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That’s Sweet!

It’s All In Your Head

My StomachAches

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PicturePotpourri

Vomitings &Diarrhea

This is the first line therapy for management of most children with

AGE

What isORT - Oral rehydration therapy (at 30ml/kg/hr)

These are the 2 most common viral etiologies for gastroenterities in

children

What are Rotavirus and Adenovirus

Bilious emesis in a child is suspicious for this condition

(Hint: Describe where the anatomical lesion is)

What is

Obstruction, distal to ampulla of vater

This bacterial cause of gastroenteritis is commonly known to be associated

with febrile seizures

What is

Shigella

These are the 4 signs that are most helpful in predicting dehydration

What are 1. CR>2s 2. Absent tears 3. Dry mucous membranes 4. General appearance(ill appearance)

This is the leading cause of mortality in children with diabetes

What is DKA

(Cerebral edema is the leading cause of mortality in DKA)

This is the % deficit assumed in patients with DKA

What is

10% (100 mL/kg)

Hypoglycemia in neonates is managed by giving this solution

(Hint: Name the solution and volume)

What is

D10W @ 5 to 10 mL/kg bolus, administered IV or IO (0.5 to 1

g/kg/dose)

Metabolic emergencies in infants often present with nonspecific features that may mimic more common conditions like sepsis.

These are the 3 most common signs & symptoms found in metabolic emergencies

What are

Vomiting, altered mental status, and poor feeding

A type 1 diabetic presents in DKA

Her labs are:

Glucose - 650mg/dl, and Na - 131meq/l

This is her corrected sodium…

What is

140 meq/L

(Correct reported sodium by adding 1.6 meq/L for every

100mg/dl of serum glucose over normal)

This disease usually presents in infancy with delayed passage of meconium or chronic constipation, but can be missed and present later in childhood

What is

Hirschsprung Disease

This neonate presented with bilious vomiting

Describe the X ray, and name the genetic condition most commonly associated with this anomaly

What is

-Double bubble sign (Duodenal atresia)

-Trisomy 21 (Nearly 40%)

This is an abdominal sonogram of a 4 month old infant with vomitings

Describe the finding, and name the diagnosis

What is

Target sign or donut appearance;

This is typical of Intussusception

This adolescent presented with an oval lesion as shown along with a more generalized rash

Name one differential diagnosis and treatment

What is

Secondary Syphilis

Symptomatic treatment

This lesion was noticed on the thigh of a toddler who presented with a seizure

Name the lesion and the condition associated with this lesion

What is

Ash leaf macule (a well demarcated hypopigmented

macule)

Tuberous sclerosis

A 4 year old girl having a GTC seizure, has not responded to 2 doses of Ativan. This is your next step…

(ABC’s, oxygen, d-stick and IV access/labs have been done).

What is

Load with Fosphenytoin (@15-20mg PE/kg IV)

These are the 3 characteristics associated with complex febrile seizures

What are

-Focal seizures-Duration >15 minutes-Two or more seizures in a 24 hour period

A 3 year old with a 3 day h/o vomiting and diarrhea has a GTC seizure.

Temp: 103 FD-stick & shock panel: normal

Describe her diagnosis and management

What isSimple febrile seizure No additional work-up needed

A 10 year old with a 7 month h/o throbbing headaches, associated with nausea and photophobia has a normal neurological exam

This is what you would do next…(Hint: Mom has a h/o headaches)

What is

Treat for migraine headacheNo imaging necessary

The most common cause of headaches in children is _(a)_,

but keep in mind these _(b)_ worrying symptoms which should prompt further work-up (name at least 7)

What is (a)viral illness

(b) Features suggesting secondary pathology:

• headaches on awakening or disrupting sleep

• new onset (< 6months)• changes in behavior,

personality, or school performance

• change in characteristics of headache

• vision disturbances (by hx or exam)

• abnormal neuro exam

• unusual locations (occipital)

• younger age (< 6 yo), • neck stiffness • exacerbated by changes in

posture, coughing, or sneezing

• endocrine changes (precocious puberty, abnormal growth)

A 3 week old male infant presents with vomiting for several daysLabs: Na 131, K 2.5, Cl 82, HCO3 31, Glucose 48, VBG: pH=7.52

Name the most likely diagnosis

What is

Pyloric stenosis

(Hypokalemic hypochloremic metabolic alkalosis)

A 3 year old male with a 2 day h/o intermittent abdominal pain &

vomiting, and the following rash

This is the most likely diagnosis

What is

HSP (Henoch Schonlein Purpura)

A 3 week old male with a 4 hour h/o progressively bilious vomiting, fussiness, and abdominal distension. The stool guaiac is positive

Name the diagnostic study of choice

What is Upper GI series

A 3 y.o.male with intermittent abdominal pain, lethargy…

Name the most likely diagnosis

What is

Intussusception

A 3 wk old male with a 3 day h/o vomiting, poor feeding, decreased wet diapers, and sleeping more than usual

Labs: Na 126, K 7.5, Cl 81, HCO3 11 Glu 40mg/dl, VBG: pH 7.21

Name the most likely diagnoses

What is

Congenital Adrenal Insufficiency

Make your wager

List at least 4 phone extensions to the Pediatric ER

(KCHC only)

What are,

3638, 3860, 3861

3634, 3643, 1435