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Pathophysiology > Chapter 2 - Pediatric Diseases and Disorders > Flashcards

Chapter 2 - Pediatric Diseases and Disorders Flashcards

1
Q

Prematurity
(1) Description
(2) S & S
(3) Etiology

A

(1) Birth before 37th gestational week
(2) Baby may weigh 12 oz or less, underdeveloped organ systems that lead to other complications
(3) Many causes including: incompetent cervix, uterus abnormalities, maternal infection or trauma, hypertension. Often idiopathic

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2
Q

Infant respiratory distress syndrome
(1) Description
(2) S & S
(3) Etiology

A

(1) Acute hypoxemia due to alveoli not being able to expand
(2) Shortly after birth: respiratory distress including: nasal flaring, grunting respirations, sternal retractions; cyanosis
(3) Insufficient surfactant needed for lungs to expand. Alveoli are stuck together and cannot function

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3
Q

Infant respiratory distress syndrome
(4) Diagnosis
(5) Treatment

A

(4) Observed symptoms, history of prematurity, blood gas panels demonstrate reduced gas exchange, radiographic chest films show abnormality
(5) Administration of supplemental oxygen, infusion of surfactant so alveoli can expand.

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4
Q

Bronchopulmonary dysplasia
(1) Description
(2) S & S
(3) Etiology

A

(1) Serious chronic lung disease resulting from insult to neonate’s lungs
(2) Periods of dyspnea, tachypnea, wheezing, cyanosis, nasal flaring, sternal retractions, decrease in O2 saturation. Coughing, difficulty breathing, wet/crackling sound heard on auscultation
(3) Often occurs as a result of IRDS, mechanical ventilation, infection, or prematurity

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5
Q

Bronchopulmonary dysplasia
(4) Diagnosis
(5) Treatment
(6) Potential complications

A

(4) Observation, radiographs of chest, arterial blood gas panel: O2 low, CO2 high
(5) Alveoli grow naturally up to 8 yrs of age, thus, the goal of treatment is to support this growth so it can replace damaged alveoli. Includes: supplemental O2 and nutritional support.
(6) Pulmonary edema, hypertension, tracheomalacia, asthma, right-sided heart failure (cor pulmonale), respiratory infections, GI reflux

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6
Q

Retinopathy of prematurity (retrolental fibroplasia)
(1) Description
(2) S & S
(3) Etiology
(5) Treatment

A

(1) Abnormal growth of blood vessels in retina of infants
(2) Blindness (though no visible signs)
(3) Unknown cause. Risk factors include: prematurity, high O2 supplementation, intense light, certain medications
(5) Mild forms may resolve w/o treatment. If needed, laser removal of blood vessels is possible

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7
Q

Necrotizing enterocolitis
(1) Description
(2) S & S
(3) Etiology

A

(1) Inflammatory disease caused my ischemic (lack of blood) necrosis of mucosal lining of one or both intestines
(2) Feeding intolerance, abdominal distension, bile covered emesis, diarrhea, blood in stool, decreased/absent bowel sounds. As the condition worsens, it can cause respiratory issues, hyperbilirubinemia, erythema, tender abdomen
(3) Unknown. Possible: breakdown of normal defense in GI tract causing infection. Risk factors may include: prematurity, hypovolemia, sepsis, umbilical catheters, transfusions, IRDS

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8
Q

Necrotizing enterocolitis
(4) Diagnosis
(5) Treatment

A

(4) Observation of feeding and activity of infant. Elevated WBC. Occult blood in stool.
(5) Aggressive and immediate: feeding stopped, monitoring of pH and electrolytes and respiratory function. If necessary: colostomy or ileostomy.

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9
Q

Robinow Syndrome
(1) Description
(2) S & S
(3) Etiology

A

(1) Disorder that affects development of skeleton and other body parts
(2) Dwarfism, short lower arms, clinodactyly (abnormally bent finger), brachydactyly (shorter fingers/toes), spinal malformations, flat face, larger head, widely spaced eyes, underdevelopment of reproductive organs
(3) Autosomal recessive or dominant

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10
Q

Hypertrophic cardiomyopathy
(1) Description
(2) S & S
(3) Etiology

A

(1) Thickening of heart muscle
(2) Seemingly healthy athlete suddenly collapses; followed by cardiac arrest or arrhythmia
(3) Autosomal dominant

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11
Q

Down Syndrome
(1) Description
(2) S & S
(3) Etiology

A

(1) Physical and cognitive abnormalities resulting from a chromosomal abnormality
(2) Physical traits: slanted eyes, small mouth with protruding tongue, simian line, small/weak muscles. Heart defects may be present.
(3) Trisomy 21

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12
Q

Cerebral palsy
(1) Description
(2) S & S
(3) Etiology

A

(1) Group of disorders involving movement, learning, hearing, sight, and speech
(2) Spastic - hyperactive reflexes, muscle contractions, toe-walking, scissor gait
Athetoid - involuntary muscle movement, reduced muscle tone, difficulty with speech
Ataxic - lack of control over voluntary movement, problems with balance and coordination
(3) Inadequate blood/O2 supply to brain during fetal development, birth/infancy, or early in childhood

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13
Q

Duchenne’s Muscular Dystrophy
(1) Description
(2) S & S
(3) Etiology

A

(1) Progressive degenerative disorder of skeletal muscles
(2) Waddling gait; toe-walking; large looking, fatty muscles; lordosis or other spinal defects; weakness and falling; eventually progresses to crippling immobility
(3) Genetic defect (recessive) causes absence of protein (dystrophin) that is responsible for muscle integrity

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14
Q

Spina Bifida Occulta
(1) Description
(2) S & S
(3) Etiology

A

(1) Least severe version of spina bifida. Posterior arches of vertebrae fail to fuse
(2) Dimpling, tuft of hair, hemangioma,
(3) Unknown etiology (genetics and nutrition of mother— folic acid and vitamin A deficiencies— may play a role)

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15
Q

Meningocele (Spina Bifidas)
(1) Description
(2) S & S
(3) Etiology

A

(1) Meninges protrude through opening in spinal column
(2) Sack of CSF visible. May be vulnerable to rupture.
(3) Posterior portion of neural tube fails to close. Cause unknown. May be influenced by genetics and nutrition

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16
Q

Myelomeningocele (spina bifida cystica)

A

(1) Most severe form of Spina Bifida. Protrusion of meninges and spinal cord through defect in spinal column
(2) Neurologic symptoms, musculoskeletal malformation, paralysis
(3) Neural tube fails to close during development. Possibly caused by genetics and exposure to agent orange

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17
Q

Hydrocephalus
(1) Description
(2) S & S
(3) Etiology

A

(1) CSF very high, either because excess or circulation blocked
(2) Enlargement of head, pressure changes in brain that cause various neurologic symptoms, high pitched cry, vomiting
(3) Lesion within circulation system, congenital defect, intracranial hemorrhage, blood clot, prematurity, infection (often meningitis)

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18
Q

Hydrocephalus
(4) Diagnosis
(5) Treatment

A

(4) Physical examination and radiographic skull studies. Also CT and MRI scans.
(5) Surgical intervention to place a shunt in ventricular or subarachnoid spaces to absorb CSF and empty it either to the right atrium or peritoneal cavity.

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19
Q

Anencephaly
(1) Description
(2) S & S
(3) Etiology

A

(1) Severe neural tube defect; neural tube fails to close
(2) Absence of cranial vault (part of the skull that holds the brain), little or no cerebral tissue, death
(3) Unknown

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20
Q

Ventricular septal defect
(1) Description
(2) S & S
(3) Etiology

A

(1) Abnormal hole between left and right ventricles.
(2) Varies in severity: characteristic murmur, failure to gain weight, restlessness, irritability, increased HR and RR
(3) Several factors may contribute to congenital heart defects. Include chromosomal abnormalities, environmental conditions, error when switching from fetal circulation

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21
Q

Patent Ductus Arteriosus
(1) Description
(2) S & S
(3) Etiology

A

(1) Ductus fails to close, leading to oxygenated blood going through pulmonary arteries
(2) Characteristic machinery murmur, thrill upon palpitation, growth/development slowed, other signs of heart failure
(3) Exact cause of failure unknown, but it is common in premature infants

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22
Q

Coarctation of aorta
(1) Description
(2) S & S
(3) Etiology

A

(1) Narrowed aortic lumen, causing partial obstruction of blood flow
(2) Left ventricular failure with pulmonary edema, cyanosis, pallor, weakness, dyspnea, tachycardia. Blood pressure is higher in arms but lower in legs.
(3) Exact cause unknown; associated with Turner syndrome

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23
Q

Atrial septal defect
(1) Description
(2) S & S
(3) Etiology

A

(1) Abnormal opening between left and right atria. Blood shunted from left to right.
(2) Varies in severity. Fatigue, shortness of breath, frequent respiratory tract infections, cyanosis, dyspnea, and syncope
(3) Chromosomal abnormalities, environmental conditions, other (exact cause unknown)

24
Q

Tetralogy of Fallot
(1) Description; what are the four defects?
(2) S & S
(3) Etiology

A

(1) VSD, pulmonary stenosis, dextroposition of the aorta, right ventricular hypertrophy
(2) Hypoxia, tachycardia, tachypnea, dyspnea, seizures, polycythemia (too many red blood cells)
(3) Chromosomal abnormalities, environmental disorders, other (exact cause unknown)

25
Q

Transposition of the great arteries
(1) Description
(2) S & S
(3) Etiology

A

(1) Aorta and pulmonary arteries reversed, leading to two closed systems of blood flow
(2) Cyanosis, tachycardia, signs of heart failure, systolic murmur
(3) Cause unknown, associated with prematurity and PDA (patent ductus arteriosus)

26
Q

Clubfoot (Talipes Equinovarus)
(1) Description
(2) S & S
(3) Etiology

A

(1) Anterior half of foot adducted and inverted.
(2) Heel drawn up, lateral side of foot convex and medial side concave.
(3) Fetal position or genetics

27
Q

Developmental dysplasia of the hip
(1) Description
(2) S & S
(3) Etiology

A

(1) Abnormal development of hip joint. Varies: instability -> dislocation of femoral head
(2) Asymmetric folds of the thigh with limited abduction of the affected hip
(3) Unknown

28
Q

Cleft lip and palate
(1) Description
(2) S & S
(3) Etiology

A

(1) Cleft in upper lip / hole in middle of roof of mouth
(2) Some infants may have difficulty with nasal regurgitation and feeding
(3) Failure in embryonic development, may have genetic factors

29
Q

Cryptorchidism
(1) Description
(2) S & S
(3) Etiology

A

(1) testes fail to descend
(2) None in infancy/early childhood besides absence of testes. If not surgically corrected, can lead to cancer or sterility later in life
(3) Not clearly understood

30
Q

Wilms Tumor (Nephroblastoma)
(1) Description
(2) S & S
(3) Etiology

A

(1) Highly malignant cancer of the kidney in children <10 years old.
(2) Non-tender mass in kidney region, hematuria, pain, vomiting, intestinal obstruction, fever
(3) Adenosarcoma arising from abnormal fetal kidney tissue left behind. Can be hereditary. Associated with aniridia and genitourinary abnormalities (WAGR syndrome).

31
Q

Wilms tumor
(4) Diagnosis
(5) Treatment

A

(4) Physical exam, blood tests to assess for anemia and kidney and liver function, abdominal ultrasound, CT scan, and urinalysis
(5) Surgical removal of tumor, chemo, possibly radiation

32
Q

Phimosis
(1) Description
(2) S & S
(3) Etiology

A

(1) Foreskin narrowing. Can be normal in neonatal period and early adolescence but is problematic if contracted
(2) Difficulty urinating, difficulty cleaning area
(3) Unknown; many males born with it

33
Q

Congenital pyloric stenosis
(1) Description
(2) S & S
(3) Etiology

A

(1) Narrowing of pyloric sphincter (exit of stomach)
(2) projectile vomiting w/o bile, hungry but can’t hold food down, failure to gain weight; can be treated with surgery
(3) Unknown

34
Q

Hirschsprung Disease (Congenital aganglionic megacolon)
(1) Description
(2) S & S
(3) Etiology

A

(1) Obstruction of distal colon
(2) Constipation, vomiting with bile or fecal matter, distended abdomen, not wanting to eat, watery diarrhea
(3) Parasympathetic nerve ganglion cells absent in segment of colon. Lack of peristalsis leads to backup of fecal matter

35
Q

Cystic fibrosis
(1) Description
(2) S & S
(3) Etiology
(4) Diagnosis
(5) Treatment

A

(1) Fatal genetic disease that affects many systems. Excess production of thick, sticky mucus
(2) Dry cough, exercise intolerance, pneumonia, bulky diarrhea, vomiting, bowel obstruction, pancreas changes
(3) Autosomal recessive.
(4) Genetic testing, family history, pulmonary function test, radiographic chest film, stool studies
(5) High calorie, high NaCl diet. Chest physiotherapy, vitamins, pancreatic enzyme supplements, mucus-thinning drugs, more

36
Q

Phenylketonuria
(1) Description
(2) S & S
(3) Etiology

A

(1) Error in metabolism that causes mental retardation; absence of enzyme needed to change phenylalanine to tyrosine
(2) Musty odor of urine and sweat, rash, hyperactivity, and as the disease progresses untreated: personality disorders and arrested brain development. (can be stopped with phenylalanine-free diet)
(3) Autosomal recessive

37
Q

Klinefelter syndrome
(1) Description
(2) S & S
(3) Etiology

A

(1) Male hypogonadism caused by chromosomal abnormality
(2) Abnormal development of testes, reduced testosterone, long legs & above-average height, infertility
(3) More than one X chromosome and a Y chromosome.

38
Q

Turner syndrome
(1) Description
(2) S & S
(3) Etiology

A

(1) Chromosomal abnormality in females
(2) Ovaries immature or absent, short and low-set ears, coarctation of the aorta, lack of sexual maturation
(3) Only one X chromosome

39
Q

Chickenpox (Varicella Zoster)
(1) Description
(2) S & S (and complications)
(3) Etiology

A

(1) Highly contagious acute viral infection
(2) Lesions on skin that progress into papules and pop, pruritus/itching, fever, malaies, anorexia
Complications include shingles, secondary bacterial infection, viral pneumonia, conjunctival ulcers, Reye syndrome
(3) Varicella zoster virus

40
Q

Diphtheria
(1) Description
(2) S & S (and complications)
(3) Etiology

A

(1) Acute communicable disease that causes necrosis of mucus membrane in upper respiratory tract
(2) Sore throat, dysphagia, cough, hoarseness, chills, swollen lymph nodes, gray patches (characteristic pseudomembrane)
Complications: otitis media, pneumonia, myocarditis, paralysis
(3) Bacterial infection of corynebacterium diphtheriae

41
Q

Mumps
(1) Description
(2) S & S
(3) Etiology

A

(1) Acute viral infection causing inflammation of parotid glands
(2) Tenderness in region of parotid glands, rash, headache, muscle aches, fever, appetite loss, earache
(3) Virus

42
Q

Pertussis
(1) Description
(2) S & S
(3) Etiology

A

(1) Highly contagious bacterial infection of respiratory tract
(2) Progresses from common cold symptoms to violent cough with characteristic whoop and vomiting
(3) Bacteria bordetella pertussis

43
Q

Measles (Rubeola)
(1) Description
(2) S & S (and complications)
(3) Etiology

A

(1) Viral disease
(2) Cough, coryza, conjunctivitis, photophobia, fever, rash (which starts behind ears and on forehead then spreads), koplik spots (white blotches) in mouth
Complications: pneumonia, otitis media, conjunctivitis, encephalitis, subacute sclerosing panencephalitis
(3) Virus

44
Q

Rubella (aka German measles and three day measles)
(1) Description
(2) S & S
(3) Etiology

A

(1) Viral disease that mimics measles but has shorter duration and fewer complications
(2) Rash, fever, tender lymph nodes
(3) Rubella virus

45
Q

Tetanus
(1) Description
(2) S & S
(3) Etiology

A

(1) Acute infection that entails painful, involuntary contraction of skeletal muscles
(2) Fever, irritability, sweat, stiff neck, lockjaw, spasms of muscles (opisthotonos) which can cause death by asphyxiation, difficulty swallowing
(3) Bacillus clostridium tetani bacteria invades deep wounds and produces exotoxins

46
Q

Sudden Infant Death Syndrome (SIDS)
(1) Description
(2) S & S
(3) Etiology

A

(1) Infant <12 yrs of age dies suddenly, usually during the night, though they appeared healthy before
(2) Body may appear cyanotic
(3) Many possible causes; overheating (due to excess clothing) and sleeping position may play a role

47
Q

Croup
(1) Description
(2) S & S
(3) Etiology

A

(1) Acute, severe inflammation and obstruction of respiratory tract
(2) Often preceded by upper respiratory infection, hoarseness, fever, high pitched cough, dyspnea, narrowing of upper airways
(3) Often viral; involves larynx, trachea, and bronchi. Blockage caused by edema and spasm of the vocal cords

48
Q

Adenoid Hyperplasia
(1) Description
(2) S & S
(3) Etiology

A

(1) Abnormal enlargement of lymphoid tissue above soft palate of the mouth, causing breathing difficulty
(2) Recurrent otitis media and hearing loss, mouth breathing, snoring, episodes of sleep apnea
(3) Unknown; but risk factors include: repeated infection, genetics, and chronic allergies

49
Q

Asthma
(1) Description
(2) S & S
(3) Etiology

A

(1) Chronic obstructive disease of the bronchioles/airway caused by increased reactivity of tracheobronchial tree to stimuli
(2) Incessant cough, pronounced expiratory wheeze, shallow respirations, rapid pulse, pallor, perspiration, nasal flaring, intercostal or sternal retractions
(3) Hereditary factors, hypersensitive bronchial tubes. Asthma attacks triggered by stress, exercise, infection, and air pollutants

50
Q

Bronchiolitis
(1) Description
(2) S & S
(3) Etiology

A

(1) Inflammation of the bronchioles. Most common in infancy
(2) Cough and nasal congestion that progresses to: wheeze, tachypnea, respiratory distress, fever, posttussive emesis
(3) Most commonly caused by RSV but can also arise from other viruses

51
Q

Epiglottitis
(1) Description
(2) S & S
(3) Etiology

A

(1) Inflammation of the epiglottis
(2) Sore throat, croup-like cough, respiratory distress, swollen epiglottis, rapidly increasing dyspnea, drooling
(3) Can follow viral infection of the upper respiratory tract. Thermal epiglottitis can be caused by ingestion of very hot foods or liquids

52
Q

Infantile colic
(1) Description
(2) S & S
(3) Etiology

A

(1) Intermittent distress of newborn
(2) Infant will periodically seem distressed, draw up knees, and have a tense abdomen. Resolves suddenly without intervention.
(3) Unknown etiology; though linked to irregular bowel movements

53
Q

Leukemia
(1) Description
(2) S & S
(3) Etiology

A

(1) Cancer of blood-forming tissues. Abnormal increase of immature WBCs
(2) Anemia, susceptibility to infection, longer bleeding due to fewer platelets, fever, easy bruising, pallor, weight loss, bone & joint pain
(3) Unknown etiology

54
Q

Erythroblastosis fetalis (hemolytic disease of the newborn)
(1) Description
(2) S & S
(3) Etiology

A

(1) Incompatibility of fetal and maternal blood that leads to destruction of RBCs
(2) Anemia, jaundice, kernicterus, enlarged liver and spleen, heart failure, pulmonary congestion, lethargy, seizures, mental retardation
(3) Baby Rh positive while mother is Rh negative, so the mother’s antibodies attack the baby’s RBCs

55
Q

Reye Syndrome
(1) Description
(2) S & S
(3) Etiology

A

(1) Brain disease and fatty invasion of inner organs
(2) Acute and often fatal illness. Disruption of urea cycle leads to swelling of brain and symptoms. Five stages: 1. lethargy, irritability, combativeness, hepatic dysfunction, vomiting. 2. hyperventilation, hyperactivity, disorientation. 3. Organ changes and coma. 4. Deeper coma and loss of brain functions. 5. Seizures, loss of deep tendon reflexes, respiratory arrest
(3) Follows viral infections; linked to use of aspirin during infections

56
Q

Neuroblastoma
(1) Description
(2) S & S
(3) Etiology

A

(1) Cancer of sympathetic nervous system
(2) Abdominal mass, abdominal pain, fullness, anemia, bone pain, fever, hypertension, raccoon eyes (periorbital ecchymosis)
(3) Unknown; arises from primitive ganglions

Pathophysiology (7 decks)

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