Memorize cards deck2 Flashcards
Functional diarrhea
1 month >/=4x daily, painless occurs during waking hours onset 6 - 60mo no FTT if adequate intake
Functinal constipation
1 month, developmentally 4 yo < 3x BM in toilet retentive behaviour hard, painful BM too large to flush fecal soiling large fecal mass in rectum
Functional dyspepsia
1 or more: 4days/month x 2mo
early satiety
post prandial fullness
epigastric pain not associated with defecation
IBS
abdo pain > 4x/month x 2mo with at least one of:
1. related to defecation
2 change in stool frequency
3. change in form of stool
if constipation, resolution does not change pain (ie not functional constipation)
abdominal migraine
paroxysmal episodes of intense, acute, periumbilical midline or diffuse abdo pain >/=1hr 2x in 6months - episodes separated by weeks/months - interferes with function - sterotypical in individual - pain associated with 2 of: 1. anorexia 2. nausea 3 vomit 4. headache 5. photophobia 6. pallor
cyclic vomiting
ALL criteria:
1. at least 5 attacks, any interval or 3 in 6mo
2. recurrent intense vomiting, lasting 1hr = 10 days and at least 1 week apart
3. sterotypical pattern for patient
4. vomiting occurs >/=4/hr and for >/=1hr
5. baseline between episodes
not other disorder
Typical 2- 5 yo. strong family history
risk to develop migraines later
Rx: hydraiton, antiemetics
lifsetyle changes, prophylatic propranolol, PHB, amitryptiline
ADHD criteria
onset <12 years
more than one setting > 6 months
6 in each category for mixed (or 6 in one)
Hyperactive
- figidty
- leaves seat
- on the go
- blurts out answers
- not wait turn
- interrupts others
- difficult play quietly
- runs/climbs excessively
- talks excessively
inattentive
- careless mistake
- unable sustain attention
- fails to complete task
- disorganized
- avoids sustined mental tasks
- loses things
- forgetful
- distractable
- not listen when talked to directly
ODD criteria
> 6 months, 4 criteria - angry/irritable -defiant -deliberately annoys/blames others - vindictive -losses temper -easily annoyed (Not Conduct disorder)
CD criteria
> 3 min 12 months hurt animal/people property distruction theft/decietfullness violation of rules
Rx: multimodal therapy
Major depressive disorder
5 or more, 2 weeks S - suicidal ideation I - interest G - guilt M - mood E - energy C - concentration A - appetite P - psychomotor S - sleep
- no mania/hypomania episode
- earlier it is, more severe
schizophrenia
> 6 months
2 more more (each >1mo) one must be 1/2/3
- delusion
- hallucinations
- disorganized speech
- grossly disorganized/catatonic behaviour
- neg symptoms
mania
3 or more, 1 week GST paid Grandiosity Sleep Talkative P-pleasurable activities, painful consequence A - activity I - ideas (flight) D - distractable
serotonin syndrome
F ever
A automomic - HTN, BP, hyperreflexia
R rigidity muscles (less than NMS)
M mental status - confusion, agitation
differentiating features
- GI (vomit, nausea syndrome)
- usually no CK elevation
- more hyperreflexia
- myoclonus, ataxia
Rx: supportive, usually resolve 24hrs
- PRN benzo for agitation, rigidity
- cyprohepatadine antidote
Neuroleptic malignant syndrome
dopamine agonists (ie haldol, antipsychotics, metroclopramide)
Fever
autonomic - HTN, BP
R - rigidity of muscles, inc CK
M - mental status - LOC, agitation
MUST: fever, muscle rigidity, CK
Rx; supportive care. more insiduous onset lasts longer than SS
Panic attack
intense fear or discomfort peak few mins, self resolve 45-60min at least 1 month and anxiety ABOUT panic attacks \+/- agoraphobia (fear of unable to escape) 4 criteria: sweat tachycardia/palpitations SOB fear of dying feeling of choking nausea tingling chest pain chills tremble unsteady/dizziness depersonalization
PTSD 4 characteristic features
- intrusive thoughts
- avoidannce of stimuli
- negative - detachment from others, inability to experience positive emotions
- hypervigilance
OCD
obsessions, compulsions OR both
- obsessions - persistent, invasive thoughts, unwanted
- aware and wants to suppress - compulsions - repetitive behavior in response to obsessions
- ie handwashing/checking/cleaning
Rx: CBT as effective as medications
OCD
obsessions, compulsions OR both
- obsessions - persistent, invasive thoughts, unwanted
- aware and wants to suppress - compulsions - repetitive behavior in response to obsessions
- ie handwashing/checking/cleaning
Rx: CBT as effective as medications
diagnostic criteria autism (4)
- social communication
- ie reciprocity - eye contact, conversation
- nonverbal - eye contact, gestures/pointing - repetitive sterotype behavior
- sterotype movements
- insist on same routine
- change in sensory - impairment in function
- not explained by IQ or GDD
- onset in early childhood
Indications for Eating disorder admission
failed day treatment HR < 50 day, < 45 night BP < 80/50 temp < 36 orthostatic (HR >20 or BP >10 change) cardiac arrhythmias Hypokalemia (< 3.2) hypophophoshatemia hypoglycemia <80% body weight
Contains what?
FFT
cyroprecipitate
FFP: all coagulation factors and fibrinogen
Cyrorecipitate - F13, 8, vWF, fibrinogen
- if low fibrinogen, might benefit from concentrated cyro
Factor replacement
Factor 8
Factor 9
vWF
F8 - 1u/kg increase by 2%
F9 1u/kg increase by 1%
wilate
inherited thrombosis
antithrombin deficiency protein C def Protein S def factor 5 leiden prothrombin mutation
Brain death criteria
- established etiology
- comatose with no motor response
- brain stem response (vestibule-ocular, corneal, pupils)
- apnea test
(PaCo2>60 AND +20 pre test AND pH < 7.28 - absent confounding factors
- temp > 36 neonate. Temp > 34 otherwise
> 1 year old - concurrent okay, 2 physicians
30d - 1 year - 2 separate test (no fixed interval)
< 30 days - min first at 48hr, 2 tests, separate by 24hrs
