Term
| Widely scattered red macules and papules concentrated on the face and trunk, rapidly progressing to clear vesicles on an erythematous base, pustules, and then crusting, over 5–6 days. |
|
Definition
|
|
Term
| When is pt with varicella no longer contagious? |
|
Definition
|
|
Term
High fever and lethargy are prominent. Sneezing, eyelid edema, tearing, copious coryza, photophobia, and harsh cough ensue and worsen. Koplik spots are white macular lesions on the buccal mucosa, typically opposite the lower molars.
discrete maculopapular rash begins when the respiratory symptoms are maximal and spreads quickly over the face and trunk, coalescing to a bright red. As it involves the extremities, it fades from the face and is completely gone within 6 days; fine desquamation may occur. Fever peaks when the rash appears and usually falls 2–3 days thereafter. |
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Definition
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|
Term
| How do you diagnose rubeola (ie. labs)? |
|
Definition
| diagnosis is usually made by detection of measles IgM antibody in serum drawn at least 3 days after the onset of rash or later by detection of a significant rise in antibody. Direct detection of measles antigen by fluorescent antibody staining of nasopharyngeal cells is a useful rapid method. PCR testing of oropharyngeal secretions or urine is extremely sensitive and specific and can detect infection up to 5 days before symptoms. |
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Term
| rash consists of erythematous discrete maculopapules beginning on the face. A "slapped-cheek" appearance or pruritus may occur. Scarlatiniform or morbilliform rash variants may occur. The rash spreads quickly to the trunk and extremities after it fades from the face; it is gone by the fourth day. |
|
Definition
|
|
Term
| What virus causes Roseola |
|
Definition
| human herpesviruses 6 (HHV-6) or 7 (HHV-7) |
|
|
Term
| Mild lethargy and irritability may be present, but generally there is a dissociation between systemic symptoms and the febrile course. The pharynx, tonsils, and tympanic membranes may be injected. Conjunctivitis and pharyngeal exudate are notably absent. Diarrhea and vomiting occur in one third of patients. Adenopathy of the head and neck often occurs. The anterior fontanelle is bulging in one quarter of HHV-6 infected infants. If rash appears (20–30% incidence), it begins on the trunk and spreads to the face, neck, and extremities. Rose-pink macules or maculopapules, 2–3 mm in diameter, are nonpruritic, tend to coalesce, and disappear in 1–2 days without pigmentation or desquamation. Rash may occur without fever. |
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Definition
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|
Term
| Infant has very high fever and then rash appears..what are you thinking? |
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Definition
|
|
Term
| first sign of illness is the rash, which begins as raised, fiery red maculopapular lesions on the cheeks that coalesce to give a "slapped-cheek" appearance. |
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Definition
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|
Term
| The lesions are warm, nontender, and sometimes pruritic. They may be scattered on the forehead, chin, and postauricular areas, but the circumoral region is spared. Within 1–2 days, similar lesions appear on the proximal extensor surfaces of the extremities and spread distally in a symmetrical fashion. Palms and soles are usually spared. The trunk, neck, and buttocks are also commonly involved. Central clearing of confluent lesions produces a characteristic lacelike pattern. The rash fades in several days to several weeks but frequently reappears in response to local irritation, heat (bathing), sunlight, and stress. |
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Definition
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|
Term
How do you differentiate erythema infectiosum from measles and rubella?
phargyngitis? |
|
Definition
| It lacks the prodromal symptoms of measles and the lymphadenopathy of rubella. Systemic symptoms and pharyngitis are more prominent with enteroviral infections and scarlet fever. |
|
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Term
rash typically begins on the first or second day of illness over the upper trunk, spreading to involve the extremities but sparing the palms and soles. The rash is made up of minute papules, giving a characteristic "sandpaper" feel to the skin. Associated findings include circumoral pallor, "strawberry tongue" (enlarged papillae on a coated tongue, which later may become denuded), and accentuation of the rash in skin folds (Pastia's lines).
what is this?
what is it assoc with? |
|
Definition
Scarlet fever
assoc with pharyngitis |
|
|
Term
Tender swelling of one or more glands, variable fever, and facial lymphedema are typical.
What could it be?
what's used for diagnosis? |
|
Definition
mumps
Paired sera assayed by ELISA are currently used for diagnosis |
|
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Term
acute onset of fever and posterior pharyngeal grayish white vesicles that quickly form ulcers (< 20 in number), often linearly arranged on the posterior palate, uvula, and tonsillar pillars. Bilateral faucial ulcers may also be seen. Dysphagia, vomiting, abdominal pain, and anorexia also occur and, rarely, parotitis or vaginal ulcers. Symptoms disappear in 4–5 days.
What is this?
What virus causes? |
|
Definition
Herpangina
caused by coxsackie viruses |
|
|
Term
localized anal pruritus.
what can you think about?
what labs? |
|
Definition
Enterobiasis
Diagnosis: usual diagnostic test consists of pressing a piece of transparent tape on the child's anus in the morning prior to bathing, then placing it on a drop of xylene on a slide. Microscopic examination under low power usually demonstrates the ova. Occasionally eggs or adult worms are seen in fecal specimens. Parents may also notice adult worms. |
|
|
Term
| What is tx for enterobiasis? |
|
Definition
| Pyrantel pamoate is given as a single dose (11 mg/kg; maximum, 1 g); it is safe and very effective. Mebendazole (100 mg) and albendazole (400 mg) in a single dose are highly effective for this infection at all ages. |
|
|
Term
pain, weight loss, anorexia, diarrhea, or vomiting. Adult worms may be seen in feces or vomitus. Rarely, they perforate or obstruct the small bowel, biliary system, or appendix. Large numbers of larvae migrating through the lungs may cause an acute, transient eosinophilic pneumonia (Löffler syndrome)
what is this? |
|
Definition
|
|
Term
| What is tx for ascariasis? |
|
Definition
| asymptomatic infection need not be treated. Mebendazole (100 mg twice a day for 3 days or 500 mg once), pyrantel pamoate (a single dose of 11 mg/kg; maximum, 1 g), and albendazole (400 mg in a single dose, or 200 mg in children 1–2 years of age) are highly and equally effective. |
|
|
Term
exudative tonsillitis, generalized cervical adenitis, and fever, usually in a patient older than 5 years of age. A palpable spleen or axillary adenopathy increases the likelihood of the diagnosis
what could it be?
what may labs show?
What type of serology is definitive? |
|
Definition
mono
labs show atypical lymphocytosis
Epstein-Barr virus serology showing an elevated IgM-capsid antibody is definitive |
|
|
Term
| pallor, fatigue, irritability, and delayed motor development are common. Children whose iron deficiency is due in part to ingestion of unfortified cow's milk may be fat, with poor muscle tone. A history of pica is common |
|
Definition
|
|
Term
| What will labs show for IDA? |
|
Definition
Red cells are microcytic and hypochromic, with a low MCV and low mean corpuscular hemoglobin
decreased serum ferritin and a low serum iron, elevated total iron-binding capacity, and decreased transferrin saturation |
|
|
Term
|
Definition
recommended oral dose of elemental iron is 6 mg/kg/d in three divided daily doses
When iron deficiency is the only cause of anemia, adequate treatment usually results in a resolution of the anemia within 4–6 weeks. Treatment is generally continued for a few additional months to replenish iron stores. |
|
|
Term
| What does AAP recommend regarding watching television? |
|
Definition
| The AAP recommends that children younger than 2 years of age should not watch any television, and that children 2 years and older be limited to 2 hours total time each day for all media. |
|
|
Term
| mall, brachycephalic head, characteristic facies (up-slanting palpebral fissures, epicanthal folds, midface hypoplasia, and small, dysplastic pinnae), and minor limb abnormalities |
|
Definition
|
|
Term
severe, autosomal-recessive neurodegenerative disorder that leads to death in early childhood.
fatal neurodegenerative disease with macrocephaly, loss of motor skills, increased startle reaction, and a macular cherry red spot. The juvenile-onset form presents with ataxia and dementia, with death by age 10–15 years. The adult-onset disorder is characterized by clumsiness in childhood; progressive motor weakness in adolescence; and additional spinocerebellar, lower motor neuron symptoms, and dysarthria in adulthood. Intelligence declines slowly, and psychosis is common |
|
Definition
|
|
Term
What bug causes tetanus?
what are sxs? |
|
Definition
bug: Clostridium tetani
sxs:
History of skin wound.
Spasms of jaw muscles (trismus).
Stiffness of neck, back, and abdominal muscles, with hyperirritability and hyperreflexia.
Episodic, generalized muscle contractions. |
|
|
Term
| What are complications of tetanus? |
|
Definition
| sepsis, malnutrition, pneumonia, atelectasis, asphyxial spasms, decubitus ulcers, and fractures of the spine due to intense contractions. |
|
|
Term
| When do you give a tetanus booster? |
|
Definition
| A booster at the time of injury is needed if none has been given in the past 10 years—or within 5 years for heavily contaminated wounds. |
|
|
Term
|
Definition
Human TIG in a single dose of 3000–6000 units, intramuscularly, is given to children and adults. Doses of 500 units have been used in infants.
Antibiotics are given to attempt to decrease the number of vegetative forms of the bacteria to decrease toxin production: oral metronidazole (30 mg/kg/d in four divided doses; maximum 4 g/d) for 10–14 days is the preferred agent. |
|
|
Term
What bug causes lyme disease?
What's the name of the characteristic skin reaction? |
|
Definition
Borrelia burgdorferi
Erythema chronicum migrans, the most characteristic feature |
|
|
Term
| Erythema chronicum migrans, the most characteristic feature |
|
Definition
|
|
Term
| Whats different about erythema chronicum migrans rash than other childhood rashes? |
|
Definition
| Erythema chronicum migrans is nonscaly, minimally tender or nontender, and persists longer in the same place than many of the more common childhood erythematous rashes. |
|
|
Term
| What is tx for lyme's disease? |
|
Definition
amoxicillin
doxycycline
erythromycin |
|
|
Term
mild sore throat, moderate fever, and malaise, followed fairly rapidly by prostration and circulatory collapse. The pulse is more rapid than the fever would seem to justify. A pharyngeal membrane forms and may spread into the nasopharynx or the trachea, producing respiratory obstruction. The membrane is tenacious and gray and is surrounded by a narrow zone of erythema and a broader zone of edema
What is it?
How do you treat? |
|
Definition
diptheria
tx: diptheria antitoxin
Pen G |
|
|
Term
insidious, with catarrhal upper respiratory tract symptoms (rhinitis, sneezing, and an irritating cough). Slight fever may be present;
After about 2 weeks, cough becomes paroxysmal, characterized by 10–30 forceful coughs ending with a loud inspiration |
|
Definition
|
|
Term
| WHat is tx of choice for pertussis? |
|
Definition
| Erythromycin is the drug of choice because it promptly terminates respiratory tract carriage of B pertussis. |
|
|
Term
| prodrome of upper respiratory infection is followed by high fever, headache, nausea, marked toxicity, and hypotension. Purpura, petechiae, and occasionally bright pink, tender macules or papules over the extremities and trunk are seen. The rash usually progresses rapidly. Occasional cases lack rash. |
|
Definition
|
|
Term
| most common primary intraocular malignancy of childhood |
|
Definition
|
|
Term
| most common presenting sign in a child with previously undiagnosed retinoblastoma is _____ |
|
Definition
| retinoblastoma is leukocoria |
|
|
Term
|
Definition
| Treatment of unilateral cases, especially of large tumors, often requires enucleation, because at the time of presentation the eye is filled with tumor. Vision and eyes can be salvaged in some cases. |
|
|
Term
| At what level do you treat lead poisoning? |
|
Definition
| No action is required for blood lead levels less than 10 mcg/dL. The cognitive development of children with confirmed blood levels higher than 14 mcg/dL should be evaluated and attempts made to identify the environmental source. Iron deficiency should be treated if present. Chelation of lead is indicated for levels of 45 mcg/dL and higher and is urgently required for levels above 70 mcg/dL. |
|
|
Term
| What symptoms are primarily affected by lead poisoning? |
|
Definition
| Lead toxicity primarily affects the nervous, cardiovascular, hematopoietic, and renal system |
|
|
Term
| What is the tx for lead poisoning? |
|
Definition
| Chelation therapy for lead toxicity uses dimercaprol (previously known as British anti-Lewisite or BAL), edetate calcium disodium (sometimes abbreviated CaNa2EDTA), and succimer (also known as dimercaptosuccinic acid or DMSA) |
|
|
Term
multiple petechiae and ecchymoses. Epistaxis is also common at presentation. No other physical findings are usually present.
platelet count is markedly reduced
latelets frequently are of larger size on peripheral blood smear, suggesting accelerated production of new platelets. The white blood count and differential are normal, and the hemoglobin concentration is preserved unless hemorrhage has been significant. |
|
Definition
| Idioapthic Thrombocytopenic Purpura |
|
|
Term
|
Definition
|
|
Term
| How do you differentiate cystitis from pyelonephritis? |
|
Definition
pyelonephritis is more systemic sxs: abdominal or flank pain, fever, malaise, nausea, vomiting, and, occasionally, diarrhea
cystitis: dysuria, urgency, frequency, suprapubic pain, incontinence, and malodorous urine. Cystitis does not cause fever and does not result in renal injury |
|
|
Term
How do you diagnose UTI?
What is tx for pt with febrile pyelonephritis? |
|
Definition
UA and urinary culture
febrile pyelonephritis: Parenteral treatment with ceftriaxone (50–75 mg/kg/24 hr, not to exceed 2 g) or ampicillin (100 mg/kg/24 hr) with an aminoglycoside such as gentamicin (3–5 mg/kg/24 hr in 1 to 3 divided doses) is preferable. |
|
|
Term
| What diagnostics do you do for UTI? |
|
Definition
|
|
Term
How does pt present with urethritis?
What are common pathogens? |
|
Definition
urethral discharge or dysuria
pathogens: chlamydia/gonorrhea |
|
|
Term
yellow-green purulent discharge
white mucopurulent discharge |
|
Definition
|
|
Term
What is this?
vaginal discharge, erythema, tenderness, and pruritus. Dysuria and bleeding may occur but are less common.
How do you diagnose? |
|
Definition
vulvovaginitis
diagnose: Vaginal culture, cytology, and vaginoscopy may be indicated for evaluation of pediatric patients with vulvovaginitis. Leukocyte esterase dipsticks are a rapid screening test for vaginitis and cervicitis. |
|
|
Term
| What is tx for vulvovaginitis? |
|
Definition
clotrimazole, miconazole, terconazole or tioconazole vaginal creams or suppositiories.
Flucoanolze is good for "virginal" adolescents |
|
|
Term
| inability to retract the prepuce |
|
Definition
|
|
Term
| when the foreskin is retracted past the coronal sulcus and the prepuce cannot be pulled back over the glans |
|
Definition
|
|
Term
undescended testis
what is this called?
is it usually unilateral or bilateral?
What side is mostly affected? |
|
Definition
cryptochordism
most often unilateral
right sided |
|
|
Term
What tests can determine if tests are present?
what is tx? |
|
Definition
in infants younger than 3-4 months
LH
FSH
and tesosterone levels
after 4 months- then do HCG stimulation test
tx: surgical orchiopexy if descent has not occurred by age 1 |
|
|
Term
| How do you define enuresis? |
|
Definition
urinary incontinence in a child age 5r or older
not due to medication or a medical disorder |
|
|
Term
pt presented with group A beta hemolytic strep infection...now they are complaiing of gross hematuria
urine is sometimes coffee colored or tea-colored
Urine reveals RBCS too numerous to count
Microscopy shows RBC casts
what is it? |
|
Definition
| post strep glomerulonephritis |
|
|
Term
| What is diagnostic of post infectious GN? |
|
Definition
RBCS too numerous to count
RBC casts |
|
|
Term
polycystic renal disease is an autosomal _____ disease.
What is an early problem? |
|
Definition
|
|
Term
| urinary meatus located on dorsal part of penis |
|
Definition
|
|
Term
| urethral meatus located on upper side of penis |
|
Definition
|
|
Term
| How does pt present with hip dysplasia? (ie positioning of hip) |
|
Definition
| flexed adducted and externally rotated |
|
|
Term
| What are complications of hip dislocation? |
|
Definition
| severe bleeding, avascular necrosis and nerve damage |
|
|
Term
What is Galleazi sign?
What is it assoc with? |
|
Definition
one femur is longer than the other
assoc with developmental dysplasia of the hip |
|
|
Term
Ortolani is what
Bartlow is what? |
|
Definition
Ortolani: pushed in
Bartlow: pushed out |
|
|
Term
If you suspect developmental dysplasia of the hip- what study should you get?
What is tx for 0-6 months? |
|
Definition
Study: US (but is not a screening tool)
PAVLIK HARNESS – 90% successful
Flex 100°
Abduct 50°
Document reduction by U/S in
3 weeks
3M MINIMUM WEAR
Complications
Femoral Nerve Palsy (flexion)
Avascular Necrosis (abduction |
|
|
Term
| Who is most likey affected by a slipped capital femoral epiphysis? |
|
Definition
|
|
Term
11 year old presents with limp, thigh/groin pain, decreased hip internal rotation and PAINFUL hip ROM.
What could it be?
Whats tx?
What labs do u want to check? |
|
Definition
Slipped capital femoral epiphysis
Check thyroid and BUN/Cr levels if atypical
Tx: immed non-weight bearing and urgen referral to ortho specialist for open reduction and internal fixation
if missed: AVN high risk |
|
|
Term
How can someone get osteomyelitis?
How do you diagnose?
What is tx? |
|
Definition
hematogenous spread (very common)
usually injury/wound such as penetrating wound or open fracture
Diagnose clinically
Tx: IV
Oxacillin
nafcillin
cefazolin
clindamycin
(all are options) |
|
|
Term
subluxation of radial head is also called:
how will pt present? |
|
Definition
nursemaid elbow
pt present with painful, fully pronated elbow |
|
|
Term
Lateral (frontal plane) curvature of spine greater than 10 Degrees
At what age does this begin?
who is affected more? boys or girls
|
|
Definition
scoliosis
usually beings at age 8 or 10
girls more affected |
|
|
Term
| Who needs bracing for scoliosis? |
|
Definition
usually curvatures <20 degrees do not require tx
tx indicated for any curvature that demonstrates progression on serial xrays
Cobb angle |
|
|
Term
| How do you reduce a nursemaid elbow? |
|
Definition
Supination
Hyperflexion
Pressure over lateral aspect of radial head |
|
|
Term
What is this called:
medial deviation of the forefoot, which is usually slightly supinated while the hindfoot remains neutral. A deep medial crease is generally present.
What is tx? |
|
Definition
metatarsus adductus
usually resolves without intervention |
|
|
Term
|
Definition
|
|
Term
What is genu varum? When is it normal?
What happens around age 8?
when do u refer to othopedist? |
|
Definition
genu varum- bowleg
normal from infancy to 2 years old
alignment then changes to genu valgum (knock knee)
refer to ortho if persistent bowing beyond 2 years of age |
|
|
Term
What is tibial torsion?
Why does it happen?
How do u fix? |
|
Definition
rotation of the leg between the knee and the ankle
usually resolves by 16 months
sometimes accentuated by laxity of the knee ligaments.
If persists beyond16 months- often due to sleeping with feet turned in and an external splint can be worn at night |
|
|
Term
| Toeing in beyond age 2 or 3 is due to what? |
|
Definition
|
|
Term
What are effective exercises for femoral anteversion?
when are you candidate for ortho consult |
|
Definition
skating or bicycle riding
if not external rotation of hip in extension- then candidate for ortho consult |
|
|
Term
| brachial plexus is comprised of: |
|
Definition
|
|
Term
| Damage to C5 and C6 is called: |
|
Definition
|
|
Term
| How can you distinguish btw Erb Palsy an dKlumpke palsy? |
|
Definition
Erb: should weakness with internal rotaion and adduction of the upper arm; good preservation of hand function
Klumpke: good shoulder function but decreased or absent hand function |
|
|
Term
| Who gets surgery if brachial plexus lesion? |
|
Definition
| primary surgery is indicated for children who have no spon recover of biceps function by 6-9 months |
|
|
Term
What is this:
Fever for more than 5 days plus:
1. bilat, painless, nonexudative cnjunctivitis
2. lip or oral cavity changes
3. cervical lympadenopathy
4. polymorphous exanthema
5. extremity changes (swelling of hands and feet with subsequent desquamation) |
|
Definition
|
|
Term
| What is immed tx of Kawasaki disease? |
|
Definition
IVIG and high dose aspirin
why? decreases incidence of coronary artery dilation and aneurysm formation
Get echo 2 weeks then 6-8 weeks after diagnosis |
|
|
Term
| painful, erythematous nodules develop on the anterior surfaces of both legs, and evolve into bruise-like lesions that resolve without scarring over a two- to eight-week period |
|
Definition
|
|
Term
|
Definition
| low potency topical corticosteroid |
|
|
Term
Phenylketonuria
offspring is more suspectiple to what?
what is it? |
|
Definition
MR
microcephaly
growth retardation
congenital heart disease
don't possess enzyme to break down amino acids
autosomal recessive |
|
|
Term
| progressive fibroinflammatory obliteral of the lumen or all, or part of, the extrahepatic biliary tree presenting in the first 3 months of life. |
|
Definition
|
|
Term
Jaundice presnt in newborn period and persisting 2-3 weeks.
hepatomegaly
stools pale yellow or acholic
ruine stains diapers
what is it?
what is tx? |
|
Definition
biliary atresia
tx: hepatoportoenterostomy |
|
|
Term
What is this?
vesicles or red papules are found on the tongue, oral mucosa, hands, and feet. Often they appear near the nails and on the heels. Associated fever, sore throat, and malaise are mild. The rash may appear when fever abates, simulating roseola.
What causes it? |
|
Definition
| hand-foot-and-mouth disease (caused by coxsackieviruses, especially types A5, A10, and A16) |
|
|
Term
What is this called?
Inflammatory papules and pustules with occasional comedones predominantly on the face occur in as many as 20% of newborns.
What do you do? |
|
Definition
acne neotorum
spontaneous resolution occurs over a period of 6 months to 1 year. |
|
|
Term
|
Definition
| Initial treatment of head lice is often instituted by parents with an over-the-counter pyrethrin or permethrin product. If head lice are not eradicated after two applications 7 days apart with these products, 5% permethrin should be used. Malathion 0.5% is highly effective but is toxic if ingested, and flammable. |
|
|
Term
erythematous papular skin lesions accompanied by severe pruritus. Two primary types of skin eruptions are seen: (1) erythematous papular or vesicular lesions that are associated with burrows, and (2) a more generalized papular rash.
what is this?
how do u treat? |
|
Definition
|
|
