Term
examiner grasps the thigh & lifts the greater trochanter while abducting the hip -- attemps to relocate a dislocated hip
flex hips to 90 deg and pushes down while abducting the hip -- attempts to dislocate the hip |
|
Definition
|
|
Term
| represents a generic group of infections that produce congenital or perinatally acquired infections |
|
Definition
TORCH infections
toxoplasmosis
other
rubella
cytomegalovirus
HSV |
|
|
Term
| most common brachial plexus injury - involves C5&6. results from excessive traction on the neck. unable to abduct, externally rotate or supinate arm |
|
Definition
|
|
Term
| separation of R and L rectus abdominis in infants -- can be seen in umbilical hernia. |
|
Definition
|
|
Term
| boggy, fluctuant pustule mass that forms on the scalp as an exaggerated response to tinea capitis |
|
Definition
|
|
Term
| complete twisting of a loop of intestine around its mesenteric attachment site. very serious. |
|
Definition
|
|
Term
| birth trauma resulting in injury to C8-T1 nerves. decreased or absent hand function. 90% resolve by 1 year |
|
Definition
|
|
Term
1.edema over presenting part of that crosses suture lines
2. pinpoint white papules on nose and cheeks due to blocked sebaceous glands |
|
Definition
1. caput succedaneum
2. milia |
|
|
Term
<10th percentile weight
AKA intrauterine growth retardation
most commonly due to maternal tobacco use
asymmetric:
length > weight, head circumference = length
occurs after 24 weeks gestation
symmetric: length = weight = head circumference
occurs in early gestation
associated with neuro sequelae |
|
Definition
| small for gestational age |
|
|
Term
>90th percentile weight
often infants of DM mom |
|
Definition
| large for gestational age |
|
|
Term
| collection of blood under periosteum of skull |
|
Definition
|
|
Term
ellis-van crevald syndrome
carpenter syndrome
meckel-gruber syndrome
polysundactyly
trisomy 13
orofaciodigital syndrome
rubinstein-taybi syndrome
all are associated wtih? |
|
Definition
|
|
Term
| hold baby supine, and abruptly lower entire body about 2 feet - arms extend and legs flex |
|
Definition
|
|
Term
1. defect where the urethra opens on the ventral side of the penis
2. earliest stools of the infant
3. Rounded or oval dark-blue pigmentation over butt and lower back due to melanoctes in dermis
4. anterior abd wall defect usually with protrusion of abd viscera |
|
Definition
1. hypospadias
2. meconium
3. mongolian spots
4. gastroschisis |
|
|
Term
1. a hemolytic disesase of the fetuss and newborn that is characterized by an increase in circulating erythroblasts and by jaundice that occur when the system of an RH- mom produces abs in an rh+ fetus
2. defect in umbilical area where the abdominal contents come out of the belly buttom |
|
Definition
1. fetal erythroblastosis
2. omphalocele |
|
|
Term
diagnostic criteria for rheumatic fever.
can improve but not confirm diagnosis
need one major and two minor or two major criteria
Major: carditis, polyarthritis, syndenham chorea, erythema marginatum, subcu nodules
Minor: previous RF, labs consisitent with infection, evidence of previous strep infection |
|
Definition
|
|
Term
TESTS:
1. used to dx autoimmune hemolytic anemia & mycoplasma pneumonia
2. an oncofetal protein produced by liver and yolk sac. serum marker for fetal body wall defects. women screened at 16-18 weeks. high levels = neural tube or abdominal wall deformity. low levels: down's.
3. used to determine whether a previous strep infection has caused a poststreptococcal disease
4. used to test for HSV or VZV |
|
Definition
1. cold agglutinin
2. alpha fetoprotein (AFP)
3. antistreptolysin O titer (ASO titer) |
|
|
Term
taken at 1 min, 5 min, and every 5 min until score >7
Components? |
|
Definition
APGAR score
HR: absent, <100, >100
Resp effort: absent, slow and irregular, good and strong
Muscle tone
reflex irritability
color |
|
|
Term
| Components of the newborn exam |
|
Definition
General: posture/tone/alertness
CN and reflexes
HEENT
Skin
Abdominal exam
chest
cardiac
ortho
GU |
|
|
Term
a common newborn problem where excess accumulation of bilirubin causes jaundice and other problems.
Defined when total bilirubin is >95% for age
from increased production or slow rate of excretion of bilirubin
TSB >17 mg/dL
jaundice extends out of "normal" range into lower body and feet
tx |
|
Definition
hyperbilirubinemia
tx: LED light (phototherapy) -- NOT sunlight
Immediate transfusion if >25 mg/dl |
|
|
Term
1. jaundice that appears 24 hours after birth and resolves within 1-2 weeks
2. jaundice due to bilirubin >20 mg/dl. causes injury to brainstem and basal ganglia. commonly due to rh incompatibility, early discharge from hospitla, and breast feeding. Effects = choreoathetoid cerebral palsy and hearing impairment. dental enamel dysplasia, paralysis of upward gaze, intellectual impairemnt.
3. sign of kernicterus is severely jaundiced babies (25 mg/dl) who appear lethargic and uninterested in feeding. CNS damage |
|
Definition
1. physiologic jaundice
2. kernicterus
3. acute bilirubin encephalopathy |
|
|
Term
| Signs & Symptoms of prematurity |
|
Definition
small plantar creases, thin skin with prominent vessels, no lanugo, imperceptible breasts, lids fused, scrotum flat/smooth, clitoris prominent, labia flat, neuromuscular immaturity (straight posture, legs bent to head), lower apgar score
delayed stooling, lack of coordinated reflexes/sucking, increased enterohepatic circulation, hyperbilirubinemia, retinopathy, resp distress, apnea, bradycardia, increased SIDS rate, increased CVA rate, immature kidneys, increased susceptibility to infection, hypoglycemia, hypocalcemia |
|
|
Term
reduced erythropoietin, decreased RBC life, frequent blood sampling, and rapid growth that can't be compensated bc bone marrow is immature
causes? |
|
Definition
|
|
Term
clinical manifestations of meconium aspiration
cxr
tx |
|
Definition
small airway obstruction --> resp distress
tachypnea, retractions, grunting, cyanosis
cxr: patchy infiltrates, coarse streaking of both lung fields, increased AP diameter, flattening of diaphragm
tx: suction, admit to NICU, resuscitaiton
|
|
|
Term
| IF a child is obese, they have a __% chance of being obese in adulthood. If an adolescent is, they have a __% chance. |
|
Definition
|
|
Term
| normal wieght gain for babies |
|
Definition
normal to lose a little after birth but gain it back by 2 weeks or so
0.5-1oz per day
after age 2: gain 5 lbs per year until adolescence |
|
|
Term
| Babies' gross motor skills develop in what fashion? |
|
Definition
| head to toe -- head coordination first |
|
|
Term
| simian lines, clinodactyly, and brushfield's spots are all associatd with? |
|
Definition
|
|
Term
| comorbidities with down's |
|
Definition
sleep apnea
hirschprung's disease
chronic nonspecific diarrhea
congenital heart problems --> most common cause is down's
|
|
|
Term
Triad of symptoms with ADHD
3 subtypes
tx |
|
Definition
Triad: impulsivity, inattention, hyperactivity
3 subtypes: inattentive, hyperactive, combined
tx: counseling, stimulant meds (methylphenidate or atomoxetine |
|
|
Term
|
Definition
| diagnostic: IQ <70 AND adaptive skills more than 2 sd below mean |
|
|
Term
pruritic, exudative or lichenified eruption of face, neck, upper trunk, wrists, hands, antecubital and popliteal folds
35% of these pts will develop asthma
Severe and prolonged itching which leads to lichenification (itch-scratch cycle). Rough, red plaques without thick scales effect face, neck and upper trunk |
|
Definition
|
|
Term
mild, acute, inflammatory eruption of unknown etiology
herald patch followed by christmas tree distribution |
|
Definition
|
|
Term
contagious and autoinnoculable infection of the skin caused by staph or strep
tx? |
|
Definition
impetigo
tx: topical antibiotics
systemic: cephalexin or doxy |
|
|
Term
1. white, adherent painless, discrete or confluent pathces in mouth tongue or esophagus
2. erythematous irritation with redness and pustules in skin folds
3. common erythematous putular perineal infection in infants |
|
Definition
thrush
intertrigo
diaper rash
all caused by candida
tx: topical azoles |
|
|
Term
|
Definition
seborrheic dermatitis
tx: steroid shampoos - zinc pyrthione, selenium sulfid, coal tar
2% ketoconazole shampoo |
|
|
Term
pharyngitis without rhinorrhea, cough, diarrhea, or conjunctivits is most likely?
may have fevr, HA, GI sx
tx? |
|
Definition
bacterial -- strep
tx: penicillin, erythromycin, azithromycin |
|
|
Term
punctate, erythematous, blanchable, sandpaper like exanthem rash in neck, groin, axilla, and in body folds (pastia's lines)
pharynx and tonsils are erythmeatous and covered with exudates
strawberry tongue |
|
Definition
|
|
Term
Otitis Media:
risk factors,
acute, subacute, and chronic
tx |
|
Definition
URI, group daycare, siblings, passive smoking, supine feeding, not breastfeeding
acute: < 3 weeks
Subacute: 3 weeks - 3 mos
chronic: >3 mos
tx: Ibuprofen, amoxicillin or augmentin, ear tubes |
|
|
Term
dx?
causes: parainfluenzal viruses, RSV, rubeola, adenovirus
more common in late fall and early winter
infection and swelling in larynx
s/s: barking cough + stridor. low grade fever
tx? |
|
Definition
croup
tx: none if mild
O2, dexamethasone (steroids), racemic epinephrine for severe |
|
|
Term
dx?
severe ear pain. increases with movement of pinna. often disproportionate to degree of inflammation
itching, hearing loss, edema, white cerumen
tx? |
|
Definition
otitis externa -- swimmer's ear
cipro/dexamethasone ear drops
oral abx if signs of systemic infection (fever)
analgesics |
|
|
Term
permenant dilation of bronchi resulting from airway obstruction by retained mucus secretions or inflammation
sx: chronic cough, purulent sputum, fever, weight loss, URI, DOE, hemoptysis
confirm dx with CT
tx? |
|
Definition
bronchiectasis
aggressive abx during pulmonary exacerbation
|
|
|
Term
dx?
congenital metabolic disorder inherited as an autosomal trait in which secretions of exocrine glands are abnormal and excessively viscous mucus causes obstruction of passageways
caused by a mutation in the ____ gene on chrom 7
sx: meconium ileus, chronic cough, recurrent bronchitis, Salty forehead, pancreatic insufficiency, azospermia (absence of vas)
labs: sweat chloride >60mEg/L, IRT positive,
tx? |
|
Definition
CF
CFTR gene
tx: promote clearance of secretions and control infection |
|
|
Term
| Ethmoid sinusitis can lead to ___ if left untreated |
|
Definition
| periorbital cellulitis (blindness) |
|
|
Term
dx?
premature child with immature lungs
sx: rapid shallow respirations >60/min, tachypnea, grunting, cyanosis
CXR: glass-like appearance of lungs
prevention? tx? |
|
Definition
Hyaline membrane disease (HMD)
prevention: give mom betamethasone 48 hours before delivery if <34 weeks
tx: monitoring in NICU, oxygen, ventilator, endotracheal surfactant |
|
|
Term
90% are on superior pole of tonsil
from tonsillar infecetion that penetrates the tonsillar capsule. most commonly gabhs
ss: sore throat, high fever, tonsil bulging medially, edematous on affected side. ear pain, dysphagia, drooling. "hot potato voice" |
|
Definition
peritonsilar abscess
tx: I&D, IV abx
|
|
|
Term
dx?
usually caused by h. influenza and thus is preventable
s/s: odonyphagia, dysphagia, drooling, voice change, resp distress
SITS ERECT, LEANS FORWARD, DROOLS
DO NOT TOUCH THE PT |
|
Definition
| epiglottitis/supraglottitis |
|
|
Term
dx?
1st episode of wheezing in a kid <2 years
due to primary infection or reinfection resulting in inflammation of smaller airways
often due to RSV
S/S:
1. sx of viral infection
2. 1-2 days later: tachypnea, retractions, wheezing, hypoxia, cough, nasal flaring
tx? |
|
Definition
bronchiolitis
tx: adequate hydration, O2 if needed |
|
|
Term
caused by sinusitis or OM
s/s:
tonsillar pain, swelling in neck, trismus (jaw spasm), edema of pterygoids, dyspnea, dysphagia, palpable mass
dx via CT
treatment? |
|
Definition
pharyngeal abscess
tx:
retropharyngeal: IV abx, external drainage
parapharyngeal: ssurgery |
|
|
Term
inflammation of airway cuased by viruses usually
s/s: cough (nonproductive at first, may become productive), fever uncommon, vomitting from swallowing mucus
ronchi possibly heard on auscultation
tx? |
|
Definition
acute bronchitis
paliative tx |
|
|
Term
inflammation of the lungs
80% are caused by viruses
s/s: nasal flaring, grunting, tachypnea, dyspnea, retractions, decreased breath sounds in areas of consolidation, rhonchi, dullness to percussion, absent freitus
dx via xray
tx? |
|
Definition
pneumonia
tx: based on pathogen. amoxicillin
mycoplasma/chlamydia/pertussis - macrolides |
|
|
Term
occurs in 3-5 year cycles
catarrhal stage: mild URI sx
paroxysmal stage: prolonged coughing attacks with inspiratory whoop, posttussive emesis, and lyphocytosis
can last up to 10 weeks
dx: nasopharyngeal mucus culture is gold standard
tx? |
|
Definition
pertussis
tx: -mycins, hospitalize if <3 mo
close contacts should have booster + 14 days of -mycins |
|
|
Term
wheezing, coughing, nighttime cough, feeling of chest tightness, SOB
brought on by triggers
dx via spirometry
mild: FEV1 > 80%
moderate: 60-80%
severe: <60%
tx? |
|
Definition
asthma
tx allergies
1. SABA
2. low dose ICS
3. Medium dose ICS
4. Medium dose ICS + LABA
5. high dose ICS + LABA |
|
|
Term
| leading cause of death 1 mo - 1 year |
|
Definition
|
|
Term
| leading cause of preventable MR |
|
Definition
|
|
Term
craniofacial dysmorphology: smooth philtrum, thin upper lip, small palpebral fissures
growth retardation: often <10th %
neuro damage & MR
dx by having facial abnormalities + growth deficits + CNS deficits |
|
Definition
|
|
Term
growth failure: child < 2 whose weight curve has falllen by 2 major percentiles from a previously established rate of growth. Weight <3rd percentile for age
associated wtih inadequate social or developmental acheivement
short stature, microcephaly are possible |
|
Definition
|
|
Term
- An unusual condition where the formation of the heart is flawed and the aorta and pulmonary artery never separate, resulting in a single arterial trunk and one semilunar valve which may be stenotic, regurgitant, or both
- Large VSD is also present, so all blood leaving the heart is partially oxygenated
Sx: cyanosis, pulmonary HTN, bounding pulses, wide pulse pressures, loud systolic murmur at base
xray: large heart with increased pulmonary vasculature
tx? |
|
Definition
truncus arteriosus
tx: surgery by 4-8 weeks of age
- close VSD
- separate pulmonary arteries from truncus and connect to RV via a conduit (must be replaced later in life)
|
|
|
Term
- Secundum is the most common type of this- it causes a left to right shunt
- sx: systolic ejection murmur and widely split S2 at LUSB, diastolic murmur at LLSB
- CXR: heart enlargement
tx?
complications |
|
Definition
atrial septal defect
tx: surgery if >3mm by age 2-5 years
complication: pulmonary HTN if not caught early
|
|
|
Term
- persistence of the normal fetal vessel that joins the pulmonary artery to the aorta
- should close spontaneously at day 3-5
- creates L-R shunt with oxygenated blood from aorta going back into lungs
sx: >20 mmg difference between upper and lower BP
- bounding pules with wide pulse pressure
- rough murmur at second left intercostal space, radiates through lungs
- large: failure to thrive, tachypnea, diaphoresis with feeding
- associated with prematurity and rubella in mom
tx? |
|
Definition
patent ductus arteriosus
tx: surgical closure for large shunts
- indomethacin for small ones |
|
|
Term
- inflammation of the parietal and visceral surfaces of the pericardium which leads to an accumulation of serous, fibrinous, hemorrhage or purulent exudate in pericardial space
- most common causes are inflammatory - viral infection
s/s: pt presents leaning forward and does not want to lay down
- dypnea, malaise, fever, tachycardia, friction rub
diagnostic studies?
tx?' |
|
Definition
pericarditis
- CXR: enlarged heart
- Echo: fluid
- ECG: reduced QRS, diffused ST segment elevation, electrical alternans
- fluid analysis
tx: treat underlying condition
- removal of fluid
- may need surgical removal of pericaridum
Meds: indomethacin, colchicine |
|
|
Term
- aorta arises from RV and pulmonary artery from the LV
- AKA "ventriculoarterial discordance"
- with or without VSD
- cannot survive without ASD or patent foramen ovale to allow mixing of blood
s/s: large profoundly cyanotic without resp distress or signficiant murmur
tx? |
|
Definition
transposition of great arteries
tx: arterial switch operation at age 4-7 days
-95% survival |
|
|
Term
- For this disease, 2 substrates are necessary:
- substrate: foreign body (prosthetic valves)
- agent: bacteria
- presents in low pressure regions or defects
- body attempts to close off with thrombus and bacteria adhere to and proliferate in thrombus - reducing the availability of abx access
commonly strep viridans and staph aureus
sx: fever, chills, nightsweats, anorexia, weight loss, fatigue, malaise, chest pain, petechiae
- new or changing murmur, splenomegaly
- Janeway lesions, osler nodes, emboli on soles and toes, splinter hemorrhages, roth spots
Labs?
tx? |
|
Definition
infectious endocarditis
labs: anemia, leukocytosis w/ left shift, hematuria, proteinuria, elevated ESR, CRP, RF
tx: IV abx 4-8 weeks
surgical: valve replacement |
|
|
Term
- Most common CHD in kids
- involves 4 heart defects... which are?
- results in a l-r shunt
s/s: squatting to raise intraabdominal pressure, cyanosis, easy fatiguability, DOE, audible S2 at LLSB, hypoxemic spells,
CXR: BOOT SHAPED HEART
EKG: Right axis deviation, RVH
tx? |
|
Definition
tetralogy of fallot
1. RV valve outflow obstruction
2. Large VSD
3. RVH
4. Overriding aorta
tx:
- surgery from birth - 2 y/o - close VSD
- palliative if surgery is too risky. B blockers + shunt to replace ductus |
|
|
Term
- Narrowing of aortic arch in the proximal descending aorta near the L subclavian and the ductus arteriosus
- thought to be caused by ductual tissue closing off the aorta when the ductus closes
Common presentation:
- Young person with HTN and difference between BP in arms and legs. Decreased or absent femoral pulses + UE hypertension and LE hypotension.
Echo is diagnostic
tx? |
|
Definition
coarctation of aorta
tx: surgery in kids <10 y/o
- stenting >10 y/o |
|
|
Term
Incomplete ventricular septum that allows L-R shunting of blood
- most common CHD
s/s: dyspnea, poor growth, sweating, feeding trouble, LOUD high pitched systolic murmur at LLSB with thrill
normal EKG & CXR
tx? |
|
Definition
VSD
tx: surgical repair of septum |
|
|
Term
mulit-system inflammatory disease involving the heart, joints, CNS, skin, and subcu tissue
- most common in 5-15 y/o
- triggered by ___ infection
s/s: JONES CRITERIA
- Major critera: polyarthritis, carditis, chorea, erythema marginatum, subcu nodules
- Minor criteria: arthralgia, leukocytosis, elevated ESR or CRP, prolonged PR, previous disease
Must have 1 major and 2 minor criteria or 2 major criteria
heart murmurs associated with this?
tx? |
|
Definition
Rheumatic fever/haert disease
- GABHS infection
murmurs: mitral regurg, aortic regurg, carey-coombs murmur (mid-diastolic rumbling at apex)
tx: bed rest, pcn, aspirin, steroids |
|
|
Term
1. non-tender, red macules in palms and soles
2. small red or purple nodules. mild to moderately painful, usually present at fingertips
3. linear dark red or brown subungual streaks
4. small bright red oval retinal hemorrhages with clear pale centers |
|
Definition
1. janeway lesions
2. osler node
3. splinter hemorrhages
4. roth spots |
|
|
Term
| mid-diastolic rumbling murmur at apex, probably due to mitral valve edema |
|
Definition
carey-coombs murmur
assocaited with rheumatic heart disease |
|
|
Term
One of the most common rheumatic diseases in kids
- characterized by idiopathic synovitis in peripheral joints, associated with soft tissue swelling and effusion, may be triggered by preceding infection
Criteria for dx:
- polyarthritis of 5 or more joints
- Oligoarthritis <5 inflamed joints
- systemic arthritis wtih characteristic fever
- age at onset <16 years
- duration >6 weeks
s/s: morning stiffness, fatiguability, joint pain & swelling, daily fever, pericardial effusion/serositis, faint erythmatous macular rash
Labs?
tx? |
|
Definition
juvenile RA
labs; elevated ESR, CRP, leukocytosis, thrombocytosis, anemia of chronic disease, elevated ANA
tx: NSAIDs, sulfas, methotrexate, etanercept, maybe glucocorticoids
|
|
|
Term
- most common systemic vasculitis in kids - unknown cause
AKA anaphylactoid purpura
- distinct systemic vasculitis characterized by palpable purpura over buttocks and lower extermities + abd pain, arthritis, and hematuria (renal problems)
- immune complex deposition with IgA
- usually seen in kids 4-7 y/o
skin biopsy to confirm dx
tx? |
|
Definition
henoch-schoenlein purpura
tx: prednisone |
|
|
Term
AKA mucocutaneous lymph node syndrome
- acute febrile multisystem disease of kids ages 3 mos to 5 years and occassionally seen in adults
- vasculitis characterized by infiltration of vessel walsl with mononuclear cells and later by IgA secreting plasma cells which results in destruction of media and aneurysm formation
dx - 4 criteria for 5 days:
- bilateral conjunctivitis
- mucus membrane changes
- peripheral extremity changes
- polymorphous rash
- cervical lymphadenopathy
+ irritability, vomiting, anorexia, cough, diarrhea
complication: arteritis --> MI
labs?
tx? |
|
Definition
Kawaksaki Disease
Labs: elevated ESR and CRP
tx: IVIG w/in first 10 days
- high dose aspirin until afebrile for 48 hours
|
|
|
Term
bacteria in joint - usually single joint
s/s: joint pain, decreased ROM, effusion, fever, renal or hepatic insufficiency
XR: bony erosion, joint space narrowing
Joint aspiration: 100,000 WBC/uL with >90% neutrophils
tx? |
|
Definition
bacterial (septic) arthritis
IV abx and drainage of joint |
|
|
Term
infection caused by entamoeba histolytica, a protozoa that exists as a resistant infectious cyst or as a motile, invasive trophozoite
- transmitter via contaminated food or water and by person-person contact
s/s: may be asymptomatic. may have acute cramping diarrhea, extraintestinal lesions, perforations, and hemorrhages
dx: stool culture (may be neg), biopsy of ulcers or abscesses, antibody testing, US or CT will show liver abscess if present
tx? |
|
Definition
Amebiasis
tx: metronidazole - tissues
iodoquinol - intraluminal |
|
|
Term
- flagellated protozoan ingested via water then live in duodenum
s/s: acute illness with sudden onset explosive watery diarrhea, foul-smelling stools, flatulence, abd distention, nausea, anorexia can last for months
dx: stool culture
tx? |
|
Definition
giardiasis
tx: metronidazole, tinidazole, or furazolidine |
|
|
Term
|
Definition
Mild (3-5%): none except for thirst/dry mucus membranes
Moderate (6-9%): Rapid pulse, dry mucus membranes, sunken fontaneles & eyes, cool skin, irritability, decreased urine
Severe (>10%): rapid/weak pulse, shock, deep/increased respirations, parched mucus membranes, markedly sunken eyes and fontanelles, cool skin w/ acrocyanosis and tenting, anuria, grunting, lethargy |
|
|
Term
|
Definition
mild (3-5%): 50 ml/kg/hr PO for 4 hours
Moderate (6-9%): 100 ml/kg PO or IV for 4 hours
Severe (>10%): 20 ml/kg bolus
Maintenance - 4:2:1 rule per hour, 100:50:20 rule per day -->
first 10 kgs: 4 ml/kg/hour (100 ml/kg/24 hours)
Next 10 kgs: 2 ml/kg/hr (50 ml/kg/24 hours)
Remainder: 1 ml/kg/hr (20 ml/kg/24 hours) |
|
|
Term
| What is maintenance fluid managment for a 35 kg child? |
|
Definition
Hourly:
4 ml x 10 kg = 40 ml/hr
2 ml x 10 kg = 20 ml/hr
1 ml x 15 kg = 15 ml/hr
___________________
75 ml/hr
Daily:
100 ml x 10 kg = 1000 ml/day
50 ml x 10 kg = 500 ml/day
20 ml x 15 kg = 300 ml/day
_____________________
1800 ml/day |
|
|
Term
acute v. chronic diarrhea in kids
time frame and possible causes |
|
Definition
Acute: <2 weeks
1. Non-inflammatory : watery, non-bloody, mild - virus or noninvasive bacteria
2. inflammatory - blood or pus, fever. Usually caused by invasive or toxin-producing bacterial -- indicates mucosal irritation. Needs lab work
Chronic: >2 weeks - consider meds, chronic infection, and autoimmune disease |
|
|
Term
types of diarrhea:
1. persists during fasting, watery, normal osmolality. Common causes - cholera, neuroblastoma, E. coli
2. slows or stops during fasting, transport defect, high osmolality, water, acidic, + reducing substances. usually due to lactase deficiency or laxative abuse
3. greasy or malodorous
4. contains blood or pus |
|
Definition
1. secretory
2. osmotic
3. malabsorption
4. inflammatory |
|
|
Term
Diarrhea-causing organisms:
1. School aged kids in winter. watery to loose stools. rarely fever.
2. summer time. watery stools. kids <2
3. gram neg rods. watery, self limiting
4. gram neg rodes. invasive wtih mucus and blood in stool. tenesmus, malaise, fever. +/- seizure. Need Ceph or azithro
5. varies in severity. can lead to bacteremia/enteric fever. commonly spread by zoonosis.
6. gram neg spiral rods. from water. abd cramps then diarrhea. flu-like prodrome. diarrhea may be bloody. can cause guillain-barre, reactive arthritis, urticaria, and erythema nodosum.
7. attained from swimming in lakes/rivers. giardia and crypto |
|
Definition
1. norwalk-like virus
2. intestinal adenovirus
3. e. coli
4. shigella
5. salmonella
6. campylobacter
7. parasites |
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Term
Common in winter mos and in kids <3 y/o
Classic triad: fever, vomiting, diarrhea (pale yellow, malodorous, frequent, large, watery)
- 5-7 days duration
- Loss of brush border and microvilli
tx? |
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Definition
rotavirus
tx: supportive - NO ANTIMOTILITY DRUGS
fluids
tylenol for cramping
probiotics may shorten course |
|
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Term
Terminal ileum telescopes into colon. Upper portion into lower portion. may involve mesentery and vessels
- most often ileocolic or ileoileocolic
s/s: Sudden onset. paroxysms of abdominal pain - screaming, dropping to knees. vomitting and diarrhea, bloody stools, lethargy, +/- fever. weak, thready pulse. shallow respirations/grunting
CURRENT JELLY STOOLS
DRE: blood
Barium enema: COILED SPRING SIGN
US: TARGET or DONUT
tx? |
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Definition
intussusception
tx: enema
surgery (bowel perforation, unsuccessful enema)
if untreated - most likely death |
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Term
AKA congenital aganglionic megacolon
- abnormal innervation of the bowel beginning at the anus and extending proximally. bowel is in constant state of contraction
s/s: THIN, RIBBONY STOOLS, progressive dilation of proximal bowel and abd distention, EMPTY RECTAL VAULT
dx: barium enema -- transition zone (dilated bowel proximal to contracted bowel)
Rectal suction biopsy - high AChE at transition zone
tx? |
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Definition
hirschprung's disease
tx: surgery (Swenson approach, Duhamel approach, Boley approach) |
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Term
Most common birth abnormality in males, esp premies
- usually spontaneously resolves in 3 mos
- may be associated wwtih infertility or malignancy
labs: LH, FSH, testosterone, ultrasound
tx? |
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Definition
cryptorchidism
tx: surgery before 15 mos |
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Term
Twisting of ____ which cuts off blood supply to affected testicle
often caused by "BELL CLAPPER DEFORMITY" - loss of gubernaculum causes the tunica vaginalis to go all the way around the testicle and thus the testicle is not anchored to the scrotum and is free to twist.
s/s: red, swollen, lifted, horizontal-lying testicle on one side. Severe acute pain. absent creamsteric reflex.
tx: needs to be treated w/in ____ to avoid loss of testicle. how is this done? |
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Definition
spermatic cord
4-6 hours
- manually untwist - outward
- surgery |
|
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Term
| What does the "blue dot sign" on the scrotum indicate? |
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Definition
| torsion of a testicular appendix |
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Term
obstruction of the appendix by a fecolith (most commonly), parasite, or unknown cause
- most common indication for emergency surgery in kids
- frequency peaks between 15-30 y/o
s/s: fever, periumbilical pain that localizes to RLQ, signs of peritonitis, anorexia, vomiting, constipation, diarrhea
PE: rectal exam may clarify site of tenderness
tx? |
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Definition
appendicitis
tx: appendectomy |
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Term
s/s: PROJECTILE VOMITING (non-bilius) after every feeding, starts in first 3 weeks of life - not present at birth, hungry infant, wants to eat all the time, palpable olive in abdomen
BMP: hypochloremic, hypokalemic metabolic alkalosis
tx? |
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Definition
pyloric stenosis
surgery: pyloromyotomy
correct dehydration and electrolytes |
|
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Term
Eneuresis
- most common form?
- what should you suspect if secondary develops?
- dx? |
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Definition
- primary nocturnal - most common
- secondary - suspect abuse, diabetes, UTI
- dx: wetting the bed 2x/week for 3 consecutive mos or when there is significant stress from bed wetting
tx: r/o UTI, reassurance, go to bathroom before bed, limit water 90 min before bed, wake up child 90 min after bed to go to the bathroom |
|
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Term
- Recent hx of GABHS infection
s/s: gross hematuria (RBCs too numerous to count), RBC cases, edema, HTN, HA
labs: elevated antistrptolysin O titer, elevated antistrep antibodies
tx? |
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Definition
poststreptococal glomerulonephritis
tx: no specific tx. erythromycin, reduce salt intake, diuretics |
|
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Term
75% are from E. coli
- Females >> males after age 1
- 3 diff types
s/s dependent on type
labs:
UA: leukocyte esterase, wbc, nitrate pos, bacteria
positive if >100,000 cfu/ml
likely if >50,000 cfu/ml
maybe if >10,000 cfu/ml + classic sx |
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Definition
|
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Term
3 types of UTI & tx for each:
1. dysuria, frequency, small voids, abd/back pain
2. fever over 101.3 (newborns may be hypOthermic), abd/flank pain, vomiting
3. no sx. seen in kids with intermittent catheterizations |
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Definition
1. cystitis
tx: amoxicillin, bactrim
in teens: fluroquinolones
2. pyelonephritis
tx: parenteral 3rd gen ceph or aminoglycoside
may need VCUG or DMSA scan to ID bladder reflux or kidney scarring, respectively
3. asymptomatic bacturia |
|
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Term
| most common cause of nephrotic syndrome in kids |
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Definition
minimal change disease
UA: large amounts of protein |
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Term
Highly contagious disease that causes necrosis of resp tract epithelium and an accompanying lymphocytic infiltrate. Small vasculitis of skin and oral mucus membranes.
WARTHIN-FINKELDEY GIANT CELLS and KOPLIK'S SPOTS - pathognomic
4 phases: incubation, prodromal illness, exanthemous phase, recovery
s/s: high fever, exanthem, cough, coryza, conjunctivitis, mild fever after 8-12 days
rash begins on forehead then spreads downward
tx? |
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Definition
Rubeola - MEASLES
tx: supportive - hydration, O2, comfort. Antipyretics for fever. |
|
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Term
a painful viral infection that leads to painful swelling of salivary glands.
s/s: face pain, fever, HA, swelling of parotid glands, and swelling of temples or jaw
tx? |
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Definition
mumps
tx: tylenol (NOT aspirin)
complication: orchitis |
|
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Term
Healthcare associated and community acquired
- not a matter of hygiene
s/s: skin infections & soft tissue abscesses
tx? |
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Definition
MRSA
tx: drain abscess, bactrium, clindamycin, doxy (not kids under 8)
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Term
| Fever >100.4 lasting for more than 14 days with no obvious cause despite a complete hx, PE, and routine labs |
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Definition
|
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Term
a condition in which the pt has bacteria in the blood stream leading to inflammation and immune overload
s/s: fever, malaise, shock, tachy
from trauma, dental work, severe UTI, untreated infection
labs: blood culture, CBC |
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Definition
bacteremia
tx: IV abx - ADMIT |
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Term
infection localized to subarachnoid space
s/s: fever, anorexia, poor feeding, HA, URI sx, Myalgia, arthrlagia, tachy, hypotension, petechia, seizure, DIC, LOC
+ brudzinski's and kernig's
tx? |
|
Definition
meningitis
tx:
<3 mos: ampicillin + 3rd gen ceph
>3 mos: 3rd gen ceph + amp + gent
Dexamethasone |
|
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Term
causes of meningitis by age
0-28 days
>28 days
2 mos - 12 years |
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Definition
0-28 days: Group B strep
28 days - 2 mos: Strep pneumo, neisseria meningitidis
2 mos-12 years: Neisseria meningitidis, strep pneumo |
|
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Term
cause by clostridium tentani
- caused by contamination of wound wtih the toxin -- causes CNS sx
s/s: mild pain at wound site, hypertonicity, spasms in jaw (trismus), irritability, inability to nurse, neck/back/abd stiffness
2-4th day: elevated BP, increased CO, tachy, arrhythmia
tx? |
|
Definition
tetanus
tx: Human TIG, IVIG, surgical debridement, abx
- anxiolytic, kept in quite room
- may need mechanical ventilation or muscle paralysis, nasogastric or IV feedings
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|
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Term
viral infection of mucosa of URT and conjunctiva
- airborn transmission or contact with lesions
- late winter/early spring
- <10 y/o usually
- contagious 1-2 dyas before rash onset until crusting phase
- incubation: 2 weeks
s/s: mild fever, systemic sx --> dew drop on a rose petal lesions that eventually get crusty
Pathognomonic: all 3 stages of rash are visible on a pt at once |
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Definition
|
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Term
Rash over single dermatome that doesn't cross midline
- if in kids - usually immunocompromised
dx: clinical
tx? |
|
Definition
zoster
tx:
supportive: hydration, tylenol or ibuprofen (NOT aspirin) , cool soaks, antihistamines
oral acyclovir: if really sick and within 24 hours of rash
can be fatal in pregnant women |
|
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Term
an enteroviral infection spread by fecal-oral or resp or placental routes
- most are asymptomatic and resolve in 2-6 days
- mild illnes = fever, malaise, sore throat, myalgia, HA
- severe illness = fever/severe myalgia/anxiety -- progress to loss of reflexes/paralysis asymmetrically, loss of cardiorespiratory function and bladder control
labs: leukocytes in CSF
tx? |
|
Definition
poliovirus
tx: supportive, bed rest, fever and pain control, iron lung |
|
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Term
common enteroviral infection - second only to the common cold
- mostly asymptomatic
- mild URI sx, fever/chills, muscle ache, petechial rash, vomiting, abd pain, diarrhea
labs: throat, stool cultures is gold standard |
|
Definition
nonpolio virus
tx: supportive |
|
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Term
aka: exanthem subitum, Sixth disease
- primary infection caused by HHV6 or 7
s/s:
- prodrome: mild URI, rhinorrhea, mild pharyngeal sx, mild conjunctival redness, cervical and post occipital lymphadenopathy, GI signs, inflamed TMs
- High Fever for 3-8 days, resolves abruptly
- Rose colored maculopapular rash lasting hours to days
tx? |
|
Definition
roseola
tx: usually none
- ganiclovir and cidofovir for 2-3 weeks in severely immunocompromised |
|
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Term
pharyngitis + fever + rash --> caused by group A strep infection
s/s:
- diffusely erythematou and appears sunburned and roughened - sandpaper rash. most intense in axillae, groin, abd, and trunk
- Pastia sign: rash blanches except in skin folds where it will appear pigmented
- fever
- desquamation - end of first week - 3rd week
- White-Strawberry Tongue
- mucosal petechiae
labs? tx? |
|
Definition
scarlet fever
* severe strep throat with a rash *
usually no labs
- throat culture, rapid strep test
- cbc - leukocytosis
tx: Abx - PCN
can turn into acute rheumatic fever |
|
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Term
infection caused by epstein barr virus (HHV4)
- >90% of pop is infected between 10-35 y/o
- spread through genital and saliva secretions
s/s: fever, HA, sore throat, fatigue, malaise, anorexia, abd pain, myalgia, lymphadenopathy, splenomegaly, hepatomegaly, maculopapular or petechial rash, exudative pharyngitis, tonsillitis, gingivitis.
labs: granulocytopenia, lymphocytic leukocytosis with atypical lymphocytes
tx? |
|
Definition
mono
monospot
tx: supportive, tylenol, no contact sports, steroids if needed to prevent airway obstruction
acyclovir only if infection is chronic |
|
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Term
antigenic ___ occurs annually
antigenic ___ occurs every 7-10 years |
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Definition
|
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Term
spread person-person via aerosols
s/s: sudden onset fever, chills, malaise, HA, myalgia, cough, coryza, pharyngitis
kids: fever, vomiting, diarrhea, abd pain
infants: sepsis, apnea
CBC: leukopenia |
|
Definition
flu
tx: supportive
antivirals must be given w/in first 48 hours of onset - amantadine
major complications: Reye syndrome |
|
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Term
|
Definition
|
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Term
Most severe form of rickettsia infection
- transmitted via tick bite, which must be attached for at least 6 hours
s/s:
CLINICAL TRIAD: HA, Fever, Rash
- after 3-12 days: abrupt onset high fever, myalgia, severe and persistent HA, toxicity, photophobia, vomiting, diarrhea.
- Rash on PALMS and SOLES
Primarily on eastern seaboard, southeast from april to september.
tx? |
|
Definition
Rocky Mtn Spotted Fever
tx: doxy for 2-3 days after fever is gone. at least 10 days |
|
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Term
benign exanthematous illness of school aged kids caused by human parvovirus B19.
s/s: rash and joint sx
- prodrome: mild URI sx, fever, HA
- 3 phase rash: slapped cheek, symmetric maculopapular pruritic, central clearing of rash giving classic lacy appearance
- rash fluctuates with temp changes and sunlight
tx? |
|
Definition
erythemat infectiosum -- 5th disease
tx: supportive, IV immunoglobulin for immunocompromised
|
|
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Term
subcutaneous tissue infection that involves necrosis of deep layer of superficial fascia but largely spares the adjacent epidermis, deep fascia, and muscle.
- complication of varicella infection (most commonly), group a strep, staph aureus
s/s: skin is pale, red, tender w/o borders. Resembles cellulitis initially
- blisters or bullae may appear
- collar deepds to purple
- tenderness out of proportion to clinical appearance
- "woody induration" - skin anesthesia due to infarct of superficial nerves
- mild to severe edema
- can become septic
dx: surgical exploration, MRI
tx? |
|
Definition
necrotizing fasciitis
tx: supprotive, surgical debridement, broad spectrum abx, meticulous wound care |
|
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Term
common tick disease in midwest/south east/mid atlantic
- march-october
s/s: fever, HA, abd pain, anorexia, N/v/d, edema, chills, photophobia, conjunctivitis, myalgia
PE: rash (erythematous, macular, papular, petechial, scariantiniform, or vasculitic) - SPARES PALMS AND SOLES. mild adenopathy/hepatomegaly
labs: leukopenia w/ left shift, lymphopenia, thrombocytopenia, elevated aminotransferase
tx? |
|
Definition
erlichiosis
tx: doxy ASAP
risk: minigoencephalitis and neuro defects |
|
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Term
CNS infection caused by a gram neg intracellular diplocci
- most common cause of bacterial meningitis 2mo-12 years
s/s: fever, anorexia, poor feeding, HA, URI sx, myalgia, arthralgia, tachy, hypotension, PETECHIAE/PURPURA, seizure, + brudzinski's/kernig's (18 mos)
labs: LP, CBC
tx? |
|
Definition
meningicoccal meningitis
tx: must be immediate
<1 mo-3 mos: ampicillin + cef
>3 mos: cef or amp + gentamycin
Dexamethasone to limit inflammation
|
|
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Term
bacterial infection (corynebacterium) characterized by nasopharyngeal/laryngitis with fever that is spread through eyes, nose, throat, skin
- bacteria produces toxins that destroy epithelium
- 2-7 day incubation
s/s: GRAY membrane over back of throat, tonsillitis/pharyngitis, low grade fever w/ resp symptoms for 1-2 dyas
possible airway obstruction, myocarditis, peripheral neuropathies
tx? |
|
Definition
diphtheria
tx: penicillin + antitoxin for 10 days
pt is cleared when 2 cultures are neg |
|
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Term
teratogenic disease - only a big deal if pt is pregnant.
80% of infections are subclinical
- transmitted via aerosol secretion in late winter/early spring
s/s: rash w/discrete macupapules begin on face and spreads to trunk and extremities for 4 days. red eyes, fever, HA, slapped cheek appearance
- Forchheimer spots in throat
CONGENITAL: 80% of infected women in first 4 mos of pregnancy deliver infected infants.
- growth retardation, cardaic and vascular anomalies, ocular anomalies, deafness, retardatoin, blood problems
labs: IgM assay - may need to terminate pregnancy
tx? |
|
Definition
rubella
tx: symptomatic therapy
- Keep out of school 7 days after rash onset
congenital defects are irreversible
- should be considered contagious until 1 y/o |
|
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Term
an entrovirus that causes acute hepatic injury. spread through FECAL-ORAL rought
incubation: 15-30 days
s/s:
- prodrome: 1 week. HA, anorexia, malaise, nausea, vomiting
PE: jaundice and large tender liver
labs: high IgM, low IgG
tx? |
|
Definition
hep A
tx: supportive.
give IG in institutes of high risk spread |
|
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Term
Most common genetic condition
1/700 births - increases wtih maternal age'
what are some physical characteristics? associated health problems? |
|
Definition
Down's
physical: small flat head, up-slanting palpebral fissures, epicanthal folds, brushfield spots, midface hypoplasia, small lowset ears, small mouth big tongue
Health problems: CHD, leukemia, GI atresia, hirschprung disease, hearing loss, OSA, ear infections, cataracts, hypothyroid, AD, celiac, atlanto-occipital instability |
|
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Term
genetic condition in a female w/ 1 X chrom. 45X is most common
s/s: webbed neck, edema of hands & feet, coarctation of aorta, triangular facies, short stature, shield chest, wide set nipples, horseshoe kidney, amenorrhea, absence of secondary sex characteristics, infertility, LD
tx? |
|
Definition
turner syndrome
tx: estrogen to produce secondary sex characteristics
growth hormone |
|
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Term
genetic abnormality in boys with extra X chrom. dx rarely made before puberty
- from nondisjunction
s/s: microorchidism, lack of libido, minimal facial hair, TALL, eunochoid build (long arms and legs), Low IQ, infertility, gynecomastia
risk factors: advanced maternal age
karyotype of peripheral blood --> gold standard
high fsh, lh and estrodiol, low testosterone
tx? |
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Definition
Klinefelter's
tx: testosterone replacement
prognosis: higher risk of breast cancer, DM, hypothyroid/parathyroid, SLE, sjogrens, RA |
|
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Term
s/s: open lesion with skin-covered lesion
clubfeet, dislocated hips, flaccid paralysis below lesion
associated: hydrocephalus, neurogenic bladder/bowel, congenital paralysis in lower extremities, CNS heart and kidney anomalies
labs: MRI
tx? |
|
Definition
spina bifida (myelomeningocele)
tx: closure in first 24-48 hours after birth
address orthopedic problems
attain continence - anticholinergics
genetic counseling
prophylactic: folic acid |
|
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Term
Chronic, static impairment of muscle tone, strength, coordination, or movement
- NONPROGRESSIVE, originates from some type of cerebral injury before, during, or soon after birth
risks: SGA, intrauterine hypoxia/bleeding/infection
-50% have no identifiable cause
PE: spasticity, hyperreflexia, ataxia, involuntary movements, microcephaly
TX? |
|
Definition
cerebral palsy
tx: PT, OT, SLP,
botox for spasticity, baclofen pump |
|
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Term
Types of CP:
1. most common form of CP
- due to injury of upper motor neurons of pyrimidal tract
- truncal hypotonia in first year
- spasticity, hyperreflexia, clonus in 2nd year
2. 2nd most common
- due to cerebellar injury
- affects fine coordinated movements. mainly UE
- wide unsteady gait
3. due to injury to basal ganglia. associatd with kernicterus (hyperbilirubinemia)
- variable tonal abnormalities - athetosis & chorea
- greater cognitive fxn than other forms
4. more than one motor pattern
- typicaly associated with more complications |
|
Definition
1. spastic
2. ataxia
3. dyskinetic
4. mixed |
|
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Term
| transient occurrence of signs and sx resulting from abnormal excessive synchronous neuronal activity in the brain |
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Definition
|
|
Term
most common seizure disorder in kdis.
do LP <1 y/o
find source |
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Definition
|
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Term
2 kinds:
1. simple: sudden cessation of motor activity or speech with a blank facial expression and flickering of lids. <30 sec.
2. complex: myoclonic face, finger, and extermity movment. possible loss of muscle tone.
tx? |
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Definition
absence seizures
tx: valproic acid or ethosuximide |
|
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Term
seizure resulting from metabolic derangement
- stiffening of muscles. arms up, legs out.
- initiead by loud "ictal cry", impaired respirations, biting of tongue, increased HR, BP, pupil size
- progrressive relaxation, unresponsiveness, flacidity
- prone to anterior shoulder dislocation
tx? |
|
Definition
tonic clonic seizure
tx: valproic acid or lamotrigine |
|
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Term
Signs of abuse vs. normal accidental injury:
burns, spanking
red flags of abuse |
|
Definition
burns:
abuse - soles and palms. no splash marks
"comet sign" - cigarette burns
spanking:
SHOULD NOT CAUSE BRUISING
abuse: upper arms, anterior thigh, trunk, genitals, buttocks, face, ears, neck
- in kid <6 mos -- those who cruise rarely bruise
should be signs of behavioral change
- anger, depression, withdrawal
- overtly sexual behaviors
- knowledge/language beond developmental expectations
Red Flags:
- hx does not make sense, history changes, vague hx, frequent accidents, multiple injuries at different stages of healing, perp is unable to defend self |
|
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Term
every infant requires between __ & __ doses of vaccine by 18 mos to protect against 14 diseases.
contraindications to childhood vaccines |
|
Definition
25-26
contraindictations: severe febrile illness,
HIV or cancer - let ped onc do the vaccines |
|
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Term
Adolescents:
- at what age should kids start being seen w/o their parents? Same age for having an annual exam
- History - HHEADSSSFFIRST
- leading cause of death for kids 15-24 is ____, ___, ___. Alcohol is a major factor in all three.
- sexual activity in HS is __%
- __ % of HSers are obese, ___% are overweight
- gardasil is recommended in girls ages __-__ |
|
Definition
- 11-12
- Hx:
home, health, eaducation, abuse, drugs, safety, sexuality, selfcare, family, friends, image, recreation, spirituality, threats/violence
- MVA, homicide, suicide
- 46%
-12%, 15.8%
- 9-26 |
|
|
Term
Types of scoliosis:
1. failure of formation causing a hemivertebrae that results in failure of segmentation and a unilateral bar
- often associated with renal and cardiac sx
2. causes flaccid weakness or spasticity, loss of sitting balance, impaired resp function, adn typically long thoracolumbar or lumbar curves due to CP, spina bifida, etc
3. onset after age 10. most common kind
how do you evaluate scoliosis?
tx? |
|
Definition
1. congenital
2. neuromuscular
3. adolescent
evaluation: cobb angle
risser sign: 0-5. 0 being no apophysis. 5 being complite fusion
-MRI for any curve to the left
tx:
- surgery - >40deg (immature) or >50 deg (mature) or for congenital or neuromuscular
- brace 25-40 deg
- observe 0-25 deg |
|
|
Term
Due to shallow acetabulum, instability of femoral head, frank dislocation, or birth defect
- common in breech presentaiton
- girls:boys 4:1
- + galeazzi, barlow, or ortolani signs
tx? |
|
Definition
congenital hip dysplasia
tx: pavlic splint - 90% effective if less than 6 mos. typically worn 6-12 weeks |
|
|
Term
progressive displacement of the upper portion of the femur that occurs in relation to the capital femoral epiphysis
- pain in groin/anterior thigh, decreased abduction, abductor lurch gait
PE: loss of internal rotation
- boys 13-15, girls 11-13
xray of both hips: check by drawing a "klein" line along superior femoral neck
tx? |
|
Definition
slipped capital femoral epiphysis
tx: refer for surgery |
|
|
Term
| salter-harris classification |
|
Definition
S: separate - needs closed reduction if displaced
A: above
L: lower (below)
T: through
R: ram |
|
|
Term
subluxation of radial head as a result of being lifted or pulled by the hand
s/s: painful, fully pronated elbow that won't bend
PE: point tenderness over radial head
tx? |
|
Definition
nurse maid's elbow - subluxation of radial head
tx: immobilize elbow w/ sling |
|
|
Term
elevation of tibial tubercle caused by the recurrent traction of the muscle-tendon unit that occurs in jumpin and running sports. fragmentation and microfractures may occur
- preteens and adolescents
s/s: pain at tibial tubercle. aggrevated by activities using quads.
xray: fragmentation or irregular ossification at tibial tubercle
tx? |
|
Definition
osgood-schlatter disease (tibial tubercle apophysitis)
tx: NSAIDS, hamstring stretches, ice after workout |
|
|
Term
knock-kneed appearance of legs during development
normal in girls around 8 y/o |
|
Definition
|
|
Term
due to blood supply being cut off to head of femur
s/s: 4-8 y/o. persistant pain with limping or limitation of motion
labs: normal
xray: effusion around joint, decreased bone density, center of bone appears denser than surrounding bone, widening of femoral head w/ coxa plana
tx? |
|
Definition
avascular necrosis of proximal femur
(Legg-calve-perthes disease)
tx: protect joint, complete replacement of femoral head |
|
|
Term
injury to lower trunk (C7-T1) from difficult childbirth with shoulder dystocia. small mom, big baby
- good shoulder fxn, decreased hand fxn = "claw hand"
- horner syndrome may be present
tx? |
|
Definition
Klumpke's palsy
tx: surgery to nerves in kids w/ no spontaneous recovery by 6-9 mos, PT |
|
|
Term
| aka compression fracture. typically in distal radius of young kids. heal in 2-3 weeks with immobilization |
|
Definition
|
|
Term
most common birth fracture
- associated with high birth weight and shoulder dystocia
tx? |
|
Definition
clavicle fx
tx: pinning sleeve for 10-14 days
|
|
|
Term
gaits:
1. shortened stance phase characterized by pain in the extremity or spine
2. shifting the trunk or shoulders toward the affected side to compensate for weakness of abductor muscles
3. foot contact wtih floor by the front of the foot may be due to heel cord contracture or to compensate for a limb length discrepency
4. characterized by swinging of entire leg out ot the side in a circle during the swing phase, such as to allow clearance of a longer leg |
|
Definition
1. antalgic
2. abductor
3. equinus
4. circumduction |
|
|
Term
aka clubfoot
- hindfoot equinus + forefoot adduction + varus + midfoot cavus (high arch)
r/o hip dysplasia and torticollis
commonly assocaited with spina bifida, arthrogryposis, and myelodysplasia |
|
Definition
|
|
Term
| increased internal or external rotation of tibia. can cause gait abnormalities and genu varum. internal usually fixes itself. external unlikely to resolve spontaneously. some cases require surgery |
|
Definition
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