bilious emesis in neonate
r/o intestinal obstruction
neonates should pass meconium within
24-48 hours
microcolon and failure to pass meconium
meconium ileus - pathognomonic for CF (autosomal recessive)
neonatal bilious emesis workup
x-ray (r/o surgical emergency) then contrast studies (barium enema) to determine level of obstruction
precocious puberty workup
first look at bone age; if advanced bone age, check LH levels to differentiate between peripheral (low LH - d/t inhibition of the hypothalamus by high circulating sex hormones) and central (high) precocious puberty
Klinefelter syndrome
47,XXY - causes primary hypogonadism, which is characterized by low testosterone and elevated LH levels; patients have tall stature and puberty is delayed
McCune Albright syndrome
- gonodotropin-independent precocious puberty
- irregular cafe-au-lait macules
- fibrous dysplasia of bone
Nonclassic congenital adrenal hyperplasia
- 21-hydroxylase deficiency
- 17-hydroxyprogesterone shunted towards adrenal androgen overproduction
- -> precocious puberty - accelerated growth and bone age with low/normal LH levels
- mineralocorticoid and glucocorticoid levels are maintained
failure to thrive, LAD, and opportunistic infections (PCP, Candida) in infant
HIV infection
aseptic meningitis, parotitis, orchitis
mumps
