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Pediatrics > Chronic Pediatric Disease Inclass > Flashcards

Chronic Pediatric Disease Inclass Flashcards

1
Q

Which drug for HTN

A
  1. ACEi/ARB
    CCB, Thiazides
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2
Q

What are the symptoms of Cerebral Palsy?

A

-Flexed elbow
-Bent wrist
-Flonated forearm
-Clenched fist
-thumb in palm

also movement disorder:
-Spasticity
-dystonia
-choreoathetosis
-ataxia

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3
Q

Which drugs are used for spasticity in children?

A
  1. Baclofen
    or Benzos (Diazepam, Clonazepam)
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4
Q

Which drugs are used for drooling in children?

A

Scopolamine (antimuscarinic)
Glycopyrrolate (anticholinergic)

drooling can cause skin breakdown

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5
Q

Which drug for Insomnia in children?

A

Melatonin

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6
Q

Which drugs are for Aggression and irritability?

Which drugs for anxiety and depression?

Which drug for ADHD?

A

Aggression and irritability: Aripiprazole (Abilify) and risperidone (Risperdal)

anxiety and depression: SSRI

ADHD: stimulants like Atomoxetine, clonidine and guanfacine

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7
Q

What are the 3 forms of IBS?

A

-IBS-D (with diarrhea)
-IBS-C (with constipation)
-Visceral hypersensitivity (altered intestinal sensation): increased pain -> anxiety

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8
Q

Treatment for IBS-D and IBS-C

A

IBS-C: Fiber and bulk-forming agents + water, laxatives, Rx: Lubiprostone

IBS-D:
-Loperamide (Imodium)
-Anitspasmatics (Hyoscyamine, Dicyclomine) - not often, peppermint oil

-SSRIs: lots of serotonin receptors in the GI
-TCAs: may use to treat comorbid depression

-oral corticosteroids, mesalamine (anti-inflammatory)
-Probiotics
-fecal transplant

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9
Q

Which disease is treated with Aspirin in children?
Why is it usually avoided in children?

A

Kawasaki disease

it is avoided in children because of Reyes syndrome

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10
Q

What is the cause of most DVTs in kids?

A

often caused by the central line (IV catheter)

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11
Q

What is the main thing to remember about
dosing of enoxaparin in kids?

A

the dose is much higher in kids

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12
Q

What is the treatment for a patient with Sickle cell disease who presents in the ER? (acute)

A

-give O2 due to hypoxia (causes pain)
-give fluids
-pain treatment: opioids
-antibiotics like ceftriaxone (it could be caused by an infection)

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13
Q

What happens over time in patients with Sickle cell disease?

A

Functional Asplenia, may end up with splenectomy

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14
Q

Which prophylactic treatment is necessary for patients with sickle cell disease or patients after a splenectomy?

A

-> Prophylaxis vaccine against encapsulated bugs:
Strep pneumo
Salmonella
Neisseria meningitis
Haemulus influenza

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15
Q

Which drug is used to treat Sickle cell disease?

A

Hydroxyurea

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16
Q

What are the three types of crises that are
dangerous in Sickle cell disease patients and why?

A

-Vasoocclusive pain crisis (sickle RBC blocks blood vessels -> causes pain): hydration, pain meds, transfusion

-Aplastic crisis (no RBC production)

-Sequestration crisis: hypovolemia of the spleen, it has filtered so many sickle cells that it can rupture

17
Q

Hydroxyurea dosing

A
18
Q

Which protein is the defect in cystic fibrosis?

A

CFTR protein
a Chloride channel !!!
-> affects water transfer -> higher viscosity (various organs, usually the lungs)

19
Q

What are the 3 common bacteria isolated from the lungs of CF patients?

A

-Pseudomans
-H. flu
-MRSA

20
Q

Which antibiotics would be a good empiric therapy in children for cystic fibrosis?

A

Pseudomonas:
-Zosyn (Pip/Tazo)
-Cefepime
-Meropenem
-Aminoglycoside (gentamicin) given with Zosyn
-Levaquin/Cipro

Staph aureus (MRSA):
-Vancomycin
-Linezolid (caution: thrombocytopenia, serotonin syndrome, seizure)

need to cover Staph aureus and Pseudomonas!!

21
Q

Why might Rocephin and Bactrim be dangerous in kids under 2 months?

FYI Naplex

A

-displaces bilirubin -> Hyperalbuminemia, kernicterus
-bind to Calcium

22
Q

How is antibiotic dosing for cystic fibrosis different in kids than in adults?

A

doses are higher in kids bc renal elimination is faster and the Vd is greater than in adults

23
Q

Patients with cystic fibrosis have decreased pancreas activity and are treated with pancreatic enzymes.

What gastrointestinal signs may indicate an
inadequate dose of pancreatic enzymes?

A

floating stool (Steatorrhea)

due to low Lipase (produced in the pancreas)

24
Q

How are exacerbations of Nephrotic syndrome treated?

Which ones are used for suppression?

A

IV albumin and a big dose of furosemide

for suppression:
Corticosteroids, or Cytoxen, cyclosporin, or mycophenolate mofetil (immunosuppressant)

25
Q

What types of adverse reactions are caused by these medications (mycophenolate mofetil, cyclosporin)?

A

-HTN
-nephrotoxicity

they often already have HTN, so it makes it worse

26
Q

Which equation is used to estimate renal
function in children?

A

Bedside Schwartz equation

27
Q

Inhaled corticosteroids can cause growth suppression in children when used long-term. T/F

A

True

28
Q

Which drug is often prescribed for patients for asthma treatment instead of Albuterol only?

A

Budesonide + Formeterol Combi

Formoterol (LABA) -> quick onset for rescue)

29
Q

What should be considered when using Montelukast in kids for asthma?

A

contraindicated in kids with psychiatric issues

but if they don’t have mental problems, its worth to try in kids who have tried other drugs

30
Q

Which diseases are often seen with Atopic Dermatitis?

A

Atopic Triad:
-Atopic dermatitis
-Allergic rhinitis
-Asthma or food allergies

31
Q

What is often seen secondary to Atopic Dermatitis?

!!!

A

Skin infections due to skin breakdown

Treatment: antibiotics for MRSA (Staph aureus) and Group A Strep

Candida and herpes are less common

32
Q

Which drugs are used for Atopic Dermatitis?

A

topical therapy (moisturizer, emollients, antihistamines, topical calcineurin inhibitor)

-avoid triggers: season change, dry skin, foods, irritants, stress, infections)

33
Q

Difference between Ulcerative Colitis and Crohn’s disease

A

Ulcerative Colitis: in the colon (curable, cut parts out)

Crohn’s disease: can be anywhere in the GI tract

34
Q

Which drugs are used for Crohn’s disease and Ulcerative Colitis?

A

-Corticosteroids, aminosalicylates

-immunomodulators, biologics and antibiotics if moderate or severe

35
Q

Which biologics are used in UC and Crohn’s disease?

A

Top-down approach:

Biologics
-Adalimumab (Humira®): can be used at home

-Infliximab (Remicade®): need infusion for administration

others: Certolizumab pegol (Cimzia), Natalizumab (Tysabri), Vedolizumab (Entyvio) & Ustekinumab
(Stelara)

36
Q

What is a rare but bad side effect of combination use of azathioprine, 6-mercaptopurine, or methotrexate with biologics?

A

Hepatosplenic T-cell Lymphoma

often seen when started with azathioprine, 6-MP, and methotrexate

but it is very rare

Pediatrics (7 decks)

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