Morning Report 1
How do you differentiate Steven's Johnson Syndrome from Toxic Epidermal Necrolysis?
SJS is the less severe condition, in which skin detachment is <10 percent of the body surface . TEN involves detachment of >30 percent of the body surface area (BSA) (picture 2A-D). SJS/TEN overlap describes patients with skin detachment of 10 to 30 percent of BSA.
Type 1 hypersensitivity is ____ mediated, and two examples are _____
IgE; urticaria and anaphylaxis
When is it recommended to screen pediatric patients for prediabetes?
Current ADA guidelines recommend screening for type 2 diabetes of prediabetes in all asymptomatic children and adolescents ages 10 and older (or after the onset of puberty) who are overweight or obese who have at least one of the following risk factors for diabetes: maternal history of gestational diabetes during the child’s gestation; family history of type 2 diabetes in first or second degree relatives; American Indian, African American, Latino, Asian American, or Pacific Islander race or ethnicity; or signs of insulin resistance or conditions associated with insulin resistance, specifically acanthosis nigricans, hypertension, dyslipidemia, polycystic ovarian syndrome, or small-for-gestational-age birth weight.
How do you differentiate serum sickness vs DRESS?
DRESS: Exanthematous/Exfoliative dermatitis, urticarial plaques, Pustular eruption, SJS-TEN, 1-8 weeks, fever, +Organ involvement, NO arthralgias, lymphadenopathy
Serum Sickness: Urticaria/Exanthematous rash, 7-14 days, fever, no organ involvement, arthralgias, lymphadenopathy
The AAP recommends that babies not be introduced to water until 6 months. After that time, until 1 year, they can have up to a maximum of 4-8 ounces per day.
What are the basic criteria for diagnosing anaphylaxis? (excluding specifics for "likely" allergen or "known allergen" caveats)
Criterion 1 — Acute onset of an illness (minutes to several hours) involving the skin, mucosal tissue, or both (eg, generalized hives, pruritus or flushing, swollen lips-tongue-uvula) and at least one of the following:
●Respiratory compromise (eg, dyspnea, wheeze/bronchospasm, stridor, reduced peak expiratory flow, hypoxemia)
OR
●Reduced blood pressure (BP) or associated symptoms and signs of end-organ malperfusion (eg, hypotonia [collapse], syncope, incontinence)
In a 5-11 y/o, after they have been on daily Low dose ICS + PRN SABA (albuterol), what is the preffered next step to Step Up therapy?
Add daily Low dose ICS+Formoterol
Name at least 5 diagnostic tests/studies that could be used in the workup of pediatric hypertension.
-Electrolytes, BUN, Cr, Divalents, TFTs
-UA w/microscopy
-ECHO
-Renal-Bladder US
-Renal US w/doppler
-Plasma renin activity, aldosterone, cortisol, plasma metanephrines
-Sleep Study
-CT/MR Angio of renal arteries/veins
-Lipid panel
What does ARISE stand for in terms of microaggression bystander training?
Awareness of microaggression
Respond with Empathy
Inquiry of facts
Statements that start with "I"
Educate and Engage
During infancy, children are expected to _____ their birth weight by 5 to 6 months of age.
During infancy, children are expected to double their birth weight by 5 to 6 months of age.
Name two symptoms of ingesting foxglove, Digitalis purpurea.
Brady or tachyarrhythmias, gastroenteritis, hyperkalemia, weakness
Describe your approach to diagnosing ADHD in the outpatient setting.
Thorough history and physical, rule out alternative diagnosis, use a validated screening tool including the Vanderbilt, Conners' Ratin Scales, Child Behavior Checklist, ADHD Rating Scale-IV
*****What is Emma and Renee’s favorite website to tell you all about for finding a therapist?******
Suicide rates in this population (U.S.) are _____ times higher than for kids who live in homes without guns. In the past decade, 40% of the suicides committed by kids and teens involved guns.
Suicide rates in this population are four times higher than for kids who live in homes without guns. In the past decade, 40% of the suicides committed by kids and teens involved guns.
Approximately, when will a babies eyes become their adult color?
American Academy of Ophthalmology (AAO) says most babies have the eye color that will last their lifetime by the time they're about 9 months old. However, some can take up to 3 years to settle into a permanent eye color.
Define vasovagal syncope?
Vasovagal syncope is a neural reflex results in usually self-limited systemic hypotension characterized by bradycardia and/or peripheral vasodilation/venodilation. It is the most common cause of syncope (approximately 35 to 70 percent of cases depending on the age group being evaluated), particularly in patients without apparent cardiovascular or neurologic disease.
Which two medications are combined for HIV PrEP (pre-exposure prophylaxis)?
Tenofovir and Emtricitabine
Name 4 clinical features of nephrotic syndrome. What is nephrotic range proteinuria?
Proteinuria 50mg/kg/day, edema, hyperlipidemia, hypoalbuminemia, hypertension
A patient with altered mental status has constricted pupils. What drugs might have caused this presentation?
opiates, organophosphates, clonidine
At what age do we get universal screening lipids in pediatric patients? Why do we get universal screening?
Non-fasting lipid panel at 9-11 years old. Looking for familial hyperlipidemia.