Tuesday 2

llbgurl's version from 2015-10-04 18:34


Question Answer
liver failure and death under 2 years of agebiliary atrasia
jaundice goes beyond 2 weeksbiliary atrasia
+ pruitis, xanthomas from retained bile salts and cholesterolbiliary atrasia
bile stained urine, alcoholic stoolbiliary atrasia
#1 sign of viral hepatitisfever
newborn vomiting most common causeinproper formula prep
vomit bileobstruction below ampulla of vater
does not cause nutritional deficencies, all family members need tx at same time, x1 dose now and again in 2 weekspinworms
celiac disease, cystic fibrosis, giardia NOT c-diffstatorrhea
ear anomolieskidney urinary problems
extreme tenderness of prepuse and glans, possible yellow dischargebalanoposthitis
foreskinprepuce = posthitis
tip of penisglans = balanitis
inflammation from infection or traumaepididymitis
pain with relief with elevation of scrotumPhrehn sign (good friend) epididymitis
unilateral testicle painepdidiymitis
seen following circumcisionsmeatal stenosis
can't reduce foreskinparaphimosis
medical emergency, restricted BF and swellingparaphimosis
foreksin can't be retractedphimosis
urthrethritissweling of urethra, possible yellow discharge
soft mass on spermatic cord with associated pain, common on left sidevariocele
accumulation of fluid in the sac, # 1 cause of painless scrotal swelling, incomplete closure of processus vaginalishydrocele
vuvlar irritation rare scratching think of pin worms
vulvovaginitisvaginal discharge
never had a period of dryness, delayed maturation of voiding and usually inheritedprimary eneuresis
6-12 months of dryness, now wetting againsecondary eneuresis
no single causeenuresis
DDAVPcan have lethal side effects
above 50,000 organisms in bladder, urethra, kidneyUTI
5x more likely to get UTI in newborn periosmales
uncircumcised x10 more likelymale newborns
highest risk of renal damage2 months to 2 years
after newborn period 10x more likely to get UTIgirls
70% of UTIsEcoli, followed by enterobactor, proteus, enterococcus, kelbsiella
#1 cause of UTI in newbornGroup B streptococcus
#1 cause of UTI after surgerystaph aeureus, pseudomonas
uti risk factorspin worms, prenatal dx renal problem
most at risk2-24 months FUO, below 12 months, fever above 39c, and fever for 2 days
diarrhea thinkpylenophritis
infant with pylenophritisfever
abdominal or flank pain with fevertoddler/preschool pylenophritis
abdominal pain/flank pain, +CVA tenderness, fever and chillsschool-aged and adolescent pylonephritis
above 5 bacteria and above 10 WBCs + nitratesurinalysis UTI
granular castspylenophreitis
urine culture 100,00 colony with one organsimclean catch + UTI
urine cath cx 10,000 - 100,000 with one organism+ UTI
above 10,000 - 100,000 of mixed or single clean catchquestionable uti
under 8 weeks of age, unable to keep oral fluids down, children with pylenophritismust be hospitalized
TMP-SMX first choice for UTi
augmentin#2 for UTI
Cephalexin or Keflex#3
cross sensitivty to PCN in 1% patientscephalosporins
UTI treatment for 2 months to 2 years7-14 days
kills gram negative, each generation has signifcantly greater gram negative antimicrobial sensitivty than the one above itcephlosporins
true broad spectrum activity, longer 1/2 life and decrease dose and frequency4th generation cephalosporins
1st generation: cedroxil, cefzolin, kelfexnarrow gram + cocci, not for OM
2nd generation: cefmetzole,cefoletan, cefoxitincan use for OM but NOT MRSA
3rd generation: omnicef, suprax, rocephinkills gram negative the best
20 month old with suspected UTIget suprapubic aspiration cath
urine should be sterile in 48 hours of abx rx
no improvement in 2 days on abx with UTIrepeat urine cx and assume abx is resistant
follow up urinalysis in 1-2 weeks s/p rx treatment for UTIyes must be done
under 2yo first UTI1/2 will have scarring of renal
under 2 yo, MALES, girls with pylenephritis, recurrent UTIs, family hx of structured renal diseaseall require further testing
children under 2 yo and improving on abxMUST get imaging
VCUGonly means of identifying reflux
significant leukocytosis with delyaed empyting from renal pelvis on IVPhydronephrosis
abnormal DMSA scan, recurrent infections, above one febrile UTI, FMH of reflux or MALESall warrant a VCUG
ages 2-13 with UTIRBUS and DMSA
direct herniaabove 3 years of age and acquired from weakened inguinal canal
indirect herniacongenital and below 3 years of age
non-communicating herniatunica vaginalis closed
communicating herniatunica vaginalis open, more likely to need surgery if goes beyond 1 year of age
bulge in ingunial canal worse with: crying, straining, coughinghernia
irritabile, anorexia, area red/swollen with abdominal distentionincarcerated hernia
examine in sitting and squattingfemales labia MAJora
sensation of 2 surfaces rubbing together as inguinal canal is palpated+ silk glove sign, + hernia
painless buldge, worse with bearing down, worsen through day and get better when laying/sleepinghernia
unilateral swelling, with bluish appearance, increase or decrease flutuance, + transilluminationhernia
can mean testicular tumorhydrocele

Recent badges