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RR-40-60
HR-120-160
SBP-65
DBP-50
Conjunctivitis Cause:
Day 1Day2-7>7 Days>3 weeks-
Day 1- chemical
irritation
Day 2-7- Neisseria
gonorrhea
>7 DaysChlamydia
trachomatis
>3 weeks- herpes
What Dx of Newborn:
X-linked, hemolytic crises.
Tx?
G-6-PD
Tx: reduce
oxidative stress
and special diet
What Dx of Newborn:
AR, mental retardation, deficiency
in enzyme phenylalanine
hydroxylase
PKU
Tx: special diet low
in phenylalanine
for first 16 years
What Dx of Newborn:
mental and developmental
retardation, inability to breast feed,
inability to metabolize galactose
Galactosemia
Tx: cut out all
lactose
What Dx of Newborn:
Cretinism
Congenital
hypothyroidism
Tx: replace
hormone
What Dx of Newborn:
multiple AR disease resulting in
errors of steroidogenesis
Congenital adrenal
hyperplasia
Tx: replace
mineralocorticoids
and
glucocorticoids
Palmar Grasp
Presents:
Disappears:
Presents: birth
Disappears:2-3
months
Rooting
Presents:
Disappears:
Presents:birth
Disappears: <1
month
Moro
Presents:
Disappears:
Presents:birth
Disappears:4-6
months
Tonic neck
Presents:
Disappears:
Presents:birth
Disappears: 6-7
months
Babinksi
Presents:
Disappears:
Presents:birth
Disappears:18
months
Parachute
Presents:
Disappears:
Presents:6-8 months
Disappears: never
What is Dx?
cyanosis of lips and extremities,
holosystolic murmur, squatting
Tetralogy of Fallot
15.
1) VSC
2) pulmonary stenosis
3) RVH
4) Overriding aorta
a/w chromosome 22
deletion
16.
3 holosystolic murmurs
1) VSD
2) mitral regurg
3) tricuspid regurg
What is Dx?
Early, severe cyanosis. Single S2.
CXR "egg on string"
Transposition of Great
Vessels
Tx: PGE1, until surgery
18.
Pulsus paradoxus
19.
Pulsus alternans
20.
Irregularly irregular
atrial fibrillation
21.
aortic stenosis
What is Dx?
-absent pulses with single S2
-increased right ventricular
impulse
-gray rather than bluish
cyanosis,
What is Dx?
Sxs in first few days of life
severe dyspnea
early and frequent respiratory
infxns
single S2, systolic ejection
murmur
Truncus Arteriosus
-single truck emerges
from R and L ventricles
24.
Tetralogy of Fallot
Transposition Great
Vessels
Hypoplastic LH
syndrome
Truncus Arteriosus
TAPVR
25.
VSD
ASD
PDA
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What is Dx?
dyspnea with respiratory
distress
holosystolic mumur
loud pulmonic S2
VSD
CXR-vascular markings
Echo-diagnostic, cardiac
cath definitive
What is Dx?
asymptomatic except fixed
wide splitting S2
ASD
-cardiac cath is definitive
-echo less invasive just as
effective
What is Dx?
machine like murmur
wide pulse pressure
bounding pulses
PDA
echo best initial
cardiac cath is most
accurate
LVH on EKG
What is Dx?
Severe CHF with resp
distress first few months
different BP in upper and
lower extremities
What is Dx?
vomiting with first feeding
esophageal atresia
-90% have TEF
Esophageal atresia
What is Dx?
Projectile vomiting
1-6 months
"olive pit" epigastrium
Pyloric Stenosis
-metabolic alkalosishypocholoremic,
hypokalemia
Initial Test- abdominal
U/S
Best Test- upper GI series
What is Dx?
child turns blue when feeding
and pink when crying
Choanal atresia
Dx with CT scan
What is Dx?
late meconium >48 hrs
extreme constipation
rectal exam shows extremely
tight sphincter, can't pass
flatus
Hirschprung Disease
AXR-distended bowel
loops
Manometry high pressure
anal sphincter
Dx-full thickness biopsy
showing lack of
ganglionic cells
VACTERL
V-vertebral anomalies
A-anal atresia
C-cardio anomalies
T-TEF
E-esopageal atresia
R-renal anomalies
L-limb anomalies
What is Dx?
bilious vomiting within 12
hours birth
CXR-double-bubble
Duodenal atresia
a/w annular pancreas and
Down Syndrome
1st step - IVF
37.
Meckel's diverticulum
Best test-technetium 99 scan aka
Meckel scan
38.
Findings in IDM-5
Findings in 17-alpha
hydroxylase deficiency
Aldosterone:
Cortisol:
Sex hormone:
BP:
Sxs:
Electrolytes:
Aldosterone:increase
Cortisol:decrease
Sex hormone: decrease
HTN
Sxs: female-normal @ birth,
delayed puberty
male-pseudohermaphrodite
Electrolyes-hypokalemia
Aldosterone:decrease
Cortisol:decrease
Sex hormone:increase
BP: hypotension
Sxs: female-look male, internal
female
male-normal @ birth
Electrolytes-hyponatremia,
hypochloremia, hyperkalemia
11-beta hydroxylase
deficiency
Aldosterone:
Cortisol:
Sex hormone:
BP:
Sxs:
Electrolytes:
Aldosterone:decrease
Cortisol:decrease
Sex hormone:increase
11-DOC-increase (weaker
aldosterone)
BP: HTN
Sxs: female-virilized
male- normal @ birth
Electrolytes:no change
Vit D. deficiency
CalciumPhosphate1-25 Vit. D25 Vit. D-
Vit. D dependency
CalciumPhosphate1-25 Vit. D25 Vit. D-
Calcium-decreased
Phosphate-normal
1-25 Vit. D-decreaed
25 Vit. D-normal
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X-linked hypophosphatemia
Calciumnormal
Phosphatedecreased
1-25 Vit. Dnormal
25 Vit. Dnormal
What is Dx?
chorioretinitis, hydrocephalus, ringenhancing lesions on CT
Toxoplasmosis
46.
Dx test Toxo
Initial-IgM
Best- PCR
47.
Tx Toxo
Pyrimethamine
and
Sulfadiazine
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What is Dx?
rash on palms, soles, snuffles, frontal
bossing, Hutchinson 8th nerve palsy,
saber shins/teeth
Syphillis
Dx test Syphilis
Initial-VDRL
or RPR
Best- FTA ABs
or dark field
micro
Penicillin
What is Dx?
PDA, cataracts, deafness, IUGR,
blueberry muffin rash, hyperbili,
hepatosplenomegaly
Rubella
52.
Dx test Rubella
Maternal IgM
53.
Tx Rubella
Supportive
What is Dx?
periventricular calcifications with
microcephaly, chorioretiinitis, hearing
loss, petechiae
CMV
55.
Dx test CMV
initial-urine or
saliva titers
best- urine or
saliva PCR for
viral DNA
56.
Tx CMV
Ganciclovir
What is Dx?
week 1-shock and DIC
week 2- vesicular lesions
week 3-encephalitis
Herpes
58.
Dx test Herpes
Initial- Tzanck
Best-PCR
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Tx Herpes
Acyclovir and
supportive
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Tx Syphilis
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What is Dx?
pruritic vesicular rash
beginning on face, fever, malaise
Varicella
What is Dx?
cough, coryzam conjunctivitis
with Koplik spots on buccal
mucosa
Measels/Rubeola
(paramyxovirus)
What is Dx?
fever and URI progressing to
rash "slapped cheek"
appearance
Fifth disease/Erythema
infectiosum (Parvovirus
B19)
What is Dx?
Fever and URI progressing to
diffuse rash
What is Dx?
fever precedes parotid gland
swelling with possible orchitis
Mumps
(paramyxovirus)
What is Dx?
Barking cough
Coryza
Inspiratory Stridor
Hypoxia
Croup
-parainfluenza virus 1
and 2, RSV
What is Dx?
Fever
Drooling in tripod position
"hot potato" voice
refusal to lie flat
Epiglottitis
H. influenza type B.
(Stept and staph too)
3-7 year olds
Tx Epigottitis
What is Dx?
severe coughing episodes with
extreme gasps for air followed
by vomiting
Whooping Cough
Bordetella pertussis
Tx Whooping Cough
Erythromycin or
Azithromycin (only in
catarrhal stage)
isolate child
Macrolides to close
contacts
DTaP vaccine-herd
immunity important
What is Dx?
gray pseudomembrane plaques
on pharyngeal wall.
Diptheria
Corynebacterium
diptheriae
DO NOT SCRAP
Tx-antitoxin, ABX
don't work
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72.
What is Dx?
Painful limp, 2-8 year old
XR?
Tx?
Legg-Calve-Perthes Dx
avascular necrosis of femoral head
XR-widening and effusions of joint
Rest and NSAIDs, then surgery on both hips
What is Dx?
Painful lump and externally rotated leg
XR?
Tx?