October 19th

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10/19/2016

Adolescent: HEADSS acronym for admission note

H = Home environment
E = Education/Employment/Eating/Exercise
A = Activities
D = Drug/alcohol/cigarette
S = Sexuality
S = Suicide/depression
Phimosis = a congenital narrowing of the penile foreskin so it cannot be
retracted.
Respiratory distress is the most common chief complaints for pediatric visits.
Scoliosis affects 2-3% of population. 8 times more common in female.
Scoliosis is more common on left side.
Bronchiolitis is the most common cause of wheezing in infant and reason to
hospitalize infants younger than 2 years old. Baby first had upper respiratory
symptoms like rhinorrhea then lower respiratory findings like wheezing and
crackles. Cause is RSV.
The long-term concern for congenital CMV is sensorineural hearing loss.
Bacteria concerned in any animal bites, especially cats and dogs?
Pasteurella.
Bacteria concerned in human bites? Anaerobic bacteria like E. corrodens.
Cat scratch disease? Bartonella
Signs of Downs syndrome? Speech delayed, short stature, lazy eyes,
congenital heart disease, flat philtrum, single palmar crease, upslanting
palpebral fissure.
Penicillin resistant bacteria? Not amoxicillin, but amoxicillin plus clavulanic
acid (augmentin) Clavulanic acid inhibits b-lactamase.
Most common cause of upper respiratory infections aka colds is adenovirus
and rhinovirus.
Which UTI medication can have side-effect of pancytopenia? TrimethoprimSulfamethoxazole.
Iron deficiency vs lead poisoning presentation? ID is anemia with sx of skin
pallor, fatigue, pica, not in lead poisoning with anorexia, irritability,
poor coordination and sporadic vomiting.
A newborn girl who makes a clunk sound when hip is abducted, flexed?
Shallow, poorly developed acetabulum, not displacement of capital femoral
epiphysis.
Head of the femur = capital. Slipped capital femoral epiphysis is the most
common hip disorder in adolescent.
Dysthymia or dysthymic disorder same as depression but less severe and
longer-lasting symptoms.
Apgar score is ranked 0 to 2 and 10 is perfect score. 4-6 is fairly low.
Recent travel few weeks ago, now child has fever, chills, pallor(always a
club for anemia), splenomegaly, low hematocrit, high leukocyte count, and
low platelet? Malaria by Plasmodium. Dx is thick and thin blood smear.

20. Normal platelet count is 150k to 400k.

21. Difficulty releasing grip = myotonic dystrophy.
22. Diabetic ketoacidosis has 3 major symptoms: metabolic acidosis (acetone
build-up), osmotic diuresis (glucose attracts water leading polyuria), and
electrolyte disturbance (further causing dehydration, which can present
with altered mental state from cerebral edema)
23. BMI of 35 and cholesterol of 214.BMI is more of a concern so management
is reduced calorie diet , not weight training exercise.
24. Trichophyton is a fungi that causes athletes foot and jock itch.
25. Imperforate hymen will lead to menorrhea building up and present with
suprapubic tenderness, and blushish red bulge between labia coming
out from vagina.
26. Down syndrome with pulmonary artery hypertension can result in
polycythemia.
27. A kid has chronic upper respiratory tract infection now has snoring, due to
nasal polyps, not tonsillar hypertrophy.
28. HIV positive mother didnt do any prenatal care and just gave birth?
Management of newborn is 6 weeks of oral AZT within 12 hours of
delivery, not 6 weeks of triple antiretroviral therapy.
29. Adams-Stokes attack? Periodic syncope due to cardiac dysrhythmia like no
QRS complexes.
30. Baby of 2 month has been on a formula but now has 3 days of vomiting after
feeding? Pyloric stenosis, doesnt usually present at birth. Key word
projectile vomiting
31. Recurrent candida infection, probably deficiency in what? T cells
32. How to prevent rotavirus in daycare? Not water filtration but strict hand
washing.
33. 4 days old baby with jaundice, management is phototherapy, not stop
breastfeeding or breastfeeding with formula.
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