Term
|
Definition
| RR 40-60 rpm, HR 120-160 bpm |
|
|
Term
|
Definition
appearance (color)
pulse (rate)
grimace (reflex/irritability)
activity (motor tone/movement)
respiration (breathing effort) |
|
|
Term
| newborn conjunctivitis ddx by time |
|
Definition
day 1: chemical irritation (silver nitrate)
day 2-7: n. gonorrhoeae
day 7-21: c. trachomatis
> day 21: herpes |
|
|
Term
| newborn conjunctivitis tx by etiology |
|
Definition
chemical: none
n. gonorrhhoeae: ceftriaxone
c. trachomatis: erythromycin PO
herpes: systemic acyclovir and topical vidarabine |
|
|
Term
| required newborn screening tests |
|
Definition
| PKU, CAH, biotinidase, beta thalassemia, galactosemia, hypothyroidism, homocysteinuria, cystic fibrosis |
|
|
Term
|
Definition
X-linked
Px: hemolytic crises
Tx: reduce oxidative stress, special diet |
|
|
Term
|
Definition
autosomal recessive
deficient enzyme (PAH)
Px: mental retardation
Tx: special diet low in phenylalanine (for at least first 16yrs) |
|
|
Term
| CAH (congenital adrenal hyperplasia) |
|
Definition
autosomal recessive
Defect: error in steroidogenesis, MC 21-hydroxylase deficiency; others 17-hydroxylase and 11-beta-hydroxylase
Tx: mineralocorticoids and glucocorticoids, +/- genital reconstruction |
|
|
Term
| congenital hypothyroidism |
|
Definition
1:4000
cretinism
associated umbilical hernia |
|
|
Term
|
Definition
| excludes congenital sensory-neural hearing loss |
|
|
Term
|
Definition
autosomal recessive
Px: abnormal thick mucus, organ dysfunction (1+)
Best initial test: sweat chloride
Most accurate test: genetic analysis of CFTR gene |
|
|
Term
|
Definition
| only to babies with mom's who are HBsAg+ |
|
|
Term
| types of newborn skull fractures |
|
Definition
linear - MC
depressed - can cause further cortical damage without surgical intervention
basilar - most fatal |
|
|
Term
|
Definition
swelling of soft tissues of scalp after birth
CROSSES suture lines
no treatment |
|
|
Term
|
Definition
subperiosteal hemorrhage after birth
DOES NOT CROSS suture lines
no treatment (watch for increased bilirubin with blood breakdown) |
|
|
Term
|
Definition
C5-C6 injury 2* to shoulder dystocia
waiter's tip position (unable to abduct, external rotate, supinate)
Dx: clinical
Tx: immobilization |
|
|
Term
|
Definition
C7-C8 +/-T1
claw hand due to lack of grasp reflex
paralyzed hand with Horner syndrome (ptosis, miosis, anhydrosis)
Dx: clinical
Tx: immobilization |
|
|
Term
| most common newborn injury from shoulder dystocia |
|
Definition
|
|
Term
| newborn facial nerve palsy |
|
Definition
usually due to trauma from delivery with forceps
improvment over few weeks to months, if none seen will require surgical nerve repair |
|
|
Term
|
Definition
80% mother plasma filtrate
20% fetal swallow/absorb/filter/urinate |
|
|
Term
|
Definition
too much fluid, fetus not swallowing
Neurologic Werdnig-Hoffman (unable to swallow) or GI (intestinal atresias) |
|
|
Term
|
Definition
too little fluid, fetus not urinating
Prune belly (no abdominal muscles, tx with catherization) or Renal agenesis (incompatible with life, Potter syndrome assoc)
Results in flat facies |
|
|
Term
|
Definition
Px: bowel sounds in chest, fluid-air levels in CXR
Morgagni (retrosternal or parasternal)
Bochdalek (posterolateral) = MC, likely left |
|
|
Term
|
Definition
Etio: intestines and organs form outside abdominal wall within a SAC due to failur of retraction at 10-12wks gestation
Assoc: Edwards Syndrome (trisomy 18)
Screen: elevated AFP |
|
|
Term
| congenital umbilical hernia |
|
Definition
assoc. with congenital hypothyroidism
90% close by 3, srugical repair after 4 recommended |
|
|
Term
|
Definition
ETio: wall defect lateral to midline with intestines and organs form outside abdomen WITHOUT SAC
Assoc: intestinal atresias |
|
|
Term
|
Definition
MC abdominal mass in children
Path: hemihypertrophy of kidney
Sx: aniridia (highly assoc.), constipation, abdominal pain, N/V
Dx: ultrasound (best initial), CT (most accurate)
Tx: total nephrectomy + chemo + radiation; partial nephrectomy if b/l |
|
|
Term
|
Definition
MC cancer in infancy and MC extracranial solid malignancy in childhood
Etio: adrenal medulla tumor (similar to pheo but less cardiac sx)
Mets: 50-60% at presentation
Px: hypsarrhythmia on EEG and psomyoclonus (dancing eyes, myoclonic jerks, and dancing feet)
Dx: increased VMA and metanephrines in urine |
|
|
Term
|
Definition
Wilms tumor, Aniridia, Genitourinary malformations, Retardation (mental)
deletion on chromosome 11 |
|
|
Term
|
Definition
Px: painless, fluid-filled sac along spermatic cord, transilluminates
Etio: remnant of tunica vaginalis
Prognosis: resolve within 6mo,
DDx: inguinal hernia |
|
|
Term
|
Definition
Px: dull ache and heaviness in scrotum
Etio: varicose vein in scrotal veins -> swelling in pampiniform plexus + increased pressure
Best initial test: PE (bag of worms)
Most accurate test: ultrasound (>2mm diameter)
Tx: when delayed growth or atrophy of testes observed
Prognosis: likely occultly bilateral |
|
|
Term
|
Definition
Px: absence of testicle (usually in canal, 90%)
Tx: orchipexy (bring down) after 1y/o
Prognosis: increased risk of malignancy regardless of orchipexy |
|
|
Term
|
Definition
Px: opening of urethra on ventral surface of penis, assoc. with cryptorchidism and inguinal hernias
Tx: surgical
Note: CIRCUMCISION contraindicated |
|
|
Term
|
Definition
Px: opening of urethra on dorsal surface, high assoc. with urinary incontinence, eval for bladdery exstrophy
Tx: surgery |
|
|
Term
|
Definition
| sucking, grasping, babinski, rooting, moro, stepping, superman |
|
|
Term
| most common cyanotic heart defect (post-neonatal period) |
|
Definition
|
|
Term
|
Definition
Defects: overriding aorta, pulmonary stenosis, RVH, VSD
Etio: genetic (chr 22 deletion), environmental
Px: cyanosis, holosystolic murmur, squatting
Dx: boot shaped heart (CXR), decreased pulmonary vasc (CXR)
Tx: surgery |
|
|
Term
| exercise intolerance and squatting (name of sx) |
|
Definition
|
|
Term
| VSD common in what syndrome |
|
Definition
| down (trisomy 21), edwards (trisomy 18), patau (trisomy 13) |
|
|
Term
| MC heart defect in down syndrome |
|
Definition
| endocardial cushion defect of AV canal |
|
|
Term
|
Definition
| mitral regurg, tricuspid regurg, VSD |
|
|
Term
| most common cyanotic heart defect (neonatal period) |
|
Definition
| transposition of great vessels |
|
|
Term
| transposition of great vessels |
|
Definition
Defects: aorta orginates from RV and pulmonary artery from LV, no oxygenation without PDA
Tx: prostaglandins E1 to maintain PDA and then two surgeries (each with 50% mortality)
CI: NSAIDS (esp. indomethacin) |
|
|
Term
|
Definition
Px: alternating strong and weak beats
Dx: LV systolic dysfx |
|
|
Term
|
Definition
Px: groups of two heartbeats close together followed by a longer pause
Dx: HOCM (hypertrophic obstructive cardiomyopathy) |
|
|
Term
|
Definition
Px: double peak per cardiac cycle can be appreciated.
Dx: aortic regurgitation |
|
|
Term
|
Definition
Px: pulse is weak/small and late
Dx: aortic stenosis |
|
|
Term
|
Definition
Px: abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration
Dx: cardiac tamponade or tension pneumothorax |
|
|
Term
| hypoplastic left heart syndrome |
|
Definition
Defects: LV hypoplasia, mitral valve atresia, aortic valve lesions
Px: absent pulses with single S2, increased RV impulse, gray cyanosis
Dx: CXR globular heart and pulmonary edema, ECHO = most accurate
Tx: 3 surgeries each with high mortality risk |
|
|
Term
|
Definition
Defect: single trunk from both right and left ventricles
Px: first few days of life, severe dyspnea, early and frequent resp infections, single S2, systolic ejection murmur, bounding pulses
Dx: CXR cardiomegaly and increased pulm vasc markings
Tx: srugery
Complication: pulmonary hypertension within 4mo if surgery is not done |
|
|
Term
| total anomalous pulmonary venous return (TAPVR) |
|
Definition
| Defect: no venous return between pulmonary veins and left atrium (instead to SVC), with or without obstruction |
|
|
Term
|
Definition
Px: early in life, respiratory distress, severe cyansosis
Dx: CXR pulmonary edema, ECHO definitive dx
Tx: surgery |
|
|
Term
| TAPVR without obstruction |
|
Definition
Px: age 1-2yrs, right heart failure, tachypnea
Dx: CXR snowman/figure 8, ECHO is most accurate and required
Tx: surgery |
|
|
Term
|
Definition
| left-to-right shunt caused by VSD reverses to right-to-left shunt due to hypertrophy of the right ventricle |
|
|
Term
| right-to-left shunt congenital heart defects |
|
Definition
| tetralogy of fallot, TGV, hypoplastic left heart, TA, TAPVR |
|
|
Term
| PDA dependent congenital heart defects |
|
Definition
| hypoplastic left heart, TA |
|
|
Term
| VSD containing congenital heart defects |
|
Definition
|
|
Term
| VSD (ventricle septal defect) |
|
Definition
MC congenital heart lesion
Px: dyspnea, high-pitched holosystolic murmur (LLSB), loud P2
Dx: CXR increased vasc markings, ECHO, cardiac cath (definitive)
Prognosis: smaller ones close first 1-2yrs, larger require surgery
Tx: diuretics and digoxin (conservative)
Complications: CHF, endocarditis, pulmonary HTN |
|
|
Term
| ASD (atrial septal defect) |
|
Definition
twice as common women
three types: primum, secundum, sinus venosus)
Px: asymptomatic, FIXED WIDE SPLITTING OF S2
Dx: definitive = cardiac cath, ECHO is just as effective, CXR increased vasc markings and cardiomegaly
Prognosis: most close spontaneously
Tx: surgery or transcatheter closure
Complications: dysrhythmias, paradoxical emboli with DVTs |
|
|
Term
|
Definition
| ASD highly assoc. with concomitant mitral valve abnormalities |
|
|
Term
|
Definition
| most common ASD type, locataed in center of atrial septum |
|
|
Term
|
Definition
|
|
Term
| PDA (patent ductus arteriosus) |
|
Definition
Defect: failure of spontaneous closure of ductus, pathologic after 24hrs of life
Etio: low PO2 can cause (prematurity, high altitude)
Px: machinery like murmur, wide pulse pressure, bounding pulses
Complication: lots of resp. infections, infective endocarditis
Dx: best initial = ECHO, most accurate = cardiac cath, EKG with LVH
Tx: indomethacin |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| dx: primary pulmonary artery HTN |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| tricuspid valve radiation |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
prostaglandins ____ PDA
indomethacin ___ PDA |
|
Definition
|
|
Term
| child + hearing loss + syncope + normal vitals and PE + FMH/o SCD |
|
Definition
| 1 type of prolonged QT syndrome |
|
|
Term
|
Definition
Defect: narrowing of aorta in area of ductus arteriosus
Assoc: Turner syndrome
Px: severe CHF, respiratory distress, first few months of life, differential pressures and pulses between upper and lower extremities
Dx: rib notching and/or 3 sign on CXR, cardiac cath = most accurate
Tx: surgical resection and then ballooning if recurrent |
|
|
Term
| pathologic jaundice of newborn (criteria) |
|
Definition
- on first day of life
- bilirubin increase > 5mg/dL/day
- bilirubin above 19.5mg/dL in term baby
- direct bili >2mg/dL at any time
- persists past 2wks of life |
|
|
Term
| complication of jaundice of newborn |
|
Definition
| bilirubin deposition in basal ganglia (kernicterus = hypotonia, seizures, writhing, chorea, hearing loss) |
|
|
Term
| hypotonia + seizures + choreoatheosis + hearing loss + jaundice + newborn |
|
Definition
|
|
Term
| work-up of newborn jaundice |
|
Definition
direct and indirect bilirubin levels
blood type check of mom and baby (ABO and Rh incompatibility)
peripheral blood smear and reticulocyte count (hemolysis) |
|
|
Term
| treatment of newborn jaundice |
|
Definition
phototherapy (helps breakdown to excretable components)
exchange transfusion at 20-25mg/dL bilirubin |
|
|
Term
|
Definition
Defect: end blindly, 90% communicate with trachea through fistula
Px: vomit with first feed, choking, coughing, cyanosis, h/o polyhydramnios, recurrent aspiration pneumonia
Dx: CXR (gastric and esophageal air bubble), coiling NG on CXR and inability to pass, CT or esophagram
Tx: surgical repair in 2 steps, abx for anaerobes, fluid resuscitation |
|
|
Term
|
Definition
Defect: hypertrophic pyloric sphincter, idiopathic usually
Px: by the first month of life to 6mo, succussion splash, NBNB projectile vomiting, hypochloremia, hypokalemia, metabolic alkalosis, olive sign
Dx: best initial = abd US; most accurate = upper GI series (string sign, shoulder sign, mushroom sign, railroad track sign)
Tx: IVF, NGT, myotomy |
|
|
Term
| palpable mass in epigastric region in baby with projectile vomiting |
|
Definition
olive sign
pyloric stenosis |
|
|
Term
|
Definition
| thin column of barium leaking through the tightened pyloric sphincter muscle |
|
|
Term
|
Definition
| filling defect in the antrum due to prolapse of muscle inward at pylorus |
|
|
Term
|
Definition
| hypertrophic pylorus against the duodenum |
|
|
Term
|
Definition
| excess mucosa in pyloric lumen resulting in 2 columns of barium |
|
|
Term
| esophageal atresia fast facts |
|
Definition
blind esophagus
frothing + couhing + cyanosis + resp. distress during feeds
no resp. distress at rest
initial test: CXR
concerns: aspiration pneumonia |
|
|
Term
| choanal atresia fast facts |
|
Definition
buccopharyngeal membrane
respiratory distress
best initial step: pass NGT
most diagnostic test: CT scan
first step: secure airway |
|
|
Term
| duodenal atresia fast facts |
|
Definition
failed duodenal canalization
NO resp. distress
BILIOUS vomiting
initial test: AXR (double-bubble)
Assoc: trisomy 21
first step: IVF resuscitation |
|
|
Term
|
Definition
Defect: membrane between nostrils and pharyngeal space, prevents breathing during feeding
Assoc: CHARGE syndrome
Px: blue when feeding and pink when crying
Dx: CT scan
Tx: surgery |
|
|
Term
| CHARGE syndrome (commonly STEP2 tested) |
|
Definition
C: colomoma of eye, CNS anomalies
H: heart defects
A: atresia of choanae
R: retardation of growth/development
G: genital and/or urinary defects (hypogonadism)
E: ear anomalies and/or deafness |
|
|
Term
|
Definition
Defect: lack of innervation of distal bowel by Auerbach plexus, constant contracture of muscle
Assoc: down syndrome, boys:girls::4:1
Px: delayed meconium >48hrs, extreme constipation, LBO, extremely tight sphincter, inability to pass flatus
Dx: AXR (distended bowel loops, no air in rectum), contrast enema (retained >24hrs), manometry with very high pressures in anal spinchter, best=full thickness bx (no ganglionic cells in submucosa)
Tx: 3-stage surgery |
|
|
Term
|
Definition
Defect: opening missing, rectum into blind sac with conservation of sphincter
Assoc: Down syndrome, VACTERL syndrome
Px/Dx: failure to pass meconium + no anus on PE
Tx: surgery |
|
|
Term
|
Definition
V: vertebral anomalies
A: anal atresia
C: cardiovascular anomalies
T: tracheoesophageal fistula
E: esophageal atresia
R: renal anomalies
L: limb anomalies |
|
|
Term
|
Definition
Defect: lack of apoptosis that leads to improper canalization of lumen of duodenum
Assoc: annular pancreas, down syndrome
Px: bilious vomiting within 12hrs of birth
Dx: CXR with double-bubble
Tx: IVF resuscitation, NGT, surgery (duodenostomy) |
|
|
Term
|
Definition
Defect: bowel obstruction due to twisting of bowel, usually midgut in kids (most in ileum)
Px: vomit, colicky abd pain
Dx: air fluid levels on AXR, bird-beak at site on upper GI series
Tx: surgical or endoscopic untwisting EMERGENTLY; usually endoscopic tried first
Complication: bowel necrosis, perforation, sepsis, death |
|
|
Term
|
Definition
Defect: part of bowel telescopes into another distal segment of bowel
Etios: polyp, hard stool, lymphoma, viral, idiopathic (MC)
Px: colicky abd pain, bilious vomit, currant jelly stool, right quadrant sausage-shaped mass
Dx: US is best initial (doughnut or target sign), barium enema (both dx and tx) = most accurate
CI: barium enema if periotonitis, shock or perforation
Tx: fluid resuscitation, NGT, barium enema, emergency surgery if recurs
Prognosis: 10% recur within 24hrs |
|
|
Term
|
Definition
Defect: true diverticulum due to persistance of vitelline duct +/- ectopic gastric tissue
Px: painless rectal bleeding (massive, frank, BRB per rectum)
Dx: most accurate = Techneitum 99m scan
Tx: surgical removal |
|
|
Term
| bilious vomiting + first day of life |
|
Definition
|
|
Term
| bilious vomiting + within first year of life + abnormal AXR |
|
Definition
|
|
Term
| bilious vomiting + within first year of life + doughnut sign on US |
|
Definition
|
|
Term
| second MC cause of infant death worldwide |
|
Definition
|
|
Term
|
Definition
| fever + abd pain +/- bloody diarrhea |
|
|
Term
|
Definition
| vomiting + crampy abd pain + watery diarrhea |
|
|
Term
| dx work-up for kid with diarrhea |
|
Definition
Stool: blood and leukocyte count (presence of invasive toxins), cultures and O&P (causative agent)
Sigmoidoscopy (psuedomembranes in C. diff) |
|
|
Term
| first step in treatment of kids with diarrhea |
|
Definition
mild: oral fluids
severe: IV fluids |
|
|
Term
|
Definition
MC in winter
Px: fever, vomiting, nonbloody, <7d, viral prodrome
Note: vaccine available |
|
|
Term
|
Definition
common all year found (endemic)
Px: fever, vomit, nonbloody, <7d, viral prodrome |
|
|
Term
|
Definition
Epidemic
Px: explosive diarrhea, cramping pain, 1-2d |
|
|
Term
| necrotizing enterocolitis |
|
Definition
Defect: bowel necrosis and bacteria invasion of intestinal wall
Px: premature infant, low birth wieght, vomiting, abd distention, fever
Prognosis: 30% mortality
Dx: AXR (pathognomotic pneumatosis intestinalis), CT (air in portal vein, dilated bowel loops, pneumoperitoneium if perforated); frank/occult blood in stool
Tx: d/c feeding, IVF, NGT, abx (vanc/gent/MTZ), surgery if not improved |
|
|
Term
| findings of infants of diabetic mothers (list) |
|
Definition
| macrosomia, small left colon syndrome, cardiac abnormalities, renal vein thrombosis, metabolic effects |
|
|
Term
|
Definition
all organs enalrged
increased output of bone marrow (polycythemia and hyperviscosity)
shoulder dystocia (brachial plexus palsy) |
|
|
Term
| IDM - small left colon syndrome |
|
Definition
distention and constipation
dx by barium study
tx with smaller frequent feeds |
|
|
Term
| IDM - cardiac abnormalities |
|
Definition
asymmetric septal hypertrophy (d/t obliteration of LV lumen --> dec. CO)
dx by EKG and ECHO
tx: beta blockers and IVF |
|
|
Term
| IDM - renal vein thrombosis |
|
Definition
flanks mass and possible bruit
hematuria and thrombocytopenia |
|
|
Term
|
Definition
hypoglycemia --> seizures
hypocalcemia --> tetany, lethargy
hypomagnesemia --> hypocalcemia and PTH decrease
hyperbilirubinemia --> icterus and kernicterus |
|
|
Term
| CAH 21-hydroxylase deficiency |
|
Definition
Px: hypotensive, hypoNa, hypoCl, hyperK, hypoglycemia, girls (ambig genitals, facial hair, virilization, menstrual changes), boys (loss of sex features),
Dx: serum electrolytes, increased 17-OH progesterone
Tx: decreased ALD, decreased cortisol, acidosis, steroid replacement, psych management of gender issues |
|
|
Term
| CAH 17-alpha-hydroxylase deficiency |
|
Definition
Px: hypertensive, normal at birth girls, pseudohermaphroditism boys
Dx: increased ALD, decreased cortisol, decreased sex hormone, hypoK
Tx: steroid replacement as needed |
|
|
Term
| CAH 11-beta-hydroxylase deficiency |
|
Definition
Px: hypertensive, virilized girl, normal at birth boy
Dx: decreased ALD, decreased cortisol, increased sex hormones, increased DOC, VERY few electrolyte abnormalities
Tx: steroid replacements |
|
|
Term
|
Definition
Defect: lack of vitamin D/Ca++/Phos, softening and weakening bones
Px: fractures, children 6-24mo, ulnar/radial bowing, femoral/tibial bowing, waddling gait
Dx: rachitic rosary (CXR, beading of ribs), bowlegs
Tx: phosphate, calcium, and vitamin D (ergocalciferol, 1,25(OH)2, calcitrol), annual blood Vit D monitoring |
|
|
Term
|
Definition
Vit D Def: lack of enough vitamin D in diet
Vit D dependent: inability to convert 25-OH to 1,25(OH)2, infant requies supplementation
X-linked hypophosphatemic: innate kidney defect results in inability to retain phosphate (inadequate mineralization of bones and weakened) |
|
|
Term
| rickets + norm/dec Ca + decreased Phos + decreased 1,25(OH)2 + decreased 25(OH) |
|
Definition
| vitamin D deficiency in diet |
|
|
Term
| rickets + decreased Ca + normal phos + decreased 1,25(OH)2 + normal 25(OH) |
|
Definition
| vitamin D dependent rickets (inability to convert vitamin d to active form) |
|
|
Term
| rickets + normal Ca + decreased phos + normal 1,25(OH)2 + normal 25(OH) |
|
Definition
| x-linked hypophosphatemia |
|
|
Term
| neonatal sepsis (MC underlying infections) |
|
Definition
|
|
Term
| neonatal sepsis (MC bacteria) |
|
Definition
| Group B strep, E. coli, S. aureus, Listeria monocytogenes |
|
|
Term
| neonatal sepsis work up tests |
|
Definition
|
|
Term
| neonatal sepsis empiric tx |
|
Definition
| ampicillin, gentamicin, IVF, +/- cefotaxime |
|
|
Term
| early neonatal sepsis MC bacteria |
|
Definition
| group B strep, E. coli, Listeria |
|
|
Term
| late neonatal sepsis MC bacteria |
|
Definition
| staphylococcal, E. coli, Group B strep |
|
|
Term
|
Definition
| toxoplasmosis, other infections (syphilis, HIV), rubella, cytomegavirus, herpes simplex virus |
|
|
Term
|
Definition
Px: chorioretinitis, hydrocephalus, multiple ring-enhancing lesions on CT
Best initial test: elevated IgM toxoplasma
Most accurate test: PCR for toxo
Tx: pyrimethamine and sulfadiazine |
|
|
Term
|
Definition
Px: rash on palms and soles, frontal bossing, Hutchinson, eighth nerve palsy, saddle nose
Best initial test: VDRL or RPR
Most accurate test: FTA ABS or dark field
Tx: penicillin |
|
|
Term
|
Definition
Px: PDA, cataracts, deafness, hepatosplenomegaly, thrombocytopenia, bluberry muffin rash, hyperbilirubinemia
Best initial test: maternal IgM status, clinical
Tx: supportive |
|
|
Term
|
Definition
Px: periventricular calcifications with microencephaly, chorioretinitis, hearing loss, petechiae
Best initial test: urine and saliva viral titers
Most accurate test: urine and saliva PCR
Tx: ganciclovir if signs of organ damage |
|
|
Term
|
Definition
Px: shock and DIC (week 1), vesicular skin lesions (week 2), encephalitis (week 3)
Best initial test: Tzanck
Most accurate test: PCR
Tx: acyclovir and supportive |
|
|
Term
|
Definition
Etio: herpes 3, VZV
Px: multiple highly pruritic vesicular rash (begins on face), fever, malaise
Best initial test: Tzanck (multinucleated giant cells)
Most accurate test: viral culture
Tx: supportive |
|
|
Term
|
Definition
Etio: paramyxovirus
Px: cough, coryza, conjunctivitis, Koplik spots
Dx: clinical
Most accurate test: IgM Abs
Tx: supportive |
|
|
Term
| fifth disease (erythema infectiosum) |
|
Definition
Etio: Parvo B19
Px: fever, URI --> rash (slapped cheek)
Dx: clinical
Tx: supportive |
|
|
Term
|
Definition
Etio: herpes 6 and 7
Px: fever, URI, diffuse rash
Dx: clinical
Tx: supportive |
|
|
Term
|
Definition
Etio: paramyxovirus
Px: fever --> parotid gland swelling, possible orchitis
Dx: clinical
Tx: supportive |
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Term
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Definition
Etio: erythrogenic toxin from Streptococcus pyogenes
Px: diffuse erythematous eruption concurrent with pharyngitis, lasts 3-6days, pentad (fever, pharyngitis, sand paper rash, strawberry tongue, cervical lymphadenopathy)
Dx: clinical, correlate with elevated ASO titer/ESR/CRP
Tx: penicillin, azithromycin, cephalosporins |
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Term
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Definition
Etio: parainfluenza types 1-2 (MC), RSV
Px: barking cough, coryza, inspiratory stridor, hypoxia, steeple sign
Dx: clinical
Tx: mild (steroids), mod-severe (racemic epinephrine) |
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Term
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Definition
Etio: haemophilus influenza type B
Px: poor vaccination hx, hot potato voice, fever, drooling, tripoding, refusal to lie flat, hot/cherry epiglottitis
Dx: clinical, xray with thumbprint sign
Tx: INTUBATE, ceftriaxone, rifampin to clost contacts |
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Term
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Definition
Etio: Bordetella pertussis
Px: catarrhal (severe congestion and rhinorrhea x14d), paroxysmal (severe coughing, gasping for air, posttussive emesis, inspiratory whoop x14-30d), convalescent stage (decreasing cough x14d)
Dx: clinical (whooping, vomiting, burst vessels in eyes), butterfly pattern on CXR, PCR of nasal secretions, Bordetella pertussis toxin ELIXA
Tx: erythromycin or azithromycin (ONLY in ctarrhal), isolation, macrolides for all close contacts, DTaP |
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Term
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Definition
Etio: bacteria and viruses
Px: productive cough 7-10d with fever
Dx: clinical
Tx: supportive |
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Term
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Definition
Etio: group A beta-hemolytic strep
Px: cervical adenopathy, petechiae, fever over 104*F, URI sx, acute rheumatic fever, glomerulonephritis
Dx: rapid DNAse Ag detection
Tx: oral penicillin for 10d (alt. macrolides) |
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Term
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Definition
Etio: corynebacterium diphtheriae
Px: gray highly vascular pseudomembranous plaques on pharyngeal wall
Dx: culture of superficial membrane
Tx: antitoxin (ABX don't work) |
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Term
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Definition
Px: infants, found on newborn exam
Dx: Ortolani and Barlow maneuver
Tx: Pavlik harness |
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Term
| Legg-Calve-Perthes disease |
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Definition
Px: ages 2-8, painful limp
Dx: xray (jt effusion, widening)
Tx: rest, NSAIDs, then surgery of both hips |
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Term
| slipped capital femoral epiphysis |
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Definition
Px: adolescent, obese, painful limp, external rotated leg
Dx: xray (widening jt space)
Tx: internal fixation of pinning |
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Term
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Definition
| Px: poor night vision, hypoparathyroidism (decreased Ca, decreased Phos, muslce spasms) |
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Term
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Definition
| Px: pseudotumor cerebri, hyperparathyroidism (weak bones) |
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Term
| vitamin B1 deficiency (thiamine) |
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Definition
| Px: beriberi (wt loss, emotional changes, sensory changes, irregular heartbeat, increased lactate, edema); Wernicke's encephalopathy (ophthalmoplegia, ataxia, confusion) |
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Term
| vitamin B2 deficiency (riboflavin) |
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Definition
| Px: angular chelosis, stomatitis, glossitis |
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Term
| vitamin B3 deficiency (niacin) |
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Definition
| Px: pellagra (diarrhea, dermatitis, dementia, death) |
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Term
| vitamin B5 deficiency (panthothenic acid) |
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Definition
| Px: burning feet syndrome |
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Term
| vitamin B6 deficiency (pyridoxine) |
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Definition
| Px: peripheral neuropathy, can be caused by INH (supplement) |
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Term
| vitamin B9 deficiency (folate) |
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Definition
| Px: megaloblastic anemia, hypersegmented neutrophils |
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Term
| vitamin B12 deficiency (cyanocobalamin) |
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Definition
| Px: megaloblastic anemia, hypersegmented neutrophils, peripheral neuropathy (dorsal column tracts) |
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Term
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Definition
| Px: scurvy (echymoses, bleeding gums, petechiae) |
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Term
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Definition
| Px: hypercalcemia, polyuria, polydipsia |
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Term
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Definition
| PX: increase PT (INR), mild to severe bleeding |
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