Tuesday 3

llbgurl's version from 2015-10-04 19:21

Section 1

Question Answer
testes develop emryologicall in abdomen12-14 weeks
testes descend into scrotum under hormnal mediation; why premies increased28-36 weeks
contraction of the ipsilateral cremaster muscle, drawing the testis upward, when the upper inner aspect of the thigh is stroked longitudinallycremesteric reflex
block external ring of canal and warm hands to preventcremesteric reflex
no testes and should be keratoype for chromosomal abnormalitiesanchoria
dx cryptorchidismultrasound
testes not descended by this age will need orchiopexy1 year
infertility is increased withbilateral cryptochordism
when gonads are in abdomen for 3-5 yearsincreases testicular maglignancy after age 20
epi think underdorsal
hypo think upperventral
surgery must be done in 6 hours to restore fertility and avoid testicle losstesticular torsion
+ physical exertion, trauma, awaken child from sleep, ages 7-12 yearstesticular torsion
phren sign does NOT relieve paintesticular torsion
prhen sign does relieve painepididymitis and is a good friend
r/o testicular torosionultrasound
tissue irritation and inflammation; 2-6 years highest; from hypoestrogen, trauma, infection, poor hygiene, sex abuselabial adhesions
Diurinal (day) eneuresis femalepools urine behind lesion resulting in dribbling or feeling need to void all the time
high resolution with cream 90% in 2 weekspremarin
premarin prescribedBID until resolution, then HS x2 weeks
prolonged use causesprecocious puberty of premerin
leukemia, subacute endocarditis, rubeola, mumps, varicella, EXERCISE, lead and sulfa drugsmiroscopic causes
alports syndromeherediatry nephritis with deafness macroscopic
smoke and tea colored urine, HTN with oliguriapost strep glomerularnephritis macroscopic causes
IGA nephropathybergers disease and macroscopic
hx sore throat, impentigo (skin infection) bloody diarrhea or familial hematuriahistory for hematuria
periorbital edema, ear malformations, check throathematuria exam
+ castskidney disease
urinalysis with microscopic exam3-6 RBCs HPF and normal
+ distorted RBCs with varying sizesglomerular disease
3 urine samples over 7-14 days with microsopic exam, check again in 1 month and again in 6 monthsmicroscopic hematuria
0.18 and aboveelevated Ca+/Creat ratio
macrscopic hematuriaconsult with physician, ESR, ANA, IgA, ASO, ECHO, BC, US
TREATment of macroscopic urineconsult and treat underlying cause
90% of childhood bacteria pneumoniaStrep Pneumonia
bacterial school aged pneumoniamycoplasma pneumonia
lobar consolidationCXR results with pneumonia
hyperinflation on CXRasthma d/t air trapping
bacterial pneumonia infantGroup B streptococci, Chlamydial Pneumonia
CBC with extreme leukocytosispertussis in adolescent d/t weaning immunity to vaccine
watery greasy foul stoolsgiardia lamblia
most common parasitic infection in US, COMMON in daycaresgiardia lamblia
treat gardiafurazolidone or flagyl 7-10 days
Enteropathypost infectious diarrhea
lactose intoleranceintestional mucosal injury after acute/chronic diarrhea, over 1 yr: lactose free =if dont respond need to refer
Triad for Leukemia (traid of leukocytosis)neutropenia, anemia, thrombocytopenia NAT
ALL+ hepatomegaly and misdxed as mono - atypical lymphocytes NO BLASTS on smear
traid for ITPcolicky abdominal pain, non-palpable purpura, arthritis
sore throat, erythematous palate/uvula, palatial petchieascarlet fever
fine papular exanthema starts at axilla, groin and neck and spreads in 24 hours DO blanch with pressure scarlet fever
starts on face and extends to chest and exremitiesSLE rash
petchial looking does NOT include fever ITP

Section 2

Question Answer
1-5 mm papules with purpuric centers on lower extremities, numerous and symmetricHSP
can start urticarial wheals and then progress to palpable purpuraHSP
purpura, arthritis, abdominal painHSP
follows a URI 1-3 weeksITP
decreased platlet countITP
can follow a GI illness, with normal platlet count - abdominal pain, vomiting, blood emesis and stoolHSP
systemic steriods if internal organs are involvedHSP

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