Pediatrics Practice Questions
Terms in this set (857)
At what age is BP screening begun?
At what age is vision screening begun?
When is a hearing test done?
Suspected language delay or @ 3-6yo
How long is breasfeeding encouraged?
Why is goat's milk not encouraged?
Low in Vit D & folic acid, can cause megaloblastic anemia
Why is whole milk not recommended before age 1?
Low iron source, can lead to iron deficiency & colitis
When is solid food recommended?
5-6mo, 1 new food/wk
Why is mixing cereal in milk NOT recommended?
What foods are NOT recommended before age 3?
Nuts, raisins, popcorn, hard candy, hard fruit
What is the #1 choking food?
When is the first dental visit encouraged?
Before age 3
When should oral exams & teeth brushing begin?
What are the best indicators of underlying health of a child?
Height, weight, HC
Weight is ______after birth, regained in _____wks, doubles in _____mo, ______ @ 1 year
Lost, 2, 6, triples
HC is ~_____cm @ birth, _____cm @ 3yo, _____by 3-18yo
35, 50, 55
A lifelong dz of social, communication, and behavioral impairment
Unable to understand non-verbal cues, lack of empathy, delayed social interaction
What is the difference between primary and secondary enuresis?
Primary = never been dry, secondary = dry and now wet
MCC of secondary enuresis
UTI, stress, trauma
1st line tx of enuresis
2nd line tx of enuresis
What is the best tx x breath holding spells?
Unpleasant dream, child is lucid, occurs during REM sleep
Tx x nightmare
Night light, benzo/TCA
Feelings of terror, occurs during non-REM sleep, assc w/ sleeping walking, somnambulism
Does a child have memory of a night terror?
Tx x night terrors
Interrupt sleep cycle, Benadryl
Best tx x thumb sucking
Ignore behavior, do not force child to quit
Pica + pallor
Iron deficiency anemia
When is lead screening done?
What are the 3 MCC's of death in adolescents?
MVA, suicide, homicide
What is the MC TB in children?
Musty/mousy/skin + excessively light skin
What enzyme is missing in PKU?
What is the tx x PKU?
diet free of phenylalanine containing foods x life
Sluggish, dry brittle hair, cold intolerance, overweight, FTT
Labs in hypothyroid?
↓ T3, ↑TSH
Tx x hypothyroid?
When is cholesterol screening done?
9-11 yo, 17-21
What are target cholesterol levels in children?
TC < 200, LDL < 130, HDL > 40
Retinal hemorrhages + subdural hematomas
Shaken baby syndrome
What type of abuse is MC?
A form of abuse in which a parent (mother MC) induces physical sx in a child to gain attention
Munchausen by proxy syndrome
Who are the MC perpetrators in child abuse?
What type of fx's are pathognomonic x child abuse?
Spiral long bone fx's, rib fx's, metaphyseal chip/corner fx's
What is a more proper name x child abuse?
What labs are dx-ic x sexual abuse?
+ GC, CT, HIV, syphilis
Irrational fear of gaining wt, wt 15% below NL body wt, fine lanugo hair, 2 °amenorrhea
Uncontrolled episodes of binge eating + purging
Dental enamel erosion, salivary gland enlargement, callus on knuckles, esophagitis
A d/o characterized by inattention + hyperactivity + impulsivity
A d/o characterized by inattention + easy distractibility + disorganization
How is ADHD treated?
Methylphenidate (Ritalin, Concerta), amphetamines (aderral)
Why is atomexetine/Strattera not used to treat ADHD?
Increased suicide risk
Paralysis involving 5th & 6th CN's
Erb-Duchenne (Erb's palsy)
What nerves are affected in erb's palsy?
Subscapular, phrenic, axillary, musculocutaneous
What is the mechanism of injury in erb's palsy?
violent stretch b/w the head & arm
"waiter's tip" sign
What cranial nerves are affected in Klumpe paralysis?
7th & 8th?
Which brachial plexus injury is more severe?
Klumpe (severe), erb's (mild)
What nerves are affected in Klumpe paralysis?
Median , ulnar, sympathetic, T1 spinal nerve
What d/o may co-exist in Klumpe paralysis?
Spasms, scissoring, toe walking, athetosis, speech delay
Treatment x cerebral palsy?
IM botulin, PT, speech therapy
What does ballard score estimate?
What does APGAR score evaluate?
Newborn's response to the stress of labor & delivery
What APGAR score is considered NL?
What 5 characteristics are assessed in APGAR ?
HR, grimace/irritability, respiration, color, muscle tone
Toxo, syphilis, rubella, CMV, HSV are all part of what d/o?
Tx x toxoplasmosis
Pyrimethamine + sulfadiazine
What is the MCC of congenital cataracts?
Decreased visual acuity w/o pathology
Tx x amblyopia
Eye patch on affected eye, 1% atropine gtts
MCC craniofacial malformation in newborns
Cleft lip & palate
Tall, slender, long limbs, pectus excavatum, pectus caritanum, "double jointed", prominent frontal eminences
Tx x marfan syndrome
BB's, but fatal @ 30yo
MCC of death in Marfan syndrome
Meningeal herniation thru vertebral column
Meningeal herniation thru vertebral column + spinal cord protrusion
MCC of NTD's?
Improper closure of neural tube
Brain on the outside of head
Tuft of hair over defect, mildest CNS dysraphic anomaly
Spina bifida occulta
Absence of cranial vault + cerebral hemispheres
What causes anencephaly + encephalocele
Improper closure of rostral neuropore
How are NTD's detected?
AFP, quad screen, amniocentesis
What is given to prevent NTD's?
Folic acid 4 g 3 mo before pregnancy
Eagle barret syndrome is aka...
Triad x prune belly
Lax abdominal wall muscles, crytoorchidism, urogenital tract dilation
Tx x prune belly
Floppiness, hypomotility, frog-like position
Spasticity, rigidity, arching of neck/trunk
Tx x hypotonia
Physiotherapy, electrical muscle stimulation, PT
Tx x hypertonia
Cat like cry
Cri du chat
MC acquired mental retardation
Fetal alcohol syndrome
MC inherited mental retardation
MC overall mental retardation
Dz characterized by defective collagen processing
Ehlers-Danlos syndrome & Osteogenesis Imperfecta
Hyperplastic skin + joint hypermobility/laxity
Labs x Ehlers-danlos syndrome
Tx x ehlers-danlos syndrome
Tightening of muscles sx
Dz d/t defective enzymes
Lysosomal storage dz
Gaucher dz, Tay-sachs, niemann-pick dz MC in..
Lysosomal storage dz
Trisomy 13 aka as...
Polydactyly, low set ears, microphthalmia, cleft lip/palate, rocker bottom feet, aplastia cutis
Trisomy 13/Patau syndrome
Trisomy 18 aka as
Prominent occiput, rocker bottom feet, hypoplastic nails, overlapping digits, narrow nose
Trisomy 18/Edward's syndrome
Trisomy 21 aka as
MCC of overall mental retardation (MR)
Growth failure, MR, flat occiput, congenital heart dz, megacolon, slanted eyes, brushfield spots, big wrinkled tongue, wide gap b/w 1st & 2nd toes
What trisomy is associated w/ increased risk of leukemia?
Trisomy 21/Down syndrome
Eunochoid body & gynecomastia are hallmark for what d/o?
The MCC of hypogonadism & infertility in MEN
Tx x Klinefelter's syndrome
In Klinefelter's, FSH & LH are?
Hypergonadotropic hypogonadism is assc w/ what d/o?
Primary amenorrhea, webbed neck, poor breast development, short stature
Tx x Turner's syndrome
What congenital heart dz is MC in Turner's?
Urethral meatus on ventral side of the penis
Urethral meatus on dorsal side of the penis
Hallmark feature of hypo/epispadias
Chordee (abn curvature of penis)
Aka brittle bone dz
"wormian bones" & dentin dysplasia
Tx for Osteogenesis imperfect
Biphosphonates, PT, sx
MC acquired form of MR
Fetal Alcohol syndrome
Flat forehead, thin upper lip, low nasal bridge, indistinct philtrum, short palpebral fissure, epicanthal folds, microgthania
Fetal Alcohol syndrome
Bluish color of newborn's hands & feet
Acrocyanosis is benign or pathologic?
Café au lait spots
NF affects what types of cells
Neural crest/schwann cells
NF aka as...
Hallmark features of NF
Café-au lait spots, neurofiromas, optic glioma, lisch nodules, sphenoid dysplasia, axillary freckling
What is a complication of NF?
Neurofibrosarcoma, MR, sz's
A newborn hematoma that DOES NOT cross the suture/midline?
A newborn hematoma that DOES cross the midline?
A newborn hematoma that causes a dark swelling of the scalp?
A newborn hematoma that causes massive hemorrhage beneath the galea aponeurotica?
What is a complication of subgaleal hematoma
A newborn hematoma that has the appearance of a "gumby" head
MCC of newborn hematomas
Retention cysts along gum margins
A small patch of blotchy red area w/ raised yellow center in a newborn is called?
What cells are prevalent in Erythema toxicum?
A dz of pilosebaceous follicles in infants
MCC of Infant acne & acne vulgaris
What causes acne?
Increased sebum production
Treatment for acne vulgaris
Mild = retinoid, benzoyl peroxide
Mod = retinoid, po abx, benzoyl peroxide
Severe = Accutane/isotretinoin
Well demarcated areas of hypopigmentation is characteristic for what d/o
Tx x Vitiligo
Bleaching creams, PUVA
What causes Vitiligo?
Absence of melanocytes
Obstruction of eccrine glands
Miniature epidermal inclusion cysts
obstruction of the eccrine duct occurs deeper in the epidermis
superficial obstruction of the eccrine duct in the stratum corneum
Aka known as prickly heat or sweet rash
Spindled shaped melanocytes
Blue-black or slate-brown lesions on lumbar/sacral area is called what?
Are Mongolian spots benign or pathologic?
Congenital Giant nevi's have a small risk of what?
Marked pruritis + lichenification
"the itch that rashes"
What are some RF's x atopic dermatitis?
Asthma, allergic rhinitis
What is the allergic triad?
Asthma, allergic rhinitis, atopic dermatitis
How is atopic dermatitis treated?
DOC = topical steroids (hydrocortisone), adjunct H2 blockers (Benadryl), Hydrate (Cetaphil), NO scratching, avoid allergen
Dermatitis characterized by coin shaped lesions
White/sandy colored empty egg cases on head
Tx x lice
Permetrin 1% (DOC), Pyrethrins
Linear burrows, intense pruritis on ankles & wrists
What organism causes scabies?
Tx x scabies?
Permetrin 5% (DOC), Lindane (more toxic)
Lindane is a treatment for scabies. What else does it treat?
What organism causes diaper dermatitis & thrush?
Satellite pustules is hallmark x what d/o?
How is diaper dermatitis treated?
Desitin/Zinc Oxide, Talc (keep area dry)
Cradle cap in infants
Red scaly patches on nasolabial folds & around ears
How is seborrheic dermatitis treated in infants?
Olive oil, baby shampoo, ketoconazole shampoo
Is seborrheic dermatitis itchy?
"black dot" sign
What organism causes tinea capitis?
Patches of alopecia
What is the DOC x tinea capitis?
What is another name x tinea corporis?
What labs confirm tinea corporis?
Circular, sharply marginated lesions w/ raised edge & CENTRAL CLEARING
How is tinea corporis treated?
-azoles (miconazole, fluconazole)
What drugs make tinea corporis worse?
This dermatologic d/o is MCC by pityrosporum orbiculare
What is another name for tinea versicolor?
What organism causes tinea versicolor?
Pityrosporum Orbiculare, Malassezi furfur
"spaghetti & meatballs" or filamentous hyphae describes the KOH scraping findings of what d/o?
Hypopigmented macules & very fine scales on sun-induced areas
What is the treatment for Tinea versicolor?
Azoles, ketoconazole shampoo, Selenium sulfide suspension
White-curd like plaques on mouth of an infant
Treatment for thrush?
Nyastatin oral suspension
Painful ulcers inside of lips and anterior mouth
What is another name for apthous stomatitis?
How do you treat canker sores?
Bethamethasome valerate ointment, Magic mouth wash (infants)
Pruritic Herald red patches in a Christmas tree pattern
"salmon colored" lesions on the trunk
What helps remission of Pityriasis rosasea?
Red, irregular patch on glabella of infant
Red, irregular patch on nape of neck of infant
MCC of angel kisses & stork bites
What is the treatment for port wine stains?
Copper Vapor laser
Sz's + glaucoma + port-wine stain + MR
What crania nerve dose Sturge weber syndrome affect?
MC tumor of infancy
How are hemangiomas treated?
Self limited, involute by 10-15yo
Subluxation of the radial head w/ sliding of annular ligament into radiocapitellar joint
Treatment x nursemaid's elbow?
Closed reduction, NO immobilization needed
A non-displaced humerus
Type I supracondylar fx
What type of supracondylar fx is MC? Extension or flexion
What is the MC mechanism of injury in supracondylar fx's?
hyperextension d/t FOOSH
A sypracondylar fx characterized by angulation of the cortex
A displaced humerus
Type III supracondylar fx
Tx x supracondylar fx's?
I & II (LAC), III (sx)
What is seen on XR of Type I supracondylar fx's?
Posterior fat pads
A wrinkling/buckling of the cortex of the distal radius
What fingers are MC affected in syndactyly
Ring & long finger
Small finger duplication
Posterior curvature of spinal column when viewed laterally
Labs x kyphosis?
Treatment x kyphosis?
Sx when Cobb angle > 50
Lateral curvature of the spine > 10 degrees
Shoulder height difference, waist assymentry
Tx x scoliosis
< 20 observe, 20-40 Milwaukee/Boston brace, >40 sx
What hip is MC affected in hip dysplasia?
Why type of d/o is hip dysplasia associated w/?
In infants, what test is used to help diagnose hip dysplasia?
Barlow (dislocates hip), Ortolani (reduces hip)
What does a (+) Galaeazzi test indicate?
Limb-leg discrepancy in hip dysplasia
Hip clicks, leg length discrepancy, trendelenberg gait
What lab is done on an infant < 6 to help dx hip dysplasia?
What lab is done on an infant >6mo to help dx hip dysplasia?
What imaging study confirms the reduction of a dysplastic hip?
How is hip dysplasia treated in <6mo?
Pavlik harness (abduction splint/brace)
What is done if Pavlik harness fails in treating hip dysplasia?
Closed reduction + spica cast, or sx if >6mo
Avascular necrosis of femoral head?
Legg-Caves perthes dz
MC age group affected by Legg-Caves Perthes dz
Young children (5-9 yo)
Painless limp in small, thin/SKINNY, wiry, very active boy
Legg-Caves perthes dz
Labs done in Legg-Caves perthes dz?
XR (AP of pelvis, frog laterals), MRI, arthrogram
Tx x Legg-Caves perthes dz?
Observation, dec activity, traction, sx (round femoral head)
Displacement of proximal femoral epiphysis on femoral metaphysis through growth plate
SCFE is MC seen in what type of pt?
Pubertal obese male
What hip is MC affected in SCFE?
Tx x SCFE?
Percutaneous in situ fixation (aka pinning)
Acute hip pain in a NON-toxic looking child
Tx x transient synovitis
Acture hip pain + fever in a TOXIC looking child
Gold standard lab x septic hip?
Tx x septic hip?
At what age is genu varum normal?
Pathologic genu varum
Tx x blount's dz?
Bracing, PT, sx
"Genu____ before Genu_____"
At what age is genu valgum considered a normal process?
Pathologic genu valgum
Renal Rickets (renal osteodystrophy)
What is CAVE?
Midfoot cavus, forefoot abducts, hindfoot varum, hindfoot equinus- club foot
Tx x club foot?
Small foot + shortened tibia + posterior foot crease
A soft tissue contracture foot deformity
Excessively dorsiflexed hindfoot + hindfoot valgus
what age group does metatarsus abdductus MC affect?
What age group does tibial torsion affect?
What age group does femoral anteversion affect?
Adduction of forefoot + lateral foot border + medial soft tissue crease
Tibia rotated medially beyond NL range
Sits in W position + patella internally rotated + awkward running style
Pain w/ knee extension & TTP @ tibial tubercle
What is the tx x Osgood Schlatter dz?
Pain w/ resisted plantar flexion & passive dorsiflexion of the foot
What is the tx x Sever's dz?
Gastroc/Achilles stretching, heel cup
Fx @ Physis only
Fx @ physis, metaphysis
Fx @ physis, epiphysis
Fx @ physis, metaphysis, epiphysis
MC salter fx
MC mechanism of injury x salter fx's
A "buckle" fx
MC location of torus fx
MC mechanism of injury of torus fx
Tx x torus fx
SAC or rigid brace x 3wks
Name 5 types of innocent murmurs
Still's, venous hum, pulmonary ejection murmur, physiologic peripheral pulmonic stenosis, carotid bruit
A hole b/w RA & LA is called?
What is the MC type of ASD?
Osteum secundum defect
Soft, medium pitched systolic ejection murmur
Widely FIXED split S2
How do you treat ASD?
Device closure (Amplatz, Helix, Cardioseal)
Does an ASD close spontaneously?
NO, requires sx
Does a VSD close spontaneously
Yes, if <2cm
Where does a CoA MC occur?
Below subclavian artery
What kind of circulation usually develops as a result of a CoA?
Weak/absent femoral pulses, UE HTN, LE hypoTN
Figure of 3 sign, rib notching
PGE, dopamine, balloon angioplasty
Short systolic murmur that commonly radiates to the back
What is the MC acyanotic congenital heart defect?
What dz is commonly seen in pt's w/ CoA?
70% of pt's w/ this congenital heart dz also have a bicuspid aortic valve
Systolic ejection murmur w/ gallop rhythm
The presenting sx of this congenital heart dz in infants is often a single S2 & loud
An interscapular murmur is a sign of which congenital heart dz?
What is the MCC of death in pt's w/ CoA?
What congenital heart dz causes a paradoxical embolization?
What is the MC VSD?
Loud, harsh blowing pansystolic ejection murmur
Holosystolic murmur & diastolic rumble
Peaked P waves on EKG
A pt presents w/ sx of volume overload (dyspnea, feeding difficulty, poor growth). Has also been treated for recurrent pulmonary infections in the past. What cyanotic heart disease is suspected?
An infant presents w/ poor urine output, lethargy, poor feeding, and a single S2 & loud. What congenital heart dz do you suspect?
Short systolic murmur that radiates to the back
An Interscapular murmur
An abnormal connection b/w the pulmonary artery and the aorta
Continuous, "machine-like" murmur
This congenital heart dz presents with respiratory distress @ high altitudes, a wide pulse pressure & bounding pulses
How is PDA treated?
Name the 4 acyanotic congenital heart dz's
ASD, VSD, CoA, PDA
Name the 6 cyanotic congenital heart dz's
Truncus arteriosus, TGA, tricuspid atresia, tetralogy of fallot, total anomoulous pulmonary venous return, hypoplastic left heart syndrome
A congenital heart dz characterized by a single blood vessel that branches off the RV & LV w/ an accompanying VSD
CHF, cyanosis, harsh systolic murmur, diastolic decrescendo murmur
Single S2 + click, bounding peripheral pulses
How is Truncus arteriosus treated?
Diuretics, digitalis, pulmonary artery banding
Absent tricuspid valve
Severe cyanosis, single S2, tachypnea, poor feeding, and a missing tricuspid valve
Treatment for Tricuspid atresia?
PGE, atrial septostomy, BT shunt, Fontan
In TGA, the aorta branches off the_____ and carries _______blood
RV, deoxygentated blood
In TGA, the pulmonary artery branches off the_____ and carries _______
Egg on a string
Cyanosis, CHF, tachypnea, S2 single & loud, and NO respiratory distress
Hyperoxic challenge & metabolic acidosis
Treatment x TGA
PGE, Atrial septostomy, atrial/arterial switch
Does O2 help in TGA?
What congenital heart dz occurs beyond infancy?
Tetrology of Fallot (TOF)
What are the 4 features of TOF?
Pulmonary stenosis + overriding aorta + VSD + RVH +/- right sided aortic arch
Cyanosis, harsh long systolic ejection murmur, S2 single
What is a Tet spell?
Hypoxia, cyanosis, syncope
How are Tet spells treated?
Knee to chest position, squatting
Boot shaped heart
A murmur that decreases in the morning
Tx x TOF?
Knee to chest position/squatting, BT shunt, patch, graft, morphine, propranolol, phenylephrine
No communication between the pulmonary veins & LA
Total Anomolous Pulmonary Venous Return (TAPVR)
What type of TAPVR is MC?
What type of VSD is MC?
Cyanosis, S2 widely split, CHF, gallop rhythm
Snowman/figure of 8
Treatment of TAPVR?
Diuretics, ECMO, atrial septostomy
What medication makes TAPVR worse?
A small LV
Hypoplastic left heart syndrome (HLHS)
The MCC of death in the 1st month of life is caused by which congenital heart dz?
Critically ill + shock + weak pulses + severe cyanosis + NOO murmur + severe metabolic acidosis
A single S2 & NO MURMUR
Treatment x HLHS?
PGE, atrial septostomy, Norwood-Fontan single ventricle repair, transplant
Vasculitis MC in coronary arteries that follows a URI?
Hallmark features of Kawasaki's dz?
Feel My Conjuntivitis (Fever >5d, exanthem (rash), extremity changes (edema), LAD, mucocutaneous changes (red lips/strawberry tongue) , conjunctivitis
Red lips + conjunctivitis + rash + fever + LAD + edema
Laboratory features of kawasaki's dz?
Sterile Pyuria (white urine), thrombocytosis, high AST/ALT
MCC of death in kawasaki's dz?
Giant coronary aneurysms
Palpable purpura + abdominal pain/bowel angina + arthritis + nephritis + intussusception
What is seen on bx in HSP?
What is the most important determinant in BP of children?
NP BP is below what percentile?
What is percentile range of pre-HTN?
What is the percentile range of stage I HTN?
What is the percentile range of stage II HTN?
MCC of HTN in children?
MC type of HTN in adolecents (>10)
MC type of HTN in young children <10
A bacterial infxn of the heart valves
MC pathogens in bacterial endocarditis?
s. aureus, viridians group strep, enterococci
Name the MC clinical features of bacterial endocardits?
Nail (splinter) hemorrhages
A new or changing murmur is characteristic of what d/o?
What criteria is used to dx bacterial endocarditis?
Name the features of Duke criteria in dx-ing bacterial criteria
2 (+) blood cx, (+) echo (valve vegetation), new murmur
How do you treat infective endocariditis?
"Big guns"IV abx Pen G + Vanco + Genta + ceftriaxome
What chamber of the heart is MC affected in hypertrophic cardiomyopathy?
What is the MCC of sudden death in athletes?
a-fib, v-fib, LOUD S4, syncope after exercise, CP
Tx x hypertrophic cardiomyopathy
Diuretics, verapamil, BB's, anti-arrhythmics (dysopyramide)
Heart valve damage d/t untreated strep throat
Rheumatic heart dz
MC age group affected by rheumatic heart fz
MC pathogen in rheumatic heart dz
What criteria is used to dz rheumatic heart dz?
Jones (2 major OR 1 major & 2 minor
What are the major clinical features in rheumatic heart dz?
What labs are done in Rheumatic heart dz?
Throat cx, Rapid strep test, ↑ASO, anti-deoxyribonuclease B, anti-hyaluronidase
How is rheumatic heart dz treated?
Bed rest, NSAID's, permanent PCN ppx
Tachypnea w/o respiratory distress
Transient tachypnea of the newborn (TTNB)
What causes TTNB?
Retained/excessive alveolar fluid in lungs
Labored breathing, cyanosis, barreled chest, grunting, retractions, NO resp. distress
Flat diaphragm, prominent vascular markings, ↑lung volume on XR
Tx of TTNB
Nasal CPAP, O2
An abnormal connection b/w the esophagus & the trachea?
What other d/o does TEF commonly occur with?
What type of TEF is MC?
Type C (distal TEF & proximal atresia)
What associated sx does TEF have?
Anal atresia (imperforate anus)
Excessive salivation, drooling, choking, inability to feed, coughing
What study is used to dx TEF in utero?
Tx x TEF?
Ligation of fistula + thoracotomy
What is another name x respiratory distress syndrome?
Hyaline membrane dz
What is the MCC of RDS?
What happens w/o enough surfactant?
Alveoli collapse, hypoxemia, VQ mismatch, actelactasis, inflammatory cascade, respiratory distresss
Cyanosis + nasal flaring + tachypnea + wheezing + retractions + labored breathing + respiratory distress
What is the function of surfactant?
↓alveolar surface tension, ↑ lung compliance
What is seen on CXR in RDS?
RETICULOGRANULAR GROUND GLASS APPEARANCE, air bronchograms, airless lung field/ "whiteout"
What is the tx in RDS?
Exogenous surfactant, CPAP
Acute resp distress in 1st week of life d/t prolonged mechanical ventilation?
Bronchopulmonary dysplasia (BPD)
> 21 % O2 dependence > 28 d
ELBW, ventilator dependent, deteriorating lung fxn, tachypnea, retrations, increasing O2 requirements
Disruption of lung development, alveolar hypoplasia, fewer & larger alveoli, ↓SA x gas exchange
Airway injury & inflammation
How is BPD dx'd?
>21% O2 x >28d
Tx x BPD
Mechanical ventilation, O2, albuterol, steroids, diuretics
Exogenous Surfactant + steroids in utero
What decreases the severity of BPD?
Surfactant & steroid ppx in utero
Severe resp distress, barrel shaped chest, scaphoid abdomen, displaced heart sounds
Congenital diaphragmatic hernia
"stomach bubbles" on U/S
Congenital diaphragmatic hernia (left)
Treatment x Congenital diaphragmatic hernia
Intubation, NGT suction, stabilization, sx
What makes prognosis in Congenital diaphragmatic hernia worse?
Obliteration of posterior nasal aperture
What is the MC congenital anomaly of the nose?
What causes chloanal atresia?
CHARGEcoloboma, congenital Heart dz, chloanal Atresia, retardation, GU defects, Ear anomalies
Nasal d/c and obstruction
Resp distress in delivery room, upper airway obstruction, noisy breathing, cyclic cyanosis
Tx x Chloanal atresia
Resection of posterior nasal septum
Collapse of epiglottis, arytenoid cartiliage & a common cause of stridor in infants
What is the atopy/allergy triad?
Asthma, atopic dermatitis, allergic rhinitis
What type of allergic response is MC?
Type I hypersensitivity
What is considered a "true" allergic response?
What is used to dx a food allergy?
Double blind placebo controlled food challege
Another name for allergic rhinitis
Hay fever, common cold
MCC of allergic rhinitis?
Swollen, boggy nasal turbinates, clear rhinorrhea, nasal polyps, paroxysms of sneezing
Allergic salute, allergic shiners, dennie morgan lines, palatal click
What lab features are seen in allergic rhinitis?
Tx is 1st line tx x allergic rhinitis
INGC (flonsase), H2 blockers (zyrtec, Claritin)
MC pathogen in Sinusitis
Nasal congestion, post nasal drip, facial/dental pain, halitosis
Infxn of paranasal sinuses
What imaging studies are done in sinusitis?
XR of sinuses (Water's view)
Tx x sinusitis?
Abx x 21 d
MC chronic dz of childhood
Airway hyper-responsiveness + reversible airway remodeling
What is the the asthma triad?
Cough, wheezing, dyspnea
What are some key features of status asthmaticus?
Unresponsive to drugs, pulsus paradoxus, resp. failure, tripoding, cyanosis, retractions
What are the lab features of status asthmaticus?
Curshmann's spirals & Charcot Leyden crystals
What is the DOC x all persistent asthma?
ICS (Fluticasone, Budenoside, Triamcinolone)
What is used x quick relief in asthma?
SABA, anticholinergics, IV steroids
What is used in the long term maintenance of asthma?
ICS, LABA, leukotriene inhibitors (singular), mast cell stabilizers, methylxanthines
Which asthma med has a bbx?
What is the treatment of status asthmaticus?
Continuous SABA, helix, mechanical vent
MCC of unintentional death in <1 yo
MC FB location
Foul smelling d/c, severe resp distress, stridor, wheezing, choking, cough
What is used to dx & tx FB aspiration?
A d/o caused by a defective CFTR gene
Cystic Fibrosis is MC in what racial group?
MC pathogens in CF?
Thick viscous secretions, steatorrhea, meconium ileus, chronic cough, mucopurluent sputum, pancreatic insufficiency, PAN-OPACIFICATION & HYPERINFLATION OF LUNGS
Gold standard lab in CF
Sweat chloride >60
How is CF tx?
CFTR modulators (Ivacaftor), abx, SABA/LABA, inhaled Dnase, inhaled tobramycin, flutter valve, percussion vest
Prognosis of CF?
Fatal @ 37
Infection of the pulmonary parenchyma
What is the treatment x PNA?
Outpt: Amoxi or macrolides
Inpt: Amp or Cefuroxime, macrolide (5-18yo)
ICU: ceftriaxome + macrolide
What is another name x pharyngitis?
Why is it important to treat pharyngitis w/ abx?
To prevent ARF
What is another name for croup?
Barky, seal-like cough
What is a classic XR feature of croup
Steeple signnarrowing of trachea/subglottic narrowing
What causes croup?
Viruses parainfluenza, influenza A, RSV
How is croup treated?
Humidified cool mist, dexamethasone, racemic epi
What causes epiglottis?
What is epiglottis uncommon now?
Tripoding, stridor, drooling, toxic-appearing child w/ high fever & in a "sniffing" position
Classic XR feature of epiglottitis
Tx of epiglottitis?
Methylprednisolone/dexamethasone + ceftriaxome
Fever, dysphagia, odynophagia, drooling, torticollis, hot potato voice, neck swelling/mass, cervical LAD
Tx x Retropharyngeal abscess
IV abx, I&D (if severe)
MC deep neck infection in children?
SEVERE SORE THROAT, hot potato voice, uvular deviation, neck pain, drooling
Tx x PTA?
I&D, IV abx, tonsillectomy
A child that has a (+) blood cx, but looks well
A child that has a (+) blood cx, and looks toxic
What constitutes a fever?
>38°C or 100.4°F
What are the main causes of FUO?
Infxn (UTI), rheumatic dz
What is Rochester criteria?
Used to evaluate sepsis in the newborn
Infant previously healthy
well appearing w/ fever w/o focal infxn
Band count <1500 (no left shift)
<10 WBC's on UA
Stool & CSF <10 WBC's
What labs are ordered in a sepsis w/u of a newborn?
Blood cx, CSF eval, UA, CBC w/ diff, CXR
How is sepsis treated in a newborn?
Empiric abx Amp + Genta + Cefotaxine
MC pathogens in sepsis of a newborn?
GBS, E coli, Listeria
Sandpaper rash, strawberry tongue, pastia lines, feder odorous, circumoral pallor, desquamation of skin
MCC of scarlet fever
Tx x scarlet fever
Pen VK (gold standard), Amoxi (MC)
What do we treat scarlet fever?
To try to prevent rheumatic feverPSGN endocarditis
Erythematous eruption MC in pretibial areas
MCC of erythema nodosum
Tx of erythema nodosum?
Self-limited w/o scarring (3-6wks)
Inflammation of the meninges?
MC pathogens in bacterial meningitis?
Newborn = GBC, Listeria, E Coli
Children = S pneumonia, N meningitides
MC pathogen in aseptic/viral meningitis?
Fever, HA, vomiting, convulsions, nuchal rigidity, bulging fontanels
+ kernig & brudzinski sign
WBCs 100-60K, protein 100-500, glucose <50
WBC's <1000, protein 20-100, glucose NL
Tx x bacterial meningitis?
<1mo: amp + genta/cefotaxime
>3mo: vanco +ceftriaxome
Fever, shock, PURPURA/PETICHAE
Shock + purpura
MCC of meningococcemia
Labs x meningococcemia
Direct microscopy, (+) blood cx, CSF eval, prolonged PTT/PT
Tx x meningococcemia
Same as meningitis, must treat close contacts w/ Rifamfin or Cipro
MCC of tonsillitis
Viral EBV, cosackie, adenovirus
MC bacterial cause of tonsilitis
Fever, tender LAD, exudate
What criteria is used to dx Tonsilitis?
Centor Fever > 38C, sore throat, LAD, NO cough, tonsilar exudate
What sx is NOT present in tosilitis?
Tx x bacterial tonsillitis
Pen VK, Amoxi
MCC of impetigo
Strep & staph
Golden-honey crusted lesions
Brown/varnish-like, turbid crusted lesions
Tx x impetigo
Muripocin, Retapamulin, Keflex, Dicloxacillin
Ulcerative form of impetigo
"punched out" ulcers, raised violaceous margins, rim of erythematous induration, eschars
Tx x ecthyma?
Systemic abx, benzoyl peroxide wash bar
MCC of SSS
Phage II Coagulase positive staphylococci/exfoliative toxin
What is the name of the generalized form of SSS?
What is the name of localized form of SSS?
Raw weeping, sunburn/scalding painful exanthema
Tx x SSS?
Treat like burn pt's, IV abs (nafcillin/oxacillin)
MCC of TSS?
Phage I & III coagulase positive staphylococci, TSS-1, enterotoxin A & B
A multisystem infxn characterized by a massive loss of fluid
Fever, malaise, vomiting, watery diarrhea, desquamation of skin, multi-organ dysfxn
Tx x TSS
Aggressive fluid replacement, IV abx
Bacterial infxn of SQ tissue
MCC of cellulitis
Staph & strep pyogenes (GABHS)
Tx x cellulitis
Vanco, clinda, Bactrim (purulent)
Clinda, Keflex(non purulent)
Dome-shaped pustules on erythematous base
MCC of folliculitis
MCC of hot tub folliculitis
Tx x folliculitis
Bulging TM, otalgia, air fluid behind TM, pulling of the ear
1st line tx of AOM
High dose amoxi
MC pathogens in AOM
S. pneumonia > Hib > M catarrhalis
MC pathogens in otitis externa
Pseudomonas, staph aureus
Severe pain w/ tragus/pinna manipulation
Tx x otitis externa
Fluid/air bubbles in middle ear
MCC of serous otitis
Narrow Eustachian tube
Labs x serous otitis
Tx x serous otitis
Watchful waiting, PE tubes
MC type of TB in children
Labs x TB in children
TST/PPD, Gastric lavage
Tx x TB
RIPE (active), isoniazid (laten)
HIGH fever followed by non-pruritic rash
MCC of Roseola
Herpes 6 & 7
Gold standard lab x Roseola
Slapped cheek, lacy/reticular maculopapular rash
What is a complication of erythema infectiosum?
Aplastic crisis in children w/ hemoglopathies
MCC of herpetic stomatitis
Herpes virus hominis
MCC of herpangina
Tx x herpetic stomatitis
Tx x herpangina
Successive crops of pruritic vesicular lesions
Dew drops on a rose pedal
Tx x varicella
Complication of varicella
MCC of winter acute gastroenteritis
Profuse, watery, non-bloody diarrhea w/ "sickly sweet" smell
MC acute respiratory infxn in infants
MCC of bronchiolitis
Copious clear rhinorrhea, fever, cough + wheezing, tachypnea, INFANT
Tx x bronchiolitis
Self-limited, Synagis (high risk pts)
Cough, coryza, conjunctivitis, pruritic rash, followed by HIGH fever
Another name for rubeola
MCC of rubeola
Parotid gland swelling
MCC of mumps
Common complication of mumps
"3 day measles"
Another name x rubella
Blueberry muffin rash, celery stalk lesions
Low grade fever, posterior cervical LAD, rash
Complications of rubella
Hearing loss, cataracts, congenital rubella synd.
Forschheimer's spots on soft palate (lange question)
Paroxysmal cough + high pitched whoop
MCC of pertussis
Bortadella pertussis (Gram - coccobacillus)
What is NOT a sx of pertussis?
Dx of pertussis
PCR of nasopharyngeal secretions
Tx x pertussis
Azithro (<1mo), any macrolide (>1mo), Bactrim >2 mo
Lassitude/weakness/fatigue, body aches, malaise, fever, anorexia, rhinitis, croup like cough, abd pain
Labs x flu
Tx x flu
Fever, sore mouth, copious drooling, LAD, red/friable gingiva, yellow ulcers surrounded by red halos on tongue, gingiva, buccal mucosa
MCC of hand, foot, mouth dz
Enterovirus (Coxsackie virus)
Prodrome, intraoral lesions, skin lesions
Hand, foot, mouth dz
Blood stained/coffee ground emesis
Bright red/maroon stools
What test distinguishes b/w maternal & fetal blood?
Abdominal distention, bilious vomiting, frank blood diarrhea
Labs x SBO
KUBabnormal position of duodenum
A lethargic infant w/ bloody diarrhea
Telescoping of bowel
Colicky pain, currant jelly stools, bilous vomiting, LETHARGY
Labs x Intussuception
gastrografin enema or air contrast enema
Tx x Intussuception
Sx (if perforation)
Malrotation of midgut
Abdominal distention, bilious vomiting, frank bloody diarrhea
Labs x volvulus
Upper GI series
Air fluid level + beak sign
Tx x volvulus
Thrombocytopenia + hemolytic anemia + renal insufficiency following a diarrheal illness
MCC of HUS
Labs x HUS
Stool cxE coli + shiga toxin
What is CI in HUS?
Painless rectal bleeding + bloody stools + poor appetite
Vestigial remnant of omphalomesenteric duct & outpouching of distal ileum
Labs x meckel diverticulum
Technetium 99 scan
"Rule of 2's" is assc. w/ what condition?
Hard-pellet like stools
Involuntary fecal leakage
MCC of functional constipation
Tx x constipation
Miralax, glycerin suppositories, Enemas (2 yo +), high fiber
Hirshprung dz is assc w/ what syndrome?
Chronic constipation + failure to pass meconium + fever + abdominal distention + ribbon like stools
Fever + bilious vomiting + explosive diarrhea (enterocolitis)
How is Hirschprung dz dx'd?
Rectal suction bx (no ganglion cells)
Barium enema (narrow distal segment + sharp transition zone)
What enzyme is elevated in Hirschprung dx
Tx x Hirschprung dz
Failure of duodenal development
DA is assc. w/ what syndrome?
Gastric distention + bilious emesis
Double bubble sign
Tx x DA
How is DA dx'd in utero?
Non-bilious projectile/forceful vomiting
Olive like mass
What is the study of choice x pyloric stenosis?
Abd. u/s or barium swallow
Tx x Pyloric stenosis
failure to pass meconium & often 1st sign of cystic fibrosis
Very distended abdomen, no meconium passed, bilious emesis, loops of thick/distended bowel
Soap bubble & ground glass appearance
Study of choice x meconium ileus
Contrast enema (dx-ic & therapeutic)
Missing anus opening
Buckle handle shaped skin tag, green bulging membrane on anal aperture, failure to pass meconium
Tx x imperforate anus
MC non-infectious diarrhea in infants, non-bloody, painless
MCC of toddler's diarrhea
TOC x diarrhea
Greasy, frothy, foul smelling diarrhea + crampy abdominal pain
Tx x Giardiasis
Labs x Giardiasis
Bloody Diarrhea MCC by uncooked/raw beef
Complication of e coli diarrhea
Bloody Diarrhea caused by pets/infected animals, contaminated poultry/eggs/milk
Bloody diarrhea + neuro sx (sz's)
MCC of shigellosis
S dysenteriae I/shiga toxin
Tx x shigellosis
Labs x shigellosis
Yellow discoloration of skin
Soluble in water
Not soluble in water
Etiology of unconjugated bilirubinemia
Hemolysis (+)-->ABO/RH incompatibility, drugs
Hemolysis (-) -->G6PD, SCD, hereditary spehrocytosis
No hemolysis-->physiologic breastfeeding jaundice, breastfeeding jaundice, Gilbert's syndrome, crigler-najar synd.
Etiology of conj bilirubinemia
Galactosemia, TORCH, sepsis, biliary atresia, drugs (VPA, INH), alagille syndrome, autoimmune
Complication of hyperbilirubinemia
HM, jaundice, dark urine, acholic/white stools
Excessive crying in healthy baby, inconsolable
Rule of 3's/Wessel criteria
Crying >3h/d, >3d/wk, >3wks
Tx x infant colic
Stops as suddenly as it starts
Common bile duct is absent, acholic stools, jaundice
Labs x biliary atresia
Tx x biliary atresia
Kasai procedure, transplant
Localized sharp & steady RLQ pain & guarding
Rosving's sign, obturator sign, Mcburney's point, psoas sign are all positive signs of what d/o?
Tx x appendicitis
Frequent postprandial spitting up/vomiting
Labs x GER
Barium swallow (older children), clinical (infants)
What is the conservative tx of GER?
Frequent burping, positional thickened feedings
What meds can be used in tx of GER?
PPI (omeprazole), H2 agonist (ranitidine), Reglan
What surgical procedure can be done to tx GER when conservative measures fail?
MCC of GER
Over-relaxation of LES
Soft PAINLESS swelling/bulge near umbilicus
Complication of umbilical hernia
Which type of hernia will not close spontaneously and require sx?
Severe perinanal itch + excoriations
Labs x entorobiasis
Scotch tape test
Tx x enterobiasis
Albendazole, Pin X
Bilateral symmetric enlargement of kidneys +HTN + hematuria + flank pain
What genes are affected in PKD?
Tx x PKD
What are the complications of PKD?
ESRD, CVD, Cerebral/berry aneurysms
One/both kidneys are missing
What is another name for renal angenesis?
Enlarged adrenal gland + ahydramnios + HTN + pulmonary hypoplasia are sx of what d/o?
Labs x renal agenesis
Tx x renal agenesis
Unilateral none, bilateralfatal
MC nephrotic syndrome in kids
Minimal change dz
Fusion of epithelia foot process
Minimal change dz
Sudden wt gain, massive proteinuria, orbital edema, scrotal/labial edema
Minimal change dz
Tx x minimal change
High dose prednisone 4-6wks
Massive proteinuria, edema, hypoalbuminemia, hyperlipidemia
Tx x nephrotic syndrome
High dose prednisone, 25% albumin, diuretics, fluid, salt restriction
MC nephritic syndrome in children
IgA nephropathy/Berger's dz
hematuria 2-3 days after a URI + "coca cola" urine
Labs x IgA nephropathy
Renal bxIgA deposits
Strep infxn followed by gross hematuria/coffee or tea colored urine weeks later + periorbital edema
Labs x PSGN
UA microscopy-->red casts
Serology-->↑ ASO, low C3
MCC of UTI in children
Labs x cystitis
UA (clean catch) + microscopy leukocyte esterase, nitrite, WBC's
Chronic UTI's may be a sign of what?
Vesicoureteral reflux (VUR)
Tx x UTI?
<2 mo (Keflex), > 2 mo (Bactrim)
Crying w/ urination, unexplained fever
What should always be ruled out in the presence of a UTI?
MC type of cryptorchidism
Tx x retractile testicles
Warm bath trick
Tx x cryptorchidism
Orchiopexy, hCG (Europe)
What are cryptorchidism pt's at a higher risk for?
Testicular CA (seminoma)
A spermatic cord twist
Sudden scrotal pain w/o relieve, high lie appearance, absent cremasteric reflex, (-) prehn's sign
Study of choice x testicular torsion
CT, or Doppler US
Tx x testicular torsion
Orchiopexy w/in 4-6 hrs
Inability to retract foreskin over penis
Inability to pull foreskin over penis
Tx x phimosis
CSF in ventricles & subarachnoid space, ↑ICP
Tx x hydrocephalus
Premature fusion of 1 or more cranial sutures
Abnormal head shape or size
MC type of craniosysnostosis?
Proximal muscle wasting, calve weakness, STILL ambulatory, mental retardation
Becker's muscular dystrophy
Progressive muscle weakness, frequent falling/tripping, hypertrophy of calve muscles, NON-ambulatory by age 12, NO mental retardation
Ducchenne's muscular dystrophy
Tx x muscular dystrophies
MCC of death in muscular dystrophies
Respiratory failure, cardiac failure
Loss of motor neurons and mutation of SMN1
Spinal muscular dystrophy
What is SMN1 replaced by?
MCC of floppy infantile syndrome
Infantile werding Hoffman
MC type of SMA
Thin, stork-like calves, cavovarus foot, clawed toes, weakess of foot muscles, high arched, feet
Charcot Marie tooth
Primitive reflexes that appear @ birth and disappear @ 4-6mo
Palmar grasp, placing/stepping, tonic neck, rooting, moro
Primitive reflex that never disappears
Abnormal moro reflex may be a sign of what?
Primitive reflex that appears @ 6-8 mo and disappears by 2yo?
Episodes of altered awareness, eye blinking, blank stare
Is a child having a absence aware of the sz?
Focal, brief sz, consciousness is preserved
Automatisms (lip smacking) + altered consiciousness
Infantile spasms/west syndrome
Hypsarrhythmia on EEG
Infantile spasms/west syndrome
3 second spike waves on EEG
Frequent sz's, different types of sz's
Tx x west syndrome
Prednisone, ACTH, Vigabratin
Tx x lennox gastaut
VPA, benzo, lamotrigine (lamictal)
MC meds x sz's
Phenobarbital, phenytoin, CBZ, VPA
Tx x status epilepticus
ABC's first, then diazepam + phenobarbital
History of stomach flu & URI followed by symmetric ascending muscle weakness
Guillan Barre syndrome
Tx x guillan barre syndrome
IVIG + plasmaphereis
What is contraindicated in Guillan Barre?
Tdap, Dtap, DT, Td, TIV/LAIV
Floppiness + hypomotility + head lag + difficulty feeding
Floppy baby syndrome
Another name for floppy baby syndrome
Traumatic brain injury
Confused, LOC, HA, flashing lights
Tx x concussion
Rest, no contact sports until sx free
Convulsion in the presence of fever > 38°C
How long do febrile sz's last?
Simple < 15min, complex >15min
What day is a febrile sz MC seen?
1st day of illness
Tx x febrile sz
Rectal APAP, body sponge baths w/ tepid water, +/- ppx phenobarbital, NO alcohol rubs
What is often the 1st sign of botulism in infants?
MC pathogen of botulism
Flat facial expression, weak sucking on feeding, weak cry, decreased moving, dysphagia, excessive drooling, muscle weakness, breathing problems
MCC of infant bolutism
MCC of foodborne botulism
Descending flaccid paralysis + bulbar palsies
Tx x botulism
Baby BIG (human botulism immune globulin)
Downward placement of medulla & cerebellum and obstruction of 4th ventricle
Tuft of hair on back, dimpling, diffuse back pain
Spina Bifida occulta
Labs x neural tube defects
AFP, amiocentensis @ 16-18wks
What is given to prevent NTD's?
Folic acid 4 g 3 mo before pregnancy
Fever, pallor, purpura, bone pain
MC leukemia in young children
Lab features of ALL
Thrombocytopenia, anemia, granulocytopenia, BLASTS
Which leukemia has a better prognosis?
Child w/ bone pain (<15yo), unexplained fevers, bruising/bleeding, abnormal CBC
Down syndrome pt's are at VERY high risk x what?
What cells differentiate AML vs ALL?
AML has Auer rods on bx
What cells confirm the dx of leukemia?
Blast cells on BM bx
Tx x ALL, AML
Presymptomatic CNS tx-->intrathecal MTX
What is a potential complication of an Rh- mother and an Rh + baby?
Fetalis hydrops, erythobloastosis fetalis
What is given to prevent hydrops fetalis in Rh incompatibility?
Rhogam @ 28 wks, delivery, and any trauma
An mother w/ O blood type and an infant w/ AB blood type poses the risk of what d/o?
Factor 8 deficiency
Factor 9 deficiency
Factor 11 deficiency
Hemarthroses, epistaxis, bruising, prolonged bleeding
What labs are done in hemophilia?
PTT prolonged, NL PT
Tx x hemophilia
DDVAP, transfusion of deficient factor
Inadequate Vit K intake in breastfeeding newborns has a higher risk of developing what d/o?
Hemorrhagic dz of the newborn
Tx x hemorrhagic dz of the newborn
1mg IM Vit K
Menometrorrhagia, epistaxis, gum bleeding
Tx x VW dz
DDVAP (I &II), replacement therapy (III)
Crescent shaped RBC's
What amino acids are switched in SCD?
Glutamic acid replaced w/ valine
Recurrent pain episodes (vaso-occlusive crisis), dactylitis, acute chest syndrome, HSM
Howel jolly bodies
What is a protective factor x SCD
Labs x SCD
↓ H&H, ↑retics, ↑WBC, ↑platelets, electropheresis Hgb S
Tx x SCD
NSAIDs/opioids, PCN, fluids, O2, transfusion, hydroxyurea/butyrate, bone marrow transplant
What risk do blood transfusions have?
Iron overload, blood-borne dz
Prognosis of SCD
Chronic Hemolytic anemia
Microcytic & hypochromic anemia MCC by inadequate iron intake
Iron deficiency anemia
Iron deficiency anemia labs
↓Hgb, ↓retic, ↓ferritin, ↓MCV/MCH, ↑TIBC
Tx x iron deficiency anemia
PO Iron salts
HA upon rising, relief when lying down, sundowning eyes, bulging anterior fontanel, vomiting
Preferred imaging studies x brain tumors
Medulloblastoma, cerebral gliomas are what kind of brain tumors
Low grade asytocytoma, malignant glioma are what kind of brain tumors?
Cranipharyngioma, pineal tumors are what kind of brain tumors?
Which brain tumors have the worse prognosis?
Braistem glioma, metastasized medulloblastoma
A malignant dz of lymphoid tissue
MC non-hodgkin's lymphoma in children
Painful abdominal mass or rapidly extending neck mass
Painless neck mass (MC in neck)
What is the most common tumor affectint neural crest tissue seen in children?
Abd pain + hard, smooth non-tender mass, periorbital ecchymosis/"raccoon eyes"
Bone pain + palpable mass + calcifications MC on metaphysis of long bones
Leukcoria, absent red light reflex/Hirscberg test, "cat's eye"
BILATERAL flank pain, abdominal mass, fever, hematuria
What d/o's is Wilm's tumor assc w/?
Aniridia, hemihypertrophy, Beckwith Weidenman
Viral infxn followed by epistaxis, gingival bleeding, ecchymosses, purpura
What is seen on CBC in ITP?
When is tx indicated in ITP?
Platelets < 20K
What is the tx in ITP?
Dexamethasone, prednisone, IVIG, slenectomy
What is the most feared complication of ITP?
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