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Pedia SB Review > Halo-halo > Flashcards

Halo-halo Flashcards

Mostly nephro, Preventive pedia, DevPed, Psych

1
Q

Cushing Triad

A

Bradycardia, Hypertension, altered breathing;
can be a sign of life-threatening increased intracranial pressure

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2
Q

Blood anion gap computation

A

[Na+] - [Cl- + HCO3-]
<12 : absence of anion gap
>20 : presence of anion gap

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3
Q

Bartter syndrome

A

hypokalemic, hypochloremic metabolic alkalosis with hypercalciuria and salt wasting

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4
Q

Gitelman Syndrome

A

hypokalemic, hypochloremic metabolic alkalosis with distinct features of hypocalciuria and hypomagnesemia

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5
Q

Type of RTA resulting from impaired bicarbonate reabsorption

A

Proximal (type II) RTA

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6
Q

Type of RTA resulting from failure to secrete acid

A

Distal (type I) RTA

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7
Q

Distinguishing features of distal RTA

A

nephrocalcinosis, hypercalciuria

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8
Q

Most common cause of ESRD in adolescents

A

Focal segmental glomerulosclerosis

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9
Q

Type of RTA occuring as the result of impaired aldosterone production (hypoaldosteronism) or impaired renal responsiveness to aldosterone (pseudohypoaldosteronism

A

Hyperkalemic (type IV) RTA

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10
Q

Disorder of water metabolism characterized by an inability to concentrate urine, even in the presence of anti-diuretic hormone

A

Nephrogenic Diabetes Insipidus

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11
Q

How can you differentiate Central from Nephrogenic Diabetes insipidus?

A

Administer vasopressin followed by serial urine & serum Osmolality measurements hourly for 4 hours

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12
Q

Treatment for central DI

A

Desmopressin (synthetic analogue of ADH)

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13
Q

Treatment for Nephrogenic DI

A

> Maintain adequate fluid intake and access to free water
Minimize UO by limiting solute load with a low osmolar, low sodium diet
Medications directed at decreasing UO
> Thiazide diuretic (induce Na+ loss and stimulate proximal tubule reabsorption of water
> K+-sparing diuretics (amiloride)

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14
Q

Rapid correction of acidosis with bicarbonate can precipitate what in a patient with renal failure

A

Tetany (because of reduction in ionized Calcium concentration)

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15
Q

Procedures to deplete body potassium stores

A

> Sodium polystyrene sulfonate resin (Kayexalate)
Calcium gluconate 10% - counteracts the K+-induced increase in myocardial irritability but does not lower the serm K+ level
Sodium bicarbonate - shifts K+ from extracellular to intracellular
Glucose-insulin solution - same MOA as NaHCOe-
Dialysis

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16
Q

Recommended storage time of breast milk at room temp (<25oC)

A

4 hours

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17
Q

Recommended storage time of breast milk at room temp >25oC

A

1 hours

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18
Q

Recommended storage period of breastmilk in the refrigerator

A

8 days

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19
Q

Recommended breastmilk storage period in the freezer compartment of a 1-door refrigerator.

A

2 weeks

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20
Q

Recommended breastmilk storage period in the freezer compartment of a 2-door refrigerator.

A

3 months

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21
Q

Recommended breastmilk storage period in a deep freezer with constant temp (-20oC)

A

6 months

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22
Q

Deworming must not be done in the children with…

A

> severe malnutrition
high-grade fever
profuse diarrhea
abdominal pain
serious illness
previous hypersensitivity to antihelminthic drug

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23
Q

Vitamin A supplementation as recommended by the DOH…

A

> Infants 6-11mos - 100,000iu (given anytime between 6-11 mos but usually given @ 9 mos of age during the measles immunization)
Children 12-59 mos - 200,000iu q6 mos.

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24
Q

Iron supplementation for low birth weight infants

A

7.5mg elemental Fe OD to start at 2mos until 6 mos when complementary foods are given

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25
Q

Iron supplementation for Infants 6-11mos.

A

15mg elemental Fe OD for 3 mos

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26
Q

Iron supplementation for children 1-5 yrs

A

30mg elemental Fe OD for 3 mos, or 30mg elemental Fe once a week for 6 mors with supervised administration

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27
Q

Iron supplementation for adolescent girls

A

60mg elemental Fe + 400mcg folic acid OD

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28
Q

For newborns discharged <48hrs after delivery, a definitive appointment must be made for the infant to be examined within ___ hours of discharge?

A

48

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29
Q

In PPD reading, an induration of >5mm is considered positive in the presence of (4)…

A
  1. hx of close contact with a known or suspected case of TB
  2. clinical findings suggestive of TB
  3. CXR suggestive of TB
  4. Immunosuppressed condition
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30
Q

EINC practice for immediate care of the normal newborn

A
  1. immediate and thorough drying of the newborn
  2. early skin to skin contact
  3. properly-timed cord clamping and cutting, and
  4. non-separation of newborn and mother for early breastfeeding
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31
Q

PSDBP recommends that developmental screening be done at which specified ages?

A

9, 18, and 30 months, and yearly thereafter

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32
Q

Process by which the health care professional recognizes the children who may be at risk of developmental and behavioral conditions

A

Developmental surveillance

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33
Q

Process of administering a standardized tool designed to identify children who are at risk for developmental and behavioral disorders

A

Developmental screening

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34
Q

Normal Visual Acuity for children starting at 3 y/o

A

3 y/o - 20/50 or better
4 y/o - 20/40 or better
5 y/o - 20/30 or better

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35
Q

Recommended fluoride concentration / amount for 6mos to < 2y/o

A

1000 ppm, 2.5mm smear, twice daily

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36
Q

Recommeded fluoride concentration / amount for 2-6 y/o

A

1000ppm, 5mm pea size, twice daily

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37
Q

Recommended fluoride concentration/ amount for 6 y/o above

A

1500ppm, full length bristle 10-20mm, twice daily

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38
Q

Most common infectious etiology for adrenal insufficiency

A

Meningococcemia

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39
Q

Adrenal crisis arising from meningococcemia infection is called…

A

Waterhouse-Friderichsen Syndrome

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40
Q

Prolonged use of this anesthetic may cause hemodynamic collapse, bradycardia, metabolic acidosis, cardiac failure, rhabdomyolysis, hyperlipidemia, profound shock, and death

A

Propofol (Propofol infusion syndrome)

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41
Q

Most common form of extrapulmonary TB

A

TB Lymphadenitis

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42
Q

After primary infection, when does disseminated and meningeal TB occur in children?

A

After 2-6 months

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43
Q

This activity in the well-child care occurs in every health encounter and is enhanced by repeated visits and observations with advancing developmental stages.

A

Surveillance

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44
Q

The tasks of each well-child visit include

A

> Disease detection
Disease prevention
Health promotion
Anticipatory guidance

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45
Q

ATVs (all-terrain vehicles) should not be recommended to children younger than ___ years of age

A

16

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46
Q

The safest place for children in a motor vehicle / car.

A

rear middle seat, properly restrained for their age and size

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47
Q

Most common cause of death in skiing and snowboarding

A

head injuries

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48
Q

This permits the central nervous system to reorganize neuronal networks in response to environmental stimulation, both positive and negative, and is critical to learning and remembering (and therefore development).

A

Neuronal plasticity

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49
Q

This describes the stable, early-appearing individual variations in behavioral dimensions, including emotionality, activity level, attention, sociability, and persistence

A

Temperament

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50
Q

Refers to a biologically determined tendency of a young child to seek proximity to the parent during times of stress and also to the relationship that allows securely attached children to use their parents to reestablish a sense of well-being after a stressful experience

A

Attachment

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51
Q

True or False.

Infants who are consistently picked up and held in response to distress cry less at 1 yr and show less-aggressive behavior at 2yr.

A

True

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52
Q

In infants, crying normally peaks at about ___ wks of age.

A

6 wks; healthy infants may cry up to 3hr/day

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53
Q

Infants rate of growth

A

1st month: 30g/day
3-4mos: 20g/day
4 mos: weight is doubled

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54
Q

Disappearance of the asymmetric tonic neck reflex occurs when?

A

3-4 mos… infants can begin to examine objects in the midline and manipulate them with both hands

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55
Q

Developmental Milestones. Ability to sit unsupported

A

6-7 mos

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56
Q

Developmental Milestones. Thumb-finger grasp

A

8-9 mos

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57
Q

Developmental Milestones. Pincer grasp

A

12 mos

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58
Q

Developmental Milestones. Crawling, pulling to stand.

A

8 mos; this is followed by cruising

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59
Q

Developmental Milestones. Object permanence (constancy)

A

9 mos

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60
Q

Time when stranger anxiety usually sets in.

A

9 mos, also corresponding to the time when object permanence develop

61
Q

Anthropometrics at 1 yr in relation to birth weight, length, and head circumference.

A

BW has tripled, BL increased by 50%, HC increased by 10cm.

62
Q

Developmental Milestones. Points to major body parts and uses 4-6 words spontaneously and correctly

A

15 mos

63
Q

Developmental Milestones. Increased clinginess. Stage of “raprochement”

A

18 mos

64
Q

Visual acuity reaches 20/20 by age ____

A

4 yrs

65
Q

All 20 primary teeth will have erupted by age ___

A

3 yrs

66
Q

Handedness is usually established by age ___

A

3 yrs

67
Q

Bedwetting is normal until what age

A

4 yrs in girls; 5 yrs in boys

68
Q

Language development occurs most rapidly between ______ yrs of age

A

2 - 5 yrs

69
Q

Stuttering resolves in 80% of children by age ____

A

8 yrs

70
Q

By age __, children have self-identified their sex

A

3 yrs

71
Q

Tantrums peak in prevalence between _____ of age

A

2 and 4 yrs

72
Q

Tantrums normally appear when___ ?

A

toward the end of the 1st yr of life

73
Q

Modesty appears gradually between age ____

A

4 and 6 yrs

74
Q

The process that allows the child to internalize controls on behavior.

A

Discipline

75
Q

Effective time-out duration

A

~ 1min/ yr of age

76
Q

What is a more dramatic sign of maturation in middle childhood?

A

Loss of deciduous teeth

77
Q

When is the diagnosis of failure to thrive usually considered?

A

FTT is usually a diagnosis of children younger than 3 yr of age, is considered if…
> a child’s weight is below the 5th centile
> the child’s weight drops down more than 2 percentile lines, or
> if weight for height is less than the 5th centile

78
Q

What remains the single best growth chart indicator of acute undernutrition?

A

Weight for height below the 5th percentile

79
Q

The lower-body segment is defined as the length from ___

A

Symphysis pubis to the floor

80
Q

Ratio of upper-body segment to lower body segment (U/L ratio)

A

at birth - 1.7
3 y/o - 1.3
after 7 y/o - 1.0
Higher U/L ratios are characteristic of short-limb dwarfism or bone disorders

81
Q

In familial short stature, the bone age is ____ (compared to chronological age)

A

Normal (similar to chronological age)

82
Q

In constitutional delay, endocrinologic short stature, and undernutrition, the bone age is ___ and comparable to the height age.

A

Low

83
Q

True or False. The timing of dental development is highly correlated with other processes of growth and maturation

A

False

84
Q

Delayed eruption is usually considered when there are no teeth at approximately ___ mos of age

A

13

85
Q

Based on the AAP policies, these are specific ages when formal developmental screening should occur

A

9-, 18-, 24-, 30- mo. Screening/ surveillance should be provided at all well visits.

86
Q

This refers to ongoing monitoring (tracking over time) of such issues as parental concerns, children’s progress with milestones, psychosocial risk and resilience factors, providers’ efforts to both detect and address problems, and follow-up regarding child/family outcoumes

A

Surveillance

87
Q

Time of exclusion from school when child has been diagnosed with impetigo

A

Until treatment has been started

88
Q

Time of exclusion from school when child has been diagnosed with Steroptococcal pharyngitis

A

Until 24hr after treatment has been started

89
Q

Time of exclusion from school when child has been found with pururlent conjunctivitis

A

Until after treatment has been initiated

90
Q

Time of exclusion from school when child has been diagnosed with Pediculosis (head lice)

A

Until after the first treatment

91
Q

Time of exclusion from school when child has been diagnosed with Scabies

A

Until after treatment has been given

92
Q

Time of exclusion from school when child has been diagnosed with Chicken pox

A

Until all lesions have dried or crusted

93
Q

Time of exclusion from school when child has been diagnosed with Rubella

A

Until 6 days after onset of rash

94
Q

Time of exclusion from school when child has been diagnosed with Pertussis

A

Until 5 days of appropriate antibiotic treatment

95
Q

Time of exclusion from school when child has been diagnosed with Mumps

A

Until 5 days after onset of parotid gland swelling

96
Q

Time of exclusion from school when child has been diagnosed with Measles

A

Until 4 days after onset of rash

97
Q

Time of exclusion from school when child has been diagnosed with Hepatitis A Virus

A

Until 1 wk after onset of illness or jaundice if the child’s symptoms are mild

98
Q

What is the doctrine of double effect?

A

The doctrine of double effect holds that an action with good and bad effects is morally justifiable if the good effect is the only one intended, and the bad effect us foreseen and accepted, but not desired.

99
Q

Hallmark of primary insomnia

A

Excessive worry about sleep and an exagerrated concern of the potential daytime consequences

100
Q

Gold standard for diagnosing Obstructive Sleep Apnea.

A

in-lab overnight polysomnogram

101
Q

These are episodic nocturnal behaviors that often involve cognitive disorientation and autonomic and skeletal muscle disturbance occurring primarily during non-REM sleep

A

Partial Arousal Parasomnias, which include sleepwalking, sleep terrors, and confusional arousals. They typically occur when slow-wave sleep (SWS) predominates

102
Q

This is a chronic neurologic disorder, characterized by an almost irresistible urge to move the legs, often accompanied by uncomfortable sensations in the lower extremities.

A

Restless legs syndrome (Willis Ekbom syndrome). It is a clinical diagnosis, versus periodic limb movement disorder which requires overnight PSG to diagnose.

103
Q

This is characterized by periodic, repetitive, brief, and highly sterotyped limb jerks typically occurring at 20-40 sec intervals

A

Periodic Limb movement disorders

104
Q

This is a clinical term that is used to describe a group of disorders characterized by recurrent episodes of excessive daytime sleepiness, reduced baseline alertness, and/or prolonged nighttime sleep periods that interfere with normal daily functioning

A

Hypersomnia

105
Q

This is a chronic lifelong CNS disorder, typically presenting in adolescence and early adulthood, that is characterized by profound daytime sleepiness and resultant significant functional impairment

A

Narcolepsy

106
Q

This term refers to the sudden and temporary loss of muscle tone, without loss of consciousness, classically triggered by an intense positive emotion

A

Cataplexy. It is considered pathognomonic for narcolepsy.

107
Q

The underlying pathogenesis of narcolepsy

A

Involves the selective loss of cells that secrete hypocretin/orexin in the lateral hypothalamus

108
Q

This is considered pathognomonic for narcolepsy

A

Cataplexy

109
Q

These involve vivid visual, auditory, and sometimes tactile sensory experiences occurring during transitions between sleep and wakefulness, primarily at sleep offset (___) and sleep onset (____)

A

Hypnogogic / hypnopompic hallucinations

110
Q

This is the inability to move or speak for a few seconds or minutes at sleep onset or offset, and often accompanies the hallucinations

A

Sleep paralysis

111
Q

These are symphatomimetic drugs that act both in the CNS and peripherally by enhancing dopaminergic and noradrenergic transmission

A

STimulants

112
Q

This class of drug is a selective inhibitor of presynaptic norepinephrine reuptake; it increases dopamine and norepinephrine in the frontal cortex

A

Atomoxetine. (with risk of suicidal thinking) less effective in the tx of ADHD

113
Q

This class of drug appear to stimulate inhibitory presynaptic autoreceptors in the CNS

A

alpha-adrenergic agents (clonidine, guanfacine)

114
Q

These drugs act on pre- and postsynaptic receptors affecting the release and reuptake of brain neurotransmitters, including norepinephrine, serotonin, and dopamine

A

antidepressants

115
Q

Approx 5% of youth taking this drug class, particularly children, develop behavioral activation (increased impulsivity, agitation, and irritability) that can be confused with mania, but the activation symptoms typically resolve when the dose is decreased or medication is discontinued

A

SSRI (e.g. fluoxetine)

116
Q

What characterize the serotonin syndrome?

A

Triad of:
1. mental status changes (e.g. agitation, hallucinations, delirium, coma)
2. autonomic instability (e.g., tachycardia, labile BP, dizziness, diaphoresis, flushing, hyperthermia), and
3. neuromuscular symptoms (e.g., tremor, rigidity, myoclonus, hyperreflexia, incoordination)

117
Q

Tricyclic antidepressant that is used in the treatment for obsessive-compulsive disorder

A

Clomipramine

118
Q

This syndrome generally manifests with fever, muscle rigidity, autonomic instability, and delirium. It is a rare, potentially fatal reaction that can occur during antipsychotic therapy.

A

Neuroleptic malignant syndrome. This is also associated with elevated creatine phosphokinase levels, a metabolic acidosis, and high end-tidal CO2 excretion.

119
Q

How is persistent (chronic) motor or vocal tic (PTD) differentiated from Tourette disorder (TD)?

A

PTD is limited to either motor or vocal tics (not both), whereas TD has both motor and vocal tics at some point in the illness (although not necessarily concurrently).

120
Q

When is the onset of stereotypic movement disorder?

A

Early developmental period, often before age 3 yrs.

121
Q

The behavioral intervention with the strongest empirical support for Tourette Disorder is…

A

Habit reversal therapy (HRT)

122
Q

Separation anxiety is developmentally normal when it begins at about ____ of age and tapers off by ____.

A

10mos, 18 mos.

123
Q

The only US FDA-approved medications to treat Tourette disorder in children and adolescents are (3).

A

2 1st gen antipsychotics (haloperidol, pimozide), and 1 atypical antipsychotic (aripiprazole).

124
Q

When is the average age of onset of separation anxiety disorder?

A

7.5 y/o

125
Q

The only antidepressants approved by the US FDA for the treatment of depression in youth.

A

Escitalopram and Fluoxetine (both SSRIs). Only Fluoxetine alone is approved for pre-adolescents

126
Q

Most efficacious agents in the treatment of mania in bipolar I disorder

A

Haloperidol, risperidone, and olanzapine

127
Q

Most common method of attempted suicide in youth

A

Ingestion of medication

128
Q

The most common method used to complete suicide in the US

A

Firearms

129
Q

This condition involves significant overestimation of body size and shape, with a relentless pursuit of thinness

A

Anorexia nervosa

130
Q

This condition is characterized by eating large amounts of food in a brief period, followed by compensatory vomiting, laxative use, exercise, or fasting to rid the body of the effects of overeating in an effort to avoid obesity

A

Bulimia nervosa

131
Q

In these conditions, food intake is restricted or avoided because of adverse feeding or eating experiences or the sensory qualities of food, resulting in significant unintended weight loss or nutritional deficiencies and problems with social interactions

A

Avoidant / restrictive food intake disorder (ARFID)

132
Q

Parenting style that is warm, responsive, and accepting but that also sets expectations for behavior and achievement. Differences are approached with reasoning and discussion rather than by exerting control.

A

Authoritative parenting. This style is most likely to be associated with positive child outcomes across multiple domains

133
Q

Most common form of self-injury.

A

Cutting

134
Q

Most common neurobehavioral disorder of childhood

A

Attention-deficit/Hyperactivity Disorder

135
Q

The most consistent and telling sign of reading disability in an accomplished young adult

A

slow and laborious reading and writing

136
Q

Refers to the correct use of speech sounds to form words

A

Phonology

137
Q

Refers to the correct use of words

A

Semantics

138
Q

Refers to the appropriate use of grammar to make sentences

A

Syntax

139
Q

The most common neck mass in the newborns

A

Lymphangioma (cystic hygroma) - a multiloculated cyst comprised of dilated lymphatics

140
Q

The most common fracture in newborns

A

Clavicular fracture. The humerus and ulna are the 2nd and 3rd most commonly fractured bones at delivery

141
Q

Manifested by an arm that is extended, internally rotated, and with limited movement

A

ERb’s palsy

142
Q

Characterized by difficulties in social interaction, eccentric behaviors, and abnormally intense and circumscribed interests despite normal cognitive and verbal ability

A

Asperger syndrome

143
Q

Defined as failure to speak in specific social situations despite speaking in other situations

A

Selective mutism

144
Q

Form of shock in cardiac tamponade

A

obstructive

145
Q

Mild blood loss in pediatric patients is defined as ___, with systemic response of (CNS, CVS, Skin, UO)…

A

<30%
CVS: Increased heart rate; weak, thready peripheral pulses; normal systolic blood pressure; normal pulse pressure
CNS: Anxiety, irritability, confusion
Skin: cool, mottled, CRT prolonged
UO: Low to very low

146
Q

Moderate blood loss in pediatric patients is defined as ___, with systemic response of (CVS, CNS, Skin, UO)…

A

30-45%
CVS: Markedly increased heart rate; weak, thready central pulses; peripheral pulses absent; low normal systolic blood pressure; narrowed pulse pressure
CNS: Lethargy; dulled response to pain
Skin: Cyanotic; capillary refill markedly prolonged
UO: Minimal

147
Q

Severe blood loss in pediatric patients is defined as ___, with systemic response of (CVS, CNS, Skin, UO)…

A

> 45%
CVS: Tachycardia followed by bradycardia; central pulses very weak or absent; peripheral pulses absent; hypotension; narrowed pulse pressure (or undetectable diastolic blood pressure).
CNS: coma
Skin: pale and cold
UO: None

148
Q
A

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