Exam 1 Flashcards

1
Q

Irreversible effects of inhalant toxicity with chronic use

A
  • Hearing loss: spray paints, glues, dry cleaning chemical, correction fluid
  • Peripheral neuropathies or limb spasms: glues, gasoline, shipped cream dispenser, gas cylinders
  • CNS or brain damage: spray paints, glues, dewaxers
  • Bone marrow suppression
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2
Q

3 locations to place the scoliometer for Adams Forward Bend Test

A
  1. Thoracic
  2. Thoracolumbar
  3. Lumbar levels
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3
Q

What constitutes scoliosis?

A

More than 10 degrees on scoliometer is abnormal.

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4
Q

Definition of pediatric hypertension

A

An average systolic BP and/or diastolic BP that is over or equal to the 95th percentile for gender, age, and height on 3 or more occasions

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5
Q

Pharmacological management of depression in children/adolescents

A

SSRI’s: fluoxetine (Prozac) and citalopram yielded statistically significant higher response rates than did other SSRI’s.
- Fluoxetine is the only drug that is approved by the US FDA for treating MDA among youth

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6
Q

Iron requirement for pregnancy <21 yo.

A

27 mg/day

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7
Q

Vitamin A deficiency

A
  • Nyctalopia (night blindness)
  • Corneal xerosis (aka drying)
  • Keratomalacia (ulcerations)
  • Blindness once ulcerations occur
  • Failure to thrive and depressed immune function
  • Increased risk of diarrhea disease
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8
Q

Vitamin B1 (Thiamine) deficiency

A
  • Wernicke-Korsakoff syndrome: irritability, peripheral neuritis, decresed tendon reflexes, ataxia, loss of vibriation sense, aseptic meningitis
  • Beriberi: cardiac failure, loud piercing cry, vomiting
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9
Q

Vitamin B2 (Riboflavin) deficiency

A
  • Cheilosis: abnormal condition of the lips characterized by scaling of the surface and by the formation of fissures in the corners of the mouth
  • Glossitis: smooth tongue, lack of papillae
  • Keratitis
  • Photophobia
  • Seborrheic dermatitis
  • Sore throat, hyperemia of the mucosal surfaces,
  • Normocytic anemia
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10
Q

Vitamin B3 (Niacin) deficiency

A

[Milk and egg]

  • Diarrhea
  • Dementia
  • Dermatitis
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11
Q

Vitamin B6 (Pyridoxine) deficiency

A

[Yeast, rice polishing, cereals]

  • Diarrhea
  • taking INH needs supplementation
  • Exclusively breastfed infants need supplementation if mother is deficient
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12
Q

Vitamin B12 (Cyanocobalamin) deficiency

A

[Absorbed in terminal ileum]

  • In young children symptoms include poor growth and development, with difficulties with movement
  • Older children and adolescent = neurological + hematologic
  • Neuro: developmental delay, parasthesia, impaired vibratory, proprioceptive sense, hypotonic, seizures, ataxia, memory loss, depression, weakness, poor school performance
  • Heme: macrocytic anemia, thrombocytopenia, leukopenia, pancytopenia
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13
Q

Diagnosis of Vitamin B12 deficiency

A
  • Methylmalonic acid (MMA): elevated in 90-98% of patients. Sensitive but not specific.
  • Homocysteine levels: Elevated homocysteine levels denote vitamin B12 OR folate deficiency, so again not specific
  • B12 level: directly measure B12 level
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14
Q

Vitamin C deficiency

A
  • Scurvy or Barlow disease occurs after 1-3 months of deficiency
  • Newborns are protected since human milk and formula contains Vitamin C
  • Signs: bleeding, osteopenia, gingival disease, pseudoparalysis, irritability, holding legs in front position, decreased appetite, fatigue, follicular keratosis on buttocks and legs
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15
Q

Folic acid or Folate

A
  • Prevents megaloblastic anemia
  • Adequate intake:
    (1-3 y.) 150 mcg
    (4-8 y.) 200 mcg
    (9-13 y.) 300 mcg
    (14-21 y.) 400 mcg
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16
Q

Vitamin D deficiency (infants)

A

[Fortified foods and sun]

  • Failure to thrive
  • Seizures and Tetany due to Calcium deficiency
  • Widened cranial sutures
  • Frontal bossing
  • Hypotonic
17
Q

Vitamin D deficiency (children)

A

[Fortified foods and sun]

  • Bony changes
  • Delayed tooth eruption
  • Bowed legs
  • Kyphosis
  • Pelvic abnormalities
  • Pot belly
18
Q

Vitamin E deficiency

A

[Found in a variety of foods]

  • Freidereich’s ataxia
  • Serum alpha tocopherol level <5mg
19
Q

Bacterial Vaginosis characteristics

A
  • Symptom: Odor, itch, discharge
  • Discharge: Adherent, thin, homogenous, milky white, foul, fishy
  • pH: >4.5
  • KOH Whiff Test: (+)
  • NaCl Wet Mount: >20% clue cells
20
Q

Candida Vaginitis characteristics

A
  • Symptom: Itch, discomfort, dysuria, thick discharge
  • Discharge: White, thick cheesy, clumpy cottage cheese
  • Exam findings: Inflammation, erythematous
  • pH: usually less than 4.5
  • NaCl Wet Mount: Few WBX (?)
21
Q

T. vaginalis (Trichomonas) characteristics

A
  • Symptom: Itch, discharge (50% asymptomatic)
  • Discharge: Frothy, grey, yellow green, malodorous
  • Exam findings: Cervical petechial lesion, strawberry cervix
  • pH: >4.5
  • KOH Whiff Test: (+)
  • NaCl wet mount: Mobile flagellated protozoa
22
Q

Treatment of VVC

A
  • Intravaginal antifungal cream (“azoles”), OR

- Oral tablet (fluconazole 150 mg, single dose)

23
Q

Amsel Criteria for Bacterial Vaginosis

A
  1. Vaginal pH >4.5
  2. Presence of clue cells on wet mount exam.
  3. Positive amine, “whiff” test
  4. Homogenous, non-viscous, milky-white discharge adherent to vaginal walls
24
Q

Recommended regimen to treat Bacterial Vaginosis

A
  • Metronidazole 500 mg orally 2x/day for 7 days
  • Metronidazole gel 0.75%, one full applicator, intravaginally, 1x/day for 5 days
  • Clindamycin cream 2%, one full applicatory, intravaginally at bedtime for 7 days