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CD3408 > Let 15-18b > Flashcards

Let 15-18b Flashcards

1
Q

What is asthma

A

A disease characterized by increased responsiveness of the trachea and bronchi to various stimuli and manifested by widespread narrowing of the airways

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2
Q

Clinical def of asthma

A

any patient with recurrent (>3) episodes of wheezing and or dyspnea

  • can cause
  • -sob
  • -tightness in the chest
  • -coughing
  • -wheezing
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3
Q

Risk factors of asthma

A

Genetic- The body predisposition to develop IgE

Environmental

chemical agents (tabaco etc)

Inflammatory triggers

Symptom triggers

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4
Q

What is exercise induced asthma+ mechanism + durations

A

Coughing, wheezin, chest tightness

mechanism- increases respiratory rate + cold dry air thru month
-Airways narrow->reduced air flow->coughing wheezing etc

Duration
After- begin during and usually worse 5-20m after stop
late- 4-12 after but ss are less severe

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5
Q

Tests used for asthma

A

Spirometry
Peark flow rate
challenge test (deliberately triggering airway obstruction)
Exhaled nitric oxide (marker for asma severity)

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6
Q

Essential components of asthma care

A 
assessment and monitoring
patient education
control of factors contributing to asthma severity
pharmacological tx
pt health and wellness
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7
Q

possible treatable traits of chronic asthmatic

A 
nutritional def
obesity
reconditioning
cachexia
fall risk 
gerd
sleep apnea
stress etc
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8
Q

Med management of asthma

A 
Bronchodialators (beta agonists)
Antiinflamatories
Inhaled NSAIDS
Inhaled steroids
Oral Steroids
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9
Q

Asthmatic emergencies in children ages 5-11

A

s/s of sig trouble breathing

  • persistent coughing or wheezing
  • no improvement after inhaler
  • unable to speak w/o gasping
  • peak flow meter (in red)
  • severe asthma attack
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10
Q

tx traits of asthma for chiros

A 
spinal mobility
myofasial tension/triggers
rehab program
trigger exposure
referal for sensitive testing
nutritional options
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11
Q

Enuresis definition

A

Defined as the leakage of urine in discrete portion of sleeping
-atleast 5yold or older

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12
Q

What is primary enuresis

A

Never been previously dry
-dx not before 5years old

(15% have natural resolution rate w/o tx)

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13
Q

What is secondary enuresis and pot causes

A

Restart bedwetting when previous dry period of at least 6 m

Multiple causes:

  • UTI
  • Small bladder capacity
  • Anatomic abnormalities
  • psychological distress/anxiety
  • family stress
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14
Q

what is mono symptomatic enuresis

A

the pt is w/o

  • lower tract sympptoms
  • hx of bladder dysfunction
  • night time wetting with day time control
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15
Q

What is poly symptomatic enuresis

A

nocturnal + day incontinence w other symptoms:

  • urgency, hesitancy, straining
  • weak stream
  • intermittency
  • holding manoeuvres
  • feeling of incomplete emptying
  • post maturation dribble
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16
Q

Genetics of eneritics

A

75% risk where both parents were
45% risk where only one parent was
15% where there is no parental hx

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17
Q

multifactorial causation of enuresis

A
  • impaired cerebral cortex maturation
  • rapid eye mvmt sleep disorder
  • disturbed circadian rhythm
  • genertic disorders
  • psychiatric disorders
  • kidney probs
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18
Q

overall tx methods for primary nocturnal enuresis

A 
timed awakenings
alarms
biofeedback
hypnosis
acu
meds
CBT
diet
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19
Q

what are the core symptoms of ADHD (3)

A
  1. Inattention
  2. Impulsivity
  3. Hyperactivity
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20
Q

diagnostic criteria for ADHD

A
  1. Inattention (need 4)
    - need a calm/quiet to get work done
    - asks things to be repeated
    - easily distracted
    - confuses details
    - doesnt finish what started
    - hears but doesnt listen
    - difficulty concentrating
  2. Impulsivity (3 of following)
    - Calls out in class
    - extrememly excitable
    - trouble waiting turns
    - talks excessively
    - disrupts children
  3. Hyperactivity (3 of following)
    - climbs onto cabinets / furniture
    - always on go
    - figids/squirms
    - does things in a loud/noisy way
    - must always be doing something
21
Q

Other key adhd criteria other than 3 categories

A

Onset before 7
Duration of at least 6 months
present in at least 2 settings

22
Q

Epidemiology of ADHD

A

1-13%

3-4x mc in boys than girls

23
Q

etiology of ADHD

A

combo of genetic, neuro and env factors contribute to pathogenesis

non inherited factors- brain injury, birth complications, inter exposure to alcohol/tabaco, low birth weight, hypixia

24
Q

Neurology of ADHD

A

sig brain areas w slow brain activity:

  • Frontal lobes
  • Inhibitory mechanism of the cortex
  • libic system
  • reticular activating system
25
Q

Chiro care for ADHD

A

Insufficent evidence to evaluate efficacy of chiro care for paediatric and adolescent ADHD

(67.6% of fams use CAM for management)

26
Q

Examples of tx traits of child living w ADHD

A 
gross motor energy management
fall risk reduction
teaching proportionality
look ahead activites
signs/signals
memory tasks
somatic stin
27
Q

Prevellenece of LBP in adolescnece

A

25-50%
more prev in 8-10yearl olds and 14-16

(1/3 trauma, 1/3 develipmental, 1/3 inf, neoplasm etc)

28
Q

effect of backpack weight on children

A

carrying more than 10% of body weight-> increased incidence of pain in neck and back

(15% changes all angles pertaining to head, neck, trunk etc)

29
Q

what % of pediatric athletes have LBP

A

10-15%

30
Q

Scheuermanns kyphosis- age, sex, pain

A

dx bw 13-17
m
Usually asymptomatic (if pain then exacerbated by forward flexion, relieved by rest)

31
Q

Discitis age group

A

<4

usually staph aureus

32
Q

mc form of downs

A

trisomy 21

33
Q

can CAM therpies help reduce antibiotic resistence

A

In paediatric practice an emphasis on accurate diagnosis, control or environmental risk and utilization off CAM could help reduce antibiotic resistance

34
Q

management of otis media

A

severe our with complications that fail to improve with observation of CAM (48-72hrs) should be tx with antibiotics

35
Q

what is the theory of chiro and set

A

control of eustachian tube dialation is by tensor deli palatine and elevator veli palini

-could be affect via tx to c1-4

36
Q

what is mild illness considered in Acute otitis media

A

otalgia + middle ear effusion

37
Q

Acute otitis external and s/s

A

an inflammation, irritation or infection of the outer ear and ear canal

s/s

  • intense otalgia
  • otorrhea
  • fullness
  • hearing loss
38
Q

what is the malignant for of otis externa

A

inf to temporal bone (necrotizing otis external)
immunocompromised pt
elderly diabetics

39
Q

General tx for otis media

A 
antibiotics
valsalva maneuver
myringotomy and tympanovstomy
diet
gum
massage
meds
40
Q

infantile vs juvenile vs adolescent scoliosis

A

infantile- seen by 3
juvenile- seen by 4-10
adolescent- 10 to skeletal maturity

41
Q

Adolelesent idiopathic scoliosis represents what % of all spinal curves

A

85%

42
Q

3 Basic AIS etiologoies

A
  1. disporortionate growth velocities
  2. nervous system dysfunction (altered sensory inputs)
  3. endocribne system involvement (calmodulin def)
43
Q

What were the conclusions of school screening study

A

only a small% of curves will undergo progression
-pattern of the curve according to curve direction and sex of the child was found to be a key indicator of which curves will progress

44
Q

vision and hearing associated probs with scoliosis

A

vision impaired inv have 5x grater incidence of scoliosis

hearing impaired inv have 3/7 times less incidence of scoliosis

45
Q

AIS progression in adulthood

A

more progressive bw detection and skeletal maturity, less rapid in next 30 years
(1 degree progression per year)

46
Q

for curves <20 what should be done

A

Obs

  • exercise, postural, economic awareness
  • cognitive/image/perception/personal goals
  • refer to physician
47
Q

for curves 20-40 what does be dome

A

bracing may be required if their is documented progression

-1/3 of curves in this range dont progress

48
Q

for curves >40 degrees what should be done

A

surgery may be indicated

CD3408 (10 decks)

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