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Pediatrics

front 1

Bronchiolitis pathopysiology

back 1

viral induced inflammation of small, distal airways; bronchiolar obstruction from sloughed epithelial cells, leukocytes and mucus; RSV most common cause

front 2

Bronchiolitis clinica presentation

back 2

Age <2; antecedent nasal congestion, rhinorrhea, cough, wheezing and crackles, tachypnea, retractions (peak severity days 3-5)

front 3

Bronchiolitis radiographic findings

back 3

bilateral hyperinflation, increased interstitial markings and peribronchial cuffing

front 4

Bronchiolitis treatment

back 4

supportive

front 5

Bronchiolitis complications

back 5

apnea (<2 months old), resp failure

front 6

Bronchiolitis prevention

back 6

nirsevimab for all children under 8 months old

front 7

Transposition of great vessels is

back 7

a congenital defect that typically presents within the first 24 hrs of life w/ cyanosis and a single loud S2

front 8

Hypertrophic cardiomyopathy in infants of diabetic mothers pathogenesis

back 8

maternal hyperglycemia leading to fetal hyperglycemia and hyperinsulinemia; increased glycogen and fat deposition in interventricular septum leading to LVOT obstruction

front 9

Hypertrophic cardiomyopathy in infants of diabetic mothers clinical findings

back 9

often asymptomatic but may have resp distress and/or hypotension; systolic ejection murmur

front 10

Hypertrophic cardiomyopathy in infants of diabetic mothers imaging

back 10

CXR: cardiomegaly

ECHO: increased thickness of interventricular septum and decreased LV chamber size

front 11

Hypertrophic cardiomyopathy in infants of diabetic mothers treatment

back 11

IV fluids and beta blockers to increase LV blood volume

front 12

Hypertrophic cardiomyopathy in infants of diabetic mothers prognosis

back 12

spontaneous regression age 1

front 13

Psychogenic pseudosyncope

back 13

a type of conversion disorder characterized by an apparent loss of consciousness w/o impaired cerebral perfusion. Prolonged duration of unconsciousness, absence of objective physical findings, and high frequency of episodes are common.

They'll say stuff like "I felt my head throbbing after I hit the floor." or "I felt weak before I passed out"

front 14

Cataplexy

back 14

an emotionally triggered, sudden loss of muscle control, can mimic syncope; however, it typically occurs in pts w/ narcolepsy, who usually have other symptoms such as excessive daytime sleepiness. The episodes are brief.

front 15

Causes of acquired QT prolongation

back 15

macrolides and fluoroquinolones, odansetron and them, azoles (fluconazole), antipsychotics, TCAs, SSRIs, some opioids (methadone, oxycodone), quinidine (class Ia antiarrythmics), dofetilide, sotalol (class III antiarrythmics), electrolytes abnormalities (decreased Mg, K, and Ca)

front 16

Congenital causes of QT prolongation

back 16

Romano-Ward syndrome, Jervell and Lang-Nielsen syndrome

front 17

Tof can present with

back 17

hypercyanotic tet spells due to RVOT obstruction and right to left shunting in the setting of exertion of agitation. Squatting increases afterload, which increases blood flow across the RVOT, which in turn improves cyanosis

front 18

Isolated ASD

back 18

an acyanotic lesion that causes a wide and fixed splitting of S2 and a systolic ejection murmur due to increased blood flow across the pulmonic valve

front 19

Partial anomalous pulmonary venous return

back 19

drainage of some but not all pulmonary veins into the right sided circulation typically demonstrating a step-up in oxygen saturation from the inferior vena cava to the right atrium. Other clinical findings include right-sided cardiac enlargement and signs of pulmonary HTN (exertional dyspnea)

front 20

Trisomy 18 (Edwards syndrome)

back 20

characterized by micrognathia, microcephaly, rocker bottom feet, overlapping fingers, and absent palmar creases. Ventricular septal defect in common in these pts w/ a holosystolic murmur

front 21

Peripheral cyanosis in children mechanism

back 21

increased tissue oxygen extraction

front 22

Peripheral cyanosis in children typical causes

back 22

vasomotor instability, cold exposure, low cardiac output, venous obstruction

front 23

Peripheral cyanosis in children features

back 23

finger, toe, perioral cyanosis, cool extremities, does not improve with oxygen

front 24

Central cyanosis in children mechanism

back 24

decreased systemic O2 sat

front 25

Central cyanosis in children typical causes

back 25

pulm disease, cyanotic heart disease

front 26

Central cyanosis in children features

back 26

diffuse and/or mucosal cyanosis, warm extremities, may improve w/ O2

front 27

Pathologic murmurs history

back 27

infants: poor weight gain, resp distress, difficult feeding

older children: exertional fatigue, chest pain, syncope

fam Hx of SCD of CHD

front 28

Pathologic murmurs characteristics

back 28

holosystolic or diastolic, harsh, grade at least 3 intensity, intensity persists w/ standing and valsalva maneuver

front 29

Pathologic murmurs other findings

back 29

central cyanosis, loud fixed, or single S2, weak femoral pulses, hepatomegaly

front 30

Pathologic murmurs management

back 30

EKG and ECHO

front 31

Benign murmurs history

back 31

asymptomatic, normal growth, no significant family history

front 32

Pathologic murmurs characteristics

back 32

early or midsystolic, musical or vibratory, grade 1-2 intensity, decreases or disappears w/ standing and valsalva maneuver

front 33

Pathologic murmurs other findings

back 33

normal vitals, normal S1 and S2, symmetric pulses

front 34

Pathologic murmurs management

back 34

reassurance

front 35

Persistent pulm HTN of the newborn pathogenesis

back 35

abnormal persistent of increased fetal pulm vascular resistance, right to left shunting across ductus arteriosus

front 36

Persistent pulm HTN of the newborn risk factors

back 36

lung hypoplasia (congenital diaphragmatic hernia), meconium aspiration syndrome, infection (neonatal pneumonia)

front 37

Persistent pulm HTN of the newborn examination

back 37

decreased postductal relative to preductal O2 sat, resp distress and cyanosis, prominent S2

front 38

Persistent pulm HTN of the newborn treatment

back 38

O2 and ventilation, inhaled nitric oxide (pulm dilator)

front 39

Infection control isolation precautions airborne

back 39

tuberculosis, varicella, SARS, measles

front 40

Infection control isolation precautions contact

back 40

VRE, MRSA, E coli O157:H7, scabies, RSV, C. diff

front 41

Infection control isolation precautions droplets

back 41

mycoplasma pneumonia, influenza, Hib, neisseria meningitidis, adenovirus

front 42

Krabbe disease

back 42

galatocerebridase deficiency, AR, presents early in infancy w/ developmental regression, hypotonia, and areflexia

front 43

Hurler syndrome

back 43

lysosomal hydrolase deficiency, presents at age 6 months to 2 yrs w/ coarse facial features, inguinal or umbilical hernias, corneal clouding, and hepatospenomegaly

front 44

Once Guillian Barre syndrome is suspected in a hemodynamically stable patient...

back 44

assess pulm function w/ spirometry. FVC and negative inspiratory force monitor resp muscle strength and serial pulm function testing should be performed given the potential for rapid progression of disease

front 45

Guillian Barre syndrome CSF

back 45

WBC: 0-5

Glucose: 40-70

Protein: 45- 1,000

front 46

Viral Meningitis CSF

back 46

WBC: 10-500

Glucose: 40-70

Protein: <150

front 47

Tuberculous Meningitis CSF

back 47

WBC: 100-500

Glucose: <45

Protein: 100-500

front 48

Bacterial Meningitis CSF

back 48

WBC: >1000

Glucose: <40

Protein: >250

front 49

Congenital Toxoplasmosis

back 49

chorioretinitis, obstructive hydrocephalus, parenchymal calcifications

front 50

Congenital Syphilis

back 50

osteoarticular destruction (Hutchinson teeth, saddle nose), hepatosplenomegaly, jaundice, rhinitis, and rash

front 51

Congenital Rubella

back 51

cataracts, sensorineural hearing loss, PDA

front 52

Congential CMV

back 52

sensorineural hearing loss, hydrocephalus ex vacuo, and periventricular calcifications

front 53

Retinal detachment typically presents with

back 53

acute vision loss, floaters, and flashes of light. Funduscopic exam shows a retinal tear and/or elevation

front 54

Open-angle glaucoma causes

back 54

painless loss of peripheral vision and presents in late adulthood. Funduscopic exam shows optic nerve cupping

front 55

Vitamin A deficiency causes

back 55

xerophthalmia, characterized by excessive dryness of the cornea and conjunctivae, and night blindness

front 56

Retinitis Pigmentosa etiology

back 56

genetic mutation causing loss of photoreceptors, progressive retinal degeneration, symptom onset from age 10 through adulthood

front 57

Retinitis Pigmentosa clinical features

back 57

night blindness, progressive visual field loss (midperiphery), decreased visual acuity (late finding)

front 58

Retinitis Pigmentosa Funduscopic findings

back 58

retinal vessel attenuation, optic disc pallor, abnormal retinal pigmentation

front 59

Retinitis Pigmentosa prognosis

back 59

most are legally blind by age 40

front 60

Most infants with congenital syphilis

back 60

asymptomatic at birth; those with symptoms typically have rhintis (snuffles), hepatomegaly, and a maculopapular rash

front 61

Use of lisinopril during pregnancy can cause

back 61

fetal renal failure and associated oligohydramnios that results in pulm hypoplasia, growth restriction, and limb defects (Potter sequence)

front 62

To minimize risk of congenital malformation, pts who require antiepileptics during pregnancy should be

back 62

titrated to the lowest dose for seizure control prior to conception and started on high dose (4mg) folic acid supplementation

front 63

Fetal hydantoin syndrome

back 63

microcephaly, cleft lip and palate, cardiac defects, hypoplasia of nails and phalanges, wide anterior fontanelle, due to in utero exposure to an antiepileptic (phenytoin, carbamazepine, valproate)

front 64

Erb-Duchenne palsy

back 64

involves the 5th, 6th, and sometimes 7th cranial nerves

front 65

Erb-Duchenne palsy management

back 65

observation and physical therapy b/c up to 80% of pts have spontaneous recovery within 3 months

front 66

Neonatal HSV infection skin, eye, and mouth clinical findings

back 66

mucocutaneous vesicles, keratoconjunctivitis

front 67

Neonatal HSV infection CNS clinical findings

back 67

seizures, fever, lethargy, temporal lobe hemorrhage/edema

front 68

Neonatal HSV infection disseminated clinical findings

back 68

sepsis, hepatitis, pneumonia

front 69

Neonatal HSV infection Dx

back 69

viral surface cultures: HSV PCR (blood, CSF)

front 70

Neonatal HSV infection treatment

back 70

acyclovir

front 71

Newborns thermoregulatory center

back 71

underdeveloped and are at risk for hypothermia. Skin to skin contact prevents heat loss. You could also swaddle w/ warm blankets and place under a radiant warmer.

front 72

Newborns underdeveloped thermoregulatory center vitamin K injection and ophthalmic erythromycin ointment

back 72

postpone for an hour

front 73

Asymmetric fetal growth restriction onset

back 73

2nd/3rd trimester

front 74

Asymmetric fetal growth restriction etiology

back 74

uteroplacental insufficiency, maternal malnutrition

front 75

Asymmetric fetal growth restriction clinical features

back 75

head-sparing growth lag

front 76

Asymmetric fetal growth restriction management

back 76

monitor/treat complications (hypoglycemia, hypothermia, polycythemia and hypocalcemia)

front 77

Symmetric fetal growth restriction onset

back 77

1st trimester

front 78

Symmetric fetal growth restriction etiology

back 78

chromosomal abnormalities, congenital infection

front 79

Symmetric fetal growth restriction clinical features

back 79

global growth lag

front 80

Symmetric fetal growth restriction management

back 80

monitor or treat complications (hypoglycemia, hypothermia, polycythemia and hypocalcemia)

front 81

Neonatal complications of diabetes during pregnancy

back 81

hypoglycemia, polycythemia (low iron), hypocalcemia and hypomagnesemia, hyperbilirubinemia, congenital anomalies, macrosomia (w/ brachial plexus injury or clavicle fracture), resp distress syndrome, hypertrophic cardiomyopathy

front 82

Pts w/ cryptorchid testes are at risk of

back 82

testicular cancer (dysgerminoma, gonadoblastoma), due in part to an increase in intraabdominal temperature that causes abnormal spermatogenesis and aberrant germ cell differentiation

front 83

Androgen insensitivity syndrome pathophysiology

back 83

x-linked mutation in androgen receptor

front 84

Androgen insensitivity syndrome management

back 84

gender identity/assignment counseling: gonadectomy (malignancy prevention)

front 85

Fibrocystic change in breast and juvenile fibroadenoma both typically present in the

back 85

upper outer quadrant of the breast after menarche

front 86

Primary amenorrhea

back 86

absence of menarche in a girl at least 13 years old w/ no secondary sexual characteristics, or a girl at least 15 years old w/ secondary sexual characteristics. If pelvic US shows uterus, test FSH levels and that'll give you your answer

front 87

First line treatment for symptomatic fused labia due to labial adhesions

back 87

topical estrogen

front 88

Balantis

back 88

inflammation of the glans penis

front 89

Balanoposthitis

back 89

inflammation of the glans penis and foreskin

front 90

Balantis and Balanoposthitis causes

back 90

irritation, infection, trauma

front 91

Balantis and Balanoposthitis evaluation

back 91

KOH microscopy for suspected candida infection

STI screen if urethral discharge present

front 92

Balantis and Balanoposthitis management

back 92

foreskin hygiene, sitz baths, topical treatment, diabetes 2 screening for candida infection w/o risk factors

front 93

Hydrocele

back 93

fluid collection within the tunica vaginalis, which surrounds the testis. Should spontaneously resolve by 1 y/o and can safely be monitored during that period

front 94

Cryptorchidism risk factors

back 94

prematurity, small for gestational age

front 95

Cryptorchidism clinical features

back 95

empty, poorly rugated scrotum on affected side(s) +/- inguinal fullness/mass

front 96

Cryptorchidism management

back 96

orchiopexy and 6-12 months

front 97

Cryptorchidism complications

back 97

inguinal hernia, testicular torsion, infertility, testicular cancer

front 98

If neither testicle is palpated in the groin area a difference of sex development is of primary concern;

back 98

evaluate 17-hydroxyprogesterone level and electrolytes. Perform karyotype and pelvic US

front 99

First step in management of hypospadias

back 99

urologic evaluation b/c most cases require surgical correction. Circumcision is deferred until after evaluation b/c the foreskin may be required for hypospadias repair

front 100

Hypospadias pathogenesis

back 100

failure of urethral folds to fuse

front 101

Hypospadias clinical features

back 101

ventrally displaced urethral meatus, dorsal hooded foreskin, +/- underdeveloped penis and glans, +/- penile curvature (chordee)

front 102

Other Hypospadias management

back 102

+/- karyotype, pelvic US if severe

front 103

Mastoiditis is a complication of

back 103

acute otitis media most commonly due to strep pneumo

front 104

Mastoiditis treatment

back 104

IV antibiotics, drain via tympanostomy or mastoidectomy

front 105

Young children w/ stroke symptoms

back 105

headache, seizure, in addition to focal neurological deficits

front 106

Young children w/ stroke management

back 106

urgent MRI/MR angio to confirm Dx and determine eligibility for potenital reperfusion therapies

front 107

Sydenham Chorea etiology

back 107

autoimmune complication that can occur months after GAS infection

front 108

Sydenham Chorea pathogenesis

back 108

molecular mimicry btw anti-GAS antibodies and neuronal antigens in basal ganglia

front 109

Sydenham Chorea clinical features

back 109

involuntary jerky movements, hypotonia, emotional lability, obsessive complusive behaviors, +/- sx of acute rheumatic fever

front 110

Sydenham Chorea Dx

back 110

GAS test w/ throat culture, ASO and Anti-DNAse B titers, ECHO and EKG

front 111

Sydenham Chorea treatment

back 111

abx and antidopaminergics (haloperidol)

front 112

Chiari I malformation etiology

back 112

displacement of the cerebellar tonsils through the foramen magnum

front 113

Condition commonly associated w/ Chiari I malformation

back 113

syringomyelia

front 114

Chiari I malformation presentation

back 114

although frequently asymptomatic, presentation may occur in adolescence/adulthood w/ occipital headache exacerbated by activity and valsalva maneuvers

front 115

Chiari II malformation etiology

back 115

herniation of cerebellum through foramen magnum

front 116

Chiari II malformation clinical findings

back 116

obstruction of cerebrospinal fluid flow through 4th ventricle, lateral ventricular dilation, myelomeningocele

front 117

3 year milestone gross motor

back 117

walks up stairs w/ alternating feet, rides tricycle

front 118

3 year milestone fine motor

back 118

dresses w/ help, uses fork, copies circle

front 119

3 year milestone language

back 119

says at least 3-word sentences, speech 75% intelligible

front 120

3 year milestone social/cognitive

back 120

knows age/sex, plays w/ other children

front 121

30 months milestone gross motor

back 121

jumps

front 122

30 months milestone fine motor

back 122

removes clothes, turns pages

front 123

30 months milestone language

back 123

says at least 50 words

front 124

30 months milestone social/cognitive

back 124

follows 2-step command, knows 1 color

front 125

2 year milestone gross motor

back 125

runs, kicks ball, walks up stairs

front 126

2 year milestone fine motor

back 126

uses spoon

front 127

2 year milestone language

back 127

says 2-word phrases

front 128

2 year milestone social/cognitive

back 128

knows 2 body parts, parallel play

front 129

18 month milestone gross motor

back 129

walks easily, climbs on/off chair

front 130

18 month milestone fine motor

back 130

scribbles, feeds w/ fingers

front 131

18 month milestone language

back 131

says at least words in addition to mama and dada

front 132

18 month milestone social/cognitive

back 132

follows 1-step command w/o gesture, imitates

front 133

15 month milestone gross motor

back 133

takes a few steps

front 134

15 month milestone fine motor

back 134

stacks 2 blocks

front 135

15 month milestone language

back 135

says 1 or 2 words plus mama and dada

front 136

15 month milestone social/cognitive

back 136

follows 1-step command w/ gesture, points to get something, shows affection

front 137

1 year milestone gross motor

back 137

pulls to stand, cruises

front 138

1 year milestone fine motor

back 138

pincer grasp

front 139

1 year milestone language

back 139

says mama and dada, understands no

front 140

1 year milestone social/cognitive

back 140

plays pat-a-cake, looks for hidden object

front 141

Glaucoma in children pathophysiology

back 141

optic neuropathy +/- increased IOP

front 142

Causes on increased IOP in glaucoma in children

back 142

impaired drainage of intraocular fluid, primary anatomic abnormaility (angle dysgenesis), Sturge-Weber syndrome, tumor, trauma, infection involving the angle, corticosteroid induced

front 143

Glaucoma in children key features

back 143

tearing, photophobia, blepharospasm, enlarged cornea or globe, optic nerve cupping, increased IOP on tonometry

front 144

Glaucoma in children management

back 144

surgery +/- pressure-reducing eye-drops

front 145

Fragile X syndrome inheritance

back 145

X-linked dominant, remember they exhibit self-injurious behavior like hand-biting

front 146

Signs concerning for pathologic microcephaly

back 146

neuro abnormalities like hypotonia and developmental delay, dysmorphic features, rapidly decreasing head circumference percentiles (ie curve crossing multiple major percentiles)

front 147

Maternal Risk factors for SIDS

back 147

substance use (cigs, alc, drugs)

front 148

Infant Risk factors for SIDS

back 148

prematurity or low birth weight, sleep environment (prone/side-sleep position, soft sleep surface, loose bedding, bed-sharing), smoke exposure

front 149

Dilated cardiomyopathy is a features of

back 149

Duchenne muscular dystrophy

front 150

Rett disorder epidemiology

back 150

greater incidence in girls, onset age 6-18 months

front 151

Rett disorder pathophysiology

back 151

initially normal development followed by loss of speech, loss of purposeful hand use, and gait abnormalities

front 152

Rett disorder additional findings

back 152

microcephaly, seizures, breathing abnormalities, sleep disturbance, autistic features

front 153

Rett disorder etiology

back 153

MECP2 gene mutations

front 154

Rett disorder neuropathology

back 154

deceleration of brain growth

front 155

Rett disorder prognosis

back 155

middle aged life expectancy, decreased mobility, seizures, resp difficulties

front 156

Tay-Sachs pathology

back 156

B- hexosaminidase A deficiency

front 157

Tay-Sachs epidemiology

back 157

AR, Ashkenazi Jews, onset 2-6 months old

front 158

Tay-Sachs clinial features

back 158

loss of motor milestones: hypotonia, feeding difficulties, cherry-red macula, hyperreflexia

front 159

Niemann-Pick Disease pathology

back 159

sphingomyelinase deficiency

front 160

Niemann-Pick Disease epidemiology

back 160

AR, Ashekensazi Jews, onset 2-6 months

front 161

Niemann-Pick Disease clinical features

back 161

loss of motor milestones, hypotonia, feeding difficulties, cheery-red macula, hepatospenomegaly, areflexia, fatal by age 3

front 162

Subgaleal hemorrhage location

back 162

btw periosteum and gala aponeurotica

front 163

Subgaleal hemorrhage clinical features

back 163

can expand over days, soft, fluctuant, diffuse, crosses sutures, +/- overlying bruising

front 164

Subgaleal hemorrhage prognosis

back 164

can cause life-threatening blood loss

front 165

Cephalohematoma location

back 165

subperiosteal (btw skull and periosteum)

front 166

Cephalohematoma clinical features

back 166

present hours after birth, firm, nonfluctuant, does not cross sutures, overlying skin is normal, forceps or vacuum assisted delivery increases risk

front 167

Cephalohematoma prognosis

back 167

increased hyperbilirubinemia risk, resorbs within a month

front 168

Caput succedaneum location

back 168

subcutaneous

front 169

Caput succedaneum clinical features

back 169

present at birth, soft and boggy, crosses sutures, overlying skin is normal

front 170

Caput succedaneum prognosis

back 170

self-resolves in days

front 171

You can also see periungal fibromas in a pt w/

back 171

tuberous sclerosus complex

front 172

Wilson disease pathogenesis

back 172

AR mutation of ATP7B --> hepatic copper accumulation --> leak rom damaged hepatocytes --> deposits in tissues (basal ganglia, cornea)

front 173

Wilson disease clinical findings

back 173

Hepatic: acute liver failure, chronic hepatitis, cirrhosis

Neuro: parkinsonism, gait disturbance, dysarthria

Psych: depression, personality changes, psychosis

front 174

Wilson disease Dx

back 174

decreased ceruloplasmin and increased urinary copper excretion, kayser-fleischer rings on slit lamp exam, increased copper on liver biopsy

front 175

Wilson disease treatment

back 175

chelators (D-penicillamine, trientine), zinc (interferes w/ copper absorption)

front 176

Ataxia-telangiectasia

back 176

AR disorder where defective DNA repair results in cerebellar ataxia, oculocutaneous telangiectasias, and recurrent sinopuml infection. Lymphoid tissue is often small/nonpalpable due to lymphopenia

front 177

Gastroesophageal reflux pathogenesis

back 177

immature lower esophageal sphincter

front 178

Gastroesophageal reflux clinical findings

back 178

spit up, normal weight gain, no pain/back-arching

front 179

Gastroesophageal reflux management

back 179

upright positioning after feeds, burping during feeds, frequent, small volume feeds, vitamin D, supplements

front 180

Beckwith-Wiedemann syndrome is associated with

back 180

omphalocele

front 181

Mild dehydration

back 181

presents w/ history of decreased intake or increased fluid loss w/ minimal or no clinical symptoms

front 182

Moderate dehydration

back 182

presents w/ decreased skin turgor, dry mucous membranes, tachycardia, irritability, a delayed capillary refill (2-3 seconds) and decreased urine output

front 183

Severe dehydration

back 183

presents w/ cool, clammy skin, delayed capillary refill, (>3 seconds), cracked lips, dry mucous membranes, sunken eyes, sunken fontanelle (if still present), tachycardia, lethargy, and minimal or no urine output. Pts can present w/ hypotension and signs of shock

front 184

Eosinophilic esophagitis pathogenesis and epidemiology

back 184

Th2-mediated inflammatory response triggered by food antigen exposure, comorbid atopy (asthma, eczema, food allergy, allergic rhinitis) common

front 185

Eosinophilic esophagitis presentation in toddler

back 185

feeding difficulties (solid food refusal), weight loss

front 186

Eosinophilic esophagitis presentation in school-aged children

back 186

abdominal pain, vomiting

front 187

Eosinophilic esophagitis presentation in adolescents

back 187

dysphagia, heartburn, food impaction

front 188

Eosinophilic esophagitis Dx

back 188

endoscopy and esophageal biopsy (eosinophils: at least 15/hpf), exclusion of alternate Dx (achalasia, infection)

front 189

Eosinophilic esophagitis treatment

back 189

elimination from diet, PPIs, topical glucocorticoids, feeding therapy

front 190

Hirschsprung disease

back 190

typically presents in neonates w/ decreased stooling, increased rectal tone, and signs of intestinal obstruction (bilious emesis, abdominal distention, dilated bowel loops). Contrast enema is performed to identify the level of obstruction

front 191

Shiga toxin-producing E. coli pathogenesis

back 191

ingestion of contaminated/undercooked beef or contact w/ farm animals, invasion of intestinal epithelial cells, production of toxin

front 192

Shiga toxin-producing E. coli clinical features

back 192

watery to bloody diarrhea within 3 days, NO high fever

front 193

Shiga toxin-producing E. coli Dx

back 193

multiplex stool PCR testing, stool toxin assay, stool culture

front 194

Shiga toxin-producing E. coli management

back 194

supportive care (aggressive fluids), avoidance of antibiotics and antidiarrheals

front 195

Shiga toxin-producing E. coli complications

back 195

HUS (may develop 1-2 weeks after diarrhea onset)

front 196

Campylobacter gastroenteritis epidemiology

back 196

most commonly transmitted via undercooked poultry

front 197

Campylobacter gastroenteritis clinical features

back 197

fever, abdominal pain, diarrhea (mucoid +/- blood), pseudoappendicitis (RLQ pain due to acute ileocecitis)

front 198

Campylobacter gastroenteritis treatment

back 198

supportive care (sx usually self-limited <7 days)

front 199

Campylobacter gastroenteritis treatment

back 199

abx only in severe of high-risk cases

front 200

Campylobacter gastroenteritis complications

back 200

Guillan Barre syndrome, reactive arthritis

front 201

Meconium Ileus pathophysiology

back 201

inspissated stool causes obstruction at terminal ileum, strong association w/ CF

front 202

Meconium Ileus clinical features

back 202

failure to pass meconium within 24hrs of birth, abdominal distention, no stool in rectal vault, +/- bilious emesis

front 203

Meconium Ileus work-up

back 203

X-ray: dilated loops of small bowel

Contrast enema: microcolon

dx eval for CF via sweat test

front 204

Meconium Ileus treatment

back 204

hyperosmolar enema, +/- surgical management

front 205

Infant dyschezia resolves spontaneously by age

back 205

9 months

front 206

Management of necrotizing enterocolitis immediate interventions

back 206

discontinuation of enteral feeds, nasogastric decompression, blood cultures, and empiric abx, IV fluid repletion

front 207

Management of necrotizing enterocolitis monitoring

back 207

serial CBC and electrolytes, serial abdominal exams and imaging

front 208

Management of necrotizing enterocolitis indications for surgery

back 208

bowel perf, clinical deterioration, despite medical management (suggestive of bowel necrosis)

front 209

Management of duodenal atresia

back 209

discontinue enteral feeds, NG tube decompression, and surgical repair

front 210

Cyclic vomiting syndrome history

back 210

personal or family hx of migraines, episodes often have identifiable trigger (infection, stress)

front 211

Cyclic vomiting syndrome symptoms

back 211

stereotypical vomiting episodes: acute onset of nausea, abdominal pain/headache, vomiting, self-limited, lasting 1-2 days

btw episodes: usually asymptomatic, often regular intervals (2-4 weeks)

front 212

Neonatal sepsis etiology

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group B strep, E. coli, listeria (age <7 days)

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Neonatal sepsis clinical features

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temp instability (fever, hypothermia), CNS signs (lethargy, irritability, apnea), poor feeding, resp distress (tachypnea, grunting), jaundice

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Neonatal sepsis evaulation

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inflammatory markers (CRP, ANC, procalcitonin), blood, urine, and CSF cultures

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Neonatal sepsis treatment

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parenteral abx (ampicillin and gentamicin)