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2.

4 yr old
.

4 yr old , Tanner 1,
.

, .

, .

.
:

Willebrand


'

,
, .

, , ,
.

- .
.

, (.., ) ,
(.. ).

( 37, 146.)

3. Munchausen '
:

(..,
)

. ,
. ( 37,

146.)

4. ;


HIV

Kwashiorkor


<5 .

,
,

?
.

,
.

, ,

. ( e41-1.)

, biogenerated de
novo .

-A. ,

55% 30%
.

,
.


. ,

. ( 45, 188.)

7. ;

, ,

? (carotenemia)
,
,
. ( 45,

191.)

8. ;

, ,

,

. , ,

, .


(PUFA).

PUFAs ,
,


, ,

( e49-1.

9. :


QRS

.
(),

. , ,
ST, PR,

P , QRS.
.

. , ,
, ,

. ( 52, 221.)

10. :

Digitalis

. ( 52, 221.)

11.
, , :

Albuterol

Kayexalate

2 : (1)

(2) .

( ), .

, .
, .

, ,
. ,

. , 3 .
,

.
.

(Kayexalate)
.

,
.

. ( 52, 222.)

12.
:

, ST, U ,
( )

P . torsades de pointes ,

.
.

, <2,5 mEq / L.

. .
?

. .
? <2.5

mEq / L, . ,
. (

52, 224)

13. , (s)
:

1. ,

2. , 3. , 4.
, 5.

1 3

1, 2, 3

3 4

2 5

,
.
(, ) (
).

, , , ,
. ( 53,

14. ;

20%
,

,
,

. osmoles,

. , , ,
.

0,5-1% .
53-1

. ( 53, 242.)

15.

(D5 NS, > 10 kg, D5 NS <10 kg);

6 mo NPO

13 ,

, C, D
(ADH)
,

. ADH

( , , , , )

, ,
.

ADH (
ADH [SIADH],

, , )
. ,

. ( 52, 243.)

16 . ;

2 hypernatremic
6 mo
4 mo
3
C
, ,
.
.
hypernatremic
. .

.
. ,
. (
54, 245

17. ;

Poison
6

, 24-7,

<6 yr, 2%

. ingestions ,
,

, ,

( ) , ,
. ( 13-19 )

74 108
2008 Poison .

. ( 58, 250.)

18.
.

, ;

(, ,
, , , , ,

, , ),

. ,

. ( 58, 253.)

19. 4 ;

, , ,

, , ,

Ipecac, , ,

, , ,

4 ,
, ,

.
,

.
,

20. 15 2 g
.
.
. 0,45% .

QRS 0,12 beats.
:

IV
7,4

TCA

QRS > 100 msec, ,


.
1-2 mEq / kg
.

QRS ,
7,45-7,55,

, QRS. ( 58,
264.) . ( 58, 254

21. 2 .
: 40,2 C,
200 / min, 52 / .
: pH 7,2, 6 mmol / L,
PCO2 18 Hg, 148 mmol / L, 3,1 mmol / L, WBC
10.200 / mm3. ,
.

ingestions ,

. salicylism , , ,
.

, ,
.

, , ,
. ,

, , .
salicylism ,

,
.

,
, .
() () . ,

, , . ( 58, 260.)

22. 2 .

, tachypneic, .

Instill

.
, ,

, , , ,

. (<1 ml)
.


(ARDS)

. .

.
,

.
. (

58, 267.)

23. 2
. .
, .
:

.
, , .


. , , ,

, .

, . ,

viscus.

. .

.
12-24

. ( 58, 266.)

24. 16 , 165 20-40 325-mg

1 . :

- 140 mg / kg

ABCs

1-2 .
NAC,

. NAC
8 . ,

NAC postingestion 4 .
,

4- NAC
. ( 58,

25. 2
.
. 160 / ,
48 / , 37,2 C.
. :

.
, ,

, , , ,

. (<1 ml)
.

,
6

.
(ARDS)

.
.

, . ( 58,
267.)

26.
"
4 . , ,
.
.
,
. :

Acetaminophen
-ingestant

.
-ingestant,


. (

58, 253.)

27. :

( [CPP)]

( []) ICP,
. ( 63, 296.)

28. (GCS)
:

1-3

3-8

9-12

TBI (GCS 3-8). ,


. , ,
,

.
, --

. , ,
underappreciating

(GCS 9-12) ,

. ,

. ICP
ICP

. .
ICP (> 20 mm Hg)

, ICP 48-72 . ICP-



. ICP,
. ( 63,

29.

.
:

ICP> 20 mm Hg

First-tier ,
,

, (, ).

, EEG
?

ICP
.

ICP,
CSF .

-
ICP . ICP ,


, , , ,

, , .
.

ICP ,
.

, .
. (32-34 C)

ICP
. ICP

(PaCO2 = 25-30 mm Hg).


,
. ( 63-12? 63, 300.)

30.
, ;

, Apgar 0-3,
,

32-34 C .

72 , 36 C

, , , Apgar 0-3
5 , ,

/
.

, , .
American Heart Association ()

( ,
),

(4-6 )?
? ,

, ? ? . 20 ml /
kg IV 30

2 C.
,

32-34 C.
1 C 4-6 . ,

72 .
.

. ( 63, 302.)

31
, :

( , IV ), (
),

(). EEG
. PICU, ,

/ .

,
/ .

,
.

,
, IV ,

. ( 63, 303.)

32.
:


, ,


(
), 50%
.

,
. ',

nidus.
,

. ,
,

.
(

)
. ( 63, 303.)

33. (VAP)
;

VAP
, ,

VAP unpreventable

, ,
VAP

VAP

30


VAP.

. ( 65, 328.)

34. :

. ( 65, 327.)

35. (.., ),

;

, , <6 ml /
kg

, / ,
(<6 ml / kg)

, / ,
(10-12 ml / kg)

, / ,
(> 15 ml / kg)

,
7-10 mL / kg

.
( , ..,

ARDS, , ) (6 mL / kg)
(25-40

/ ). (
, .. , )

(10-12 ml / kg)
. ( 65, 327.)

36. , :

,
,

. , ,
, , ,

.
(, ) .

, .

- , . ( 2-1).

37. (PDSA);

Plan-Do--Act (PDSA) (. 2-1). PDSA


, ,
(, PDSA

PDSAs). PDSA
,

PDSA.
PDSA .


,
. ( 2-3).

39. 4 yr old 40% 2nd- 3


(BSA) . ,
:

2 > 10% BSA


. ,

3
.

. ( 68, 353.)

40. 10 yr old 30% BSA

.
;

IV

lorazepam

,
.

,
, .


. ( 68

41.

> 10-15% BSA,


, hightension

()

, . 1st- 2
, , , ,


24

()
.

( 68-2, 68, 349.)

42. ,
,

midlevel

, 3 ,
,

. epithelialize
.

43.
;

, /

(), ,
.

. ,
2008

, , .
( 72, 377.) ( 68-5, 68, 351.)

44.
;

quad

72-2, . (

45. ;
,
,

Gaucher Pompe

.
.

.
,

?
?

1-.
,

, .

. ( 72, 379.)

46. ;

,
.


, ,

, .

.
.

.
,

. Tandem (MS /
MS)

. ( 78, 416).

47.
:

(1)

(2) , ,

. ,
.

,

.
, ,

, . (
78, 416 . 78-1.)

48.
:

, ,

, ,

, ,

, ,

, ,

, ,

(. 78-1).

pH ?

acidemias.
.

, ,
aminoacidopathies (.., )

?
, , .

( 78, 417).

49. 2 , ,
.

. :

(OTC)

Reye


. ,

,
. ,

. , ,
,

. . 79-13
.

OTC, .

OTC . ( 79 - 13 79,
449.)

50. ,
;
.
;

Niemann-Pick

Fabry

Tay-Sachs

Krabbe

Gaucher

,
, X- Fabry

. ( 80, 483.)

51. GM1 :

Angiokeratomas

GM1

, , (angiokeratomas).
6 mo

-set , ,
, philtrum.

50% - .

, ,
,

, . ( 80, 483.

52. 4 mo old ,
, . ,
-
. :

GM2

Gaucher

Fabry

GM2 Tay-Sachs
Sandhoff?

- GM2 ,
.

Sandhoff Tay-
Sachs. Tay-
Sachs Sandhoff
- .

4 5 mo

() . ,
, . 2

,
. ,

4 5 yr. ( 80, 482.)

53. 15 1 .
.
.
Erlenmeyer .
:

Gaucher

Sandhoff

GM3

Gaucher lipidosis
, ,

,
. 1

Gaucher ,
,

. ,
,

,
, , .

,
Erlenmeyer . (

80, 487.)

54. Fabry :

Acroparesthesias

Angiokeratomas

Fabry
angiokeratomas

( ), ,
, acroparesthesias,

, , / . ( 80, 489.)

55. 14 mo old , , Genu recurvatum


.

GM3

Fabry

Gaucher Neuromyopathic


, ,

12 18 mo , ,
, , Genu

recurvatum.

,
.

. ,

. , , ,
, ,
1 . ,
, ,

. ( 80, 490.)

56. 15 , .
, .
.
.
, 9,0 g / dL 3.000 / mm3 ,
.
60.000 / L. :

Tay-Sachs

Niemann-Pick

Gaucher

Mucolipidosis IV

Canavan

Gaucher
,

,
. , 99% ,

. Gaucher

, , ,
.

,
,

, , . (

57. 7 mo .

, .
.
,
:

mucopolysaccharides

GM2

, ,
- .

4 5 mo
()

. , , .

- .
GM2

, Tay-Sachs -
, Sandhoff

- . ( 80,
485.)0, 487.)

58. 3 ,
.
,
regurgitant , , , .
.
. .
:

Hunter

Sanfilippo

Hunter (MPS II)


.


.
MPS II Hurler

.
, ,

dysostosis multiplex, , 2
4 . ( 82,

511.)

59. Hurler :

multiplex Dysostosis

Hurler 6 24 mo

, , ,
, , , ,

dysostosis multiplex.
1

. . (
82, 511.)

61. :

> 40

Long interpregnancy

89-1
.

20-
30 .

40 yr, ,
,
, . interpregnancy
. ( e89-1.)

62.

(
, )

, , ,
, ,

?
,

, . ( e89-1.)

63. :

Potter

?
? , ,

? .
20

, .

. ,
, , spadelike
, .
.

, ,
,

. ( 89-4 e89-2.)

64. :

Candida

, ,

.
( )

. ( 90, 552)

65. ;

Monovular

monovular


Born

monovular
. Polyovular

2 , ,
polyovular . (
91, 553.)

66. ;

. ,
. ,

, 5 g / dL 20%
. ( 91-2,

91, 554.)

67. (VLBW)
:

VLBW <1500 g . ,
2008, VLBW

1,46% , 3,01% , 1,18% .


VLBW

. VLBW 50%
50% ?

, 20% 500
600 g > 90%

1250 1500 g . VLBW


,
, .

VLBW . , VLBW

1 , , ,
. ( 91,

68.

Ballard 2


, ,
lanugo

( ), ,

.
. , Ballard

2 .

, . ( 91-6,
91, 557.) 556.)

69.
2 30 2
. .

, :

pH

, , ,

2
.

. ,
.

, ,
(Narcan), 0,1 mg / kg,

.
,

. ( 94,
575.)

70. :

Zero CO2

,
, ,

> 100 / , ,
CO2 . ( 94,

74. 2 - 24
.

x-ray follow-through

Head

-
, .

(-- [KUB] cross- )


- -
, ,

( : ),
( ).

follow-through
. ( 96,

75. Meconium :

Hypermagnesemia

Hirschsprung

Meconium

, aganglionosis, ,
. ( 96,

76. ;

Rhogam 72
Rh- ?

ABO

Rh 95%

ABO ,
.
? ,
.

, . 1
24 . , ,

kernicterus . ABO

. , IVIG
.

O Rh

. ( 97,
619.)]\

77.
:

36

Periconception
,


. 1,

( <95 mg / dL)
birthweights

. (
101, 629.)

78. ;

, , ,
, ,
50% Tanner 2-3

-
.

,
.

,
,

. ( 104, 651.)

79. :

16

21

3
21 ,

3
21 yr, ? HPV DNA

29 yr
. (

106, 667.)

80. :

Klinefelter

Albuterol


, 60%
,

.
10 13

yr, Nonpubertal
Klinefelter

.
nonpubertal

, , , ,
.

109-1, . ( e109-1.)

. 81.
:

:
(, ,

), ,
. ,

. , , , ,
.

( 112, 700.)

. 82. :

()

,
( )
.
.

. , 20-39
,

, , ,

, 1 .

. , ,

, . Teen
,

,
40% ,

'20 '30 .
(<16 lb)

. birthweights
83. (XLP)

Epstein-Barr

meningitidis Neisseria

Pneumocystis jiroveci

(XLP)
-

Epstein-Barr (EBV).
EBV

. <5 yr. 3
: (1) , ,

(50% )? (2) , -
(25%)? (3)

(25%).

(), (VCA)
.

XLP ? 70%
10 yr. ( 118, 727.) . ( 112,
701.)

84. 1 yr old
WBC ,

, , .
IgG,

IgA, IgM, IgE 95% .


:

DiGeorge

(XLA)

XLA
1 6-9 mo IgG

. , ,
Streptococcus pneumoniae

Haemophilus influenzae,
.

, , , , , .
, ,

. XLA
(

),
IgG, IgA, IgM, IgE

95% -,
<100 mg / dL.

( 118, 124.)

85. Wiskott-Aldrich
:

Wiskott-Aldrich, -,
,

,
,

.
.

1 . Streptococcus pneumoniae
,

, , . , , jiroveci

. ? , ,
EBV

. ( 120, 734.)

86.

(Trichinella spiralis)

Pinworms (Enterobius vermicularis)

Wiskott-Aldrich

(1,500-5,000 / L)
(> 5000 / L)

( 123-1).
.
,
.

migrans .

, .


, Giardia lamblia

Enterobius vermicularis .
,

-, Wiskott-Aldrich, Omenn.
( 123, 740.)

2 5 , ? ,
:

2 5
. 50-100

2.000.
( )

. , 2 5 yr,

(2 2 yr, 3
3 , ). 21 mo 2 ,

(" "), ( "" , "I "), ,


. ( 10,

93.
;

-
- -

,
.


( , , )


CH50 AP50. ( 128,

753.) 35.)

94. ;

, , - (HUS),
,

, ,
.


( , , )


CH50 AP50. (

128, 753.)

95. :

Dennie (Dennie-Morgan )

Purple

Xerosis

, .
60%

40% .
Dennie (Dennie-Morgan ),

.
.

. ,
,

. (
135, 765.)

96. 7

,
.

pilaris

Fibroepitheliosis

Hidradenitis

Xerosis

Acrochordon

pilaris,
,


.

. ( 135, 765.)

97. (RAST) -IgE :

IgE -

,
IgE,

IgE
in vivo in vitro

IgE (-IgE) .
-IgE

(RAST),
-IgE. RAST

-IgE -
-IgE.

,
as-IgE

. ,
-IgE

-IgE as-IgE .


as-IgE

. ( 135, 766.)

98.
:

20 20-30


/ . ,

.
/

,
.

26-gauge 0.01-0.02 mL
.

/ ,
1,000- 100

/ .

.
,

, 1: 100 : ,
. /

, /

. ( 135, 767.)

98.
:


,

20 20-30


/ . ,

.
/

,
.

26-gauge 0.01-0.02 mL
.

/ ,
1,000- 100

/ .

.
,

, 1: 100 : ,
. /

, /

99.
, RAST

IgE;

, RAST


(as-IgE RAST)


. ,

.
-IgE .

,
, , ,

, -IgE
. ( 135, 767.)

100.

IgE

(AD)
/

, " ."
.

IgE (
) 70-80%

. - IgE
20-30% AD.

. ( 139,
801-802.)

101.
:

(AD) 3 :
, eczematous

.
,

, , IgE, ,
. ..

. ,
excoriated, . ,

AD ,
,

( ). ..,
. AD

,
, .

. ..

. .. ,

. (
139, 802-803

102. 5

dermatomes. .
:

Coxsackie

.. .
Kaposi
, , HSV
. 5-12

, , vesiculopustular
. umbilicated,

, Crusted. ( 139,
806.)

103. ;

Staphylococcus aureus

ringworm

AD ,
. Antistaphylococcal


Staphylococcus aureus. S. aureus

> 90% AD . ,
- , , ,

. AD .
Kaposi

, , HSV
.

.
, , ,

, , ,
(..,

S. aureus HSV) . ,

.. erythroderma.
AD

, . (
139, 806.)

104. 2 .

(AD) ,

, ,
, , ,

. 15-20

. AD
- .

, , , ,

. AD
pH.

-?
2

. ,
, .

-
. ( 139, 804

105. :

, ,
. ( 143,

106. 12

, 1 2 , ,
, -

, .
, ,

. ,
.

, (0,01 mg
/ kg? max 0.3-0.5 mg).

12 yr, 0,5 mg.


2 3

5 15 ,
.
(, )
. (

143, 817.)

107. 8-yr-old
, 15
V , .
; `

Benadryl,
30

,
,

,
.

(, ) ( 2
)

( , )
.


: ?

, ( )? , ,
,

, , ,
, , ,

? , , , ?

( ? )?
.

.

20% ,

. ( 143, 816.)

108. .

;

, , , . (
143, 816.)

109.
;

(1: 1000)

(1: 1000)

(1: 1000)

.
,

. ,

(0,01 mg / kg? Max 0.3-0.5 mg). 12 yr,


0,5 mg.

2 3 5 15 ,

. (,
)

. ( 143, 817.)

110.
:

,
, ,

, .
. (

111. ;

Kawasaki

-19

- 2

: , , , .

, SLE, , , Behcet,
, Kawasaki,

Henoch-Schnlein . Nonrheumatic ,
, Lyme

, , (.., , , 19),
Epstein-

Barr, , . ( e147-2.)
112. ;

-malar

Kawasaki

() -Gottron

Henoch-Schnlein -

malar nasiolabial
,

. .

Henoch-Schnlein .

. Nonblanching

. Gottron

.
(periungual telangectasias) ,

, Raynaud.

. Sun
,

. Kawasaki
,

113. :

Shigella

Chlamydia trachomatis

Yersinia enterocolitica
Campylobacter jejuni

Salmonella,
Shigella, Yersinia enterocolitica,

Campylobacter jejuni, Cryptosporidium parvum, intestinalis Giardia


trachomatis Ureaplasma. ( 151, 839.). ( e147-1


147-2).

114. 18 yr old
. 2
? , ,
.
, (
), .
:

,
. ( 151, 84

115. :

. ,

, . -

, , . ,

, .

7 10-28 .
19,

( ), ,
, ,

Epstein-Barr.
,

. HIV

(). 151-1,
. (

116. , 14 yr old
, , ,
. :

Raynaud (RP)
, 70%
.
Raynaud,

, ,
/ . Raynaud

(
Raynaud),

( 154-2). ( 154, 852.)

117.
( )

Henoch-Schnlein

.
(

[FMF],
[], CAPS,

D [HIDS]), ,

). FMF
.

( Alzheimer),

(TTR)
TTR .
,

, (.., ,
,

), (.., ), ,
, ,

. ( e158-1.)

118. (PAN);

PAN ,

PAN

(PAN)
.

'
. PAN .

. ,
9 yr. ,

PAN ,
,

PAN .
, Epstein-Barr,

Mycobacterium tuberculosis, , 19,


C, PAN.



. .

, . (
161, 872.)

119. 3 yr old .
.

1 / mL

10 / mL

103 / mL

105 / mL

, .

,
.

, Gram
20-30

.
.

,
?

,
.

.
103

/ mL. Clean- 105 / mL


, , ,

104-105 / mL . ,

, ,
. Gram

1
105 / mL. (

e164-2.)

120. ;

MIC in vivo> 4 MIC in vitro

MBC in vivo> MIC in vivo

MIC in vivo> 2 MIC in vitro

MIC> 4 MBC

MBC> 4 MIC

(MIC) g / mL,
, .


(MBC),

. MBC

(MBC> 4 MIC). ( e164-3.)

121. 14
.

Borrelia burgdorferi IgG 1:32.


5 ,

1:64. :

Lyme

Lyme


, IgG,
IgG

. 4 2-3

. Lyme ,

. (Western blot)

Lyme. Lyme, IgG IgM


( ) ,

, IgG,
IgM

.
,

122. 4 4 yr
old .
126 / mm3.
:

Gram

Kinyoun

, Gram
,

(). Gram ,
104-105

(gram-
),


. ( ..
125.
:

ADH


5-2

,
sites,

.
,

(.., ), ,
, , ,

(.., ), , ,
,

. , , ,
, ,

.
,

, Tourette, .
, ,

, (, , , .)

. ( 19, pa

126.
;

MRSA

Wolff-Parkinson-White


19,
64-65. : (1)

-
( )

SSRI,
SSRI, , , . (2)

Wolff-Parkinson-White PR
(<0.12 sec) QRS

TCA. Trazodone
. SSRIs

.
(3)

- ,
. (4)

?
. (

19, 64-65).

127. 3
.
, , .
,
. :

(SAD)
,

03.05 05.04%. ,
7,5 yr.

, .

.
,

,
,

, ,
. 1

3 4 ,
,

,
, .

( 23, 78.)

138.
:

395-1, . (
395, 1482.)

139. 7 3-yr ,
2 36 41 mEq / L.

:
CT

(72-hr )

DNA F508


( 60 mEq / L),

1 :
,

, .
,

, ( 395-3).
,

( 395 - 4).
60 mEq / L
CF 1

. 30-40
mEq / L . Borderline (

) 40 60 mEq / L
CF

,
.

, ,
-

. DNA?
( 1500

CF, F508 ). (
395, 1488.)
140. 12
8 .
.
. :

()

( [])
,

. ( 395,
1486.)

141. 48 .
.
:

(CF)

Manometry

,
.

, diatrizoate (Gastrografin)
,


.
.

CF . CF

. ( 395, 1495.)

142. 9 Broviac
8 mo .
, .
.


(Hickman, Broviac,

),
.


7-14 ,

. CRBSI Staphylococcus aureus


.

, ,

3 4 . (
e172-2.)

143. 18 mo ,
.
4 mo .
.
38,7 C. .
:
WBC ,
4

1-20%,
10%.

.
,

. S. aureus
20% gram- 15%

. ,
shunt

.
VP , , ,

fontanel. .
.

,
. ( e172-2.)

144. ()

( );

mirabilis

Staphylococcus epidermidis

influenzae Haemophilus

catarrhalis Moraxella
Coagulase staphlococci
,

,
,

. ( 174, 909.)

145. Coagulase-
:

Coagulase- (CONS)

, ,
, (),

(), ( ),
(),

(). CONS, S. epidermidis,


,

. ,
,

, , , ,
, ,

, ,

. saprophyticus
.

CONS

. CONS,
, CSF

. CONS . ( 174,
909-910).
146. ,

,
7

GBS

, ,
, .

,
1 24 .

. GBS
(50%), (30%),

(15%). , .
,

, , , ,
.

, ,
, , , .

, ,
, , .

. ,
GBS

.
,
,
() . Lateonset

GBS 7
(45-60%)

(25-35%). ,
, ,

20% . adenitis

. ,

GBS.

, .
1990,

65%
GBS

, 1,7 / 1.000 0,6 / 1.000 ,


0,4 / 1.000. ( 177, 925-927).

147.
;

37

( )

35
36

37
(> 20 )

39

, vaginorectal GBS

35-37 .
, GBS

, GBS
.

( , , )
(<37 )

(18 ) (38.0 C)

. amnionitis ,
GBS

GBS .
GBS


. ( 177,

928.)

148.

--

. (
181, 929

149. ;

Cefotaxime

(100-200 mg / kg / 6
[IV]? 200-400 mg / kg /

6 IV )
(5,0-7,5 mg / kg / 8

hr IV).

. ( e181-2.)

150. Listeria
monocytogenes :

<1 mo

,
,

, .

, ?
?

, ,
?

. ,

. ( e181-
2.)

. 151.
Listeria monocytogenes

Listeria

.
,

, 4 C
,

. .

.
trimethoprimsulfamethoxazole

Listeria.

, ,

. ( e181-3.)

152.
nondisseminated

N. gonorrhoeae,
( 3 )
. N.
gonorrhoeae


, , ,

.
,

.
( 185,

154.
2-
104 F, ,
, , .

7-14 ,

3 30 .
,

, , ,
. ,


. ,

,
. 25% ,

( spots)
7-10 ,

10-15 2-3 . ( 191,


956.)
155. A 1 yr .
. ,
.
;

Corynebacterium

botulinum Clostridium

Shigella dysenteriae 1

jejuni Campylobacter

tetani Clostridium

Guillain-Barr

C. jejuni.
Campylobacter

Campylobacter Guillain-Barr,
Miller-Fisher, ,

, .
. Campylobacter

. ( 194, 969.)

156. Aeromonas 4 ,
. Aeromonas
;

Aeromonas ,

<3 . Aeromonas 3 4

2-10% 1-5%
.
0-19%, .
-,


. , ,

. hydrophila sobria
-,

30% caviae
4-6 . sobria

caviae . Aeromonas

, , -,
. caviae

. ( e196-1.)

157. 16 yr old .
Legionella ;

IgM

(IgM IgG)

Legionella , ,
,

,
.

L. pneumophila
Legionella

80% 99% .

,
. ,
. ,
,

.
-

,
L. pneumophila

.
,

,
. ( e200-2.)

158. 18
. 1
. .
12 yr,
. ;

TD

Td

DTaP

( Td Tdap)
,

(1) 10 yr
(2)

5 yr .
Arthus

Td
10 yr,
.
,

.
,

. ( 203,
994.)

160. 9 PPD
. . ,
, .
;

Mycobacterium

Mycobacterium

Mycobacterium tuberculosis Mycobacterium

Mycobacterium tuberculosis Mycobacterium

( )
M.

. (TST)

. ""

.
40% ,


5-10%.

1 2 yr . ( 207, 996.)

161. Mycobacterium tuberculosis :

--

--
M. tuberculosis ,
1-5 m

M. tuberculosis.

.
,

, ,
.

2 ,
.

. ( 207, 998.)

162. PPD 5
:

24 48

PPD

(DTH)

TST . Mantoux TST


0.1 mL

(PPD) Tween 80.


,

, ,
,

.
48-

72 . > 72
? .


(<24 )
. 3 3
mo ( 4-8 )

.
M. tuberculosis,

, , ,
(, , , ),

, .

, . TST
.

10%
( 50%

) PPD?
.

Nonreactivity
, ""

. ( 207,
1001.)

163. 3 PPD
.

,
.

(
)


M. tuberculosis.

. jet


1 mo.

,
.


. ,

, 3
<50% .

,
.

.
TST IGRA,

. (
207, 1003.)

164. :

9 mo

6 mo

, 6-9 mo

6 ,
1 2 mo

6 , 2 mo

. ,
,

. ( /
)

CDC AAP 6-mo


1 2 mo

100%,
<2%. ( 207

165. 2 ,
, . ,
, .

PPD

PPD

Acid-


, 2 3

. , ,
, ,

, , ,
, , .

.
,

.
.
30-50% .


, , ,


. ,

. TST
,

1-3 mo. -

. ,
, , (

) . ,
M. tuberculosis . (

207, 1007.)

166.

1 , ,
,

. , , ,
.

HIV



.
, ,

( )
. ,

. 7-12 ,
2-7 ,

,
(CSF), .

2
leptospiruric .

,
CSF

, , ,
.

. .
,

, , , , ,
.

, ,
,

.
.

(, , ), ,
.

16-40%
. ( 212, 1023

167. Chlamydia trachomatis


;

75% C. trachomatis

50% - C.
trachomatis

nonpregnant

75% C. trachomatis .
C. trachomatis

( ), , , ,
.

.
. 50%

- C. trachomatis.

, .
1 CDC

C. trachomatis
nonpregnant (1 g

) (100 mg 7 ). (
218, 1035-1036).

168. :

, ,
48 . in vitro
chaffeensis phagocytophilum

. ,
.

<8 ,

. ? ,
chaffeensis phagocytophilum

in vitro ,

. ( 223, 1050.)

169.
, .
Malassezia furfur.
:

fungemia

, , ,
.

,
Malassezia fungemia

. Fungemia M. furfur

.
, ( lipidcomplex

), , .
Malassezia. (

. 171.
:


(CRS).

.
--

, .

, .

1 8 .
,

. ,
.

.
10-20%

CRS 12 mo.
9-12 yr

,
,

. . (
239, 1077.)

172. 19
:

( -" )

Lacy,

19 .

. , ,
polyarthropathy

. , , ,
.

15-30%
, ,

.
, 3

. ,
-"

2 . ,
, .

,
.

. .
.

1-3 .
, , ,

.
19

. (
243,

173. ,
.
, .
, . , 1 mo
.
"hydrops fetalis. "
;


19

HIV

-
,

<5%.
RBC


, ,

. ( 243, 1096.)

174.
:

5%

60%

ganciclovir

CMV
. 5%

, 5%
, 90%

, , CMV.

, ,
, blueberry muffin- ,

, .

, ,
.


. Re-
CMV .
CMV

, 7-10%
CMV,

. CMV
CMV

DNA PCR, 1 2 ,

.
,

PCR. CMV
CMV . (

247, 1116.)

175. , .
,
.
(CMV).
.
. :

CMV
,

7-10% CMV,
. ( 247

176. 18
.
CD4 97 / mm 3.
, , , .

.
;

CMV IgG
IgM CMV

CMV DNA PCR


( )

, CMV, IgG,
IgM

,
.

, CMV , DNA
CMV PCR

,
, . ( 247,

177. 1.050-g 31
.
27 Hg
3 .
.
.
346 U / L, 61 mg / dL ,
20.000 / mm3, 60%, 15%,
20%. 60.000 / mm3 . CT
. :

Neisseria gonorrhoeae

CMV
. 5%

, 5%
, 90%

, , CMV.

, ,
, blueberry muffin- ,
, .

, ,
.

. ( 247, 1116.)

. 178. 4 yr old , barky ,


, .

, .
:

, , , ,
. ( 251,

1126.)

179. 2
yr,

.
:

Chlamydia trachomatis

( ),
.
, ,
,

. " ,
,

,
, , ,

. ( 251, 1125-1126).

180. :

ICAM-1

CD23

(TNF)

IL-10


-1

(ICAM-1), ( )
LDL.


. (

255, 1133.)

181. ;

Over-the-counter

(HRVs)
.
,

,
,

. HRV.
HRV

, , , . HRV

.
over-the-counter .

, .

HRV . (
255, 1133-1134).

182.
;

, Encephalitus (EEE)
, 8

1964 2.007.
EEE

. ,
, ,

, , .
, fontanel, ,

.
, .
,
,

() .

, . ,
cuffing

. ,

La Crosse .
,

.
. EEE,

.
?

. 33-75%
. ,

. ( 259, 1143.)

184.
choriomeningitic (LCMV);

2 : ,

LCMV

. (
) ,

. 2 . 1 ,

, , , , .

, 2 ,
() . 2

, , ,
, , .

1-3 .
LCMV .

.
.

,
, , .

,
.

. LCMV
.

,
LCMV .

. LCMV
.

,
LCMV. ( e264-

1 e264-2.)

185. -

(HTLV-) :

- /

(TSP)

, HTLV-I

HTLV-I

-HTLV

HTLV-1
, 3-

> 6 . ( e269-1.)
186. 18 mo old out-of-home
. ,
.
,
.
:

E. coli
O157: H7

,
, Giardia

Cryptosporidium

Giardia ,

. Giardiasis nondysenteric
, ,

, , crampy
, , .


, ,

,
.

()
Giardia giardiasis

.
Giardia .


Giardia ,

2 . , giardiasis

, 3
>

90%.
,
Giardia.
Cryptosporidium

,
. ( 274, 1182,

275, 1184.)

187. :

nonulcerating

, , ,

Leishmania, . Leishmania

, .

. ( 277, 1186.)

188. 7
1 , . 37,5
C, 80 / min, 30 / ,
95/60 mm Hg. .
, .
;

Trichuris trichiura

lumbricoides Ascaris

vermicularis Enterobius

Mycobacterium tuberculosis

Streptococcus pneumoniae

1 , 4
.

, ,

geophagia. ,
.

.
, ,

, .
Loeffler

, ,
.

.
,

.
( 283, 1217.)

189. ,
. .
8% .
:

Trichuris trichiura

spiralis Trichinella

stercoralis Strongyloides

canis Toxocara

lumbricoides Ascaris

()

Trichinella spiralis, - .

.
,
.

,
1 1-2

.
.

.
, , , ,

2-3
encyst . (

291, 1229.)

191.
;

-,

-, crampy /

-, , RLQ

,
, .

298-14, Tract .
( 298,

192. .
;


, , ,

, , lymphonodular .
.
298 - 15, . (
298, 1248.)

193. 5-yr-old .
48 hr . 4
8 mo. ,
.
?

2 5
.

( 12 )
2-3

4 .
.

, ,
, , . ,

, , ,
. ,

.
, migrainerelated

, .
80% 1stdegree

? .
( 298, 12

194. :

Drooling


.
. Globus

. ( 298, 1240)

195. :

3 5 yr

2-3

2 5
.

( 12 )
2-3

4 .
.

, ,
, , . ,

, , ,
. ,

.
migrainerelated

, .
80% 1stdegree

? .
( 298, 1242

196.
. :


Pierre Robin
.

, foreshortened.
,

, .

,
.

.
, ,

. ( 303, 1254.)

197. .
:

HSV

aphthous ( ) ,
.

307-1. 20%
. ,

, , ,

. , ,

. 10-14
. ( 307, 1260.)

198. :

.
, , ,

, .
.


. ( 307, 1261.)

199. .
;

,
,

web

Manometry

?
,

, , , .
,

, videofluoroscopic
, .

.
,

( ) . ,
,

. ( 312, 1263.)
200. 8 chlild
hematemesis.The .
, ;

10-12
mm Hg

, ,
.

"? ,

(SVC) ."
SVC.

,
.

?
,

,
.

,
,


. ( 318,

201. 6
KUB. :

CT
GI ( )

GI

.
,


. volvulus

,
.

, gasless
" "

. malposition ,
20% .

.
Treitz

"
.

, ,
. ( 322,

202. 6 mo 6
. .
Meconium 2 .
;

KUB



KUB

1 500 1 6.000
.

1 yr , > 50% 1 ,
.

.
1

.
/

. -

.
Ladd

. Volvulus

.
,

. ,
gasless

" ".
malposition

20% .

.
malposition

Treitz
"

" .
.


.
,
, . (

322, 1281.)

203.
1 . " ".
IV ,
:

, C, D

1 .
.

.
.

" " .

orogastric
. , ,


. ( 322, .

204. 4 yr old .
.
:


6 6 yr.

.
4-6 ,

3-4 . ,

. .

.
, , ,

.
3-4


. (

326, 1290.)

205. 18 mo , ,
, , . 9 mo .
, .
. :

Giardiasis

(1%
).
.

.
.

?
1

.
.

1 ?
, , ,

, , ,

206. :

. ? ,
,

.
,

, , ,
,

, , ,
, ,

.
.

. (
330, 1309.) . ( 330,

207.
;
1

IgA

, ,

. 1,
, Addison, Sjogren,

, , , IgA
, ,

.
HLA.

?
,

.
IgA, Down,

Turner Williams. ( 330, 1309.)

208. 5 ,
.
, . .
, ;

.
,
( 330-6).

.
,

. , ,

, .

(
,

). ( 330, 1309-1311).

209. 11 yr old , Tanner 2,


2
. , . , ,
2 .

. ,
.
? .
:

Crohn

adenitis

? ,
"" .

?

" . ,
,

? appendiceal
48 ,

() .
, ,

, ,
.

12-24
,

. ""
, ,

, , , .
,

,
.

. ,
(

), ,

. , .
.

( 335, 1349-1350).

210. 4 yr old 4 . 24
.
38,4 C? WBC, 9.400 / mm3 75 20
? , 36? ,160.000 / mm3.
, 3+ .
, .
:

Henoch-Schnlein

. ,
(

), ,

. ,
.

. ,
,

, .

. ( 335,
1350.)

211. :

divisum

Choledochal

divisum, 5-15% ,

. Anlagen
, , ,


Wirsung.


. ( e339-3.)

212. 10
. 5
.
.
:

.
, ,

. 50%
10%.

( ).

2-4 wk
.

( 344, 1373)

213. ;

amebic

, ,

( vs )

, , , ,

, , ,
? .

?
.

.
,

.
50% .

. (70% )
(75% ) ,

. Amebic

. ultrasound- CT-

,
. ( 351, 1404.)

214. hydrops ;

Kawasaki

adenitis

noncalculous,

, ,
.

, .

,
.
(RUQ)
. , ,


. 358-1,

hydrops . ( e358-1.)

215.

215. 4 yr old 3-
, 2 ,
xiphoid . , ,
. :


xiphoid

. ?
, ,

<1% 5%.
2-3

. ,
.

, , .
( 364, 1418 e364-1.)

216. ;

Arhinia


1 / 7.000 .

(90%) (10%)
?

. 50-70%

, . (
368, 1430.)

219. ;

( adenoiditis)


( adenoiditis),

,
,

, ,
.

. ( 375, 1444.)

220.
;


( 375-1).

(0.5 mg / kg), .

(0,15 mg / kg),
.


1 .

1 .
,

, .

. (
375, 1445 1442.)

221. 4 mo , 1
laryngomalacia. , .
?

supraglottoplasty

,
,

. .

(
, , ,

) supraglottoplasty
. ( 378,

222. 3 mo .
. 1-cm
.
:

,
1 2 mo ,

6 . ,
. ,

, .

. .

. ( 382, 1455.)

223. 15 yr old
,
.
. .

( Screamer )

.
.

phonating

. ,
.


. ( 382, 1455.)

224.
20 .
;

()
,

CCAMs

CCAMs 1

(40%),
(14%), (26%)?

21 . 1 ,
7% , hydrops,

, , , ? 96%
, 2

. hydrops .
, ,


. CT

, 1 ,
. <10%.


, radiolographically
.
,

.
.

. ( 375,
1464-1466).

225. 8 yr old 24 , , ,
.
tachypneic . ? ,
,
.
:

precipitins

(HP)

,
(, ) . HP

. HP

. ,
.

HP, (
), HRCT ,

(BAL) ,
HP,

. ,
. 4

2 HP,

. ( e391-1.)
226. 17 yr old
24 .
- tachypneic
. .
:

Cyanide

(
)

. (
)

2 .
2

. ,
,

. ( 391, 1473.)

227. 16 yr old paraquat


. ;

40 mg paraquat kg

91%

3 paraquat .

<20 mg paraquat / kg
, ,

. 20-50
mg paraquat / kg.
, ,

, , ,
.

> 50 mg paraquat / kg.


,

100% .
paraquat

( paraquat)
,

( , paraquat ) . (
e391-4.)

228. 6-yr-old 1-mo ,


, , .
100 / ? 25 / min?
.
.
. :

(PIE)

Mycoplasma


. ( 391, 1474.)

229. 3 6 .
, , .
, .
;


, ,

.
.

.
atelectatic,

, , , ,
.

, .

, .

, , .

atelectatic . .
,

. ,
,

.
.

(CPAP) . ( e402-1.)

230. 3 yr old
Fontan.
Thoracentesis .
;

NPO

pleurodesis

> 50%
.

,
. Thoracentesis

?
. 1-2 ,
? ,
pleuroperitoneal , ,

> 50 ml / kg / 3 .
80 100 g / kg /

,
.

, iodopovidone
,

. .
.

OK432 (picibanil)
. ( 409, 1515.)

231. nonpulmonary .
nonpulmonary
;

?
,

,
, tic

,
.

,
.
,

. ( 413-1
413-2, 413, e413-1.)

232. :

Fallot

418-1
. (

418, 1549.)

233.
:

valvotomy

valvotomy

Blalock-Taussig shunt

(.
421 - 4).

, Noonan,
.

,
valvotomy . (

421, 1563.)

. 234. Fallot
4 ;

looping

secundum primum

Fallot

(
).

4 : (1)
( ), (2)

(VSD), (3)
dextroposition

, (4) (. 424-1). ( 424,


1235.

235. 18 mo
.

. ,
, hyperpneic, . 10 ,
. :

Fallot

,
.

, .
. ,


?
.
.

hypercyanotic (, "" "tet" ),


1 .

hyperpneic , ,
, .

. .

. ,
, .

. ( 424, 1574.)57

236. 10 yr
.

. ,
, 2 .
.
.
. :

Fallot

Stills

. ,
.

, 1,7: 1? ,
.

? ,
, , ,
. ,
. 1


. 2 , ,

?
.

decrescendo .
,

. roentgenograms

. ,

. ( 427, 1600.)

237. 7 yr old 3 ,
, Staphylococcus aureus.
,
6 , .
.
, :

,
viridans

. (,
, )

. ,
, ,

. ,
.
, , ,
, , , , , ,

. ,
.

. 90% ,
1 2 .

Duke .
(1) (2

, 2 ) (2)
(

, regurgitant , ,
,

regurgitant). ( 431, 1623-1624).

238. Duke
:

Osler

Duke .
(1) (2

, 2
) (2)

( , regurgitant
, ,

, regurgitant ).
, , -

, (, ,
, Osler, Roth ),
,
.

, 1 3, 5
.

, .
:

clubbing, , ,
?

? C- ?
nonfeeding, ,

. ( 431, 1624

239. :

Fibroma


. Rhabdomyomas

70-95%
. ( e435-1.)

240.
:

Isoimmune ABO


. ,


RBC? , ,

. ( 452, 1661.)

241. 241. ()
:

PK

PK

Nonincubated PK

PK

, 5-6
. ,


(30-60%) .

?
,

. ( 457, 1677.)

242. 242. :

Gaucher

Progeria

480-1
. ( e480-1.)

243. Epstein-
Barr;

-Hodgkin

Ewing

Wilms

.
Epstein-Barr

(EBV) Burkitt > 30


yr, EBV

. EBV
Hodgkin

-,
EBV

. EBV lymphogenesis
-

,
AIDS. ( e486-3.)

244.
;

> 1

<10 yr

<50.000 / mm3

, , D

, ,
(,

).
, 1

10 yr <50.000 / L
. > 10

> 50.000 / L
.

,
.

, , t
(9? 22) t (4? 11),

, .

. ( 489, 1734.)

245. 4 yr old 4%
. .
.
:

ALL > 25%


. AML > 20%




,


-- .

( 489, 1734.)

246. (ALL)
:

( 85%) -

ALL

ALL

ALL - (CD10 +
[CALLA] )

( 489 - 2), 1-10


. ( 489, 1734

247.
:

2 ,
.

<5%.

.
, ,

, . (

489, 1735.)

248. 248. 15 yr , ,
3 mo. ,

. .
4-hr. ,
:

CT

CT

, nontender, , ,

.
,

(, , ),
, ,

(, ).

3% . ,

, > 39 C, > 10%


3 mo, drenching .

. ( 490, 1741.)

249. 4 yr old ,
. .
:

Hodgkin
Ewing

.
.

, , , , ,
, ,

, .

, ,
, .

Horner.
,

.
,

opsoclonus-- .

, ,
. (

492, 1754.)

250. 250.
;

<1

> 5 yr

3 4

MYCN
1 80-90%

,
.

, > 1
,

.
(INSS),

( 492-3).
INSS 1

. INSS 2

, ( 2) ( 2)
. INSS 3

,
, INSS 4

, , , ,
. INSS 4S

<1 ,
/

INSS 1 2.

1 2
4S > 90%

. ,
3 4

, >% 90
. (

492, 1754.)+

251. 2 yr old ,
1 , , .
. ,
38 C. 150/95 mm Hg, 24
/ min, 130 / . 1 kg
18 mo . ,
.
. ,
,
. ,
, .
:

CT

, PT, PTT,

.
.

,
.

, > 1
,

.
,

, , , . Lung
, 3% .

.
,

, , , , ,
, ,

.
,

, ,
.

.

Horner. ,

.
,

opsoclonus-- .

, ,
. ( 492,

1754.)

252. 20 mo old
' , .
.
, , , .
1 , . , ,
,
. ,
.
MRI .
;

encephalomalacia

.
,

, , , , ,
, ,

.
,

, ,
.

.

Horner. ,

.
,

opsoclonus-- .

, ,
. ( 492,

1754.)

253.
;

<5

5-10

Ewing. <10 , Ewing ,


.

2 . ( 495, 1763.)

254.

254. 15
.
. :

Ewing

, limp,
.
,
?

,
, .

( 495 - 2). (
495, 1763.)

255. 255. A 1 yr old , ,


, , .
-out . :

Langerhans

Ewing

Langerhans .
80%

, > 5
. Bone

(. 501 - 1).
, , , , .

.
50%

,
, , ,

, , .
, , .

, .

33% .

, , , ,
, .

.
LCH

( )
()

, , . ( 501,
1774-1775)

256. :

IgA 1-2

Alport

IgA

lenticonus Alport

Ig , 1-2

,
,

. IgA
. ,

- -3 ,
.

,
. Alport

,
.

1-2

50% . Alport,
, 1

, , .
lenticonus

. (TBMD)

(GBM) (
)

.
.

,
.

. (
504, 1782-1783).

257. :

,
(MN),

, .
,

2 , ,
.

2-6%
.

.
20%

.
, . (

506, 1786.)
258.

Henoch-Schnlein

Goodpasture

" "
(RPGN)


. ,

(RPGN) crescentic (CGN)


.

CGN
. CGN

GN,
GN RPGN

CGN ( 510-1).
, ,

, CGN.
CGN

?
.

CGN. Henoch-Schnlein
(HSP), antineutrophil

(ANCA) GN (
Wegener),

(SLE) CGN.
GN CGN,

GN
CGN

. GN
CGN.
IgA , GN, .
Goodpasture

GN ,

CGN. ( 510, 1789.)

258.

Henoch-Schnlein

Goodpasture

" "
(RPGN)


. ,

(RPGN) crescentic (CGN)


.

CGN
. CGN

GN,
GN RPGN

CGN ( 510-1).
, ,

, CGN.
CGN

?
.

CGN. Henoch-Schnlein
(HSP), antineutrophil

(ANCA) GN (
Wegener),

(SLE) CGN.
GN CGN,
GN
CGN

. GN
CGN.

IgA , GN, .
Goodpasture

GN ,

CGN. ( 510, 1789.)

259. 259. ,
, 120/80 mm Hg.
hyperechoic .
?

,
(ARPKD)

1: 10.000 1: 40.000.

.
1

.
, ,

, .
,

20-30% . ,

45% .
. ( 515

260.
(ARPKD )
:
ARPKD 4 5

ARPKD

85% ,
1 16

ARPKD
.

, ARPKD ,
:

(, ,

, , )

. , , ,
.

,
, 5%

, .
12%

.
.

. ( 515, 1796-1798).

261. 261. 15 macrocysts



, . 40 yr
.
;

.
,

. -
/

.
, , , ,

, , ,
.


. ( 515,

1798.)

262. 262.
:

(C3)

24

, 1 : ,
, .

.
(: 0,2-1,0)

, ,

( 4-6 mo,
)
, 1

: .
(: > 1,0) /

, , . ( 520,
1801.)

263. 3 mo
14 mmol / L .
, ;

, , , , ,
pH

. (.., ),
" "

,
,

. ( 523,
1811.)

264. 4 mo
.
140 mmol / L, 3,5 mmol / L, 116 mmol / L,
13 mmol / L.
:

Fanconi

1 RTA

, ,
,

, ( 52).
,

.
totalbody

,
RTA

.
,

.
IV RTA,

.
[Na +] - [Cl- + HCO3-

]. <12 . > 20

. , (
, , )

. ( 523, 1811.)

265. A 1 mo .
.
137 mmol / L, 3,2 mmol / L, 90 mmol /
L, 38 mmol / L.
:

Bartter

Bartter
hypokalemic

.
.
, <2,5 mmol / L,
.

; ,
Gitelman.

Bartter ,
,

.
,

, Bartter
. (

266. 16 yr old
.
, :

nephrotoxins
, .

, ,
, ,

, , , / .

. , ,
,

.
, ,

- renoprotection
.


nephrotoxins
. ,
nephrotoxins. 527-1

nephrotoxins. ( 527, 1816.)

267. 3 yr old

. ;

nephrotoxins
, .

, ,
, ,

, , , / .

. , ,
,

.
, ,

- renoprotection
.


nephrotoxins

. ,
nephrotoxins. 527-1

268. 16 1,9
mg / dL

24- 1800 mg.

( <75
)

, .

- <55
-.


darbepoetin,

, , ,

.
,

,
. (

529, 1825)

269. 12 yr old
, , , ,
, . ,
6-mo .
BUN 125 mg / dL
8,7mg / dL.
:

,
, (

), , , ,
.

. normochromic,
.

.
.

(GH) ,
GH, 1

. CKD, GFR 50%


,

1-,
D

(1,25-).
D ,

, .
()

.
, , GFR

20-25% ,
,
,
PTH. ( 529, 1824.)

270. 14 yr old
Henoch-Schnlein .
:

,
( ,

, , HUS)? (SLE, )?
(SLE, , ,

HUS)? ()? ?
, ,

, ( )?
(). ( 529,

1819.)

271. 271. 2
.
BUN 80 mg / dL 2,5mg / dL.
, BUN 20 mg / dL 0,5 mg / dL
2 . :

ARF, ,

, GFR.
.
ARF , , ,
, .

,
.

, . (
529, 1819.)

272. 272.
1 4 .
.
:

Eagle-Barrett

ARF
.

ARF. ,
( ),

, ARF
. 2

, .


. (

273. 6
3 , , ,
. ,
, .
BUN 65 mg / dL, 5,5 mEq / L, 14 mEq / L,
3,0 mg / dL. :

Kayexalate 1 g / kg

NaHCO3 1 mEq / kg IV

20 ml / kg 30

ARF, ,

, GFR.
.

ARF , , ,
, .

,
.

, . (
529, 1819.)

274. 274.

:
, , ? ;

; ; ? , , .
.

, , , ,
.

<24 mo
.

. ( 532, 1829
275. :

?
, ,

, , .
.

. (
532, 1830.)

276.
:

, 1
.

532-1. , IV, V
, 90%

. ,
,

.
,

.
,

, .

.
.
UTI
.

cystourethrogram
.

UTI ,
.

.
, /

- .
,

. 4-7% ,
.

,
. ( 532, 1830

1832.)

277. 15 yr old 5-
, , .
, . 110 / ?
40 C. costovertebral .
131 mmol / L, 6,7 mmol / L, 108 mmol / L,
15mmol / L. :

Addison

:
, , ? ;

; ; ? , , .
.

, , , ,
.
<24 mo
.

. ( 532, 182

278. 10 yr old
. :

, ,
,

. ( 539, 1890.)

279. 279. 2 old ,


. :

antistaphylococcal

CBC

, , D

. ,

(Milklike) ( " ").


. ,

?

. ( e545-1.)

280. 3 ,
. :

antistaphylococcal

CBC

, , D

.
nonlactational

, (
), , (..,

), (.., ), .

. Staphylococcus aureus ( 174,1)


.

Gram , .
.

( , )
.

, , periareolar . ( e545-2.)

281. 17 Tanner 2
2 mo.
12 yr, 4 mo
. ,
2 . .
;

IGF-1

,
() .

, ( ).
,


. ,
,

.
.

( )
.

, transsphenoidal , . ( e545-
3.)

283. 7 . 17
mg / dL. microphallus.
:

nonketotic

, , .
Microphallus
. GH
.

.
. (

551, 1879.)

284. 284.
:


1 4-12 mo .

.
,

, .

( ) ,
, . IGF-1

,
. GH

, .

. > 2

14 .

. ( 551, 1880)
285. :

Classic

Turner

1,5 SD

GH. GH
,

Turner, ,
Prader-Willi,

, .
1,2 (-2.25 SD)

, 5 , .
GH

2 3 ,
. ( 551,

1881.)

286. 286. 14-yr-old ,


.
.
18 mo .
?

. , () 1
(10-11 ),
() 6-12 mo .
() 2-

2.5 yr, 6 yr. , 1


95%

12 99% 13 .
( -,

11 12 ) .
12,75 yr. ,

, ,
, ,

. ( e555-1.)

287. 14 yr old .
.
. :

Hashimoto

Graves

II

""
"" .

, . 2-4
, .

1 3 , 6

.
.

. ,
, nontender. 30% ,

lobular .
?

,
.
, ,

. ,
, ,

, ,
. (

560, 1903.)

288. 288. 12

. .
Chvostek. 6,1 mg /
dL 9,4 mg / dL.
312 pg / mL ( 10-60 pg / mL). :

- -

, -(PHP)


().

. ( 566, 1919)

289. 5 yr old .
.
130/90 mm Hg.
;

17-
11-Deoxycortisol

11- 5%
?

1 / 250.000 1 / 100.000.
,

,
. ,

,
, , ,

. 65% ,
.

,
.


glomerulosa zona

.
21-

11-.
11-deoxycortisol

. ( 570, 1935

290. :

Von Hippel-Lindau

MEN

Sturge-Weber


Hippel-Lindau,
() -2 -2,

. ,
Sturge-Weber,

-. ( 574, 1942)

291. 291.
:

, .

, ,

. ,
. ,

, , , ? ,
, .

.
, ?

over-the-counter .
,

,
.

.
. 180

260 mm Hg 120 210 mm Hg ,


.
papilledema, ,
. ( 574,

292. :

Klinefelter

CMV

, ? ,
,

. ,
, ,

,
(.., ),

(.., Kleinfelter), . ,

. ,
,

.
( e584-

293. Gowers :

dysraphism

.
<2 mo ,

Moro .

.
, ,

hopping. ""
,

Gowers (. 584-5). ( e584-7.)

294.
12 yr .
.
;

Down


(<2 ),

antiepiletic
,

acidopathies .
, , ,

. ( 586, 2032.)

295. 295. 10 yr old 1 5mg / kg /


( 20-40 mg / kg / ). .
.
:

. , ,
.

1 () ,
.

, ( )
2

. ,
EEG

. ( 586,

296. Sydenham (SC)


:

SC , ,
.

. .
,

20% hemichorea. " pronator"


( ,

) (
).

, ,
, .

, .

. (
590, 2056.)

297. 11 yr old
.
,
, .
:

Focal

, ,
.

,
.

, , ,
.

(AIS) .
:

arteriopathic, , ?
.


AIS, > 50%

.
(FCA) specfically

(TCA) postvaricella
(PVA). ,

, .

( 594-3). -

, . ( 594,
2080.)

298. 3 yr old 2
bifrontal , , .
, .
10- . obtunded
100,8 F (38,2 C), 118 / ,
mm Hg 96/70 ,
. .
pansystolic
. papilledema.

. :

Moyamoya

,
4 8 yr

.
--

( Fallot), , ,
,

, , ,
, ,

. cerebritis
,

, , .
,


. , ,

, , , (),
.

, , .

, . (
596, 2098.)

299. 4 yr old , ,

. :

Duchenne

Hypokalemic

Duchenne (DMD)

.
, ,

, .
1: 3.600 .

-. ( 601,
2119.)

300.
;

,
trophe, "".

4
: ,

, ,

. , ,
nonhereditary

, , -

(CMFTD), .

,
(

). ( 601, 2119.)

301. cytopathies
:

Ragged-

-c (COX) ,

,
, , Krebs

.
,

, -c
/ -

, . ( 603,
2131.)

302. 302. 4 yr old


, .
.
24-27 , 15-20 ,
, ,
. :

Duchenne
Fabry

( Riley-Day)

Guillain-Barr

( Riley-Day)
.

.
. 3 ,

24-72
.

15-20 , , blotching
, ,

. , ,
.

. ( 607, 2142.)

303. 303.
;

, ,

, ,
, ,

Fundi. ,
( ), cycloplegic

, .
,

, , ,
(VER),

. ( 611, 2148.)
304. 304. 18 mo , ,
. MRI .
:

Spasmus nutans

Spasmus nutans
. ,

, , .
, ,

, ? , .
1 1 2 yr .

.
, ,

, . spasmus nutans,
,

. nutans spasmus
,

chiasmal . neuroradiologic

, . ( 615,
2161.)

305. 2
2 mo. ,
. :

Duane



() . "
2 3

.
.

esotropia , , .

() .
,

( ).
( ).

hyperopic

, .
, ()

.
, .

( 615, 2159.)

306. 306. .

:


: (1)

? (2)
,

, ? (3)
.

.

.

.
.

. ,
, ,

, ,
,

(.., , , , ,
, ).

,
,

, , ,
.

. ( 620, 2171.)

307.
:

Nyctalopia


: (1)

? (2)
,

, ? (3)
.

,

.
.

. ,
, ,

, ,
,

(.., , , , ,
, ).

,
,

, , ,
.

. ( 620, 2171.)

308. 308. :

Lowe

Hyperoxygenation


,
, ,
( 620-1).

,
,

, ,
. .

(.., , , , , ).

, ,
, ,

.
.

prediabetic .

. .
oculocerebral L.)owe . (
620, 2170-2171).

309. 3 mo ,
. ,
. :

Peters


(), (

), ( ).
. 30%

.
,
, . ,

. .


. ( e624-1

310. A 1 .

. . :

Aniridia

Coloboma


(), (

), ( ).
. 30%

.
,

, . ( e624-1.)

311. 311. ( )
:

Lyme

,
(TM),

,
, , 1 .
(
/ ),

, , , .
TM

, ,
( )

. ( e628-1.)

312. :

Meniere

Vertigo
.

.
Vertigo ?

,
.

/ ,
,

perilymphatic
,

, , ,
Meniere,

.
?

dysequilibrium , . ( e628-1.)

313. :

()

(. 628-2). ,

.
.

. ( e628-2.)

314. 314. 12 mo old


() 3 mo.

30 dB.
. ,
.
. check-up,
, , 1 yr , .
,
;

, 3-6
mo

,
.

, ,

;
reaccumulates .

, 12-16 mo ,

,
. ,

, ,


, ,

. .

, ?

.
,

. ( 632, 2209.)

315. 4 yr315. 4 yr old


() . 10 mo
. 6 mo
.
2 yr, 6
.
. .

, ENT.

;

1 2

,
, .

,
,

, ,
,

, ,
. (

632, 2213.)

316. 8 mo . 4
, ,
.
;


Cefixime

1
,

, , ,
. ,

-
- S. pneumoniae.

40-45 mg / kg / 24 80-90 mg / kg / 24

- .
<2

, -,


S. pneumoniae.

( 632, 2206.)

317. 2 yr old
38.5oC.
. , , ,
, 3 + / 4 + ? ,
, , .
;


: (1)

, (2) (), (3),


,
otalgia.
, , ,
,

. ( 632,
2203.)

318. :

. ,
, ,

,
. ( 632,

2200.)0

318. :

. ,
, ,

,
. ( 632,

2200.).
319. 12 mo
. .
Streptococcus
pneumoniae.
;

, 50% S. pneumoniae
,

- , ,
.


. S. pneumoniae

- -,
.

6 ,

.
-

321. 2 mo
.
,
. :

Ultrasound

occulta diastomyelia.
(,
cutis, )
dysraphism ( 585).

1 3 mo ,
, ,

lumbosacral
. ( 640, 2220.)

322. Stevens-Johnson ( )

Stevens-Johnson
.

. ,

, Stevens-Johnson,

. ,
()

. IV (IVIG) (1.5-2.0 g / kg / 3 )
. (

646, 2243.)

, ,
,

, ,
. flulike

.
, Stevens-

Johnson, . ,
, panophthalmitis,

, , , , , ,
,

. ( 646, 2242.)

324. :



(),

(HSV) . HSV , , HSV genitalis


60%

EM
EM, .

HSV DNA ,
nonlesional .

33, 62, 35, DQB1 * 0301, DR53


HSV- EM,

.
. HSV-

(-EM) 10-14
HSV,

,
. HSV

EM, . ( 646, 2241)

327. :

Alagille

6 .
(

hemivertebrae), (
),

.
. (
)

6 ,

, .
,

. 20-40%

, ,
. 2%

, (CT, MRI).

10-25% . ?

. 20-40%
.


dysraphic.

. dysraphism
.

diastematomyelia, ,
( ), ,

, , , terminale filum.

dysraphism ,
, , .

,
/ ,

, ( cavovarus),
. (

671, 2369.)

328. 12 ,
. , -off
. .
:

spondylolysis

Spondylolysis
ipz

occulta

Diskitis

spondylolysis

, .
,

. ,
,

10-20 .

. ,
.


. ,

, .

. ( ,
),

( lumbosacral
).

off ,
.

, spondylolysis.
,

, , swing.
.

, (
) cauda

equina . ( 671, 2374.)

329. :

, 3-
, ,

. > 10
Cobb.

? (
671 - 1).

,
.

,
(, 3 ), (3-10 ), (11 ).

(AIS) (~ 70%).
(> 10 vature)

~ 2-3%? , 0,3% > 30 .


(<10 ), 10
> 30 . ( 671,

2365.)

329. :

, 3-
, ,

. > 10
Cobb.

? (
671 - 1).

,
.
,
(, 3 ), (3-10 ), (11 ).

(AIS) (~ 70%).
(> 10 vature)

~ 2-3%? , 0,3% > 30 .


(<10 ), 10
> 30 . ( 671,

2365.)

330. Sports :


( )

. ,
,

, ,
, ,

,
.

,
.

678-2, . (
678, 2402.)

331. ,
2 ,
3 5 yr,
. .
,
. , .
.
.
?

tarda

Diastrophic

Schmid

- (CHH)
-McKusick.

2
, ,

, . ,

. , , ,
. hypopigmented. CHH

. ( 691,
2434.)

332.

( 699 11).

.

(.., Gaviscon)
.

.
,

.
16

mg ? 32 mg 3 yr? 65 mg 3-18 yr.


1 .

( )
.

. (
)

(). ( e699-6.)

356.
:

1-2

8-12

15-24

24-30

30-36

: ,
8-12

, . (
7-1).

357. 40 ,
.
?

: , 40
, .

,
. -

,
. ( 7-1

358.
:

. : , , ,
, , . ( 7-2).

359. 9 mo old ,

.
,

-of-the-
.

. 6-7 /

. ,
;

.
,

. .

,
. (

8, 30.)

360. 3 /
.
:

6 mo

4 mo

: 6 ,
3 / , , 1

h 3 mo. ( 8, 27.)

363.
:

0-2 mo

3-5 mo

6-7 mo

8-9 mo

10-12 mo
: (-to-)
8 . ( 8-1, 8, 28.)

364.
,

, :

3 mo

4 mo

9 mo

6 mo

11 mo

: 8-1 2 ,
8-2

. ( 8, 27-28)

. 365. 8 mo ""
. 2

mo ,
DTP,

, .
,

.
:

,
DTP

: 8-9

.

, .
.

. ( 8, 30.)

366.
:

10%

, 30 g /

: 10%
1

, ,

. 2
30 g (1 oz) /

1 . . (
8, 27, 13-1.)

367. 2 mo :

3 /


: 2
( ),

. 6 ,
3 / , , 1

3 mo.
. 6-12 ,

.
,

. ( 8, 27 30.)

368. , ,
, :

8 mo

13 mo

16 mo

20 mo

24 mo

: 8-1 2 ,
8-2

. ( 8, 27-28).

369. ,
, -

"," :

7-8 mo

10-12 mo

12-15 mo

3-4 mo

15-18 mo

: 8-1 2 ,
8-2

. ( 8, 27-28).

370. 3 4 mo :

45 g /
10 g /

20 g /

20 g /

0 2 mo

: 3 4 mo , 20 g /
. 4 mo,

. ( 8, 29.)

371. 6 12 mo
:

: 6-12 , . ,
.

. 2- (1 1
), ,


. ( 8, 30.)

372. , ,
undresses :

15 mo

24 mo

30 mo

18 mo

60 mo
: 9-1 1-5
. ( 9, 32.)

373. :

: 1
? 15 mo .

. (
9, 31.)

387. M-CHAT;

AAP 18 24-30

:
18 mo

24-30 mo.
.

, ,

(, , , ). (
14, 14-1, 41-43).

398. 5 .

. .
, , nonexudative . :

, polysomnography. ( 17, 50,


17-5).

399. 399. 10 -
,
.
22:30 .
, .
07 ..
.
1-2 , . ,
09:00 ..
, , .
30 kg / m2 3+
. ;

: , OSA
,

, , .
OSA

, ,
,


OSA.

,
, , / .

(,
) ""
, , ,
, .

OSA
ADHD,

, , . ( 30.)
OSA

, ,
, , , ,

- ?
. ( 17,

51.)

400. 400.
" "
. polysomnogram .
;

EEG

HLA

: polysomnography (PSG)
(MSLT)

. PSG
, OSA,

EDS. MSLT 5 ( 20 ),

- ,
REM . (

17, 53.)

402.
:

Retroposition

21
Prader-Willi

:
/ ?

, /
?

? ?
.

,
,

.
Arnold-Chiari

. , ?
Down,

, , , ,
,

OSA, 70%
. ( 17, 49.)

407.
:

ADH

:
5-2

,
sites,

.
,
(.., ), ,
, , ,

(.., ), , ,
,

. , , ,
, ,

.
,

, Tourette, .
, ,

, (, , , .)

. ( 19, 62.)

408.
;

MRSA

Wolff-Parkinson-White

:
.

19,
64-65. : (1)

-
( )

SSRI,
SSRI, , , . (2)
Wolff-Parkinson-White PR
(<0.12 sec) QRS

TCA. Trazodone
. SSRIs

.
(3)

- ,
. (4)

?
. (

Chapte

414. :

2 3
5 yr

3
3

3 3
4 yr

2 5 yr

:
, 3

5 . (
21, 71.)

415.
, :


: 2-4 yr,
. ,

:
, ( suprapontine)

() ,
,

, . ( 21, 71.)

401.
:

Bilevel

: ,

(CPAP)
. ( 17,

416.
:


: , ( , ,
, / ),

/
,

, , .
-,

, , 2-4 ,

enuretic . ,

( ).
. (

21, 72.)

417. 417. :

:
, ,

. -,
,

, 2-4 ,

enuretic . ,

( ).
. ( 21, 72

418. 8 sleepover
. ;
Desmopressin

Bell--pad

:
(.. , ),

. ,
. Desmopressin

,
.

, 50%
. (

21, 73.)

419. 4 (
). .
:


. ,

,

. ,

, , , .
( Chapt

421. :

:
(.., )

(.., ). DSM-IV-TR
( )

, ,

.
4

, ,
, (

.)
.

25% 2 15%
5 yr.

45-60%. 5-30%
- 4-

5% 8 yr. ( 22, 75.)

422. Gilles de la Tourette


;

OCD ADHD

: Tourette (TS)
(

). TS 4-5 10.000. 1,5-3


. TS

, ,
7 yr. ,

, ,
10-12 yr.

() , 10%
. TS

, , . ,

(OCD), - / (ADHD), -
. TS


. (

22, 77.)

423. :

, tic

EEG

, , ,

.
,

/ . ( 22,
76.)

424.
:

: Tic

(.., , Huntington)
(.., ).

( )

.
- .

(.., ) . (
22, 76.)

425. 3
.
, , .

,
.
:

: (SAD)
,

03.05 05.04%. ,
7,5 yr.

, .

.
,
,
,

, ,
. 1

3 4 ,
,

,
, .

( 23, 78.)

426. 430. ,
:

: ,

. ?
,

(
),

. ( 24,
83.)

431. :

:
2

/

. ,
, ,

; ? , ,
. ( 24, 82,

432.

:
,

.
,

, ,

4 6 ,

. ,
,

, /
. (

24, 84.)

433. ;

Depakote


: ,
?

(< 50%).
, ,

(, , , ,
.)

,
, ,

. ( 24,

437. (),
, ,

(AN) ()

:
(..,

) (.., ),


. .

,
,

.
,
.
,

AN,
,

, , ,
, .

, Rathke
,

,
, ,

,
.

,
. ( 26, 91.)

438. .

: ,
QT, ,


. , ,

( , ,
,

)
. ,

,
. ,
. (
26, 91.)

440. ;


preteens

: .

, ,
, ,

, , .
,

. ( 27,
99.)

443. 3

, . ,
.

: (AD)
3 : ?

; , ,
( 28-2).

, ,
. ( 28,

100.)

444. 444. (AD)


;

, ,
,

: AD 15 .

AD
AD,

AD .

-- AD. (
28, 101

445.
:

- /

: ,

. ,

, , ,
.

.
, (,

LSD, , , ), (,
,

), (, , ,
Wilson? ? ?

? ? ). ,

, , ,

,
, . (

28, 106.)

446. 446.

- 6

-
,

-7
11

:
(

/ ) (

/ ).

, , .

, .
oromotor ,

, .
.

. ,
, .

, , .
,

, (
).

().

, , (,
, ) . ( e29-2).

448.
:

:

.
(,

),
, , ,

, .

.
,


. ( e29-

8.) 450.
/

:
, ,

, , . ( 30-4
, 30, 111

449. 451. TRUE FALSE:


True

: ADHD

, ,
,

. ,
,

obstrutive,
.
, '

, ,

. (
30-1, 30,

452. ;

vs

, /


, effortful

, ,

: ,
.


, effortful

, , .

,
? .

( 31, 112.)

453. 455. ;

15 mo

18 mo

A 30 mo -.

A 24 mo ,

:
,

32, 120, 32-3.

460.
:

21

: 21, ,

. ( 33, 125
33-4.)

462. ,
:

EEG

CT

, , /

( 33, 125.)

476. 6 mo
,
.
.

.
10

(CPR),
fontanel

.
.

CPR

: (AHT)
.

, , .
,

( ),

AHT, .

-
,

AHT. ,
.

, ,
,

. - ,
AHT

.

AHT. AHT ,

.
,

,
,

.
-

. , ,

; , . (
37,

487.
:

:
?

. ( 38-3, 38,

498. 6
.
;

, ,

:


.

,
. (

42, 164.)

500. ;

1
2

10-14 oz /

, ,

5-7

: ?
, , ,

1 3-4 yr . 4-6 oz /
1-6 yr 8-12

7-18 yr. ( 42, 165.)

501. vegan

;

12

: 12. 12

, vegans
.

vegan
12. ( 42,

168.)

502. ;

: (,

)
thyroids ()

(g / L).

,
. (

503. kwashiorkor :

Achromotrichia

: (kwashiorkor)

, , / . kwashiorkor
, ,

, , , ,
,
, , .

. .
,

, , ,
.

,
.

, . ,

, . ( 43, 175.)

504.

2 , 80-100 kcal / kg /

: ,
.

,
,

1 24 .
F75 (75

kcal). ?
,

12 8 6 24 .
80-100

kcal / kg / . 2 ( 2-6)

F100 RUTF 100 kcal / kg / .

4 . ,

.
?

, (),
kwashiorkor,

kwashiorkor .

. ( 43, 178? 43-9.)

505. 505.

nigricans

: Tanner

. ( 44, 185?
44-2.)

508. ;

: , biogenerated de
novo
. , -A.
,

55%
30%

.
,

.
,

. ( 45,
188.)

509. ;

, ,

: ,

?
(carotenemia)

, ,

. ( 45,
191.)

510. ;

3
4 yr old American

: ( ), , nonvegetarian

. , , ,
. toeat

.
?

- ?

,
.


( -)?


, faddists

(Occidental beriberi). ( 46, 191.)

511. 511. ;

Vegans 12

(6)

:

12,

. ( 46, 197.)

512. 512.
;

Beriberi

: (-
)

. ( 47, 198.)

513. :

513. :

: ,
D, ,

, .
( 48-2,

48, 201.)
514. 514. D-
:

Bitot

Craniotabes

costochondral

Bowlegs

: Bitot . 48-3

. ( 48, 201.)

515. 515. ;

, ,

: ,

, , ,
.

(PUFA).

,
,

; .

, ,

( e49-1.)

516.

A 7

: 3 K- (VKDB)
. VKDB

1-14
.

VKDB

1 .
,

2 .
VKDB

(
).

VKDB 2-12 ,
6
. ,
.


VKDB

. ,

VKDB. , (1 mg),

USA, , .


. -

, , (celia

517.
;

: . (
51, 51-1 e51-

518. ,
.
:

(ICF) (ECF)

Na

+
-

: ECF ICF

, , .

ICF ECF

2 .

. ,

ICF
.

, ,

. ,

, . ( e52-2.)

519. 519. ;

285-295 mOsm / kg

, ,


10 mOsm / kg,

osmoles
osmoles , ,

:
, ,

: = 2 [Na] + [] 18 + [BUN] 2.8.


(BUN) mg / dL. Division 18 2,8,


,

, mmol / L.
2

, .

. ( e52-2.)

520. ;

osmoreceptors ADH


ADH

ADH,

: ,

osmoreceptors ADH. osmoreceptors,


, .

. , ADH
,

.
,
1-2% .
,

II, ,
. ,

, . ( e52-4.)

521. :

Nephrogenic

:
(, ),

( , ),

(, ). ( 52, 52-1,
213.)

523. myelinosis (CPM)


;

, , Na 120 mEq / L,

3% NaCl IV

Na 120 mEq / L 60
mL / kg

IV


Na

125 mEq / L ? 3% NaCl

Na 125 mEq / L ? 3% NaCl


: CPM

. ,

, CPM. CPM

, >
12 mEq / L / 24

> 18 mEq / L / 48 . Desmopressin ,


. ,
,

CPM. , ,

Addison?
.

( 52, 218.)

524. 524. - 6 mo
30 .
.
WIC . ,
,
.
:

: Brain
.

, , ,
, , , ,

, , , .
Cheyne-Stokes

. ?

. ( 52, 217.)

525. :

Digitalis

Albuterol

Yasmin

.
,

Yasmin-28 , . (

526. :


QRS

. .

() . ,

, ST, PR, P
,

QRS.
.

. , , ,
,

. ( 52,
221.)

527. :

Digitalis

: ?

.

.
(

528.
, , :

Albuterol

Kayexalate

: 2 : (1)

(2) .

( ),

.
, .

,
.

. , ,
. ,

. ,
3

. ,
.

(Kayexalate) .

,
.

.


,

. (
52,

529. :

: .

, ST,
U ,

( ) P .
torsades de

pointes ,
.

, <2,5 mEq / L.

. .

? .
.

? <2,5 mEq / L,
.

, .
( 52, 224

530. hypermagnesemia ;

Hypermagnesemia
hypermagnesemia

IV

hypermagnesemia

Hypermagnesemia IV

hypermagnesemia

: Hypermagnesemia
,

, , ?
.

; .

, .

.
.

, ,
.

( e52-11.)

531.
:

: , <1-1,5 mg / dL,


.

.
,

. ,

( ).
,

, , , ,
, ,

532. :

Methylmalonicacidemia

:
. ,

.
,

, . ( 52 11, 52,
231.

533. :

. ,

,
?

. (
52, +

534. ;

6 pH 7,2

17

10

. ,

, .
,

.
(, )

( ,
).

?
,
.

. ,

. alkalemia
,

, .

,
pH,

. ( 52, 234.)

535. 535. , (s)


: 1. ,2. , 3.
, 4. , 5.

1 3

1, 2, 3

3 4

2 5

: ,

. (, )
(

).
, ,

, , . ( 53, 242.)

536. ;

: 20%

, ,

, .
osmoles,

, , , , .

0,5-1% . 53-1

. ( 53, 242.)

537. 537.
(D5 NS, > 10 kg, D5 NS <10 kg);

6 mo NPO

13 ,

, C, D

: (ADH)
,

.
ADH
( , , , ,

),
,

, .
ADH

( ADH
[SIADH],

, , )

. .


. (

52, 243.)

538. ;

2 hypernatremic

6 mo

4 mo

: , ,
.

hypernatremic .

. . ,

. ( 54,
245.)
539. 10 mo , ,
, , 2 sec,
, . :

<3%

3-5%

6-9%

10-12%

> 12%

: ?
?

/ ? fontanel? ?
?

( )? (> 1,5 sec)?


.

5-10% . ( 54, 54-1,


246

540. 4
IV . :

Ringer

D5

5%

, (NS) Lactated
Ringer (LR).

bolus , 20 mL / kg , 20
.



.
(

), LR
. ,

, 5% , , .
(NS

LR) , . (
54,

541. hypernatremic ,
, :

: Hypernatremic

.
,

.
, ,

, .

. (
54, 248.)
542.


, ,

: , ,
,

, ,

. (,
)

,
, agerelated

.


(.., 1 mo ?

= 1-24 m ? = 2-12 ? = 12-18


),

.
1 18

mo , . ( e56-2
56

545. ?

A 3 104 F, , .

, .

6 .
, . 8 .

A 6 101 F, . ondansetron

Popsicle.

, 101 F.

A 9 mo .

: .


defervescense.

, ,

- ,
defervesced.


.
/
inconsolability,

, , , ,
. (

60, 275.)

546.
;

Nonaccidental

:
/ inconsolability,

, , , ,
.

, ,
, ,

, . Nonaccidental
. (

60, 275.)

547. 547.
:

GBS

: ,

. Streptococcus
, ,
, .

. ( 60, 275.)

548. 2 ,
, . :

Viral

: - ,

, ,
.


Haemophilus influenzae b

(Hib)
.

. ,
,

, .
( 60, 275

549. 7
.
. .
;

(KUB)

1
Air-

: ,

; .

stooling.

, 10%
.

. ,

intussusceptions . ( 60, 276.)

550.

551.
.

,
C;

, ,

: ,
.

.
, ,

, ,
.

. ( 60, 277.)
552. 6 yr old
asthmaticus . 3
IM . , wheezes,
40 / .
, 30 .
. :

albuterol

(.., ,
).

EMS

.
,

EMS. ,

,
. (

60, 278.)

553.

556. :


: 62-5
. (

558. :

: ( [CPP])

( []) ICP,
.

( 63, 296.)

559. (GCS)
:

1-3

3-8

9-12

: TBI (GCS 3-8). ,


. ,
,

, --die
.

, underappreciating

TBI (GCS 9-12) ,


. ,

. ICP

ICP.
.

ICP (> 20 mm Hg) ,


ICP

48-72 . ICP-
.

ICP,
. ( 63,

298.) 560.

.
:

ICP> 20 mm Hg

:
,

, ,
(,

). ,
EEG

ICP .

ICP,
CSF .

-
ICP . ICP

,

, , , , , , .

ICP ,
. ,

.
. (32-34 C)

ICP
.

ICP (PaCO2 = 25-30 mm Hg).


, . ( 63-12?
63

561.

, ;

, Apgar 0-3,
,

32-34 C .

72 , 36 C

: , , , Apgar 0-3
5 ,

. ,
,

. (AHA) American Heart Association (

, ),

,
,

(4-6 )?
?

, , ? ?
. 20 ml / kg IV

30

2 C. ,
32-34 C.

1 C 4-6 .
,

72 .
.

. ( 63, 302.)

562562.
, :

:
,

( , IV ),
(

), ().
EEG

. PICU, ,
/

.

, /
.

,
.

, IV , . ( 63,
303.)

563.
:


, ,

( ), 50%

, . ',

. ,
.

,
,

( )

. ( 63, 303.)

564. ;

Shock

Shock

, -

: Shock

. ,

,
,

(, ) , , . (
64, 305.)

565.
:

" "

"cool "

,
.

.
,

, , , , ,

. ( 64, 305.)

568. 2 mo
, , (RR) 70. RSV .

. , . RR 45.
5 . :

24 hs

stat

: ,
.

. , ,

, , . (
65,

569.
;

- , ,

asthmaticus-,

- , ,
Viral - , suprasternal ,

-, ,

: .

. ,
suprasternal, ,

,
.

. ,

, , .

. (
65-1

65-2.) ( 65, 315.)

570. 570.
;

: ,

( , )

(, [] ).

2
:

.

[ARDS],
,

, . ( 65-3,
65, 315