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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
Q

Indications for Pharmacotherapy in GERD

A

Mild esophagitis
Significant symptoms when conservative measures have failed
3-6 months therapy with repeat esophagoscope
PPI preferred

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26
Q

How to Diagnosis Colic?

A 
Rule of Threes
>3 hours/day crying
>3 days/week
Lasts >3 weeks
Infant
27
Q

Associated Characteristics of Colic

A 
Paroxysmal
More often in evening
Qualitatively different than normal crying
Hypertoina
Inconsolability
Normal when not colicky
First few weeks unremarkable
28
Q

Colic Soothing Maneuvers

A 
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
Q

Colic Treatment Suggestions

A

Elemental formula for one week
Hypoallergenic diet for mom
Probiotic
Support the parents

30
Q

How to asses a baby’s level of hydration?

A

Mucus membranes
Lethargic
Skin turger
Fontanelles

31
Q

Oral Rehydration Therapy

A

Small amounts of liquid
Pedialyte 1st choice
Coat esophagus without causing a large bolus in stomach
Increase as tolerated

32
Q

Characteristics of Mild Dehydration

A 
Full, normal rate
Normal BP
Normal respirations
Normal fontanelles
Normal eyes
Normal skin turgor
Normal skin
Normal urine output
Increased thirst
33
Q

Characteristics of Moderate Dehydration

A 
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
Q

Characteristics of Severe Dehydration

A 
Rapid, week pulse
Low BP
Deep, tachypnic
Parched mucosa
Sunken afontanelle
Sunken eyes
Tenting skin turgor
Cool, mottle, acrocyanosis
Anuria
Grunting, lethargy, coma
35
Q

Severe Hypovolemia Treatment

A

Rapid infusion of 20mL/kg of isotonic saline

Reasses

36
Q

Reasons to Hospitalize a Child with Diarrhea

A 
Life-threatening diarrhea
Severe dehydration or electrolyte abnormality
Lack of improvement with rehydration
Copious diarrhea
Inability to drink
37
Q

Define Constipation

A

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
Q

4 Reasons US Citizens are Constipated

A

Lack of fiber
Inadequate fluids
Sedentary lifestyle
Too busy

39
Q

Functional Retention Due to Traumatic Events

A

Painful passage of stool
Painful diarrhea
Physical/sexual abuse

40
Q

Functional Retention Due to Difficult Psychosocial/ Environmental Changes

A

Difficulty potty training

Divorce

41
Q

Define Encopresis

A

Stretching of rectum and decreased sensation to empty bowel

Liquid stools leak around stool mass

42
Q

Organic Causes of COnstipation

A 
Hirschsprung's disease
Anatomic abnormalities
Meds: antacids, opiates, phenobarbitol
Spinal cord abnormalities
Infant botulism
Hypothyroidism
Celiac disease
DM
CF
Cow's milk intolerance
43
Q

Warning Signs of Constipation

A 
Weight loss
Anorexia
Delayed growth
Delayed passage of meconium
Urinary incontinence
Blood in stool
Fever
Vomiting/diarrhea
Extraintestinal symptoms
44
Q

Concerning Findings on PE

A 
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
Q

Findings that Support Functional Etiology

A 
Dietary change
Toilet training
Painful BM
Stool withholding behavior
Good response to laxatives
46
Q

Various Meds for Constipation

A 
Docusate sodium (Colace)
Polyethylene glycol (Miralax)
Mineral Oil
Lactulose
Psyllium (Metamucil)
Methylcellulose (Citrucel)
Senna (Ex-Lax)
Besacodyl (Dulcolax)
47
Q

Treatment of Encopresis

A 
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
Q

Define Enuresis

A

Involuntary discharge of urine after the age at which bladder control should have been established

49
Q

Enuresis

A

Genetic component

Exacerbated with stress/emotional problems

50
Q

Define Monosymptomatic Enuresis

A

Children without history of urinary tract symptoms or bladder dysfunction

51
Q

Characteristics of Monosymptomatic Enuresis

A

No daytime symptoms
Primary- never had nighttime dry period
Secondary- enuresis after 6+ months dry period

52
Q

Neurologic/Anatomic Problem for Enuresis

A 
Urinary tract abnormality
UTI
Kidney disease
Trauma of spinal cord
Seizures
Hyperthyroidism
DM
Sleep apnea
Pinworms
53
Q

Treatment Options for Enuresis

A

Behavior modifications
Bedwetting alarms
Medications

54
Q

Define Amblyopia

A

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
Q

Types of Amblyopia

A

Strabismic amblyopia
Refractive amblyopia
Deprivation amblyopia

56
Q

Define Strabismic Amblyopia

A

Occurs in non dominant eye of strabismic patient

57
Q

Define Refractive Amblyopia

A

Results from refractive errors

Unilateral/bilateral

58
Q

Define Deprivation Amblyopia

A

Occurs with congenital cataracts, unilateral ptosis, corneal opacities, or vitriol hemorrhage

59
Q

How to Test the Nonverbal Child

A

Fixation test
Differential occlusion test
Prism test

60
Q

Define Strabismus

A

Misalignment of the visual axes of the two eyes

61
Q

Define Esotropia

A

Inward turning misalignment of the eyes

62
Q

Define Exotropia

A

Outward turning misalignment of the eyes

63
Q

Treatment of Strabismus

A

Glasses
Patches
Surgical correction

Pediatrics (23 decks)

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