MIX STUFF Flashcards
Evoked oto acoustic emission
USED in new borns
looks at the cochlear function and if its nromal
Auditory brainstem response (ABR)
series of auditory stimuli - computed analysis of EEG waveforms
Age for distraction test
7-9 months
visual reinforcemnet audiometry
10-18 months
Discrimination test
18 - 4 months
When can u do audiometry
greater than 4 years
SHOCK
Early vs. LATE Early - increase - heart and lung - Skin - decrease skin tugor, mottled , pale and cold - Sunken - eyes and fontelle - decrease urine output
Late - ACIDOSIS - kusmaual brething - BRADYCARDIA Hypotensive Confusion Blue pheriphery NO URINE OUTPUT
status epilepticus treatment
we know this is a seziure or multiple sezirues greater than 30 minutres or longer
Lorazepam IV or diazepam PR or midoazolam buccal
Paraldehyde in 10 minutes
Phenytonin
Phenobarbital
Thiopental
PCIU
what do you do if development is abnormal you want to
check bone age
pelvic ultrasound
what does short stature mean
2 centile below the normal height
Genetiic target centile
mean of the mom and dad THEN
Boys - + 7 cm (+/- 10cm)
Girls - 7cm (+/- 8.5cm
What thyroid condition causes short stature
Automimmune thyroiditis - growth failur and wieght gain
What chronic illness and chromosomal illness cuase short starture
Chomosomal
- Turners
- Downs
- noon
- Russell Silver Syndrome
Chronic
- celiac
chrons and
chronic renal failure
Laron syndrome
this is EXTREME short stature
Laron-type dwarfism, is an autosomal recessive disorder characterized by an insensitivity to growth hormone (GH), usually caused by a mutant growth hormone receptor.
TREAT WITH IGF-1 (expensive but works)
abnormality in the SHOX
(short stature homobox) - located at the X chromosome and leads to short stature with skeletal abnormalities
Tuners - one SHOX MISSIN
Klienfielters - one additional SHOX - talller
You get one copy from each of your parents
syndromes ass . w/ tall stature
long legged tall stature Merphan syndrom Homocystinuria klienfelters Syndrome Portionate tall stature at birth - marphans, hyperinsulinesim , beckwidt Sotos syndrome
Sotos syndrome
Large head and neck
facial characteristic
learning difficulties
secondary cause of tall stature
Hyperthyroidism
Excess sex steroids - percious puberty
Excess adrenal steroids
True Giatism (excess GH steroid)
when does posterior fontelle close
8 weeks
when does anterior fontelle close
12 - 18 months
causes of microcephaly
below the 2nd centile -FAMILIA AR CONGENITAL INFECTION AQUIRED INSULT _ CP and seziure
MACROCEPHALY
tall stature FAmiliaal Increase ICP Hydrocephalus Chronic subdural heamatoma Cerebral tumor NF Sotos syndrome CNS storage disorder (hurler syndrome
Assymetrical heads
Skull assymetry - results from an imblance
plagiocephaly - flat base from lying on head
Causes of prenicious puberty
GT dependent - central / true
- Idiopathic / familial
- CNS abnormalities (congenital, post irraiation, infection, sx or tumor )
- hypothyroidism
GT non dependent - ovarian - testicular exogenous sex steroids Adrenal disease
Treatment of prenicious puberty
GNRH dependent - GNRH analgous
GNRH independent - medoxyprogesterone , cypoterone acetate , testolactone , ketoconazole
age of premature breast development
6moths - 12 years
Adrenarche
Premature pubarche - BEFORE THE AGE of 8
Causes of delayed puberty
CONSTITUTIONAL
LOW GNRH sections
Systemic
- CF , asthma , Chorns , organ failure
HPA AXIS
- panhypothyroidsm, isolated GH decreased, intercrnial tumor and kallamn syndrome
AQUIRED
HIGH GNRH SECTION
- leinfelters and tuners
- Steroids hormone or exzyme decrease
AquiredTreatment
MALEs
oxandrolone (steroid)
low dose IM testosterone
FEmales - estradiol
MARASMUS
KWASHIOKOR
severe protein malnutrition w/ generalized edam
- weight might not be severely reduced
- RASH - w/ hyperkeratosis Distended abdomen and enlarged liver Hair - spares and depigmented Diarrhea and hypoththermia and bradycardia Angular stomatitis Low plasma albumin and glucose
labs of rickets
calcium decrease or normal
decrease phosphorus
INCREASE alk phosphate
Decrease 25 hydroxy D
Xray of rickets
Shows cupping
Fraying of the metaphysis
Widening o epiphyseal plate
clinical vitamin A
Complication of fat malabsorption Clinical - blindness eye damage (xerophthalmia - progress from ulceration to scarring Increase risk of infection
Treat HIGH DOSE vitA
failure to thrieve
fals across 2 centile lines
weight below 0.4centile
Dennie morgan folds
Fold below lower eyelid seen in allergies
how fast does a food allergy come on
TYPE 1 - IgE - fast –> 10-15 minutes
Causes of dealth in adolescent
INJURY and POISONING - 60%
Cancer 10%
what percentage of adolescent use contraception 1st time in intercourse
1/2
Organism for meningitis
Neonate - 3 months
- Group B strep
- Listeria
E.coli
1 month - 6 year
- N.meningitis
- Strep pneumo
- h.influnza
> 6 years
- n. meningitis
- strep pneumonia
Labs for bacterial vs. viral infection vs. TB
Bacterial
- turbid CSF , increase polymorphs , Increase protein and decrease glucose
Viral
- clear CSF , increase lymphocytes, normal or Increase protein and normal glucose
TB
- trubid or clear CSF, high lymphocytes HIGH protein and LOW glucose
Criteria for Toxic Shock
Staphyloccouus or GAS FEVER > 39 Hypotension Diffuse Erythma macula rash
treatment of impitigo
MUPIROCIN
chicken pox complication
Necrotizing facititis
Person with chicken pox who fever goes away and then comes back
think
2ndary bacterial infection
Age of RTA
5-9 and they are usually due to the children being the pedestrians
number 1 cause of death 1-14 years old
accidents and posioning
head injury in kids
Since their sutures have no fused –> if they get a extraadural or subdural bleed BEFORE neuro symptoms
THEREFORE you will get a decrease hb and child becomes shocked
number 1 cause of burns in children
House fires
Scalds
child are scaled at lower temps bC skin is THIN
Treatment of burns
- calculate the surface area of the burn -2. morphine - pain
treat shock with IV fluids - plasma exchange
Wound care - cover in CLING FILM - decrease infection
TENTUS
Removal of dead tissue and replace sterile dressing - plastics
Drowing in kids - who is more at risk
3 X more in MALES than girls
Babies - bath
Tolders - pools and lacks
Older - pool, lakes , ssea
What type of water is better for near drowning
HYPOTHERMIA water is better because it prevents hypoxic brain injury
(no diffence b/w fresh or salt water)
Chocking what to do
Cough - encourage - check airway
No cough - unconcious - open airway
concious - 5 back thrust and 5 thurst
older - heimleck
treatment of dog bites
CO - AMOXICLAV
treatmet of lead posioning
D - penicillinase
EDTA - severe
clinical if child takes digoxin
arrythmias
hyperkalemias
Treat - activated charcol, ECG and digoxin
Button batteries
mild GI symptoms , esophageal stricture , perforation release of MURCURY
Treatment for Iron and clinical
Toxicity - > 60mg/kg DESFERIOXAMINE for chealtation Clincial - Initial : - vomitting , diarhea, melena, heamatemsis , gastric ulceration LATER - drowsiness , shock , coma and liver F
What happens if hild takes paracetomol
Gastric ulceration
liver failure 3-5 days
Treat - if > 150 mg/kg you want to give iV acelycystein
Salicylates clinical and treatment
tinnitus, deafness, N+V and dehydration
1st Resp ALKALSION
2nd MED ACIDODID
Hypoglycemia
alcohol
CLinical: hypoglycemia coma and rsp failure
monitor blood glucose IV glucose and blood levels
when do you operate on hydrocele
if they persist past 18-24 months
