Turner syndrome

• related: Pediatric

After initial diagnosis, management:

• echo for cardiac defects: coarctation of the aorta, bicuspid aortic valve, mitral valve prolapse, and hypoplastic heart
• visual/hearing test
• renal US: horseshoe kidney
• TSH: hypothyroidism
• If Y chromosome mosaicism: increased association of malignancy. Streak gonads need to be removed
• increased diabetes when older
• estrog

cryptorchidism

• related: Pediatric

• pt: premature, SGA
• cause: undescended testes
• sx: hypoplastic, hypopigmented, poorly rugated, and empty scrotum
• dx: PE. No imaging needed
• orchioplexy:
  • surgical fixation of testis to scrotal wall
  • referral by age 6 month, surgery before 1 year
• prognosis:
  • increases fertility potential
  • decreases testicular torsion
  • cancer risk decreased but not e

Erb palsy

• related: Pediatric

• sx

  • arm weakness
  • asymmetric Moro reflex

foreign body aspiration

• Keywords: Pediatric

• Obtain 2-view (posteroanterior [PA] and lateral) neck and chest x-ray top confirm the location of the foreign body
  • an esophageal coin appears linear on lateral x-ray; a tracheal coin appears linear (project on end) in the PA view.
• Xray also distinguishes between a coin and battery (the latter can cause perforation in just a few hours).

Medicine

• Keywords:: 000 Index
• Related: Step 3, Step 1, mksap, notes

Todos

• tolearn
• MKSAP todos
  • heart murmurs

Organ Systems

• Allergy and Immunology
• Rheumatology
• Cardiology
• Dermatology
• Endocrine
• ENT
• GI
• Hemeonc
• ID
• MSK
• Nephrology
• Urology
• Neurology
• Pulmonology
• Podiatry

Subject Areas

• General
• Biostats
• Psychiatry
• [[Geriatric

acute mastoiditis

• related: Pediatric

This febrile child with a bulging tympanic membrane who has mastoid tenderness and displacement of the external ear likely has acute mastoiditis, the most common suppurative complication of acute otitis media (AOM). The mastoid air cells are in continuity with the middle ear, allowing spread of the infection. In addition to the symptoms of fever and ear pain seen in AOM, infection of the mastoid causes erythema and tender

avoid antibiotic in bacterial enteritis

• related: Pediatric

Management of gastroenteritis focuses on supportive care, such as maintaining adequate hydration with an oral rehydration solution. Antimicrobials should be avoided as they can increase the likelihood of developing hemolytic uremic syndrome (HUS) in patients infected with EHEC. Beta-lactam antibiotics such as ceftriaxone (Choice A) are among the medications most commonly associated wit

cranial hematomas

• related: Pediatric

Caput succedaneum

Caput:

• path: subcutaneous, above periosteum, between skin and galea
• pt: pressure against dilating cervix in head first delivery (vertex), after prolonged labor or vacuum assisted delivery
• symptoms
  • extend across midline/sutures
  • poorly defined margins
  • discoloration

croup

• related: Pediatric

Croup (laryngotracheitis) is a viral infection that most frequently affects children age <3. It typically begins with a brief prodrome of rhinorrhea and fever, followed by the abrupt onset of a harsh, "barking" cough; hoarseness; and stridor. Symptoms develop due to narrowing of the subglottic space from viral inflammation, which is classically seen on neck radiograp

delayed growth

• Keywords: Step 3, Medicine, Pediatric

Delayed Growth

Puberty is considered delayed if no secondary sexual characteristics (typically testicular enlargement [>4 mL] or breast development) are present by age 14 in boys or age 12 in girls. This patient with short stature but normal growth velocity (4-6 cm/yr) most

delayed puberty

• Keywords: Step 3, Medicine, Pediatric

Delayed puberty in boys

Causes

• Primary hypogonadism
  • Klinefelter syndrome
• Secondary hypogonadism
  • Constitutional, chronic illness, malnutrition
  • Hypothyroidism, hyperprolactinemia
  • Kallmann syndrome
  • Craniopharyngioma
• Clinical features
  • Absent testicular enlargement by age 14
  • Delayed growth spurt
• **Initial w

developmental dysplasia of hip

• related: Pediatric

DDH:

• pt: female, breech position, family hx
• cause: abnormal dev, femoral head displaced, excessively tight swaddling
• sx:
  • asymmetrical inguinal folds. Fold extend beyond anal aperture
  • leg length discrepancy on Galeazzi test
• dx:
  • barlow, ortolani maneuvers
  • US < 4 months
  • Xray > 4 months
• rx:
  • when diagnosed within first 6 months of life, treat with Pavlik harness for 3 months, but needs mo

juvenile rheumatoid arthritis

• related: Pediatric

may be the same thing as idiopathic arthritis?

• Symptoms: asymmetrically involves swelling in large joints, especially the knee, and often has no other symptoms.
• Association: A major morbidity is chronic uveitis, resulting in blindness. About 20% of girls who have the monoarthritis or pauciarticular form of juvenile rheumatoid arthritis have iridocyclitis (anterior uveitis) as their only significant s

legg calve perthes

• related: Pediatric

• pt:

  • 4-8 years, male predominant
  • higher risk with FHx, low birth weight, 2nd hand smoking

• cause: idiopathic avascular necrosis of the femoral head. Interruption of the blood supply by a currently unknown cause.

• symptoms:

  • slow onset
  • gradual painless limp
  • intermittent knee, hip, groin, thigh pain

• dx

  • Hip stiffness with loss of internal rotation and abduction
  • Gait disturbance
  • **Limb length

neonatal lupus

• related: Pediatric

• path: transferred maternal IgG autoantibodies

• symptoms: Infants can have thrombocytopenia, neutropenia, rash, liver dysfunction (petechiae), and a congenital heart block.

• Most manifestations are self resolved; however, the congenital heart block is permanent and frequently requires pacing.,

Neonatal lupus can develop from transplacental passage of maternal anti-SSA (Ro) and anti-SSB (La) antibodies. The presence o

oppositional defiant disorder and conduct disorder

• related: Pediatric

Oppositional Defiant

• features
  • negative, hostile, and defiant behavior
  • disobedient with authority figures, and are argumentative and angry.
  • angry/irritable mood
  • behavior does not include cruelty towards people/animal, stealing, destruction
  • more reactionary than deliberate

Treatment of oppositional defiant disorder centers on psychotherapy.

Conduct

• features:

parvo b19

• related: Pediatric

Erythema infectiosum, or fifth disease, is a common, benign childhood illness caused by parvovirus B19. Presentation begins with a nonspecific prodrome (eg, malaise, congestion, cough, fever), followed by an erythematous rash on the cheeks after initial symptoms have resolved. This "slapped-cheek" rash can be described as facial flushing, as in this patient, and usually spares the nasolabial folds. A lacy, reticular r

pediatric bone cancer

• related: Pediatric

Ewing

• path: translocation 11.22, mid shaft
• symptoms: focal atraumatic bone pain
• diagnosis: onion skin X-ray, MRI, biopsy
• treatment: resection

Osteosarcoma

• path: rb gene, distal femur
• symptoms: focal atraumatic bone pain
• diagnosis: sunburst on xray, MRI, biopsy
• treatment: resection

pediatric bone disorders

• related: Pediatric

This patient has physiologic genu valgum, a condition in which the knees angulate toward midline, giving the appearance of "knock-knees." Genu valgum, part of the normal progression of lower extremity alignment, occurs in children age 2-5. Patients with physiologic genu valgum do no

slipped capital femoral epiphysis

• related: Pediatric

SCFE

• pt: overweight adolescents, AA, hypothyroidism, down syndrome, or thin pt with rapid growth spurt
• cause:
  • slippage of epiphysis relative to metaphysis at growth plate
  • Cartilage in the hypertrophic zone acts as the weak point where the slippage occurs.
• symptoms:
  • presents with a limp. Pain when moving hips
  • thigh and groin pain, knee pain
  • Trendelenburg gait
  • external rotation

transient synovitis

• related: Pediatric

• pt: 3-8 years, boys, following viral illness
• cause: unknown
• sx:
  • limp, well appearing, afebrile or low grade fever
  • The affected hip may be flexed, slightly abducted, and externally rotated. This position maximizes the joint space, thereby providing pain relief.
  • able to bear weight
• dx:
  • nl WBC, CRP, ESR
  • X-rays reveal normal hip joints
  • ultrasound (>95% sensitivity) may show small

acute viral myositis

• related: Pediatric

This patient's presentation (calf pain, abnormal gait, and elevated creatine kinase) is consistent with viral myositis. Viral myositis, also known as benign acute childhood myositis, is most common in young children who are recovering from viral infections. Influenza is the most commonly implicated virus. Viral myositis presents with the acut

juvenile idiopathic arthritis

• related: pediatric

This patient with midline spinal point tenderness most likely has a vertebral compression fracture due to poorly controlled juvenile idiopathic arthritis (JIA)-associated osteoporosis. JIA is a chronic (>6 weeks), relapsing-remitting inflammatory condition that causes pain, swelling, and stiffness of multiple joints. The disease varies in severity and may be difficult to control. Treatment includes a combi

pediatric septic arthritis

• related: Pediatric

Septic arthritis is a joint infection that frequently involves the hip or knee in young children. Most cases occur in healthy children, but patients with immunodeficiencies, prior joint surgery, hemoglobinopathies, juvenile idiopathic arthritis, and diabetes mellitus are at inc

Medicine

• Related: Step 1, mksap, notes

Todos

• tolearn

Organ Systems

• Allergy and Immunology
• Rheumatology
• Cardiology
• Dermatology
• Endocrine
• ENT
• GI
• Hemeonc
• ID
• MSK
• Nephrology
• Urology
• Neurology
• Pulmonology
• Podiatry

Subject Areas

• General
• Biostats
• Psychiatry
• Geriatrics
• OBGYN
• Pediatric
• [