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Pediatrics > Exam 1 Treatment > Flashcards

Exam 1 Treatment Flashcards

1
Q

TTN tx

A

supportive, sup O2, CPAP, self-limited course

Prevent by avoiding elective c-section <39 wks

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2
Q

RDS tx

A

Mild cases may respond to CPAP

More severe require mechanical ventilation

Diuresis

No clear guidelines regarding when to administer exogenous Surfactant

Prevention- Reduce pre-term births, provide antenatal steroids

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3
Q

MAS tx

A

O2 sup, CPAP/mech vent., surfactant, ECMO if severe

Suction does NOT help to prevent

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4
Q

PPHN tx

A

mechanic ventilation, cardiotonic therapy, inhaled nitric oxide, ECMO

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5
Q

Apnea of prematurity tx

A

usually resolves by 36-40 wks, CPAP, methylxanthine (theophylline and caffeine)

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6
Q

Congenital Diaphragmatic Hernia yx

A

mech vent, treat pulm HTN, consider ECMO, surgical repair

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7
Q

Tx for neonatal sepsis

A

empiric therapy for early-onset sepsis combo against G and G-

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8
Q

Management of down syndrome

A

well child care, devel & behavior, audiology, vision, thyroid, neck, sleep, heme-onc (↑ risk leukemia - AML b4 1, ALL for older)
Echocardiogram, thyroid screen, audiology, dental care, diet

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9
Q

Turner Syndrome tx

A

Renal US to ID anomalies, cardio (coarct of aorta), EENT (structural abnormal), endocrine (autoimmune d/o), estrogen in early teen yrs to stim secondary sex characteristics

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10
Q

Positional Plagiocephaly tx

A

↑ “tummy time” while awake, repositioning in crib, sleep on backs but while away be on tummy

PT: repositioning head with neck
ROM

Helmets therapy (can start as late as 18 mo)

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11
Q

Craniosynostosis tx

A

Surgical

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12
Q

Lead posioning tx

A

Chelation for BLL ≥45 mcg/dL (succimer 10 mg/kg PO every 8 hours x 5 days, then every 12 hours for 14 days)

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13
Q

Food protein proctocolitis tx

A

resolves within days to 2 weeks fo removing agent (if breast feeding have mom avoid milk proteins)

will resolve fully by 12 mo of age and will not have to avoid

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14
Q

Food Protein Induced Enterocolitis Syndrome (EPIES) tx

A

Can be medical emergency- fluid resuscitation and anti-emetics

Long term—avoid offending food

Can outgrow after several months to years

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15
Q

What is the first line therapy for allergic rxn?

A

epinephrine into lat aspect of thigh

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16
Q

What is the dose of epi?

A
  1. 15 mg ≤ 25 kg
  2. 3 mg ≥ 25 kg

or 0.01 mg/kg (Max 0.5 mg) every 5 minutes
as needed to control symptoms

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17
Q

What is second line therapy for anaphylaxis?

A

antihistamines

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18
Q

How long should pt be observed in ED after allergic exn?

A

4-8 hrs or when sx fully resolved

if >1 dose epi, hypotensive, laryngeal edema, severe asthma, ingestion as trigger then admit

19
Q

Tx for GER

A

reassurance but if sx persist >18 mo refer to ped GI

20
Q

Tx for GERD

A

PPI for 8-12 wk but if no improvement after 2-4 wk or relapse after tx then d/c and refer

21
Q

Methods to prevend GER

A

thicken formula with rice cereal, consider acid suppression therapy

22
Q

Pyloric Stenosis tx

A

Correct dehydration and alkalosis

Surgical Correction with pyloromyotomy

23
Q

Malrotation tx

A

Require emergent diagnosis and repair: Ladd’s procedure

24
Q

volvulus tx

A

Surgical consultation and operative intervention are essential

25
Q

Intussusception tx

A

Fluid resuscitation
Antibiotics
Surgical consultation
Options include air-contrast enema or exploration

26
Q

Meckel’s Diverticulum tx

A

Stabilization (may need PRBCs if significant bleed)

Surgical consult

27
Q

Hirschprung’s Disease tx

A

Surgical resection of aganglionic segment

Colostomy followed by endorectal pull-through at later date

28
Q

Complications of Hirschprung’s Disease

A

Hirschsprung’s associated enterocolotis
Constipation
Stricture
Fecal incontinence

29
Q

Constipation tx

A

Assess for large volume of stool in rectum—disimpact via oral or rectal “clean out” before
starting tx

PEG-3350 (Mitalax)

Prune juice for infants

Behavioral therapy

30
Q

How long should you continue maintenance meds for constipation?

A

> 2 months and should not be stopped until
symptoms resolved for >1 month

should continue until toilet training well established

31
Q

Encopresis tx

A

stool softeners

timed sitting after meals in conj with oral laxative

32
Q

Cryptorchidism tx

A

Most descend spontaneously within 1st 3 months of life

If still undescended by 4 months—likely permanent

Surgery at 6 mo NO later than 9-15 mo of age

Hormonal tx

33
Q

Consequences of Cryptorchidism

A

Infertility
Testicular malignancy
Associated hernia (usually indirect)
Torsion of cryptorchid testis

34
Q

Micropenis tx

A

Most will have satisfactory sexual function

Androgen Rx controversial—may limit growth potential in pre-pubertal boys

35
Q

Hypospadias tx

A

Surgical repair for all 2nd and 3rd degree to correct functional and cosmetic deformities

Some boys with 1st degree may not have functional abnormality

36
Q

Non-specific vulvovaginitis tx

A

Keep area dry and aerated

Decease irritants

Sitz baths twice daily with 3 tablespoons of baking soda while symptomatic, may continue for prevention

Distraction/redirection

37
Q

Labial Adhesions tx

A

Often resolve spontaneously

Gentle traction to separate labia

Hormonal cream

Occasionally surgery by pediatric urologist

38
Q

Complications of Febrile Urinary Tract Infection (UTI)

A

Urosepsis
Abscess formation
Renal scarring

39
Q

Treatment of febrile UTI in 2-24 month old

A

Oral abx for 7-14 days

Cephalosporin, Amoxicillin, Amoxicillin-clavulanate, Trimethoprim-Sulfamethoxazole

40
Q

What is recommended after febrile UTI?

A

US to ID anatomic anbnormalities

41
Q

Who is Voiding cystourethrogram (VCUG) recommended for after UTI?

A

recommended for children (not yet toilet trained) if urinary dilatation, scarring, or findings suggestive of vesicoureteral reflux or bladder outlet obstruction on ultrasound or recurrence
or atypical sx

42
Q

Antibiotic Prophylaxis for VUR

A

Trimethoprim-Sulfamethoxazole 2-4 mg/kg once daily

43
Q

Enuresis Treatment

A 
Behavioral modification
limit fluid intake before bed
dry bed training-wake at night to urinate
bladder stretching exercises
bed alarm therapy-most effective

pharm only if >7 yo and if other therapy unsuccessful - DDAVP

Pediatrics (7 decks)

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