NSG 6435 PEDS FINAL Exam with complete solutions

atopic dermatitis - ANSWER scaly erythematous plaque, symmetric lichenified scaly red plaques seborrheic dermatitis description - ANSWER symmetric red scaly confluent plaques, thick tenacious scale with crust and underlying erythema seborrheic dermatitis- other names and management - ANSWER cradle cap (infants) dandruff (adolescents) overproduction of serum infants- spontaneous resolution, emollients or shampoo to remove thick scale, no FDA approved tx under 2 yo adolescents: antifungals, antiinflammatory, keratolitic, tar based prep candidal diaper rash - ANSWER confluent, bright red papules and plaques with scattered pustules, overlying scale, and satellite lesions at the periphery Molluscum contagiosum - ANSWER viral skin infection benign disappears in weeks to months itching at site not easily treated firm, small, pink flesh color papules, cheesy core warts - ANSWER proliferation of epidermis large percentage resolve in 2 years, high recurrence rates verruca vulgaris (common warts) risk factors for DDH - ANSWER gender- 5-8 girls for every boy 1st born breech multiple gestations family hx (1st degree) positional LGA ortolani sign - ANSWER hip click- DDH Galeazzi sign - ANSWER uneven knees- DDH Alli's sign - ANSWER Uneven knees- DDH Barlow's sign - ANSWER hip clunk- DDH DDH diagnosis - ANSWER B/L hip ultrasound NBs (2 weeks- 3months) X-rays (3 months of age), landmarks become more visible DDH treatment - ANSWER pavlik harness genu varum - ANSWER bowed legs common in NB-2 years in utero positioning steadily improves, maximally seen at 19 months When is genu varum abnormal? - ANSWER 3 years of age -rickett's disease (Vitamin D def) -blount's dx genu valgum - ANSWER knock-knees common at 2 years, max at 3-5 years tx: observation if severe in adolescence may require surgery febrile seizures - ANSWER caused by rapid rise in temp occurs in 2-5% of all children peak incidence- 1-3 years majority tonic-clonic most last less than 5 minutes R/O MENINGITIS LP indications: signs of meningitis, 6-12 months febrile seizure treatment - ANSWER manage airway lorazepam iv if indicated control fever look for source of fever Partial-focal origin, one hemisphere - ANSWER simple partial complex partial generalized bilateral- involves both hemispheres - ANSWER absence grand mal (clonic-tonic) myoclonic clonic tonic atonic epilepsy triggers - ANSWER chemicals, foods, sleep deprivation, stress, flashing lights, menses, meds (BCPs) Headahces - ANSWER common, school aged/adolescent more in girls tension (most common in adolescents) sinus migraines (fam hx) Headache triggers - ANSWER fatigue, bright lights, changes in weather, stress, anxiety, depression, food, noise, beverages HA management - ANSWER headache log, neuro exam, tylenol/motrin NO ASA 15 YO CT or MRI referral abdominal headache - ANSWER 2% of children have them pain is near navel or midline vomiting, paleness, can't eat TX: tricyclics, sz meds, manage stress Most common hematologic disorder of childhood - ANSWER anemia when are maternal iron stores depleted - ANSWER by 4-6 months Other at risk group for IDA - ANSWER adolescents IDA risk factors - ANSWER AA children, obesity, prematurity/low birth weight, maternal anemia, cephalo-hematoma, birth trauma Iron requirements - ANSWER 0.5-0.8mg/day full term needs 1mg/kg with max of 15mg per day for breast fed infants begin at 4 months, continue until infant taking iron fortified cereals 1-3 years 7mg/day 4-8 years 10mg/day 9-13 years: 8mg/day Iron replacement - ANSWER elemental iron 3-6mg/kg per day for 4 months recheck hgb at one month, if not responding further testing (consider GI source and if concerned hem-onc referral) definitive SSD test - ANSWER hgb electrophoresis most common form of childhood cancer - ANSWER leukemias 3-4 cases per 100,000 caucasian children 15 more frequent in males 1 peak between 2-6 years Most severely affected organs in leukemia - ANSWER liver and spleen cause of epiglottitis - ANSWER HIB