Term
| nonorganic failure to thrive (FTT) |
|
Definition
| related to poverty or poor caregiving |
|
|
Term
|
Definition
| seen in babies who are lying in a bed too much --> sign of nonorganic failure to thrive |
|
|
Term
| how much calories do infants need |
|
Definition
120cal/kg in first year
100/kg after that |
|
|
Term
| caloric requirement in FTT inhfants |
|
Definition
|
|
Term
| how long should meals last |
|
Definition
|
|
Term
| signs of baby with CMV inrauterine infection |
|
Definition
developmental delay
IUGR
microencephaly
cataracts
seizures
hepatosplenomegally
jaundice
pupura |
|
|
Term
| diff twix cmv and toxo intrauterine infection |
|
Definition
look the same in a neonate
however in CMV babies will show calcified brain densities of CMV in perventricular pattern
it is scattered brain densities in toxo |
|
|
Term
| when do kids become "picky" eaters |
|
Definition
|
|
Term
| what is renal tubular acidosis |
|
Definition
| inherited or acquired defect that affects the kidneys ability to absorb filtered bicarb OR excrete ammonia |
|
|
Term
|
Definition
normal anion gap
hyperchloremic
metabolic acidosis
net loss of bicarb and gain of H |
|
|
Term
|
Definition
1. distal
2. proximal
3. mixed
4. hypoaldosteronism
"DPMH"
"Renal tubes Dip Pretzels in Mixed Horseradish" |
|
|
Term
| most common types of RTA in children |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Substance abuse vs substance dependence |
|
Definition
| Energy is used to acquire drugs in dependance |
|
|
Term
| Drug that causes nystagmus and ataxia |
|
Definition
|
|
Term
| Drugs that cause pinpoint pupils |
|
Definition
|
|
Term
|
Definition
3500 is average
2700 to 4600g is ok |
|
|
Term
|
Definition
|
|
Term
| Cause of clinodactly in Down's syndrome |
|
Definition
|
|
Term
|
Definition
Association of fetal dysmorphic features that includes
Vertebral problems
Anal atresia
Tracheoesophageal fistula OR
esophageal atresia
Renal problems/radial annomolies
Limb problems |
|
|
Term
|
Definition
| Grey spots around iris seen in Down syndrome |
|
|
Term
| Most common cardiac defects in Down's syndrome |
|
Definition
Endocadial cushion #1
Vsd #2 |
|
|
Term
| Gi issues in Down syndrome |
|
Definition
| 12% have gi atresia of some sort |
|
|
Term
|
Definition
|
|
Term
| Down's syndrome hypotonic or hypertonic mm? |
|
Definition
|
|
Term
| Genetic cause of Down syndrome |
|
Definition
Non disjunction
Failure of chromosomes to separate in meiosis |
|
|
Term
| Long term risks of Down syndrome |
|
Definition
Leukemia
Early aging + Alzheimer's
Cervical spine instability
Hypothyroidism
Hearing/vision issue |
|
|
Term
|
Definition
Area of missing skin and hair
Seen in pataus (13) |
|
|
Term
|
Definition
|
|
Term
| Which trisomy has omphaceole |
|
Definition
|
|
Term
| What reflex is impaired in Down's syndrome |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Unique allergies seen in pataus |
|
Definition
|
|
Term
| How does the HIV screening test work |
|
Definition
|
|
Term
| When will HIV test be positive |
|
Definition
|
|
Term
| Lase neg and false pos in HIV test |
|
Definition
False posi is rare
False neg more coming, esp in early infection or in severe aids or sp immunization |
|
|
Term
| Confirmation test after posi screen for HIV |
|
Definition
|
|
Term
| How do we prevent vertical transmission of HIV in HIV + pregnant woman |
|
Definition
| Ziduvine given in 2nd trimester and given to baby for first 6 weeks |
|
|
Term
|
Definition
| HIV posi mothers should not breast feed |
|
|
Term
|
Definition
|
|
Term
| How long do we test neonates for HIV if born from posi mother |
|
Definition
|
|
Term
| When do you start pcp prophy In HIV+ infants |
|
Definition
|
|
Term
| Common ade to all HIV meds |
|
Definition
N/v/d
Ha
Osteopenia
Drug rash
Neutropenia, anemia
Hyperlipidemia and hyperglycemia |
|
|
Term
|
Definition
|
|
Term
| Childhood vaccines NOT given to HIV kids |
|
Definition
|
|
Term
|
Definition
| Leukocyte adhesion deficiency |
|
|
Term
|
Definition
Slow wound healing
Recurrent resp infections
Skin infections |
|
|
Term
|
Definition
|
|
Term
|
Definition
T cell deficiency --> B cell dysfunction
Thymus problem
Bubble boy (very sever, nearly absent immune system)
Recurrent infantile infections
Different types, most common is adenosine deaminase |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Major feature of Digeorge |
|
Definition
|
|
Term
| Other features of Digeorge |
|
Definition
Boot shaped heart
Small chin, pointy ears
Ftt
Velocardialfacial abnormalities |
|
|
Term
| Electrolyte abnormality in Digeorge |
|
Definition
|
|
Term
| Presentation of klinefelters in adolescence |
|
Definition
1. Gynecomastia
2. Long extremities
3. Hypogonadism
4. Developmental delay (spec ed)
5. Immaturity/insecurity |
|
|
Term
|
Definition
|
|
Term
| What learning difficulties do klinefelters kids have |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Explosive tempers
Social issues (jail)
Modular acne
Large teeth
Long asymmetric ears
Pectus excavatum |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Increased carrying angle of arms seen in turners |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Risks of goats milk for infants vs breast milk |
|
Definition
FolTe, b12, iron def
Brucellosis if not pasteurized |
|
|
Term
| What is breast. Ilk low in |
|
Definition
|
|
Term
| Metabolic disturbance in infants breast feeding from vegan mothers |
|
Definition
|
|
Term
| Signs of b12 def in infants. |
|
Definition
Seizure
Encephalopathy
Stroke |
|
|
Term
|
Definition
Hyperostosis (pain/swelling of long bones)
Hepatomegaly
Alopecia
Increased ICP |
|
|
Term
| Vit E def in premature infants |
|
Definition
|
|
Term
|
Definition
Pellagra
Diarrhea
Dementia
Dermatitis |
|
|
Term
|
Definition
|
|
Term
| Fontainel fullness in infant |
|
Definition
|
|
Term
|
Definition
|
|
Term
| galactosemia caused by _____ in infants |
|
Definition
| uridyl transferase deficiency |
|
|
Term
|
Definition
N/V
FTT
hepatosplenomegally
liver, kidney failure
jaundice, aminoaciduria, hypogly
seizure, lethargy |
|
|
Term
| infection in galactosemia |
|
Definition
|
|
Term
| longterm issues with galactosemia |
|
Definition
speech difficulty
ataxia
dysmetria
premature ovarian failure
cataracts
lo bone density
MR |
|
|
Term
|
Definition
|
|
Term
| inheritance of galactosemia |
|
Definition
|
|
Term
| low phenylalanine formulas are for |
|
Definition
|
|
Term
| low isoluecine, leucine, valine formulas are for..... |
|
Definition
| maple syrup urine disease |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| use bowel loop to form ducts to allow bile to drain from liver in biliary atresia |
|
|
Term
| fractures in pt with biliary atresi |
|
Definition
| biliary atresia = no bile in gut = fat malabs = vit ADEK malabs = vit D rickets |
|
|
Term
|
Definition
|
|
Term
| bone problem in infants without vitD |
|
Definition
|
|
Term
| tx kids with liver gailure and ascites |
|
Definition
|
|
Term
| most common form of nunutritional rickets |
|
Definition
| familial primary hypophosphatemia |
|
|
Term
| who gets familial primary hypophosphatemia |
|
Definition
|
|
Term
| pathogenesis of familial primary hypophosphatemia |
|
Definition
| kidney issue = low P and low conversion of inactive to active vit D = low Ca |
|
|
Term
| labs in familial primary hypophosphatemia, what must it be differentiated from? |
|
Definition
NORMAL PTH (must be differentiated from hyperparathyroid)
low D
low Ca
hi AP
hi P in urine |
|
|
Term
| signs of calcium deficietnt rickets |
|
Definition
myopathy
rachitic rosar
pectus deformities
tetany |
|
|
Term
| teeth issues in D rickets vs C rickets |
|
Definition
vitD rickets = intraglubular dentin issues
Ca rickets = enamel issues |
|
|
Term
| phosphorous levels in vitD def |
|
Definition
|
|
Term
|
Definition
celiac
cystic fibrosis
gi tract anomolies |
|
|
Term
| radiological findings in familial hypophosphatemia |
|
Definition
coarse trabecular bone
widening, fraying, cupping of metaphysis in distal tibia, femur, radius and ulna |
|
|
Term
|
Definition
sun makes previtD in skin
converted to 25-D in liver
converted to 1,25-D in kidney |
|
|
Term
| how do urine amino acid levels change with Ca and phorphorus levels |
|
Definition
| they are usually hi in deficiencies of P and Ca |
|
|
Term
| what does hepatic disease do to Ca and P |
|
Definition
|
|
Term
| what do anticonvulsants do to Ca and P |
|
Definition
|
|
Term
| how do AP levels change with Ca and P levels |
|
Definition
| elevated in deficiency of Ca and P |
|
|
Term
| what anticonvulsants have the greatest effect on Ca and P. how does it work |
|
Definition
phenobarbital and pheyntoin
inc CYP450 activity --> lo vit D |
|
|
Term
| tx low Ca and P in pts on anticonvulsants |
|
Definition
|
|
Term
| renal osteodystrophy pathogenesis |
|
Definition
damaged kidney retains phosphorous
this turns on parathyroid
hi PTH ==> increased bone turnover
also kidney damage diminishes vitD |
|
|
Term
| what are Ca levels in renal osteodystrophy |
|
Definition
|
|
Term
|
Definition
AR
reduced activity of 25-D hydroxylase
tx with massive vitD doses |
|
|
Term
| Fanconis sydrome affects what anatomically |
|
Definition
|
|
Term
| what abnormalities are there in fanconis syndrome |
|
Definition
wasting of glu, amino acids, uric acid, phosphate and bicarb
the low phosphate causes low PTH and low Ca |
|
|
Term
| clinical features of fanconins in children |
|
Definition
polyuria, polydipsia
rickets
ftt
elevated P, glu, aa etc in urine |
|
|
Term
|
Definition
renal tube acidosis
hypokalemia
hyperchloremia
non-anion gap |
|
|
Term
| UE fracture in infants indicative of abuse |
|
Definition
| spiral fracture of humerus |
|
|
Term
| vit replacement in CF kids |
|
Definition
|
|
Term
| Schmid metaphyseal dysplasia |
|
Definition
AD
rickets in children
short stature, leg bow, waddling gait
normal serum Ca, P and AP |
|
|
Term
| labs in familiarl hypophosphatemia (ca, p, vit D, AP, amino acid in urine) |
|
Definition
low P
low-normal Ca
low vit D
hi AP
hi amino aciduria |
|
|
Term
|
Definition
slow return of skin to normal position after it has been pinched
sign of dehydration |
|
|
Term
| pathogenesis of ketoacidosis |
|
Definition
| insulin unavailability --> lipid oxidation --> hi ketones and free fatty acids |
|
|
Term
|
Definition
| deep rapid inspirations associated with acidosis |
|
|
Term
|
Definition
| hypotension, hypothermia, kussmaul resp, tachy |
|
|
Term
|
Definition
|
|
Term
|
Definition
| anion gap metabolic acidosis |
|
|
Term
|
Definition
|
|
Term
|
Definition
| elevated in reflection of dehydration |
|
|
Term
| first step in pt with dka |
|
Definition
|
|
Term
| 4 things to manage in DKA |
|
Definition
|
|
Term
| how do you manage IVF in DKA |
|
Definition
1. give 1-2 L NS bolus
2. check Na (corrected), if less than 135 --> NS if>135 use .5NS
3. check glu q1hr
4. if glu <200 add D5 to IVF |
|
|
Term
| how do you manage K in DKA |
|
Definition
1. check it
2. if < 3.3 give KCl piggyback until over 3.3, if >5.3 continue without KCl, if 3.3>5.3 add 20mEq to IVF |
|
|
Term
| how do you manage insulin in DKA |
|
Definition
1. give .1 U/kg bolus IV
2. start pump at .1U/kg/hr IV
3. if glu has not fallen by 50 after 1st hr rpt bolus
4. once glu <200, dec pump to .05/kg/hr
5. stop when DKA is over |
|
|
Term
|
Definition
glu <200 fasting
anion gap <10 |
|
|
Term
|
Definition
if pH > 7, do nothing
if pH 6.9-7 give 50 bicarb
if pH less than 6.9 give 100 mmol bicarb |
|
|
Term
|
Definition
|
|
Term
|
Definition
1. birth
2. 1-2mo
3. 6-18mo |
|
|
Term
|
Definition
|
|
Term
|
Definition
| 2 doses within 1 and 2 yrs |
|
|
Term
| # of rotavirus vacc doses |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| meningeococcal vacc schedul |
|
Definition
dose 1 at 11-12 yo
booster at 16yo |
|
|
Term
| pneumo vacc type for children |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| 2mo, 4mo, 6mo-2yr, 4-6 yr |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
1st dose at 1 yr
2nd dose at least 3mo later |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
start between 9-12 yo
give at time =0, 1-2mo, 6mo
(3 total doses) |
|
|
Term
|
Definition
|
|
Term
| allergy to neomycin or gelatin? |
|
Definition
|
|
Term
| at what age can you no longer get hib |
|
Definition
| not recommended if over 5yo |
|
|
Term
| how should babies sleep to prevent sids |
|
Definition
|
|
Term
| when will baby sleep thru the night |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| when can potty training start |
|
Definition
| no earlier than 2 yrs. start when child shows interest |
|
|
Term
| when can babies fix and follow human face? |
|
Definition
|
|
Term
| when is screening hct done on child |
|
Definition
|
|
Term
| what vacc can you give to asymptomatic hiv pts |
|
Definition
|
|
Term
| bugs that cause bacterial pneumonia in children up to 5 yo |
|
Definition
#1 viral causes
#2 pneumococcus and HiB |
|
|
Term
| cause of pneumonia in peds pts over 5 |
|
Definition
| mycoplasma or pneumococcus |
|
|
Term
| tx of pneumonia in peds pt over 5 |
|
Definition
azithro (macrolides)
or
cephalosporin like ceftriaxone or cefuroxim |
|
|
Term
| pneumonia cause in intubated pts |
|
Definition
|
|
Term
| pneumonia in ppl with chronic lung disease |
|
Definition
| aspergillosis and pseudomona |
|
|
Term
| dermatomal skin rash and pneumonia sx |
|
Definition
|
|
Term
| retinitis and pneumonia sx |
|
Definition
|
|
Term
| pt with refractory asthma and pneumonia |
|
Definition
|
|
Term
|
Definition
|
|
Term
| SW US travel and pneumonia |
|
Definition
|
|
Term
|
Definition
|
|
Term
| infected sheep or cattle and pneumonia |
|
Definition
|
|
Term
| standard antituberculous therapy while awaiting culture and sensitivities |
|
Definition
| isoniazid, rifampin and pyrazinamide |
|
|
Term
| drug to add if suspect drug resistant TB |
|
Definition
|
|
Term
|
Definition
optic neuritis and cataracts
"ocular toxicity) |
|
|
Term
| newborn with pneumonia sx and eye discharge |
|
Definition
|
|
Term
| very general rules of age groups and pneumonia cause |
|
Definition
1. newborn GBS
2. toddler RSV
3. adolescent mycoplasm |
|
|
Term
| how to confirm organophosphate poisoning |
|
Definition
| decreased serum pseudocholinesterase and erythrocyte cholinesterase levels |
|
|
Term
| first thing to do in child with suspected organophsophate poisoning |
|
Definition
| undress them, they can continue to absorb poison from clothes |
|
|
Term
|
Definition
cardiac=htn, tachycardia, arrythmia
mm= fasciculations, weak, tremor
resp= diaphrag paralysis |
|
|
Term
|
Definition
GI emesis, diarrhea, no bowel control
urinary incontinence
bronchorrhea and bronchospasm
hypotension bradycardia
tearing, drooling, miosis |
|
|
Term
| pesticides that cause organophosph poisoning |
|
Definition
parathion
malathion
diazinon |
|
|
Term
| signs and sx of cholinergic excess |
|
Definition
Diarrhea
Urination
Miosis
Bradycardia
Broncorrhea
Emesis
Lacrimation
Salivation
dumbbells |
|
|
Term
| cetnral effects of cholinergics |
|
Definition
|
|
Term
| drugs to counteract organophosphates |
|
Definition
|
|
Term
|
Definition
| antagonizes muscarinic receptor |
|
|
Term
| when was asbestos used to build shit |
|
Definition
|
|
Term
| what happens if a child eats the mercury in a thermometer |
|
Definition
|
|
Term
| sx of large amount of mercury poisoning |
|
Definition
gi if ingested
if vapor=gi sx, fever, chill, HA, visual change, chest pain, pneumonitis, Pulmonary edema |
|
|
Term
| ataxia, dysarthria and paresthesis = toxicity from? |
|
Definition
| seen in methyl mercury intox (from fish) |
|
|
Term
| gingivostomatitis, tremor and neuropsych issues = toxicty from ? |
|
Definition
| chronic inorganic mercury intox (like from a work place or home) |
|
|
Term
|
Definition
nausea, vomiting, abdo pain, diarrhea (hemorrhagic)
thrid spacing of fluids --> hypovolemic shock
arrythmias |
|
|
Term
| leading nonpharm ingestion fatality from toxic substance |
|
Definition
|
|
Term
| toddler with ear pain and fever |
|
Definition
|
|
Term
| what does tympanic membrane look like in acute otitis media |
|
Definition
| red, opaque, poor movement, bulging |
|
|
Term
|
Definition
| surgical procedure with TM incision and placement of pressure equalization tubes to ventilate the middle ear and prevent fluid accumulation |
|
|
Term
|
Definition
| fluid behind TM but no signs and sx of acute otitis media |
|
|
Term
|
Definition
| surgery to drain pus from middle ear. cut TM, need specialist to preform |
|
|
Term
| most common bacterial causes of acute otitis media |
|
Definition
|
|
Term
| systemic sx of acute otitis media |
|
Definition
| malaise, fever, diarrhea, HA, N/V |
|
|
Term
| abx for acute ottitis media |
|
Definition
|
|
Term
| how long should a pt take amoxicillin for acute otitis |
|
Definition
|
|
Term
| what if amoxicillin fails to treat middle ear infection |
|
Definition
| switch to amox-clav or a cephalosporin or consider draiage |
|
|
Term
| how long can fluid stay behind the ear after infection |
|
Definition
|
|
Term
| rare/serious complications of acute otitis media |
|
Definition
mastoiditis
temporal bone osteomyelitis
facial nerve paralysis
epidural/subdural absess, meningitis, other brain infections |
|
|
Term
| otitis media + signs of increased ICP |
|
Definition
|
|
Term
|
Definition
red ear
can be swimmers ear
painful external canal |
|
|
Term
|
Definition
topical polymixin
insertion of wick to help drain |
|
|
Term
|
Definition
|
|
Term
| pt with otitis media + bluging behind the ear |
|
Definition
|
|
Term
|
Definition
|
|
Term
| very young (babies) with otitis media tx> |
|
Definition
admit to hospital and evaluate for sepsis
in neonates it is easy for otitis media to turn to sepsis fast |
|
|
Term
| initial test for gonno and chlamydia? |
|
Definition
| nuclaic acid amplification test (NAAT) |
|
|
Term
| F/U test if NAAT + for gonnorhea in a child |
|
Definition
| culture or do a second NAAT that targets a different part of the genome |
|
|
Term
|
Definition
|
|
Term
| do you always have to culture/rpt test if first NAAT is + for gonno or chlamydia? |
|
Definition
| only in children. because a + test --> sexual abuse |
|
|
Term
| how long after a sexual assault can you still get dna from the perpatrator from the victims clothes (rape kit) |
|
Definition
|
|
Term
| anal conylomatata in children under 3 yo |
|
Definition
| HPV condylomata 2/2 contact during birth |
|
|
Term
| itching anus + wt loss + abdo pain |
|
Definition
|
|
Term
|
Definition
|
|
Term
| loss of stellate pattern of anuse, low anal tone and fissures around anus |
|
Definition
| suspect repeat penetrating injury |
|
|
Term
| tx narcotic related respiratory and mental status depression |
|
Definition
|
|
Term
| how do you administer APGAR score? |
|
Definition
| do it at 1 minute and 5 minutes of life |
|
|
Term
| what is measured in APGAR |
|
Definition
appearance (color)
pulse rate
grimace (response to stimuli)
activity (motor)
respirations |
|
|
Term
| what are the scores you can get for appearance in APGAR |
|
Definition
0 = blue/pale
1 = body pink and extremities blu
2 = pretty pink baby |
|
|
Term
| what are the score you can get for pulse in APGAR |
|
Definition
0 = absent
1 = <100
2 = >100 |
|
|
Term
| what are the scores you can get for grimace in APGAR |
|
Definition
0 = no response to stimuli
1 = grimace only
2 = cough/sneeze |
|
|
Term
| what is the stimuli you give a baby to measure grimace? |
|
Definition
| stick something up their nose (catheter, suction bulb) |
|
|
Term
| what are the scores you can get for activity in APGAR |
|
Definition
0 = limp
1 = some flexion of extremities
2 = flexed active motion |
|
|
Term
| what are the scores you can get for respiration in APGAR |
|
Definition
0 = no effort
1 =slow irrigular breathing
2 = good crying |
|
|
Term
| infant with scaphoid abdomen, heart sounds on right side and respiratory distress |
|
Definition
|
|
Term
| how do you manage an infant with scaphoid abdomen, heart sounds on right side and respiratory distress? |
|
Definition
| must do endotracheal tube? |
|
|
Term
| why are infants with diaphragmatic hernia in respiratory distress? |
|
Definition
| if they had the hernia in utero, they lungs dont have room to develop properly and they get pulmonary hypoplasia |
|
|
Term
| why cant you bag and mask an infant with a diaphragmatic hernia? |
|
Definition
| it will cause accumulation of bowel gas and because the bowels are in the thorax this will cause further compression of the lungs |
|
|
Term
| management of a newborn with bradycardia and otherwise uncomplicated pregnancy |
|
Definition
1. give 100% O2
2. if HR still less than 60, do chest compressions for 30 seconds
3. if HR still less than 60, give epinephrine (or other drug) |
|
|
Term
| how is infant breathing different when crying and when quiet |
|
Definition
| babies are obligate nose breathers. when crying they can breath thru mouth, but when quiet they go thru nose. |
|
|
Term
| baby who is well ventilated ONLY when crying. baby goes in respiratory distress when not crying. |
|
Definition
|
|
Term
|
Definition
| when back of the nasal passage is blocked due to congenital abnormality |
|
|
Term
| management of choanal atresia |
|
Definition
| endotracheal intubation to bypass teh nasal airway obstruction followed by surgical repair |
|
|
Term
| how can you identify choanal atresia |
|
Definition
try to pass a feeding tube thru the nostril
see if mist is coming out of nostrils by holding up a cold metal under the nose. |
|
|
Term
| definition of cerebral palsy (CP) |
|
Definition
disorder of movement or posture from the CNS
must be CNS issue, this differentiates it from neuropathies or myopathies |
|
|
Term
| what are the most common comorbidities with CP |
|
Definition
1/3 of CP pts also have seizures
2/3 of CP pts are also mentally retarded |
|
|
Term
| how must the CNS insult occur in order to qualify as CP |
|
Definition
must be a 1 time insult
must present in 1st yr of life
must be static (non progressing although the symptoms may progress like skeletal deformities 2/2 the mm weakness, the insult in the cns itself is not degenerative) |
|
|
Term
|
Definition
periventricula leukomalacia
atrophy or small ifnarctions |
|
|
Term
|
Definition
| if you hold a baby upright with feet touching the floor they step forward. |
|
|
Term
| when should stepping response go away? |
|
Definition
|
|
Term
| what if the stepping response persists |
|
Definition
|
|
Term
|
Definition
stepping response after 3 mo
Moro reflex after 6mo
asymmetrical tonic neck reflex after 6 mo |
|
|
Term
|
Definition
| babies reach out arms when they lose support |
|
|
Term
| asymettrical tonic neck reflex |
|
Definition
| when the face is turned to one side, the limbs on that side are extended and the limbs opposite the face are flexed |
|
|
Term
|
Definition
| involvement of single lateral side |
|
|
Term
|
Definition
| four-limb involvement with greater impairment of lower extremities |
|
|
Term
|
Definition
| four-limb involvemtn with significant impairment of all extremities although the upper limbs may be less impaired than lower limbs |
|
|
Term
| when do most children walk? |
|
Definition
|
|
Term
| asthma, rectal prolapse and digital clubbing |
|
Definition
|
|
Term
|
Definition
recurrent sinusitis
diarrhea/failure to thrive in children
nasal polyps
mouth breathing |
|
|
Term
| why diarrhea/failure to thrive in CF |
|
Definition
| pancreatic exocrine deficiency |
|
|
Term
| what is the respiratory issue most CF pts have |
|
Definition
|
|
Term
| bugs that cause pneumonia in CF pts |
|
Definition
|
|
Term
| what is unique about the strains of psudomonas found in CF pneumonia |
|
Definition
| heavy, slime producing mucoid varients |
|
|
Term
|
Definition
| lung colonizer seen in CF pts, assocaited with rapid clinical deterioration |
|
|
Term
| do airways react to bronchodialators in CF? |
|
Definition
| about 50% of CF pts have some airway reactivity tho inhalers etc have unpredictable responses |
|
|
Term
| complications of advanced CF |
|
Definition
pneumothorax
hemoptysis
cor pulmonale |
|
|
Term
|
Definition
|
|
Term
| what is the longterm effect of CF stool? |
|
Definition
| can increase risk for obstruction, volvulus and intussception |
|
|
Term
|
Definition
| fatty liver, large liver, or biliary cirrhosis, gallbladder disease |
|
|
Term
|
Definition
|
|
Term
| causes of false + sweat chloride |
|
Definition
anorexia
hypothyroid
nephrogenic DI |
|
|
Term
| what chromosome is effected in CF |
|
Definition
|
|
Term
| what is the most common mutation in CF |
|
Definition
| amino acid 508, single phenylalanine deletion |
|
|
Term
| how does the blood test for CF work |
|
Definition
| detects a pancreatic enzyme seen in newborns with CF, called immunoreactive trypsinogen |
|
|
Term
| management of infants with positive blood test for CF |
|
Definition
| follow up with sweat chloride testing |
|
|
Term
| what vit def are seen in CF |
|
Definition
|
|
Term
| metabolic abnormality in CF |
|
Definition
| hyponatremic hypochloremic alkalosis |
|
|
Term
|
Definition
| must be careful about dehydration |
|
|
Term
|
Definition
| ileus in a newborn that begins in utero |
|
|
Term
| what is the likely cause of meconium ileus |
|
Definition
deficiency of proteolytic enzymes
associated with CF |
|
|
Term
| what type of infants get necrotizing enterocolitis |
|
Definition
|
|
Term
| bulging frontal fontanelle |
|
Definition
| indicates increased intracranial pressure |
|
|
Term
| how does vit A relate to a bulging frontal fontanelle |
|
Definition
| disorders of vitA metabolism, including vitA toxicity or excess can cause pseudotumor cerebri --> bulging anterior fontanelle |
|
|
Term
| clinical manifestations of ALL in children |
|
Definition
joint pain
leg pain
low grade fever
petechiae
hepatosplenomegally |
|
|
Term
| most common childhood cancer |
|
Definition
|
|
Term
| what is more common ALL or AML |
|
Definition
|
|
Term
| peak age of incidence of ALL |
|
Definition
|
|
Term
|
Definition
| most leukemias come with easy bleeding as a sign/sx as well as easy bruising |
|
|
Term
| major features of idiopathic thrombocytopenic purpura |
|
Definition
bleeding, bruising
low platelets |
|
|
Term
|
Definition
| NO, unlike ALL, ITP does not present with and leukocyte or RBC abnormalities |
|
|
Term
| major features of aplastic anemia |
|
Definition
|
|
Term
| what do lymphocytes look like in mononucleosis |
|
Definition
| they actually look the same as leukemic lymphoblasts |
|
|
Term
|
Definition
| hi leukocytes that resemble a leukemia |
|
|
Term
| what causes a leukamoid reaction |
|
Definition
sepsis
pertussis
acute hemolysis
granulomatous disease
vasculitis |
|
|
Term
| what is most commonly the misdiagnosis of a pt with ALL |
|
Definition
| juvenile rheumatoid arthritis, they can get hepatosplenomegally |
|
|
Term
| end-all diagnostic test for ALL |
|
Definition
|
|
Term
| what is the typical leukocyte count for kids with ALL |
|
Definition
|
|
Term
| can you dx leukemia with a peripheral blood smear? |
|
Definition
| no, sometimes you wont see the leukemic blasts in peripheral smear, though if you do its a good indication to investigate further. bm biopsy is the best test. |
|
|
Term
| most common site for bone marrow aspiration |
|
Definition
|
|
Term
| normal marrow concentration of blasts |
|
Definition
|
|
Term
| normal marrow concentration of blasts in ALL |
|
Definition
| must have a minimum of 25% to dx ALL |
|
|
Term
| who has a better prognosis in ALL, boys or girls |
|
Definition
|
|
Term
| what age group has the worst ALL prognosis |
|
Definition
| those less than 1 yr andn those over 10 |
|
|
Term
| what leukocyte counts have a worse prognosis in ALL? |
|
Definition
| pts with HIGHER leukocyte counts (over 50K) have a WORSE prognosis |
|
|
Term
| where else do you have to look for leukocytes in ALL (besides bone marrow and peripheral smear? |
|
Definition
also check CSF
abnormal leukocytes in CSF = worse |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what is combination chemotherapy? |
|
Definition
step-wise chemo
1. Induction
2. Consolidation
3. Prophylactic CNS tx
4. Maintenance |
|
|
Term
|
Definition
prednisone
vincristine
asparaginase
--this causes remission in about 4 wks in most kids with uncomplicated ALL |
|
|
Term
|
Definition
neuropsych issues
seizures
leukenceophalopathy |
|
|
Term
|
Definition
| growth hormone deficiency |
|
|
Term
| ade of cylcophosphamide in tx ALL of children |
|
Definition
|
|
Term
|
Definition
DS increases risk for ALL
also kids who have siblings with DS are at higher risk for ALL |
|
|
Term
| chemotherapy and immunizations |
|
Definition
| children CANNOT have any immunizations while on chemotherapy |
|
|
Term
| best initial screening to test if trying to differentiate twix ALL and juvenille rheumatoid arthritis |
|
Definition
| CBC with dx and platelets |
|
|
Term
|
Definition
|
|
Term
| step-wise management of blue/gray baby born with a heart beat but not breathing spontaneously |
|
Definition
1. try O2 and physical stimulation to spark spontaneous breathing
2. back and mask
3. endotracheal intubation |
|
|
Term
| what do babies born to uncontrolled diabetics look like? |
|
Definition
they are large
they are usually blue/grey because they are often born in respiratory distress |
|
|
Term
| what are the insulin and glucose levels in babies born to uncontrolled diabetic mothers? |
|
Definition
hyperinsulinemia
hypoglycemia |
|
|
Term
| how do you manage a newborn with hypoglycemia? |
|
Definition
1. check glucose
2. if 25-40 feed the baby
3. if less than 25 give IV glucose |
|
|
Term
| besides hi insulin and lo glucose, what other blood abnormalities are found in infants born to diabetic mothers |
|
Definition
hypocalcemia
hyperbilirubinemia
polycythemia |
|
|
Term
| glucose levels that dx gestational diabetes (GDM) |
|
Definition
|
|
Term
|
Definition
|
|
Term
| at what hct is polycythemia treated in infant |
|
Definition
|
|
Term
| how is polycythemia treated in infant |
|
Definition
| partial exchange transfusion |
|
|
Term
| caudal regression syndrome |
|
Definition
| rare congenital malformation found in GDM babies characterized by hypoplasia of the sacrum and lower extremities |
|
|
Term
| when are women screen for GDM |
|
Definition
|
|
Term
| why are babies born from GDM so big? |
|
Definition
| growth hormone effects of insulin |
|
|
Term
| where is the weight distributed in macrosomia |
|
Definition
|
|
Term
| why elevated bilirubin in babies from GDM |
|
Definition
| because of the polycythemia because of the o2 insufficiency because the babies are too big |
|
|
Term
| signs of hypocalcemia in babies of GDM |
|
Definition
irritability
decreased cardiac contractility |
|
|
Term
| what other congenital defects are possible in babies of GDM (besides caudal regression syndrome) |
|
Definition
neural tube defects
congenital heart disease |
|
|
Term
|
Definition
| insulin dependant AND vascular disease |
|
|
Term
| what is at greatest risk of thrombosing in babies with polycythemia |
|
Definition
|
|
Term
|
Definition
|
|
Term
| common heart abnormality in babies of GDM |
|
Definition
septal hypertrophy
subaortic stenosis
cardiomyopathy |
|
|
Term
|
Definition
| insulin requiring but without vascular disease |
|
|
Term
|
Definition
|
|
Term
|
Definition
| insulin dependant with no vasc disease |
|
|
Term
| baby with respiratory distress and born to GDM who still has bradycardia after ET intubation? |
|
Definition
| suspect cardiac abnormality (from hypocalcemia) |
|
|
Term
| baby born to GDM that is managed initally but then presents with new abdo mass? |
|
Definition
| suspect hydronephrosis from renal vein thrombosis |
|
|
Term
| surfactant and babies from GDM |
|
Definition
| they will have surfactant deficiency and RDS at less premature ages than other babies |
|
|
Term
| head circumference in babies born to GDM |
|
Definition
|
|
Term
| baby that is SMALL for gestational age and has a mother with GDM |
|
Definition
| suspect placental insufficiency |
|
|
Term
| small left colon syndrome |
|
Definition
| seen in babies from GDM, can result in obstruction that is seen as decreased meconium passage |
|
|
Term
| does breast feeding increase or decrease risk for hyperbilirubinemia |
|
Definition
|
|
Term
| which is neurotoxic conjugated or unconjugated bilirubin? |
|
Definition
|
|
Term
|
Definition
| increased rbc destruction due to transplacental maternal ab passage active against the infants RBC antigens |
|
|
Term
| what parts of brain are more susceptible to kernicterus |
|
Definition
|
|
Term
| signs of kernicterus in infant |
|
Definition
loss of moro reflex
lethargy
poor feeding |
|
|
Term
| what is direct bilirubin attached to |
|
Definition
|
|
Term
| what is high, direct or indirect bilirubin, in physiological hyperbilirubinemia of a newborn |
|
Definition
|
|
Term
| what are signs of non-physiological jaundice |
|
Definition
1. appearance in the first 24-36 hrs
2. rise over 5mg/dl/24hrs
3. total over 12mg/dl
4. persists after 10-14days |
|
|
Term
| what infection causes non physiological jaundice |
|
Definition
| rubella and toxoplasmosis |
|
|
Term
| work up of hyperbilirubinemia in newborn |
|
Definition
if suspect physiological just monitor bili levels
if more suspicious or persistant do CBC, coombs, lft, peripheral smear |
|
|
Term
| tx unconjugated bilirubinemia |
|
Definition
|
|
Term
| when do you start phototherapy |
|
Definition
if bili is 16-18mg/dl in day 1-3 of life
after day 3 only do if bili is 20+ |
|
|
Term
| what if phototherapy does not work |
|
Definition
|
|
Term
| what is deficient in fcrigler najjar |
|
Definition
|
|
Term
| what drug given to mother reduces neonatal jaundice (tho it is not used therapeutically) |
|
Definition
| barbituates induce glucuronyl transferase --> decreased risk of jaundice |
|
|
Term
| how do sepsis and acidosis effect bilirubinemia? |
|
Definition
| they increase the risk of kernicterus from hyperbilirubinemia by weakening BBB |
|
|
Term
| coombs test in gilberts syndome? |
|
Definition
|
|
Term
| why do babies get physiological jaundice? |
|
Definition
| they have physiological reduction in UDGT |
|
|
Term
| faint wheezes in an asthmatic |
|
Definition
| indicates that the asthma exacerbation is more severe and less air is passing thru the airways |
|
|
Term
| cardiovascular findings in asthmatic |
|
Definition
|
|
Term
|
Definition
blood pressure that varies more widely with respiratoration than normal.
bp variance greater than 10mm Hg between inspiration and experiation |
|
|
Term
| other things that cause pulsus paradoxus |
|
Definition
other obstructive airway disease
pericardial tamponade
constrictive pericarditis |
|
|
Term
|
Definition
| kids who get RSV bronchiolitis develop asthma |
|
|
Term
| acute v late phase of asthma |
|
Definition
acute: immediate IgE response --> vasodialation and leaky cappillaries, sm mm constriction, mucus secretion
late: infiltration of inflammatory cells into the airway parenchyma --> causes the chronic inflammation seen in asthma |
|
|
Term
|
Definition
|
|
Term
| do you use corticosteroids for acute or chronic asthma tx |
|
Definition
|
|
Term
| when does the late phase reaction occur |
|
Definition
| 2-4 hours after initial wheezing episode |
|
|
Term
sudden onset respiratory symptoms
fever
in a baby who was previously healthy |
|
Definition
|
|
Term
|
Definition
hyperinflated lungs
atelectasis |
|
|
Term
|
Definition
|
|
Term
| What labs do you want to test in a pt suspicious for GH deficiency |
|
Definition
|
|
Term
| What does the growth curve look like in a pt with GH def |
|
Definition
| they "fal off " the curve |
|
|
Term
| are the bodies of children with GH deficiency proportional to head size?` |
|
Definition
|
|
Term
|
Definition
| GH injections until full size is reached |
|
|
Term
|
Definition
how old the bones appear compared to the chronological age
provide an extimate of the rematining growth pot'l of the bones |
|
|
Term
| consititutional growth delay (CGD)? |
|
Definition
when a healthy child grows slower than expected
seen in kids who had a parent who was also a "late bloomer" |
|
|
Term
| will the bone age be >,< or = the chronolocial age in a kid with CGD |
|
Definition
|
|
Term
|
Definition
| age at which the child's measured height is in the 50%ile |
|
|
Term
| growth RATE in CGD vs GH deficiency |
|
Definition
in CGD the rate is normal
in GH def the rate slows |
|
|
Term
| how does the bone age compare to the chronological age in a kid with familial short stature |
|
Definition
|
|
Term
|
Definition
| usually in school aged kids |
|
|
Term
| what do you always want to check in girls who "fall off" growth curve? |
|
Definition
|
|
Term
| other endocrine cause of short stature |
|
Definition
|
|
Term
| early onset sepsis syndrom |
|
Definition
| sepsis in the first 6d of life |
|
|
Term
| prophy for GBS sepsis in neonate |
|
Definition
| give IV penicillin or ampicillin during labor |
|
|
Term
|
Definition
respiratory distress
tachypnea
bradycardia
hypotn |
|
|
Term
| most common first sign of neonate sepsis |
|
Definition
|
|
Term
| pallor and delayed cappillary refill in neonate? |
|
Definition
| indicates overwhelming shock |
|
|
Term
| platelets in neonate with sepsis |
|
Definition
|
|
Term
| other non GBS causes of early onset neonate sepsis |
|
Definition
|
|
Term
| respiratory signs of sepsis |
|
Definition
grunting
refuse to feed
apnea
cyanosis
tachypnea |
|
|
Term
| risk factors for GBS neonate sepsis |
|
Definition
premie
mother under 20 yo
ROM over 18 hrs from delivery
intrapartum fever |
|
|
Term
| when do you screen for GBS |
|
Definition
|
|
Term
| tx early onset sepsis in neonate? |
|
Definition
| IV AMG + penicillin or ampicillin |
|
|
Term
| tx late onset sepsis in neonate? |
|
Definition
| vanco or 3rd gen cephalosporin |
|
|
Term
| newborn with puffy eyelids red conjuctivae, purulent eye discharge in 3rd day of life? |
|
Definition
|
|
Term
| time frame of gonno opthalmia vs chlamydial conjuctivae? |
|
Definition
gonno in day 2-5 after birth
chlam day 5014 |
|
|
Term
| tx chlamdyia conjuctivitis? |
|
Definition
|
|
Term
| risk of oral erythromycin in newborn |
|
Definition
| hypertrophic pyloric stenosis |
|
|
Term
| managment of a baby born to a well-managed HIV+ mother (mom was on antivirals during pregnancy to keep viral load low) |
|
Definition
| still give baby ziduvine after brith |
|
|
Term
| transient tachypnea after birth |
|
Definition
| result of incomplete evacuation of fetal lung fluid in a healthy term infant |
|
|
Term
| management of transient tachypnea in newborn |
|
Definition
|
|
Term
| how do you know a baby with tachypnea has transient tachypnea vs another problem? |
|
Definition
| they will be tachpneic but still have a good sucking in of air with each breath |
|
|
Term
| sick neonate with diffuse rash that has monocytosis and eventually dies? |
|
Definition
|
|
Term
| age that SIDS is most likely |
|
Definition
1mo-5mo
risk upto 10yr of life |
|
|
Term
| sleep position that INCREASES risk for SIDS |
|
Definition
|
|
Term
|
Definition
| pulmo htn --> R2L blood shunt |
|
|
Term
| causes of eisenmenger syndrome |
|
Definition
VSD
atrioventricular canal lesion
PDA |
|
|
Term
| causes of wide pulse pressure |
|
Definition
fever
hyperthyroid
anemia
AVF
PDA |
|
|
Term
|
Definition
pulmo congestion
systemic hypoperfusion |
|
|
Term
| are acyanotic heart defects usually LtoR or RtoL |
|
Definition
|
|
Term
| how can a person switch from an acyanotic heart defect to becoming cyanotic? |
|
Definition
| initially blood is shunted to lungs, then once pulmo congestion causes pulmo HTN the flow switches |
|
|
Term
| most common heart lesion in kids |
|
Definition
|
|
Term
| what part of septum do most VSDs occur |
|
Definition
|
|
Term
|
Definition
harsh
holosystolic
left sternal border |
|
|
Term
| what if a VSD does not sound very harsh? |
|
Definition
| this is actually a bad sign, means there is a big hole |
|
|
Term
| signs of severe VSD in newborn |
|
Definition
dyspnea
poor feeding
sweating when feeding
ftt |
|
|
Term
|
Definition
| after first few weeks of life, even into months, present late as the pulmo pressure decreases |
|
|
Term
|
Definition
| cardiomegally and pulmo vasc congestion |
|
|
Term
| direction of shunt in VSD |
|
Definition
|
|
Term
|
Definition
| yes, biventricular. both sides hypertrophy |
|
|
Term
| what happens to small vsds? |
|
Definition
| close spontaneously 6-12 months |
|
|
Term
|
Definition
| diuretics (furosimide or hydrochlorothiazide) |
|
|
Term
|
Definition
|
|
Term
| after how long will a baby with a vsd start to develop pulmonary vascular resistance |
|
Definition
|
|
Term
| when does eisenmenger usually happen? |
|
Definition
|
|
Term
| what are the major acyanotic heart defects? |
|
Definition
VSD
ASD
PDA
atrioventricular septal defects |
|
|
Term
| function of ductus arteriosus |
|
Definition
| shunts blood from pulmonary arteries to aorta to bypass lungs |
|
|
Term
| what causes normal closure of ductus arteriosus |
|
Definition
|
|
Term
| when does ductus normally close |
|
Definition
| always at least by 2 days |
|
|
Term
| what does PDA sound like? |
|
Definition
| systolic or continous machine like murmer |
|
|
Term
| when do you NOT close a PDA |
|
Definition
| if they also have an interuption in aortic flow. like coarc of aorta |
|
|
Term
|
Definition
most are asymptomatic
large ones --> mild growth failure, exercise intolerance |
|
|
Term
|
Definition
|
|
Term
| murmur of ASD diastolic or systolic? |
|
Definition
|
|
Term
|
Definition
| left upper and midsternal border |
|
|
Term
|
Definition
| enlarged RA, RV and pulmo artery |
|
|
Term
| what hypertrophies in ASD |
|
Definition
|
|
Term
|
Definition
usually nothing in children
in adults may lead to pulmo HTN |
|
|
Term
| management of atrioventricular septal defect |
|
Definition
|
|
Term
| signs of untreated atrioventricular septal defect |
|
Definition
ftt
heart failure
recurrent pulmo infections |
|
|
Term
| most common downs syndrome heart defect |
|
Definition
| arioventricular canal defect |
|
|
Term
|
Definition
|
|
Term
| cyanotic heart lesions make the skin look _________ |
|
Definition
|
|
Term
| what besides severe coarc of aorta requires a pda for life? |
|
Definition
| transposition of the great vessels |
|
|
Term
| what direction is the shunt in transposition of great vessles (TGV) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
prostaglandins to keep PDA
then atrial septostomy |
|
|
Term
|
Definition
| creating an atrial septum |
|
|
Term
| is pulmonary valve stenosis cyanotic or acyanotic? |
|
Definition
|
|
Term
| diseases with pulmonary stenosis |
|
Definition
glycogen storage disease
noonans syndrome |
|
|
Term
| boot shaped heart and dec pulmo vasc |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| supracardiac shadow caused by the anomalous pulmo veins endering the innominate vein and persistant left vena cava |
|
|
Term
| child assuming a squatting position after a bout of agitation or stress |
|
Definition
|
|
Term
| tricuspid valve abnormalities are cyanotic or acyanotic |
|
Definition
|
|
Term
|
Definition
|
|
Term
| does ebstein anomoly require pda |
|
Definition
|
|
Term
| major features of pulmonic stenosis heart murmur |
|
Definition
systolic murmur
mitral area to back
loud in axilla |
|
|
Term
| heart defects in tetralogy |
|
Definition
overriding aorta
pulmonary stenosis
rvh
vsd |
|
|
Term
| body aches that wax and wane with fever for a long time (20 days) |
|
Definition
juvenille rheumatoid arthritis
(JRA) |
|
|
Term
|
Definition
rash
spiking fevers that come and go
joint swelling
LAD
organomegallly |
|
|
Term
| child with exercise induced cyanosis and a systolic murmur |
|
Definition
|
|
Term
|
Definition
leukocytosis
thrombocytosis
anemia |
|
|
Term
|
Definition
|
|
Term
| ddx for fever of unknown origin in a child |
|
Definition
infectious
hematologic
rheumatologic |
|
|
Term
| what type of fever seen in JRA |
|
Definition
|
|
Term
| arthritis characteristics |
|
Definition
1. swelling/effusion and 2+ of following
-limited ROM
-tenderness/pain on motion
-increased heat in 1+ joint |
|
|
Term
|
Definition
pauciarticular = 1-4 joints effected
polyarticular = 5+ joints |
|
|
Term
| more severe systemic signs of JRA |
|
Definition
pericarditis
pleural effusion
hepatitis
encephalopathy |
|
|
Term
|
Definition
irritation of the iris
seen in the early onset pauciarticular type of JRA |
|
|
Term
|
Definition
|
|
Term
|
Definition
| seen in late onset pauciarticular type of JRA |
|
|
Term
| who gets early v late onset pauciarticular type of JRA |
|
Definition
|
|
Term
sore throat
postauricular and occipatal LAD
joint swelling |
|
Definition
|
|
Term
|
Definition
| salmon colored and diffuse |
|
|
Term
| who gets slipped capital femoral epiphysis |
|
Definition
|
|
Term
| what makes pain better or worse in pericardidits |
|
Definition
better when leaning forward
worse when taking deep breaths or coughing |
|
|
Term
| EKG of pericarditis in kid |
|
Definition
ST elevation
low voltage qrs complexes |
|
|
Term
| systemic onset disease JRA |
|
Definition
| type of JRA with more systemic signs (rash, organomegally, LAD) |
|
|
Term
| what do hypothyroidism and trisomy 21 have in common |
|
Definition
| both cause macrocytic anemia |
|
|
Term
| what part of GI tract absorbs b12 |
|
Definition
|
|
Term
| juvenile pernicious anemia |
|
Definition
| child cannot secrete intrinsic factor |
|
|
Term
| besides malabs or malnutrition what else can cause b12 def |
|
Definition
| diphyllobothrium lactum (tapeworm) |
|
|
Term
|
Definition
|
|
Term
| unpastuerized goats milk risk |
|
Definition
|
|
Term
| signs of juvenile pernicious anemia |
|
Definition
weakness
glossitis
anemia and fatigue |
|
|
Term
| what part of gi makes GIF |
|
Definition
|
|
Term
| where does diphyllobothrium come from |
|
Definition
|
|
Term
|
Definition
| alternate name for lead poisoning |
|
|
Term
|
Definition
|
|
Term
|
Definition
anorexia
hyperirritability/emotional lability
decreased playing in kids
speech regression
abdo pain and bone pain
vomiting/constip |
|
|
Term
| signs of lead encephalopathy |
|
Definition
persistant vomiting
ataxia
ams
coma
sz |
|
|
Term
| long term complic of lead |
|
Definition
cognitive deficits
aggressive behaviour |
|
|
Term
| where is lead stored in the body |
|
Definition
|
|
Term
|
Definition
CaEDTA chelation
DMSA aka BAL |
|
|
Term
| at what level do you consider chelation |
|
Definition
|
|
Term
| what do you do if pt has level 10-14 of lead |
|
Definition
educate
close monitor (recheck in 3mo) |
|
|
Term
| at what lead level do you start environmental investigation |
|
Definition
|
|
Term
| when do you do long bone xr in lead poisoning |
|
Definition
|
|
Term
| infants exposed to mercury show what signs |
|
Definition
microcephaly, LBW, sz
developmental delay
hearing loss |
|
|
Term
|
Definition
ataxia
blurry vision
tremors
smell and taste issues
dementia |
|
|
Term
|
Definition
|
|
Term
| chronic arsenic exposure signs |
|
Definition
skin lesions
peripheral neuropathy
encephalopathy |
|
|
Term
|
Definition
|
|
Term
| signs of orellanine poison |
|
Definition
|
|
Term
| signs of ethanol toxicity in children |
|
Definition
|
|
Term
|
Definition
hypertension
dialated pupils
hyperthermia |
|
|
Term
| lab studies in post-strep glomerulonephritis |
|
Definition
|
|
Term
| what will c3 and c4 look like in post strep glomerulonephritis |
|
Definition
|
|
Term
| other signs of post strep gn |
|
Definition
|
|
Term
|
Definition
IgA nephropathy
recurrent painless hematuria preceded by URI |
|
|
Term
| Henoch Schonlein purpura major features |
|
Definition
nephritis
palpable purpura
4-5 yo
Purpura, Abdominal Pain, Arthralgias and Hematuria |
|
|
Term
| what else has nephritis with low c3 |
|
Definition
|
|
Term
|
Definition
|
|
Term
| do abx decrease the risk of post strep gn? |
|
Definition
|
|
Term
| interval twix GBS throat and post strep gn? for impetigo and post strep gn? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
supportive
maintain fluid balance with restriction/supplementation |
|
|
Term
| risks of IgA nephropathy? |
|
Definition
|
|
Term
| benign familial hematuria |
|
Definition
AD
persistent/intermittent hematuria without preogression to CKD |
|
|
Term
| biopsy of benign familial hematuria |
|
Definition
|
|
Term
| immune complex deposition with IgA in mesangium? |
|
Definition
IgA Nephropathy or
henoch schonlein purpura |
|
|
Term
| endothelial cell swelling with fibrin deposition |
|
Definition
|
|
Term
|
Definition
|
|
Term
| kidney issues and oral ulcers? |
|
Definition
|
|
Term
|
Definition
wilms tumor
gonadal dysgenesis
nephropathy |
|
|
Term
| first tests to do in precocious puberty |
|
Definition
FSH
LH bone age radiograph |
|
|
Term
| what makes you more suspicious for central vs non-central precocious puberty? |
|
Definition
if under 6yo, more likely to be central
if male central more likely |
|
|
Term
|
Definition
| no signs of puberty in girls by age 13 |
|
|
Term
|
Definition
| 2ndary sex characteristics in girls before 8 and boys before 9 |
|
|
Term
| precocious pseudopuberty and causes |
|
Definition
gonadotropin INDEPENDANT cause of puberty
exogenous hormone or adrenal/ovarian tumors usually the cause |
|
|
Term
|
Definition
| early active adrenal androgens (hi pubic/axillary hair and vertical growth) |
|
|
Term
|
Definition
| early breast development without the pubic/axiallary hair |
|
|
Term
| cause of true precocious puberty |
|
Definition
|
|
Term
| bone growth in girls with central precocious puberty |
|
Definition
if under 6yo early maturtion of bone
loss of ultimate height portential
if over 6yo they have slowly maturing bones with preserved height potl |
|
|
Term
| most significant family history in precocious puberty |
|
Definition
| any hx of congenital adrenal hyperplasi |
|
|
Term
| scrotum in prepubertal and pubertal boy |
|
Definition
prepubertal = thick and non vascular scrotum
pubertal= thin and vascular |
|
|
Term
| test LH in precocious puberty |
|
Definition
| use immunometric assay. With this test LH should be undectable in normal prepubescent children |
|
|
Term
| tx cetnral precocious puerty *moa) |
|
Definition
| GnRH agonist to desensitize pituitary |
|
|
Term
|
Definition
1 = flat
2 = buds
3 = buds + areola grow
4 = nipple and areola form separate mound from breast
5 = areola rejoins berast contour, end |
|
|
Term
|
Definition
1 = none
2 = straight and fine
3 = coarser darker hair
4 = adult but limited area
5 = full |
|
|
Term
| when do tanner stages 2 start |
|
Definition
|
|
Term
| at what tanner stages does penis grow in length v width |
|
Definition
|
|
Term
| virilization in child with PREPUBERTAL testes |
|
Definition
| think congenital adrenal hyperplasia and check 17alpha deoxyhydrogenase |
|
|
Term
| most common cause of fullterm newborn with ambiguous genital |
|
Definition
| congenital adrenal hyperplasia |
|
|
Term
| inheritance of congenital adrenal hyperplasia |
|
Definition
|
|
Term
|
Definition
| discrepancy between gonad morphology and external genitalia |
|
|
Term
| female pseudohermaphroditism |
|
Definition
| XX with ambigous gennitalia |
|
|
Term
| most common cause of female pseudohermaphroditism |
|
Definition
| congenital adrenal hyperplasia |
|
|
Term
| male pseudohermaphroditism |
|
Definition
| XY with ambiguous genitalia |
|
|
Term
|
Definition
| xx or xy with opposite internal sex organs (ovary and testes) |
|
|
Term
|
Definition
1. usually a mixed 46 XY/45XO
2. testis with sertoli and leydig cells but no germinal elements
3. maybe a streak ovary on one side
4. labioscrotal fusion |
|
|
Term
| hyperpigmentation of labioscrotal folds |
|
Definition
| more common infants with congenital adrenal hyperplasia |
|
|
Term
| most important factor in determining and infants sex assignment |
|
Definition
|
|
Term
| what cells used to find karyotype |
|
Definition
|
|
Term
| circumcision and hypospadias |
|
Definition
dont do it
foreskin will be used for reconstruction |
|
|
Term
| hypotonia, small penis, cryptoorchidism |
|
Definition
|
|
Term
| salt-losing CAH is deficiency of what |
|
Definition
|
|
Term
| features of salt losing CAH |
|
Definition
FTT
gi obstructive signs and vomit
cardiovascular collapse |
|
|
Term
| testicular feminization results from |
|
Definition
-decreased androgen binding to target or androgen insensitivity
- |
|
|
Term
| testicular feminization karyotype |
|
Definition
|
|
Term
| appearance of testicular feminization |
|
Definition
phenotypical females
short or atretic vagina |
|
|
Term
| later signs of prader willi |
|
Definition
|
|
