
Definition
Dance's Sign
Term
prone xray shows minimal gas in the right abdomen and ascending colon
Definition
intussesception
Term
tx of intussesception
Definition
barium or water soluble contrast enema
air insufflation
if caught late = surgery
Term
what is contraindicated if perforation is suspected with intussesception?
Definition
air insufflation and ememas
Term
3 MC locations for foreign bodies to get lodged
Definition
cricopharyngeal muscle
level of the aortic arch
LES at the diaphragm
Term
cough, stridor, odynophagia, retrosternal pain, increased salivation
Definition
foreign body ingestion
Term
what foreign body ingestions are a medical emergency?
Definition
batteries and sharp objects that might penetrate the mucosa
Term
the esophagus ends in a blind pouch rather than connected normally to the stomach
Definition
esophageal atresia
Term
esophageal atresia is often associated with
Definition
tracheoesophageal fistula (TEF)
Term
complication associated with TEF and duodenal atresia
Definition
polyhydramnios
Term
excessive drooling, cough, sneezing, choking, cyanosis
Definition
esophageal atresia
Term
2 types of esophageal atresia
Definition
A (proximal esophageal atresion with distal fistula) = MC
B (esophageal atresia)
Term
tx of esophageal atresia
Definition
emergency surgery, NPO, IVF
Term
supine and erect abdominal xray shows multiple (>6) gas fluid levels
Definition
intestinal obstruction
Term
abdominal pain, abdominal distention, vomiting, fecal vomiting, constipation
Definition
intestinal obstruction
Term
often the first sx of cystic fibrosis
Definition
meconium ileus
Term
what is the tx for malrotation?
Definition
emergent surgical intervention
Term
classic features of intussesception (4)
Definition
fever
intermittent colicky abd pain
currant jelly stools
sausage-like abdominal mass
Term
classic features of pyloric stenosis (3)
Definition
projectile vomiting
olive shaped abdominal mass
hypochloremic metabolic alkalosis
Term
typical presentation of acute appendicitis
Definition
periumbilical pain that migrates to the RLQ, emesis usually follows, rather than precedes the onset of pain
Term
why is surgery necessary with appendicitis?
Definition
prevent risks of perforation and intra-abdominal abscess formation
Term
comfirmatory test for GERD
Definition
24 hr pH probe measurements confirm the presence of abmonral acid in the esophagus
Term
how often should you feed formula: neonate, 2m, 3m
Definition
neonate: q 2-3 hrs
2m: q 3-4 hrs
3m: q 4-6 hrs
Term
how much formula should you feed: 0-1wk, 1wk-1m, 1m-3m, 3m-6m
Definition
0-1wk = 1-3 oz/feeding
1wk-1m = 3-4 oz/feeding
1m-3m = 4-6 oz/feeding
3m-6m = 6-8 oz/feeding
general rule = 2 plus the age of the infant in months until reaches 8oz
Term
deficiency of calcium, phosphate, and vitamin D leads to
Definition
rickets/osteomalacia
Term
deficiency of vitamin A leads to
Definition
night blindness
Term
vitamin C deficiency leads to
Definition
scurvy, bleeding
Term
vitamin E deficiency leads to
Definition
hemolytic anemia, neuropathy
Term
vitamin K deficiency leads to
Definition
petechiae, ecchymoses
Term
thiamin (vitamin B1) deficiency leads to
Definition
beriberi, heart failure
Term
Niacin deficiency leads to
Definition
pellagra dematitis (sun-exp)
Term
riboflavin (vitamin B2) deficiency leads to
Definition
angular stomatitis, cheilosis
Term
vitamin B6 deficiency leads to
Definition
anemia, dermatitis, neuropathy
Term
vitamin B12 deficiency leads to
Definition
anemia, neuropathy
Term
folate deficiency leads to
Definition
anemia
Term
iron deficiency leads to
Definition
anemia, kiolonychia
Term
biotin deficiency leads to
Definition
rash, hair loss
Term
essential fatty acid deficiency leads to
Definition
rash, coagulopathy
Term
zinc deficiency leads to
Definition
rash, growth failure, delayed sexual development
Term
conjunctvitis, rhinitis, pharyngitis, preauricular LAD, low grade fever/malaise, generalized rash wth blanching, maculopapular lesions, morbilliform
Definition
adenovirus
Term
when is adenovirus most contagious?
Definition
adenovirus
Term
when is adenovirus prevalent?
Definition
late winter thru early summer
Term
fever, mild malaise, adenopathy, headache, sore throat, coryza.
distinct pinkish, red, fine maculopapular eruption begins on face and spreads cephalocaudally becoming generalized in 24 hrs then fades and completely clears in 72 hrs
Definition
rubella (German Measles)
Term
small reddish spots on the soft palate, seen on day 1 of the rash
Definition
Forchheimer spots, associated with Rubella
Term
when is Rubella most contagious?
Definition
from a few days before the rash to a few days after the rash
Term
can rubella cross the placenta?
Definition
yes - it's the R in TORCH
Term
when is rubeola most contagious?
Definition
4 days before the rash and 4 days after the rash has resolved
Term
fever, malaise, dry cough, coryza, conjuncitivitis.
blotchy, erythematous, blanching, maculopapular eruption that appears at the hairline and spreads cephalocaudally over 3 days ultimately involving the palms and soles
Definition
Rubeola
Term
complications of Rubeola
Definition
OM, PNA, acute encephalitis
Term
tiny bluish white dots surrounded by red halos
Definition
Koplik spots = Rubeola
Term
tx of rubeola
Definition
supportive
vaccination prevents disease if given to contacts within 72 hours
immune globulin will prevent or modify measles if given within 6 days
Term
affects childen 6-36m, caused by HHV6
abrupt rise in temp, anorexia, irritability, exam shows no source of fever.
erythematous, maculopapular exanthem after fever subsides
Definition
Roseola Infantum (exanthem subitum)
Term
exanthem begin on the face with large, bright red, erythematous patches appearing over both cheeks, warm non-tender, macular with circumscribed borders.
Facial lesions fade then a slightly raised lacy erythematous rash appears on the extensor surfaces of the extremities, then the flexor surfaces, buttocks, and trunk.
resolves in 3-7 days
Definition
Erythema Infectiosum
Term
rash = discrete rose pink macules that begin on the trunk and spread rapidly to the extremities, neck, face, and scalp. May last several hours - 1-2 days before resolution
Definition
Roseola Infantum
Term
causative agent of Erythema Infectiousum
Definition
Parvovirus B19
Term
are fever and constitutional sxs common with erythema infectiosum?
Definition
no
Term
what is a complication of erythema infectiosum in sickle cell pts?
Definition
aplastic crisis
Term
causative agent of infectious mononucleosis
Definition
EBV
Term
fever, fatigue, pharyngitis, LAD, splenomegaly, atypical lymphocytosis, positive hterophile antibody response
Definition
infectious mononucleosis
Term
prodrome of mono: fatigue, malaise, anorexia, fever, headache, sweats, chills. How long does it last?
Definition
3-5 days
Term
how do you dx herpes?
Definition
Tzanck smear
Term
high fever, irritability, anorexia, mouth pain, copious drooling, small yellow ulceration with red halos (buccal/labial mucosa), may auto-innoculate other body parts, herpetic whitlow (lips, fingers, thumbs)
Definition
herpetic gingivostomatitis
Term
MC age for gianotti-crosti syndrome
Definition
1-6yo
Term
crops of lesions appear abruptly
lesions are discrete, firm, lichenoid plaques with flat tops and range from 1-10mm in diameter.
papules can be flesh colored, pink, red, dusky, coppery, or purpuric.
distributed symmetrically over the extremities (includes palms and soles), buttocks & face, sparing trunk and scalp
Definition
Gianotti-Crosti syndrome
Term
T/F Koebner phenomenon is seen in conjuction with Gianotti-Crosti syndrome
Definition
True
Term
what is contraindicated in the tx of Gianotti-Crosti syndrome?
Definition
steroid creams
Term
multi-system, tick-borne infection caused by Borrelia Burgdorferi
Definition
Lyme disease
Term
what type of rash is associated with Lyme disease?
Definition
erythema migrans (target shaped)
Term
neuro/CV manifestations of lyme disease
Definition
aseptic meningitis
unilateral/bilateral facial nerve palsy
Term
tx for lyme disease
Definition
children > 8yo = doxycycline
adults, young children, pregnant/breast feeding women = amoxicillin, cefuroxime (Ceftin)
Term
exanthemous disease caused by Rickettsia Rickettsi
Definition
RMSF
Term
2/3 of cases of RMSF occur in who?
Definition
children younger than 15
Term
fever, headache, anorexia, chills, N/V, abdominal pain
rash begins distally on the wrists, ankles, palms, and soles. Erythematous, blanching, fine, macular/maculopapular eruption. spreads centripetally and becomes petechial. Conjunctival erythema and photophobia are present with rash
Definition
RMSF
Term
tx of RMSF
Definition
doxycycline BID until 3 days after the fever subsides
Term
Se of tetracycline, doxycycline
Definition
tooth discoloration, usually not seen if the child takes the med for 14 days or less
Term
causative agent of cat scratch disease
Definition
bartonella henselae - gram negative rickettsial bacterium
Term
aside from a cat scratch, what else can cause "cat scratch fever"
Definition
splinters, puncture wounds, dog scratches
Term
common ages for cat scratch fever
Definition
5-14yo
Term
when do you sxs of cat scratch fever begin?
Definition
3-30 days after innoculation
red papules, or a series of papules at the site of innoculation, regional nodes are enlarged.
Term
tx of cat scratch fever
Definition
supportive
if not resolving = azithromycin
Term
what CHD are associated with Trisomy 21 (Down's syndrome)
Definition
ASD, VSD
Term
what CHD are associated with Marfan syndrome?
Definition
MVP, aortic aneurysm, aortic root dissection
Term
what CHD are associated with CHARGE syndrome?
Definition
ventricular, atrioventricular and atrial spectal defects
Term
what CHD are associated with Turner syndrome?
Definition
Coarctation of the Aorta, Bicuspid Aortic Valve
Term
What CHD is common in Noonan syndrome?
Definition
pulmonic stenosis
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