Critérios diagnostico Flashcards
Critérios diagnósticos de cefaleia abuso medicamentos.
Headache occurring on 15 or more days per month in a patient with a preexisting primary headache and developing as a consequence of regular overuse of acute or symptomatic headache medication (on 10 or more or 15 or more days per month, depending on the medication) for more than three months. It usually, but not invariably, resolves after the overuse is stopped.
-Regular intake for ≥15 days per month for >3 months of simple analgesics (ie, acetaminophen, aspirin, or NSAID).
-Regular intake for ≥10 days per month for >3 months of ergotamine, triptans, or opioids, or combination analgesics, or any combination of ergotamines, triptans, simple analgesics, NSAIDs and/or opioids without overuse of any single drug or drug class alone or when the pattern of overuse cannot be reliably established.
Sibilancia recorrente
3 ou mais episódios nos 3 primeiros anos de vida ou 3 ou mais no ultimo ano que respondem a broncodilatadores e intervalos livres de doença independentemente de queixas associadas a esforços.
Dx de asma com espirometria, adultos e crianças
Adults: increase in FEV1 of >12% and >200 mL (greater confidence if increase is
>15% and >400 mL).
Children 6-11: increase in FEV1 from baseline of >12% predicted.
Measure change 10–15 minutes after 200–400 mcg salbutamol (albuterol) or
equivalent, compared with pre-BD readings. Positive test more likely if BD withheld
before test: SABA ≥4 hours, twice-daily LABA 24 hours, once-daily LABA 36 hours
A favor de dx de asma no PEF
over 2 weeks:
Adults: average daily diurnal PEF variability >10%*
Children 6-11: average daily diurnal PEF variability >13%*
Daily diurnal PEF variability is calculated from twice daily PEF as (day’s
highest minus day’s lowest) divided by (mean of day’s highest and lowest), averaged over one week. For each PEF measurement, use the highest of 3
readings.
Dx asma na crianca 6-11
Documented* excessive variability in lung function and Documented* expiratory
airflow limitation (At a time when FEV1 is reduced (e.g. during testing above), confirm that FEV1/FVC is also reduced compared with the lower limit of normal (it is usually >0.75–0.80 in adults, >0.90 in children)
Calve perthes pode evoluir para cura? e epifisiolise?
Sim. A epifisiolise nao
ITU atipica em crianca?
serious illness, poor urine flow, abdominal or bladder mass, elevated creatinine, septicemia, infection with an organism other than E. coli, and failure to respond to antibiotics within 48 hours;
ITU recorrente crianca
Two or more episodes of UTI with acute upper UTI (acute pyelonephritis), or
One episode of UTI with acute upper UTI plus 1 or more episodes of UTI with lower UTI (cystitis), or
Three or more episodes of UTI with lower UTI
Send urine samples for culture if a baby or child:
is thought to have acute upper UTI (pyelonephritis; see the section on clinical differentiation between acute upper UTI and lower UTI)
has a high to intermediate risk of serious illness (see the section on assessment of risk of serious illness)
is under 3 months old
has a positive result for leukocyte esterase or nitrite
has recurrent UTI
has an infection that does not respond to treatment within 24 to 48 hours, if no sample has already been sent
has clinical symptoms and signs but dipstick tests do not correlate. [2017]
tira teste em urina de crinaca com 3 ou mais anos Leukocyte esterase and nitrite are both negative
Assume the child does not have a UTI. Do not give the child antibiotics for a UTI or send a urine sample for culture. Explore other possible causes of the child’s illness.
segundo a noc ITUs crianca a analise laboratorial de urina é obrigatoria quando?
Análise laboratorial de urina é obrigatória:
o Em crianças ≤ 24 meses com febre sem foco;
o Em crianças > 24 meses + sintomatologia sugestiva de ITU, nomeadamente febre e dor abdominal ou lombar, disúria, polaquiúria, hematúria ou incontinência urinária de início recente
vaginite em crianca
indagar sintomas oxiuros (enterobius vermicularis) mas mais frequentemente é assintomatica
complicacao mais frequente de ascaris lumbricoides
Obstrucao intestinal ALTA
DiARREIA MUCOSANGUINOLENTa TENESMO MAIS EM QUE PARASITAS
Trichuris trichiura (muitos sao assintomatico), pode haver prolapso retal tenesmo e diarreia mucosanguinolenta
Entamoeba histolytica (grande maioria assintomatico mas pode causas doenca invasiva grave diarreia sanguinolemta e tenesmo, megacolon). diarreia nao sanguinolenta na fase cronica
Schistosomas - diarreia mucosanguinolenta comum hepatomegalia dolorosa
Ténias: frequentemente assintomatica Passagem das proglótides através do ânus: desconforto e sensação de tenesmo.
Eosinofilia comum em que parasitoses
Ancilostomas - entra pela pele ou boca
Strongyloides stercoralis - entra pela pele
Ascaris lumbricoides - boca mas depois migra figado e pulmao
