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Pediatrics > Common Medical Problems > Flashcards

Common Medical Problems Flashcards

1
Q

When should infants double their birth weight?

A

By 4 months

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2
Q

When should infants weight be tripled?

A

By 1 year

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3
Q

Abdominal Disorders of Pediatric Patients

A 
Pyloric stenosis
Necrotizing enterocolitis
Other disease of bowel obstruction
GERD
Colic
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4
Q

Clinical Presentation of Pyloric Stenosis

A 
3-5 weeks
"Projectile" nonblious vomiting
Infant immediately hungry
Dehydrated
Jaundiced
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5
Q

PE in Pyloric Stenosis

A

Check hydration status
Check for jaundice
Palpate abdomen for “olive”

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6
Q

Evaluation of Pyloric Stenosis

A

Labs

Ultrasound

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7
Q

Treatment of Pyloric Stenosis

A

Pyloramyotamy

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8
Q

Why is it important to inquire about forcefully a baby is vomiting?

A

Differentiate between normal spit-up and pyloric stenosis

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9
Q

What is the term commonly used to describe forceful vomiting?

A

Projectile

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10
Q

What is in a baby’s differential with projectile vomiting?

A

Infection

Pyloric stenosis

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11
Q

What is the significance of a baby’s weight when presenting with pyloric stenosis?

A

Above/at/below birth weight

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12
Q

Why is the color of a baby’s emesis important?

A

Helps to determine if there is a bowel obstruction

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13
Q

How can you determine a baby’s hydration status?

A

Palpate the fontanelles

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14
Q

What are the 2 categories of vomiting in a baby?

A

Bilious

Non-bilious

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15
Q

Examples of Bilious Vomiting

A 
Malrotation
Volvulus
Hirschsprung disease
Incarcerated hernia
Intussusception
Intestinal atresia
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16
Q

Examples of Non-Bilious Vomiting

A

GERD
Cow/soy milk protein intolerance
Pyloric stenosis
Gastritis

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17
Q

Differential Diagnosis of Abdominal Pain in Newborns

A

GERD
Necrotizing colitis
Volvulus

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18
Q

Differential Diagnosis of Abdominal Pain in Infancy to 2 years

A

Intussesception
Meckel’s diverticulum
Bacterial enteritis

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19
Q

Warning signs of underlying pathology in GERD

A 
BIlious vomiting
GI bleeding
Forceful vomiting
Prolonged constipation
Dirrhea
Abdominal distension
HSM
Bulging fontanelle
Seizures
Micro/macrocephaly
Hyper/hypotonia
Stigmata of genetic disease
Chronic infections
Fever
Pneumonia
Lethargy
Failure to thrive
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20
Q

If GERD warning signs are absent and infant has these symptoms, a workup can be considered.

A

Poor weight gain
Irritability
Feeding refusal
Gross blood in stool

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21
Q

Workup of GERD

A

Esophageal pH monitoring

Endoscopy

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22
Q

GERD Treatment Options

A

Lifestyle changes
Positioning therapy
Pharmacotherapy

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23
Q

Lifestyle Changes for the Treatment of GERD

A

Avoid tobacco smoke
Smaller feedings
Remove all cow’s milk

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24
Q

Positioning Therapy for the Treatment of GERD

A

Keep infant upright 10-20 minutes after a feed

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25
Indications for Pharmacotherapy in GERD
Mild esophagitis Significant symptoms when conservative measures have failed 3-6 months therapy with repeat esophagoscope PPI preferred
26
How to Diagnosis Colic?
``` Rule of Threes >3 hours/day crying >3 days/week Lasts >3 weeks Infant ```
27
Associated Characteristics of Colic
``` Paroxysmal More often in evening Qualitatively different than normal crying Hypertoina Inconsolability Normal when not colicky First few weeks unremarkable ```
28
Colic Soothing Maneuvers
``` Pacifier Car/stroller ride Place them in front carrier Rock them Change scenery Infant swing Warm bath Rub abdomen Provide white noise CD of heartbeats Sing to baby Quiet time in crib 5-10 minutes ```
29
Colic Treatment Suggestions
Elemental formula for one week Hypoallergenic diet for mom Probiotic Support the parents
30
How to asses a baby's level of hydration?
Mucus membranes Lethargic Skin turger Fontanelles
31
Oral Rehydration Therapy
Small amounts of liquid Pedialyte 1st choice Coat esophagus without causing a large bolus in stomach Increase as tolerated
32
Characteristics of Mild Dehydration
``` Full, normal rate Normal BP Normal respirations Normal fontanelles Normal eyes Normal skin turgor Normal skin Normal urine output Increased thirst ```
33
Characteristics of Moderate Dehydration
``` Rapid pulse Normal to low BP Deep respirations Dry mucosa Sunken fontanelle Sunken eyes Reduced skin turgor Cool skin Reduced urine output Irritability, listlessness ```
34
Characteristics of Severe Dehydration
``` Rapid, week pulse Low BP Deep, tachypnic Parched mucosa Sunken afontanelle Sunken eyes Tenting skin turgor Cool, mottle, acrocyanosis Anuria Grunting, lethargy, coma ```
35
Severe Hypovolemia Treatment
Rapid infusion of 20mL/kg of isotonic saline | Reasses
36
Reasons to Hospitalize a Child with Diarrhea
``` Life-threatening diarrhea Severe dehydration or electrolyte abnormality Lack of improvement with rehydration Copious diarrhea Inability to drink ```
37
Define Constipation
Decrease in a person's normal frequency of defections accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool
38
4 Reasons US Citizens are Constipated
Lack of fiber Inadequate fluids Sedentary lifestyle Too busy
39
Functional Retention Due to Traumatic Events
Painful passage of stool Painful diarrhea Physical/sexual abuse
40
Functional Retention Due to Difficult Psychosocial/ Environmental Changes
Difficulty potty training | Divorce
41
Define Encopresis
Stretching of rectum and decreased sensation to empty bowel | Liquid stools leak around stool mass
42
Organic Causes of COnstipation
``` Hirschsprung's disease Anatomic abnormalities Meds: antacids, opiates, phenobarbitol Spinal cord abnormalities Infant botulism Hypothyroidism Celiac disease DM CF Cow's milk intolerance ```
43
Warning Signs of Constipation
``` Weight loss Anorexia Delayed growth Delayed passage of meconium Urinary incontinence Blood in stool Fever Vomiting/diarrhea Extraintestinal symptoms ```
44
Concerning Findings on PE
``` Failure to thrive Abdominal distension Lower spine abnormalities Anteriorly displaced anus Tight, empty rectum Absent anal wink Absent cremasteric reflex Decreased lower extremity tone Absence of delay in lower limp DTR's ```
45
Findings that Support Functional Etiology
``` Dietary change Toilet training Painful BM Stool withholding behavior Good response to laxatives ```
46
Various Meds for Constipation
``` Docusate sodium (Colace) Polyethylene glycol (Miralax) Mineral Oil Lactulose Psyllium (Metamucil) Methylcellulose (Citrucel) Senna (Ex-Lax) Besacodyl (Dulcolax) ```
47
Treatment of Encopresis
``` Clear child's bowel Continue laxative Regular toilet sitting time 2-3 x a day Stool near toilet Rewards for sitting on toilet Note time when BM occurs & in toilet Wean off laxatives ```
48
Define Enuresis
Involuntary discharge of urine after the age at which bladder control should have been established
49
Enuresis
Genetic component | Exacerbated with stress/emotional problems
50
Define Monosymptomatic Enuresis
Children without history of urinary tract symptoms or bladder dysfunction
51
Characteristics of Monosymptomatic Enuresis
No daytime symptoms Primary- never had nighttime dry period Secondary- enuresis after 6+ months dry period
52
Neurologic/Anatomic Problem for Enuresis
``` Urinary tract abnormality UTI Kidney disease Trauma of spinal cord Seizures Hyperthyroidism DM Sleep apnea Pinworms ```
53
Treatment Options for Enuresis
Behavior modifications Bedwetting alarms Medications
54
Define Amblyopia
Unilateral or bilateral reduction in central visual acuity due to the sensory deprivation of a well-formed retinal image that occurs with or without a visible organic lesion commensurate with the degree of visual loss
55
Types of Amblyopia
Strabismic amblyopia Refractive amblyopia Deprivation amblyopia
56
Define Strabismic Amblyopia
Occurs in non dominant eye of strabismic patient
57
Define Refractive Amblyopia
Results from refractive errors | Unilateral/bilateral
58
Define Deprivation Amblyopia
Occurs with congenital cataracts, unilateral ptosis, corneal opacities, or vitriol hemorrhage
59
How to Test the Nonverbal Child
Fixation test Differential occlusion test Prism test
60
Define Strabismus
Misalignment of the visual axes of the two eyes
61
Define Esotropia
Inward turning misalignment of the eyes
62
Define Exotropia
Outward turning misalignment of the eyes
63
Treatment of Strabismus
Glasses Patches Surgical correction

Pediatrics (23 decks)

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