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CPS > General > Flashcards

General Flashcards

0
Q

What are hypoglycemia prevention measures that can be taken at school?

A 
regular scheduled snacks
adjust intake based on activity
clean area for glucose checks
spervising children to help they recognize lows
access to emergency kits
accommodations for tests
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1
Q

what is the leading cause of sport and recreational injury?

A

bicycling

20-40% of bike injuries are head injuries

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2
Q

what are potential barriers to safe mgnt of hypoglycemia in schools

A

no training of staffs
unscheduled activities
altered snack times
lack of rapid access to emergency kit

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3
Q

who should get IE prophylaxis?

A
  1. prosthetic cardiac valves
  2. previous IE
  3. congenital hear disease
    - unrepaired cyanotic heart disease - even if have shunt
    - repaired CHD + prosthetic for 6 month
    - partially repaired with residual defect and prosthetic
  4. heart transplant who develop valvuloplasty
  5. rheumatic heart disease with prosthetic valve
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4
Q

when should Abx be given for IE prophylaxis?

A

30 min pre

and up to 2 hours post

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5
Q

what procedure should IE prophylaxis be given for?

A

manipulation of gingival tissue/periapical region of teeth

perforation or oral mucosa

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6
Q

what are the Abx options for IE prophylaxis?

A

amox
if allergic - cephalexin or clinda
can do IM if can’t do pills

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7
Q

what are the components of the vaccine safety program

A
  1. pre-licence reviews - stric and approval - gov regulators
  2. current magnufactoring practice- strict, global, regular checks
  3. test lot before release
  4. independent expert review of safety and efficacy data
  5. post-marketing surveillance of adverse effects
  6. rapid response - recall or non distr if safety concerns
  7. expert causality assessment if serious adverse event occurs
  8. International collaboration
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8
Q

What are the 3 categories of inhalants

A
  1. Aliphatic, aromatic, halogenated hydrocarbons
  2. Nitrous oxide
  3. Volatile alkyl nitrites
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9
Q

What are the effects of inhalants?

A 
Stimulation
Disinhibition
Euphoria
Hallucinations
Depression- slurred speach, dizzy, drowsiness
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10
Q

What is the leading cause of death from inhalant?

A

Sudden sniffing death syndrome- arrhythmia and

Inhalants sensitize the heart to adrenaline. Sudden surge in adrenaline can cause fatal arrhythmia

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11
Q

What are some side effects of inhalants?

A

CnS: damage myelin, ataxia, tremor, nystagmus, slurred speach, decreased bison, deafness

CVS: cardiomyopathy, dyspnea, emphysema
Renal: TA, 
Gi: hepatitis 
Women: PET, abortion
Fetal solvent syndrome and withdrawal
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12
Q

What are some side effects of inhalants?

A

CnS: damage myelin, ataxia, tremor, nystagmus, slurred speach, decreased bison, deafness

CVS: cardiomyopathy, dyspnea, emphysema
Renal: TA, 
Gi: hepatitis 
Women: PET, abortion
Fetal solvent syndrome and withdrawal
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13
Q

What is CRAFFT screen

A 
Car driven by someone under the influence
Do you do drugs to Relax
Do drugs Alone
Do you Forget things when on drugs
Do Friends/family worry
Trouble because of drugs
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14
Q

how to biologics work - 2 ways

A
  • target the cytokine receptor or

- they are antibodies against proinflammatory cytokines

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15
Q

Biologics can increase the risk of ….

A

reactivation of TB, viral infection(EBV, HZV, Hep B) and fungal (histo, toxo)
increase incidents and severity of the same

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16
Q

if about to start patient n biologics, what should you do from an infection perspective?

A

Mantoux- + if >5mm
CXR
can do interferon gamma release assay as may be more sensitive in an immunocompromised py
if high suspicion - treat INH for 9 mo
start biologics one month post completion

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17
Q

what counselling do you give for someone on biologics?

A
  1. avoid raw meat, soft cheeses, raw eggs
  2. stay away from kittents and litter
  3. away from reptiles
  4. stay away from construction site of caves
  5. avoid farms
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18
Q

what vaccine can temporarily suppress TST reactivity?

A

MMR

do TST 4-6 weeks post MMR vaccine

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19
Q

risk factors for positional plagiocephaly

A 
male
firstborn
congenital torticollis
supine sleeping
bottle feeding
low activity
tummy time < 3 times per day
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20
Q

when does plagiocephaly resolve?

A

by 2 yrs

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21
Q

what are possible complications of helmet therapy for PP

A

contact dermatitis
pressure sores
local skin irritation

can only do if 8 mo or less

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22
Q

What is OCAP in relation to research involving first nations

A

Ownership
control
Access
Posession

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23
Q

what are the complications of chronic insomnia?

A

depression
learning disability
poor school performance
potential effect on the family

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24
Q

what are the 2 most common types of sleep disorders?

A

delayed phase type - sleep latency >30 min

behavioural insomnia of childhood - behaviours to delay sleep

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25
Q

what is an appetite stimulant?

A

cyproheptadine-antihistamine
cannaboid derivatives
megestrol acetate

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26
Q

what are the suggested childcare ratios for ages

A

< 24 mo - 3:1
24-30 mo - 4:1
31-36 mo - 5:1
> 36 mo - 7:1

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27
Q

what are barriers for children in foster care to getting help?

A

lack of medical records
lack of consistency or FU BC moving
difficulty accessing services

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28
Q

what are Vitamin D recommendations by age

A

< 1 year - 400U
< 2 yrs and above 55 parallel - 800U from Oct to april
> 1 year 200 U

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29
Q

what is appropriate sun exposure to prevent Vit D def

A

3 X per week - 20 to 30 min of face and hands

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30
Q

vegetarian or vegan diets - what are the needs to ensure growth?

A
  1. need more proteins
  2. need more Iron
  3. babies > 7 mo to vegan mom will need fortification
  4. vegans need precursor od essential FA linolenic acid - flaxseed, canola, nut oils, soya
  5. VIt D supp
  6. should only have 0.5g/kg/day of fibre
  7. vegans need vit B 12 fortification
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31
Q

what intake/supplementation should a vegan pregnant mom take?

A 
Vit B12
Vit D
Iron
Folic acids
linolenic acid
calcium
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32
Q

what are the most important risk factors for unhealthy weight control?

A

dissatisfaction with weight
obesity
low self esteem

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33
Q

what are personal risk factors the correlate with dieting and unhealthy wgt mgnt behaviours

A 
female
poor self esteem
overwgt
poor body image
low sense of control
depression/anxiety
vegetarian
early puberty
chronic illness - DM
already ahve risky behaviours
34
Q

what are FAMILY factors the correlate with dieting and unhealthy wgt mgnt behaviour

A 
lack of role model
parental dieting
parents wanting and supporting dieting for their kids
criticism of child's wgt
low connectedness
35
Q

what are environmental factors the correlate with dieting and unhealthy wgt mgnt behaviours

A

teasing
poor school involvement
peer group endorsement
wgt related sports

36
Q

what is the most common acquired disorder of coagulation? vs most common inherited disorder?

A
  1. ITP

2. Von Willebrand- 1% of pop

37
Q

if you suspect a drug-herb interaction,what should you do?

A

report to Pediatric Surveillance Program

38
Q

How do you counsel a family who uses CAM

A
  1. Ask about use
  2. be nonjudjemental, watch your attitude
  3. Find out more about the CAM used
  4. evaluate the CAM
  5. Identify potential risks and harm
  6. provide the family with an array of therapeutic options
  7. educate the family on how to evaluate info
  8. avoid dismissal
  9. Offer to assist in closemonitoring
39
Q

what are the Rome criteria for functional constipation?

A

must fulfill criteria once per week for 2month
must be > 4 yrs
not meet criteria for IBS
need 2 or more

  1. 2 or less stools per week
  2. one episode of fecal incontinence per week
  3. Hx of retentive posture
  4. History of painful or hard stools
  5. large fecal mass in rectum
  6. Hx of large diameter stools that may obstruct toilet
40
Q

What are possible complication of enemas

A 
High PO4
Low Ca
Abdo distention 
Vomiting
Trauma
41
Q

Who should get enemas?

A

PEG 3 day clean out is better
Need to be > 2yr

if > 2, phosphate enema, 6ml/kg with Max off 135 ml

42
Q

What is the dose f PEG

A

Clean out: 11.5g/kg/day for 3 days

Maintenance: 0.4 to 1 g/kg/day

43
Q

discribe a bruise that is most likely accidental

A 
small
oval with non distinct borders
near or above bony prominence
in front of body
usually - forehead, knees, shins  
not in a pattern
44
Q

what skin finding can be mistaken for a bruise?

A 
stria
mongolian spot
hemangioma 
nevi of Ito
erythema multiforme
eczema
incontinentia pigmenti
cultural-coining, cupping
dye
45
Q

how do platelet issues tend to present?

A

mucocutaneous bleed

46
Q

how do factor deficiencies tend to present?

A

deep tissue bleed - joints, soft tissue, GI or GU bleeds

47
Q

what are CF of hyponatremia?

A 
HA
nausea/vomiting
irritability
decreased level of consciousness
seizures
apnea
48
Q

how much Na is in NS

A

154 mmol/L

and 154 of Cl

49
Q

how much glucose is in D5

A

50g/L

50
Q

what patients are particularly at risk of hyponatremia in hospital

A

from inappropriate secretion of ADH

  • peri or post op
  • resp infections
  • neuro infections
51
Q

if pt has Na that is 135 to 145, what should be their IV fluid?

A

D5W 0.45%NS

52
Q

in what situation would a parent not be an appropriate decision maker? 4

A
  1. if lack decision making capacities
  2. if irresolvable differences between parents regarding care
  3. if parents relinquished responsability
  4. if legal guardian appointed
53
Q

what is needed for someone to have decision making abilities?

A
  1. must understand the issues
  2. must understand the purpose of the intervention
  3. must understand the consequences of consent and refusal
  4. must understand the magnitude and probabilities of harm and benefits
54
Q

What are the 5 criteria for effective discipline?

A
  1. given by adult with affective bond
  2. consistent and close to the behaviour
  3. perceived as fair by the child
  4. dev and temperamentally appropriate
  5. self-enhancing to lead to self-discipline
55
Q

How do you counsel a parent about discipline?

A
  1. reinforce their competence
  2. help them find strategies
  3. suggest age appropriate techniques
  4. provide resources
56
Q

what is the purpose of effective discipline?

A

help them organize themselves
internalize rules
acquire appropriate behaviour patterns

57
Q

in what age group should a a child be allowed to develop some tolerance to frustration and learn to self soothe

A

B to 12 mo

58
Q

how do you manage a temper tantrum of a 2.5 yrs old

A 
avoid situation that might be the cause of tantrum
take the child away from area 
allow them to regain control
give simple explanation and reassurance
redirect
59
Q

when should time outs start?

A

> 2

60
Q

how do you manage a 3-5 year old who missbehaves

A
  1. Time out or

2. redirect or small consequences

61
Q

how do you discipline a 6-12 yr old

A

withdrawal or delay of privileges
consequences
time outs

62
Q

colic definition

A

paroxysms of irritability, fussiness or crying that start and stop without obvious cause;
episodes lasting 3 h or more per day and occurring at least three days per week for at least one week; and
no failure to thrive.
starting at 3 weeks

63
Q

What are the 4 errors of car seat installment

A
  1. wrong size
  2. not attached to car
  3. moving more than one inch
  4. harness not snug enough and not in right location
  5. air bag
  6. wrong angle - need 45 de
  7. using recalled or
64
Q

what makes car seat unsafe

A
  1. > 10 yrs
  2. beyond manufacterer date
  3. Car accident
65
Q

Transition to a forward facing are appropriate

A

walking
> 10 kg
12 mo

66
Q

child is 15kg and 15 month, what type of car seat should he get

A

forward facing

67
Q

when can you use a booster

A

18 kg

68
Q

when can you stop using a booster seat?

A

Must be:
> 8 yrs,
> 36 kg and
4’9 (145 cm)

69
Q

lap belt syndrome

A

lumbar fracture
bowel bladder and
internal organ

70
Q

when can they seat upfront

A

above 13

71
Q

what is the most common inherited bleeding disorders - 3

A

hemophilia A - factor VIII
VWF
hemophilia B

72
Q

what are important Hx points to find out for an infant pt getting assessed for bruising?

A 
post circumcision bleeds
cephalohematoma
bleeding at umbilicus
delayed stump separation
post venipuncture bleed
hematuria
petechia at clothing lines
or at sites of pressure - car seat
73
Q

who should get WU for bruising

A

if testing will impact health
if will impact child’s wellfare
if clinical suspicion
if unexplained bruising in a precruising baby

74
Q

what is the WU for bruising

A 
CBC+diff
blood smear
INR/PTT/fibrinogen
vWF
blood group
factor VIII and IX levels
renal and LFTS
75
Q

who is more likely to sue natural health products?

A 
CF
Eating disorder
Homeless youth
cancer
arthritis/RF
if had set back or relapse
76
Q

what 3 factors increase the likelyhood of drug-herb interaction?

A
  1. Pt with most serious disease are the ones more likely to use alternative med
  2. use to complement treatment, not replace it
  3. tend to use more than one
77
Q

how do you counsel a family who is using complementary alt med.

A
  • ask about use
  • non-judgemental attitude
  • seek info and share with family
  • evaluate risk
  • offer a range of therapeutic options
  • avoid dismissing
  • do not become defensive
  • offer to assist and monitor
78
Q

what factors are assocaited with fatalities from over the counter cough med

A
  • < 2 yrs
  • use med for sedation
  • used in daycare setting
  • combine 2 or more meds
  • fail to use measure device properly
  • product misidentification
  • use adult products
79
Q

who is not allowed to use cough and cold meds?

A

< 6 yrs

Caution for > 6yr

80
Q

how is honey good during a cold

A

decreased cough frequency and severity
improved sleep quality
less bothersome

demulcent properties
antioxidant properties
inc cytokine release

81
Q

how to protect yourself online

A
  1. Protect patient confidentiality
  2. preserve your privacy - high privacy setting, avoid friendship with pt
  3. maintain boundaries - keep business/personal websites separate
  4. behave professionally - provide clear, uptodate info from reputable sites, no advertising
82
Q

Lyme disease testing

A

serology - ELISA
followed by
western blot

CPS (10 decks)

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