Beruflich Dokumente
Kultur Dokumente
Treatment of HMD?
What are the four levels of cognitive development and the ages at which they occur?
What are 3 antithyroid drug treatments and their side effects (2)
What
What
What
What
What
age can children recieve radioactive ablation with no concerns for malignancy?
percent of patients remain hyperthyroid after initial ablation?
are the remission rates after 2 years of medication therapy for hyperthyroid?
is the most appropriate treatment of a 13 year old with Graves disease?
is the DDx for a congenital goiter?
Roseola infantum
Erythema Infectiosum
How long are varicella patients contagious for? What test can be used to test for it?
Hand Foot Mouth disesase
What is the most common cause of hematogenously spread cellulitis?
Treatment of the following Tineas:_x000D_
Capitis_x000D_
Corporis/Cruris/Pedis
Describe the Dawn Phenomenon
Describe the somogyi phenomenon
Single most critical value in evaluating growth?
A baby is screened with a total T4 level which is decreased. The TSH is normal. What is the
next step?
When do kids adopt adult stooling patterns?
Osmotic Diarrhea. . _x000D_
stool sodium? _x000D_
Osmolarity?_x000D_
Exogenous vs. endogenous DDx?
Secretory Diarrhea_x000D_
Sodium?_x000D_
Osmolarity?_x000D_
DDx?
Treatments of the following:_x000D_
Giardiasis_x000D_
Cryptosporidium
VACTERL
MURCS
Features of Trisomy 18
Trisomy 13
What vitamin deficiencies are associated with the following diets?_x000D_
Vegan?_x000D_
Goats Milk?
What anemias are the following ethnicities associated with?_x000D_
African American?_x000D_
Mediterranean?_x000D_
Southeast asian?_x000D_
Northern European?
What type of anemia is associated with nail spooning?
What are the two types of microcytic anemia?
What are the 4 types of macrocytic anemia?
Macrolides:_x000D_
2 Examples_x000D_
7 bugs it can treat well
Lincosamides:_x000D_
1 Example_x000D_
Spectrum of activity
TMP/SMX:_x000D_
Mechanism of action?_x000D_
Spectrum of activity?
Tetracyclines:_x000D_
2 examples_x000D_
Spectrum of activity
Quinolones:_x000D_
Spectrum of activity_x000D_
1st, 2nd, 3rd, 4th generation?
Linezolid_x000D_
spectrum of activity?
Streptogramins:_x000D_
2 examples_x000D_
spectrum
Daptomycin_x000D_
spectrum
Telithromycin
Tigecycline
Calculate MIV req. per day for a 70 kg child and convert to hourly rate
HMD is due to insufficient surfactant at the time of birth. This increases surface tension and
decreases lung compliance. _x000D_
_x000D_
Risk factors include:_x000D_
Male, Premature, Caucasian, Gest. Diabetes, Csection, 2nd born twin, FHx.
Right to left shunting via:_x000D_
_x000D_
shunt vessels in the lung_x000D_
past atelectatiic air spaces_x000D_
PDA, PFO
TTN CXR shows higher lung volumes_x000D_
_x000D_
Bacterial PNA difficult to distinguish from GBS. Routine to treat all HMD babies with ABX
until ()Cx are received_x000D_
_x000D_
Pulmonary Edema many causes_x000D_
_x000D_
Aspiration PNA meconium or amniotic fluid.
1) Prevent premature delivery. _x000D_
2)If preterm delivery is inevitable, then treat with steroids antenatally_x000D_
3)Surfactant replacement therapy
TTN
TTN is a delayed clearance of fetal lung fluid. _x000D_
_x000D_
Treatment:_x000D_
self limited with resolution within 4872 hours. Some treatment includes fluid restriction and
oxygen._x000D_
_x000D_
Risk factors include: _x000D_
Csection_x000D_
Premature_x000D_
Delayed clamping of the umbilical cord_x000D_
Maternal sedation_x000D_
Maternal diabetes_x000D_
Fetal distress
Sensorimotor 2 years_x000D_
Preoperational 27 y/o_x000D_
Operational 712 y/o_x000D_
Formal >12 y/o
1)
2)
3)
4)
5)
1)
2)
3)
4)
5)
6)
Caused by HHV6, begins with abrupt fever (103106) for 15 days, child appears well during
the fever, after 34 febrile days a MP rash develops on trunk and spreads peripherally, fever
resolves as rash appears,
Parvovirus B19 Mild, self limiting, no prodrome, low grade fever (if any), Rash begins as
slapped cheek, erythematous, pruritic MP rash develops on arms and spreads to trunk/legs.
Associated with fetal hydrops during pregnancy.
24 hours before rash until all lesions are crusted (1 week)_x000D_
Tzank prep
Coxsackie A virus prodrome of anorexia, fever, oral pain followed by crops of ulcers on oral
mucosa
S. Pneumo
Oral griseofulvin for 46 weeks_x000D_
topical antifungals for 4 wks
Increasing insulin resistance from 3am8am. Nocturnal GH secretion. Sugar is normal at 3am
and high at 8am
Rebound hyperglycemia following hypoglycemia. Low sugar at 3am and high at 8am
Height velocity
012 25cm_x000D_
1224 12cm_x000D_
2436 8cm_x000D_
36mopuberty 47cm per year_x000D_
Puberty 814cm/year
Pathologic until proven otherwise
2 SD below mean (,3%ile)
Cortisol excess or Hypothyroidism
CBC w/diff, Complete metabolic panel, T4/TSH, IGF1/GFBP3, UA/ESR, Celiac panel (Serum
IgA, Antiendomysial Ab, Tissue transglutaminase), Bone age film
Because of the TSH surge that occurs in the first 24 hours of life.
Treat vigorously to prevent HF. Hospitalize to monitor HR and EKG_x000D_
Treat with:_x000D_
PTU rather than methimazole because PTU decreases conversion of T4 to T3._x000D_
Beta Blockers_x000D_
Lugols solution to block release of preformed thyroid hormone_x000D_
Pharmacological doses of glucocorticoids which block conversion of T4 to T3.
Free T4. . .if decreased along with normal TSH then you need to rule out central
hypothyroidism. If normal, then they have TBG deficiency
1 year old
Stool sodium < 70 meq/L _x000D_
OSM >2x(Na+K)_x000D_
Exogenous: laxatives, artificial sweeteners, antacids, excessive CHO, lactulose_x000D_
Endogenous: disaccharidase deficiency, pancreatic insufficiency, infectious diarrhea, loss of
surface area (short gut, IBD, Celiac, milk protein enteropathy, rota)
Giardiasis:_x000D_
Metronidazole, nitazoxanide, furazolinide_x000D_
Cryptosporidium:_x000D_
Nitazoxanide, azithromycin
Verterbra (hemivertebrae)_x000D_
Anus (imperforate)_x000D_
Cardiac (VSD)_x000D_
TE fistula_x000D_
Renal (horseshoe)_x000D_
Limb (clubfoot)
Coloboma_x000D_
Heart (ASD)_x000D_
Atresia choanae_x000D_
Renal (fused kidneys)_x000D_
Ear (deafness)
Mullerian duct (absent prox 2/3 of vagina)_x000D_
Renal agenesis_x000D_
CSpine defects C5T1
Bicuspid aortic valve_x000D_
coarctation_x000D_
horseshoe kidney_x000D_
low set ears_x000D_
wide nipples
PPS_x000D_
Paucity of intrahepatic bile ducts_x000D_
Direct hyperbili_x000D_
Opaque margin of cornea_x000D_
Butterfly/hemivertebrae, Triangular face_x000D_
Deep set eyes. _x000D_
_x000D_
AD inheritance_x000D_
mutation of JAG1
Infant: hypotonia, poor feeding, small hands/feet, almond shaped eyes_x000D_
Older child: marked weight gain, MR, unusual eating behaviors, skin picking, rage
Growth retardation, long eyelashes, thick eyebrows, upturned nares, hirsutism, hypoplastic
nipples, short limbs, missing digits, genital abnormalities. No diagnostic test available
Left sided heart lesions, hypocalcemia, _x000D_
prominent nose, _x000D_
long fingers, _x000D_
high arched/cleft palate. _x000D_
_x000D_
Sporadic inheritance, _x000D_
AD for affected individual
Vit. K_x000D_
Eye infxn prophylaxis with erythromycin or tetracycline eye ointment_x000D_
HepB mom's status, HBIG vs. vaccine
Cephalohematoma _x000D_
Blood under periosteum_x000D_
Does not cross suture lines_x000D_
Leave alone, will go away_x000D_
Caput Succedaneum_x000D_
scalp edema from pressure_x000D_
Diffuse, crosses suture line_x000D_
Resolves in 12 days
34 years
after 812 weeks, the O/B sign isn't positive and limited abduction is a more reliable sign
Before 4 months U/S_x000D_
After 4 months plain hip xray
Moro 3 months_x000D_
Stepping 6 weeks_x000D_
Suck and Root 4 mo. awake 7 mo. asleep_x000D_
Palmer Grasp 4 months_x000D_
Plantar Grasp 10 months_x000D_
Fencer 6 months
23 oz./pound
until 20 lbs or 1 year
1)PNA_x000D_
2)UTI_x000D_
3)Skin/Skin structure infxns_x000D_
4)Empiric tx in febrile neutropenic patients
G+, G aerobes, G anaerobes
Meropenem is:_x000D_
232x more active against Enterobacter_x000D_
24x more active against pseudomonas_x000D_
less active against G+_x000D_
Equivalent activity agains anaerobes_x000D_
MRSA/Enterococcus resistance
G rods
Gentamicin, Tobramycin, Amikacin_x000D_
_x000D_
G enterics, MRSA_x000D_
_x000D_
Synergistic effect with Beta lactams against G+, G
G+
Erythromycin, Azithromycin_x000D_
_x000D_
L. Pneumophila_x000D_
M. Pneumoniae_x000D_
C. Pneumomoniae_x000D_
C. Trachomatis_x000D_
B. Pertussis_x000D_
M. Cattharalis_x000D_
Camphylobacter
Clinda_x000D_
_x000D_
G+ aerobes_x000D_
G+/G anaerobes
inhibition of folic acid pthwy_x000D_
_x000D_
G aerobes_x000D_
Staph aureus
Doxycycline, Minocycline_x000D_
_x000D_
Rickettsia_x000D_
M. Pneumo_x000D_
C. Pneumo_x000D_
C. Trachomatis_x000D_
S. aureus MRSA
1st gen: G rods_x000D_
2nd gen: G rods, pseudomonas, Staph aureus _x000D_
3rd gen: G rods, pseudomonas, Staph aureus, PCN resistant S. pneumo, Legoinella,
Chlamydia, Mycoplasma_x000D_
4th gen: everything above plus anaerobes
G+ (incl. beta lactam resistant and vanco resistant)
Dalfopristin, Quinupristin_x000D_
_x000D_
G+ (except enterococcus and those resistant to beta lactams and vancomycin)
skin infections due to strep spp. MRSA and E. Faecalis
effective against respiratory pathogens
G+/G aerobes/anaerobes_x000D_
_x000D_
Adult soft tissue and intraabdominal infections
carbamazepine_x000D_
oxcarbazepine_x000D_
felbamate_x000D_
gabapentin
6 months 6 years
33%
CP
AEDs_x000D_
Ketogenic Diet_x000D_
Surgery_x000D_
Vagus nerve stimulator
Mild Intermittent: Sx<1x per week, brief flares, nighttime sx<2x per month_x000D_
_x000D_
Mild persistant: Sx>2x per week but not daily. night sx 2 times per month_x000D_
_x000D_
Moderate persistant: daily sx, flares limit activity. night sx>1x per week_x000D_
_x000D_
Severe persistent: continual sx, limit activity, frequent night sx.
slit lamp
NSAID
1)T_x000D_
2)T_x000D_
3)F_x000D_
4)T
612 wks
Fever for 5 days plus 4 of the following:_x000D_
1)Rash_x000D_
2)Bilateral Conjunctivitis_x000D_
3)1.5 cm node_x000D_
4)changes of lips/oral cavity_x000D_
5)edema/erythema of extremities