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Primary Immunodeficiency Disorders
IMMUNO- DEFICIENCY Cellular Humoral Combined Adaptive T Cell DiGeorge IL-12 receptor Chronic MC Candidiasis B Cell Bruton’s XLA CVID IgA Deficiency Hyper IgM T Cell + B Cell Wiscott Aldrich Ataxia Telangectasia SCID Innate Macrophage/NK (Phagocytosis) CGD LAD Chediac Higashi Job Syndrome Complement Hereditary Angioedema C5-9 MAC Attack ADAPTIVE...
Read morePeds – Gastroenterology
Bilious Vomiting Duodenal Atresia Volvulus Intussusception Onset Day 1 Year 1 Year 1 Initial test AXR → Double bubble AXR U/S → Doughnut First step NGT IV fluid IV fluid Treatment Surgery Surgery Air enema Volvulus Twisted bowel loop → bowel obstruction Presentation Bilious vomiting Colicky abdominal pain Diagnosis Best initial...
Read morePeds – Neurology
Cerebral Palsy Pyramidal (spastic) Extrapyramidal (dyskinetic) Seizure Febrile Seizure Etiology 6-60m High fevers in Roseola Otitis media 30% recurrence Types Simple <15m Generalized tonic-clonic 1 in 24h Return fast to baseline T>39℃ Complex >15m Focal >1 in 24h No return to baseline Low-grade fever Treatment >5m → Abort with Benzodiazepine First...
Read morePeds – ENT
Acute Otitis Media Etiology S. pneumoniae H. influenza M. cataralis Influenza A virus RSV Parainfluena virus Presentation Crying Pain ↓ Hearing Fever Irritability Difficulty feeding/sleeping Diarrhea Tug on ear Diagnosis Tympanic Redness Bulging ↓ Light reflex Most sensitive → Pneumatic Insufflation ⇒ Immobility Most accurate → Tempanocentesis → Sample Recurrence No response to treatment...
Read morePeds – Allergies
Anaphylaxis Defined by severity, not cause! Anaphylactic reaction Previous sensitization Immediate hypersensitivity IgE mediated Binds to mast cells → Release granules Histamine Prostaglandins Leukotriens Anaphylactoid reaction No previous sensitization Non-IgE mediated Etiology Insect bite Food Latex Medications Penicillin Phenytoin Lamotrigine Quinidine Rifampin Sulfa drugs Presentation Rash Urticaria Hypotension Tachycardia SOB...
Read moreSickle Cell Disease
Etiology Beta globin chain 6th position → Point mutation → Valine replaces Glutamic acid Presentation African American Acute crisis Billirubin gallstones ↑Infections Autosplenectomy Encapsulated bacteria Salmonella Osteomyelitis Retinopathy Stroke Heart Enlarged Hyperdynamic Systolic murmur Skin ulcers in lower limb Avascular necrosis of femoral head Best initial test → X-ray Most accurate...
Read morePreventable Trauma
Parkland formula in kids Only difference is we subtract 9% from the legs and give it to the head
Read moreVaccinations
Hep B 3x Hep A 2x DTaP 3x <1y 2x 1-4y 2x in adults Tdap Td Tetanus Vaccine Td every 10y One Tdap booster Tetanus Ig in nonvaccinated Dirty wound → Booster after 5y Clean wound → Booster after 10y MMRV 2x Prevents shingles Zostavax All adults >60y Hib Disease does...
Read morePeds – Urology
Posterior Urethral Valve Etiology Redundant tissue at the beginning of urethra Presentation No urine at birth Distended bladder Oligohydramnios Seen on prenatal U/S ↑Cr Diagnosis Best initial → U/S → Hydronephrosis Next → VCUG → Rule out reflux Catheter → Massive output Treatment Best initial → Catheter Most accurate → Surgery Hypospadias/Epispadias...
Read moreCongenital Defects
Abdominal Abnormalities Diaphragm Hernia Presentation Respiratory distress Bowel sounds heard in chest Air fluid level on CXR Types Morgagni → retrosternal/parasternal defect Bochdalek → posterolateral defect (most common) More common on the Left side Omphalocele Failure of GI tract retraction at 10-12w Highly associated with Edwards syndrome (trisomy 18) Diagnosis Intestines...
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