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40 Cards in this Set
- Front
- Back
Petechiae and purpura |
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Hepatomegaly? |
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Causes of hepatomegaly |
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Examination of hepatomegaly |
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Signs/symptoms of HSP? |
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Complications of HSP |
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Treatment of HSP? |
controversial early corticosteroids in hospitalized children |
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ITP |
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HSP talking to parents |
prognosis: lasts a month or so follow up: repeat urine samples to monitor for resolution of kidney inflammation and follow BP instructions: seek urgent medical attention if:
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What is intussusception? |
Intussusception occurs when a proximal segment of bowel invaginates or telescopes into the distalsegment adjacent. The accompanying mesentery becomes entrapped, causing vascularcompression and eventual ischemia.
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Intussusception presention |
Paroxysms of severe abdominal pain with inconsolable cryingPassage of "currant jelly" stool containing blood and mucusPalpation of a "sausage-shaped" mass in the right abdomen
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Diagnosis/treatment of Intussusception? |
US initial eval then reduce by air or hydrostatic pressure |
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Complications of HSP |
intestinal bleed kidney involvement |
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HSP recurrence |
30% |
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Emergent findings |
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urgent manifestations |
fever, pallor, pain |
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Key questions to ask patient |
"What do you think is going on?"
"What do you think is going on?" "What worries you about what is happening?" "What do you think might happen next?" |
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How to examine lymph nodes? |
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Causes of splenomegaly? |
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Hemolysis |
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Malignancy |
leukemia lymphoma |
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Systemic inflammatory disease |
Systemic lupus erythematosus
Juvenile idiopathic arthritis |
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Congestion |
complication of portal hypertension |
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Spleen |
s helpful to have the patient lie supine and flex his or her legs torelax the abdominal muscles. In this position, it may be possible to gently "bounce" anenlarged spleen, which is located somewhat posteriorly, forward using a lifting maneuveralong the left flank.Alternatively, having the patient roll onto his or her right side may rotate the spleen anteriorlyinto a palpable position.As in the liver exam, having the patient inhale deeply to lower the diaphragm, or palpatingfirst in the pelvis then moving superiorly may facilitate detection of an enlarged spleen.
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DDx for bruising and leg pain? |
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Coagulation disorder? |
may present with petechiae or superficial bruising, but more oftenpresents with easy bruising in deep tissues or hemarthrosis
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Hemophilias? |
painful bleed into joints |
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HSP |
Often presents in an otherwise well appearing child with bruising and leg pain (due toarthritis).In roughly 50% of cases, a URI precedes the diagnosis of HSP
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ITP |
Often presents with asymptomatic petechiae.A nonspecific URI precedes ITP more than 50% of the time
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Leukemia |
Usually presents with constitutional symptoms such as fever, malaise and weight loss.Bone pain is also a common presentation of leukemia in children. The pain results frominfiltration of the bone marrow by malignant cell.Petechiae can be caused by thrombocytopenia due to bone marrow replacement bymalignant cells.
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Viral infection |
petechial rash low grade fever |
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Bacterial endocarditis |
fatigue, fever, weight loss, petechial rash, fever |
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Drug reaction |
reaction to medication distribution diffuse |
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Menigoccal septicemia |
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RMSF |
rash is often petechial starts on extremities before moving centrally fever is hallmark |
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SLE |
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DDx of rash and leg pain? |
HSP ITP Leukemia |
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HSP |
involves lower extremities periarticular vasculitis |
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ITP |
not associated with splenomegaly |
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Leukemia |
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