ECOS Simon Flashcards

Question

Tx Trichomonas vaginalis

Answer 1

* Metronidazole 2 grams PO x 1 or * Metronidazole 500 mg PO daily x 7 days

Answer 2

**Hospitalized** * Cefoxitin 2 grams IV q 6 hours + Doxycycline 100 mg PO q 12 hours * Alternative: Clindamycin + Gentamicin * Oral therapy after 24 hours of clinical improvement (No fevers, no systemic symptoms) * Doxycycline 100 mg PO BID to complete 14 day course * Add metronidazole 500 mg PO BID x 14 days for those with a pelvic abscess or trichomoniasis **Outpatient** * Ceftriaxone 250 mg IM x 1 + doxycycline 100 mg PO BID x 14 days +/- metronidazole 500 mg PO BID x 14 days

Answer 3

* Medical differential - HypoT4 - Addisson / insuffisance surrénalienne - Néo - Tb - VIH - SAOS - Anémie - Mononucléose - autre Mx chronique * Sleep hygiene * Substance use * Eating disorders * Depression * Anxiety * Bullying * Conflict at home * Pregnancy

Answer 4

- Libre - Éclairé - Capacité

Answer 5

* Arthritis * Obesity * Hypertension * Diabetes * Metabolic syndrome * Cardiovascular disease * Inflammatory bowel disease * Depression * Eating disorders * Suicidal ideation * Strep récent si en goutte

Answer 6

* Posterior fossa abnormalities * Hemangioma (segmental) * Arterial anomalies * Cardiac abnormalities/coarctation of the aorta * Eye abnormalities

Answer 7

* post-inflammatoire * Ptyriasis alba * Tinea versicolor * Vitiligo * Naevus dépigmentosus * Sclérose tubéreuse

Answer 8

**Majeurs** (FAST) * Facial angiofibromas, forehead plaque * Ash leaf spots ≥ 3 (hypomelanotic macules) * Shagreen Patch * T-Tumours - ungual or periungual fibromas * Cortical tubers * Giant Cell Astrocytoma * Subependymal nodules * Cardiac Rhabdomyoma * Lymphangioleiomyomatosis * Kidney Angiomyolipoma * Multiple retinal hamartomas **Mineurs** * Dental enamel pits * Gingival fibromas * Confetti skin lesions * Rectal polyps * Bone cysts * White matter lines * Non-renal hamartoma * Retinal achromic patch * Multiple renal cysts

Answer 9

* Amelanotic (skin coloured, pink or red), symmetrical * Bleeding, bump, border regular * Colour uniform * Diameter – variable, de novo development * Evolving

Answer 10

At least 2 of 7 criteria: – 6 or more CALMS, ≥0.5 cm if prepubertal or ≥ 1.5 cm if postpubertal – inguinal or axillary freckling – 2 Lisch nodules – sphenoid wing dysplasia/pseudoarthrosis – 2 or more neurofibromas, 1 plexiform neurofibroma – optic glioma – affected 1st-degree relative

Answer 11

- < 35 semaines: Célestones, pas de cooling - < 34 semaines: MgSO4 - < 33 semaines: ATB si chorio/RPM - < 32 semaines: Neowrap, ETF (4-7j + 4-6sem) - < 31 semaines: ROP (après 4 sem ou à 31 sem si né avant 27) - < 30 semaines - < 29 semaines - < 28 semaines: HC x 10jrs si chorio - < 27 semaines - < 26 semaines: ETF (4-7j + 4-6 sem + terme) - < 25 semaines - < 24 semaines

Answer 12

Indications: (≥35-36 weeks) Criteria A or B AND C A. Cord pH ≤ 7 or BD ≥ -16 or B. pH 7.01 – 7.15 of -10 to -16 (cord or 1 hour gas) AND Hx of acute perinatal event AND APGAR ≤ 5 at 10m or at least 10m of PPV C. Signs of moderate to severe encephalopathy

Answer 13

– Dehydration – ‘Breastmilk’ – Infection – Polycythemia – Hemolysis – Endocrinopathies (hypoT4) – Extravascular blood – Genetic disorders – Increased enterohepatic circulation (GI obstruction, delayed meconium)

Answer 14

– Extrahepatic obstructive * Biliary atresia, choledochal cysts – Bacterial infection – TORCH – Neonatal hepatitis * viral, bacterial, parasitic, idiopathic – Metabolic: * alpha-1 antitrypsin, IEM, endocrinopathies, CF, Iron storage disease, bile acid synthesis defects – Cholecystasis syndromes * Dubin Johnson, Byler – Toxic: hyperalimentation

Answer 15

Definition * > two weeks spiking fever * Arthritis + at least one of: * Rash * generalized lymphadenopathy * Hepatosplenomegaly * Serositis

Answer 16

Levetiracetam- aggression / rage (20%) suicidality (rare) Carbamazepine- rash, hepatitis, anemia Topiramate- weight loss, kidney stones Lamotrigine- rash (5%) VPA- weight gain, hepatitis, pancreatitis, iplatelets, rash, hair loss Vigabatrin- retinal toxicity (5%) Phenytoin - Gum hypertrophy

Answer 17

Si pneumocoque (diplocoque +) Decadron 0,6mg/kg/j divisé en 4 doses x 4 jours Si HiB (coccobacile -) Decadron 0,6mg/kg/j divisé en 4 doses x 4 jours Rifampin selon critères Si N meningitidis (diplocoque -) Rifampin chez tous les contacts +/- vaccination

Answer 18

3-14 ans - Exudate or swollen tonsils - Tender or swollen anterior cervical lymph nodes - Fever - No cough Swab si 3-4

Answer 19

Mild (< 4 selles/jr): Discontinue precipitating antibiotic; follow-up First episode; moderate (4 selles et + et F° bas grade, dlr abdo lég) or mild, no change with Abx stoppage PO metronidazole 30 mg/kg/day ÷ QID, 10-14 days (max 2 grams/day) First episode; severe uncomplicated PO vancomycin 40 mg/kg/day ÷ QID, 10-14 days (max 500 mg/day) First episode; severe complicated PO vancomycin 40 mg/kg/day ÷ QID, 10-14 days (max 500 mg/day) PLUS IV metronidazole 30 mg/kg/day ÷ QID, 10-14 days (consider PR vancomycin with complete ileus) First recurrence Repeat regimen used first time or use vancomycin Second recurrence Vancomycin in tapered or pulsed regimen

Answer 20

Hypoglycémie non cétogène Cardiomyopathie/arythmie Rhabdomyolyse Éviter le jeûne +/- éviter les lipides / augmenter les MCAD

Answer 21

Hypoglycémie Hépatomégalie Acidose lactique Tg élevées Hyperuricémie

Answer 22

Dans le sucrose Insuffisance hépatique Coagulopathie Hyperbilirubinémie

Answer 23

Gaz AL Ions Gluco FSC Fct hépatique: INR, Alb Enzymes hépatiques: ALT/AST, GGT, PAL, LDH U/C NH4 CK Cétones urinaires +/- AAS AOU Acylcarnitine / carnitine Dépistage galactosémie (galactose-1P-uriryl-transferase) Id sucre dans les urines

Answer 24

* Hypothyroidism * Celiac Disease * Lead Poisoning * Medications * Cystic Fibrosis * HYPERcalcemia * HYPOkalemia * CNS disorders o Hirschprung’s o Cerebral palsy o Neural tube defects * Idiopathic (90%)

Answer 25

Infants * Swallowed Maternal Blood * AVM * Gastritis * Trauma (NG Tube) * Intestinal Duplication Children / Adolescents * Esophageal Varices * Mallory-Weiss * Foreign Body/Ingestion * NSAIDs * PUD/H. pylori * AVM * Hemobilia

Answer 26

Infants * Allergy * Fissure * Swallowed Maternal Blood * AVM * Meckel’s (< 2 ans, < 2 pieds valve iléocoacale, 2 muqueuses, 2% pop, 2M:F, 2% sgmt) Children * Fissure * Infection * Polyp * Meckel’s * IBD * Rapid upper GI tract bleeding Adolescents * Fissure * Infection * IBD * Meckel’s * Rapid upper GI tract bleeding

Answer 27

2 months of 2 of the following: * <3 bowel movements/week * Excessive stool retention * Painful or hard bowel movements * Large fecal mass in rectum * 1/wk episode of incontinence after toilet training * Large-diameter stools that block toilet vs Occurs 1/week for 2 months Not IBS 2 symptoms in a child developmentally ³4yo: * <3 bowel movements/week * 1 episode of fecal incontinence/week ou + * Retentive posturing * Painful or hard bowel movements * Large fecal mass in rectum * Large diameter stools that may block toilet

Answer 28

* 2 periods of intense nausea and hyperemesis or retching lasting hours to days (in past 6mo) (Over, and over, and over, and over (4x/hr for 1hr–10d)… ) * Episodes are stereotypical * Return to usual state of health lasting weeks to months * Symptoms not attributable to other conditions (Family history of migraine)

Answer 29

Abdominal pain >4 times/month with >1 of the following symptoms: * Timing related to defecation * Change in frequency of stool * Change in form of stool If patient experiences constipation (IBS-C), pain does not resolve with resolution of constipation

Answer 30

* Must occur >2x: > Paroxysmal episodes of intense, acute, periumbilical pain for 1 hour > Healthy for weeks to months between episodes > Interferes with normal activities * Stereotypical pattern * 2 of the following symptoms: > anorexia > nausea > vomiting > headache > photophobia > pallor

Answer 31

>1 of the following with symptoms at least 4 days per month for >2 months: * Post prandial fullness * Early satiety * Epigastric or burning pain not associated with defecation (gastrocolic reflex) * Not attributable to another condition

Answer 32

- Alim q 3-4h - Shaking baby - Éval risque sepsis, NAS, ictère, hypoglycémie - Sommeil sécuritaire - Vaccins - Vit D - Fer - F° / infx - Nirsevimab - EP - SV et T° - Pds / T / PC - Urine + Selle - 2 boires - Séro mat - Audio - PKU - Vit K + ppx conjonctivite - Siège auto - Cardiopathie - Suivi 48h

Answer 33

Puberté N Fille 8-13 ans Garçon 9-14 ans **Central** - Idiopathique (surtout filles) - aN SNC (masse) - NF1 **Périphérique** - Tumeur gonadiques - McCune-Albright - CAH - HypoT4 - Hormones exogènes IRM si F < 6 ans ou Sx neuro ou Garçon

Answer 34

**Central** - Hypopituitarisme (Trauma, Irradiation, Chx, Septo-optique) - Hypogonadisme hypothalamique fonctionnel (Mx chronique, TCA) - Syndromes (Prader-Willi) - Kallman **Périphérique** - Turner - Klinefelter - Atteinte gonadique: trauma, irradiation, chimiotx, infx, auto-immun

ECOS Simon Flashcards

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