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Pediatrics Exam 2 > Chronic Disease > Flashcards

Chronic Disease Flashcards

1
Q

Cystic fibrosis genetics and epidemiology:

A

Autosomal recessive; whites; boys = girls

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2
Q

What are two findings that suggest CF in both kids and adults?

A

Kids: Nasal polyps under 12
Adults: Allergies

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3
Q

What are three metabolic findings of CF?

A
  • Hyponatremic hypochloremic dehydration
  • Metabolic alkalosis
  • DM
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4
Q

What are the two options for the newborn screen?

A

IRT

DNA

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5
Q

What number is a positive sweat chloride?

A

60 mEq/L

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6
Q

What two things should you supplement a CF patient with for diet?

A
  • Fat soluble vitamins (DEAK)

- Pancreatic enzymes

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7
Q

Median age of survival:

A

40

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8
Q

Most common rheumatologist disease:

A

Juvenile Idiopathic Arthritis

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9
Q

What is the race that is most commonly affected by JIA? Age distribution?

A

Native Americans; BIMODAL (1-3), (8-10)

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10
Q

Who is affected more with JIA?

A

Girls 2-3x more

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11
Q

What can be a finding in all types of JIA? What increases the risk for uveitis?

A

Uveitis - circumlimbal; if ANA positive you are at increased risk for this

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12
Q

Symptoms must be present for how long to diagnose JIA?

A

6 weeks

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13
Q

Most common form of JIA?

A

Oligioarticular (4 or fewer joints involved for 1-6 months)

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14
Q

Two types of oligoarticular JIA?

A
  • Persistent (better): Never develop more than 4 joints, 75% remission
  • Extended: 5+ joints involved after the first 6 months
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15
Q

What type of joints does Polyarticular JIA affect? What are the two types?

A

Smaller, symmetrical, 5+ joints in the first 6 months of illness

Rh (-): More common and early in childhood
Rh (+): Adolescent females, resembles RA

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16
Q

Type of JIA associated with the most mortality or morbidity:

A

Systemic, fever spikes 1-2x daily for at least two weeks (may accompany or proceed the joint pain)

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17
Q

What will occur with the fever spikes in those with systemic JIA?

A

A discrete salmon colored macule pattern on the trunk and extremities

18
Q

What is Enthesitis Related arthritis (JIA)?

A

Inflammation where the tendon inserts at the bone - to Dx need at least (2)

19
Q

What are two other findings in those with psoriatic arthritis (JIA)?

A
  • Oncycolysis - nail pitting

- Dactylitis - swelling

20
Q

Peak onset for those with Enthesitis-Related arthritis:

A

Middle childhood

21
Q

What imaging study can be helpful with JIA?

A

MRI; but a clinical diagnosis so not needed

22
Q

Initial mild treatment for those with JIA:

A

NSAIDS

23
Q

For additional JIA management, what else can be used? (3)

A
  • Methotrexate (anti-RA)
  • Etanerecept (tumor necrosis)
  • Corticosteroids - for the eyes and injections for the joints (not long term)
24
Q

When do detection of DM1 antibodies show up and when do you see destruction and clinical presentation?

A

Antibodies circulate 5-10 years before clinical presentation

- Clinical signs show up when 80-90% of the beta cells are destroyed

25
Q

Type1 disease onset and epidemiology:

A

Bimodal: 4-6, 10-14
Boys and girls are equal
Common in whites

26
Q

Type2 disease onset and epidemiology:

A
  • Girls

- American Indians –> Pacific Islanders –> AA

27
Q

Four criteria for the diagnosis of diabetes:

A
  1. A1C >6.5%
  2. Fasting plasma glucose >126
  3. Two hour glucose >200
  4. Random >200 + crisis
28
Q

When do you screen for DM?

A

Every 3 years starting at age 10 or when they hit puberty

29
Q

You are at risk for diabetes with the following four things:

A
  1. FH
  2. At risk race
  3. Acathosis nigricans, dyslipidemia, HTN, PCOS
  4. Maternal gestational diabetes
30
Q

Glycemic control can be more difficult during what three things?

A
  • Exercise
  • Adolescence
  • Acute illness
31
Q

Initiate kids on insulin with T2DM when any of the four apply:

A
  • DKA
  • Glucose levels >250
  • A1C >9%
  • When you can’t tell if they have type 1 or 2
32
Q

BMI > ___ = obese

BMI > ___ = Overweight

A 
>95% = Obese
>85% = Overweight
33
Q

What is the main reason kids gain weight?

A

Reduced energy expenditure

34
Q

Highest risk factor to a child for obesity under the age of 10:

A

Parental obesity

35
Q

What ages do kids add on fat cells for life?

A

3-7

36
Q

The majority of childhood obesity is from:

A

Exogenous causes - energy intake vs. expenditure

37
Q

What are three endocrine issues that can cause obesity?

A
  • Hypothyroidism
  • Cushing’s
  • GH def.
38
Q

What are three things obesity causes?

A
  • Early menstruation
  • CAD
  • OSA
39
Q

When should you start anticipatory guidance for obesity?

A

6 months

40
Q

Digital screen recs:

A

<2: None
2-5: 1 hr a day
>6: Use discretion

41
Q

Age 2-11 weight loss and >11 weight loss limits:

A

2-11: No more than 1 pound/week

>11: No more than 2 pounds/week

Pediatrics Exam 2 (7 decks)

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