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NP 2- TOP 8 > PEDIATRIC 1: ASSESMENT HEAD TO TOE > Flashcards

PEDIATRIC 1: ASSESMENT HEAD TO TOE Flashcards

1
Q

ASSESSMENT: Head to Toe
VITAL SIGNS

A

HR: 120-160 bpm
RR: 30-60 cpm
BP: Sytole: 60-80 mmhg
Diastole: 40-50 mmhg
Temperature:
-1st rectal: imperforated anus
-2nd axillary
-36-5- 37.2
SaO2: >95%

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2
Q

HEAD/FONTANELS
“BAD TEACHER (LPT)”

A

B-A-D
-Bregma-Anterior-Diamond
-Size: 3x4
-Closure: 12-18 months

            L-P-T -Lambda-Posterior-Traingle -Size: 1x1 -Closure: 2-3 months
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3
Q

-Swelling made of fuids
-Vaguely outlined :crosses suture line
-Disappears: 1 week

A

CAPPUT SUCCEEDANEUM

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4
Q

-Swelling made of blood
-Well outlined swelling :doesn’t cross the suture line
-Disappears: weeks- months
-Causes jaundice

A

CEPHALHEMATOMA

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5
Q

Head is Sunken/Depressed

A

Dehydration (↑BP,↓ HR& ↓RR)

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6
Q

Head is bulging/swelling

A

-↑ ICP (N: 0-15 mmhg)
-Narrow pulse pressure <30 mmhg
-Cushing Triad (Hyper, Brady, Brady)

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7
Q

Neural Tube defects:
-protusion of sac in occipital area that contains CSF & Meninges
-1-10 weeks of life: occurrence

A

ENCEPHALOCELE (back)

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8
Q

Neural Tube defects:
-Absence of cranial bone
-Brain is visible = death
-breech presentation :
↓ head weight= cannot move

A

Anencephaly

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9
Q

Neural Tube defects:
-Abnormal early closure of suture line= can’t moulding

A

CRANIOSYNOSTOSIS

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10
Q

NOSE:ABNORMAL
-closure of nasal passage
-Both nostrils: Immediate cyanosis after birth

A

Choanal Atresia

Assessment done by:
-Alternately Pinching/occluding each nostrils that leads to cyanosis.
Management:
-Surgery

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11
Q

NOSE:ABNORMAL
Down syndrome (Trisomy 21)

A

Flat nasal bridge

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12
Q

EAR: ABNORMAL

A

Hearing loss: No startle Reflex

Low set ears: Down syndrome

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13
Q

NECK: ABNORMAL
Short neck:

A

Down syndrome

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14
Q

NECK: ABNORMAL
-Overstreched fascia
-missing x chromosomes (23rd)

A

Webbed neck/Turner Syndrome:

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15
Q

NECK: ABNORMAL
-weakness of SCM
-Breasfeeding baby should lean on affected side; to exercise

A

Torticollis (Wry neck)

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16
Q

CHEST:
-Normal
-DUE TO: ↑Estrogen & ↑Prolactin

A

Witch Milk

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17
Q

chest: Abnormal
-Protusion & displacement of sternum
-Seen in pt with Marfan syndrome

A

Pigeon’s Chest

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18
Q

chest: Abnormal
-See-saw respiration (in-in)
-Sign of respiratory distress

A

Chest indrawing/ Chest retraction

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19
Q

ABDOMEN: ABNORMAL

A

↑abdominal diameter
-necrotizing enterocolitis: inflammed large & small intestines

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20
Q

closure of membrane

A

7-10 weeks

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21
Q

ABDOMEN: ABNORMAL

Protrusions: Immediate surgery within 24 hours
↓
(-) sac : (+) sac:
Raw intestines Small <4cm
(lumabas) Umbilical Hernia
↓ Large >4cm
↓ ↓
Gastroschisis Omphalecele

A

MANAGEMENT: Gastroschisis (-) sac
-NPO
-No Breastfeeding
-IV
-Moist Pnss

MANAGEMENT: Umbilical Hernia
-allow breastfeeding
-Moist: PNSS

MANAGEMENT: Stomach, liver,
Intestine
:Omphalocele
-NPO
-No breastfeeding
-Moist: PNSS

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22
Q

BACK: ABNORMAL

divided/split spinal cord

A

Spina Bifida

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23
Q

BACK: ABNORMAL

-“dumpling”; lumbar sacral
-Hair tuft or dimple at site.
-common in 1 out of 20
-most common & least serious

A

Occulta

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24
Q

BACK: ABNORMAL

Protrusion: sac of Meninges + CSF

A

Meningocele

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25
Q

BACK: ABNORMAL

-Protrusion: sac of Meninges +CSF+ Spinal cord
-Incontinence & paralysis
-Most serious

A

MyelomeningoceLe

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26
Q

absence of extremity

A

Amelia

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27
Q

Incomplete extremity

A

Phocomelia

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28
Q

Small extremity

A

Micromelia

29
Q

Medication that cause loss of extremities:

A

Thalidomide/ Anti-emetic

30
Q

fusion of digits

A

Syndactyly

31
Q

Excess digits

A

Polydactyly

32
Q

Talipes Disorders: Foot

abnormal flexion of foot (plantar flexion)

A

Clubfoot

33
Q

Talipes Disorders: Foot

Turned inward

A

Varus deviation:

34
Q

Talipes Disorders: Foot

Turned outward

A

Valgus deviation

35
Q

Talipes Disorders: Foot

Forefoot (toes) lower than the heel

A

Equinus/horse foot:

36
Q

Talipes Disorders: Foot

Heel first

A

Calcaneus

37
Q

Management for Talipes

A

Management:
Casting
Corrective Boots

Danger:
-Always check toes
-Neurovascular compromised

38
Q

GENITALS

-Normal
-Exposure to maternal hormones
-↑ Estrogen & Progesterone

A

Normal: Pseudomenstruation

**Abnormal : Pseudohermaphroditism

39
Q

GENITALS

-Undescended testis
-Expected in premature baby

A

Cryptorchidism

40
Q

DOC for Cryptorchidism

A

HCG hormone

41
Q

GENITALS

unretracted foreskin/prepuce

A

Phimosis

42
Q

Management for Phimosis:

A

Circumcision at birth

43
Q

Genitals

Urethral opening : Upper/Dorsal aspect

A

Epispadias

(UpEpiDor)

44
Q

Genitals

Urethral opening: Lower/Ventral aspect

A

Hypospadias

LoHyVen

45
Q

Management for Hypospadias

A

Hooding (Surgery)

46
Q

Republic act about newborn screening
-after 24 hours to 3 days
-6 disorders

Expanded Newborn screening
6 to 28 disorders

A

RA 9288

47
Q

NEWBORN SCREENING

-inability to metabolize protein
-Valine
-isoleucia
-leucin
Hallmark sign: Maple syrup urine odor

Complications:
-Brain damage & Kidney failure

A

MSUD (Maple Syrup Urine Disease)

48
Q

MANAGEMENT FOR MSUD (Maple Syrup Urine Disease)?

A

↓ animal protein
B-complex (IM)(IV)

49
Q

NEWBORN SCREENING

Inability to metabolize protein
Phenylalamine
↓
Precursor: Melanin (skin
Thyroxine (heat; t4)
Epinephrine (Fight-Flight

Toxic: Brain= brain damage
(Pround=IQ; Mental Retardation)

A

PKU (Phenylketonuria)

50
Q

Management for PKU

A

Phenylalanine Free milk:
LOFENALAC

Diet: low animal protein
↑fruits & Vegetables

51
Q

NEWBORN SCREENING

Etiology: Mother has Hyperthyroidism
-Common In girls

Problem:
at Birth
-Hypothermia/Hypoglycemia
-Bradycardia, Apnea
-WOF: SIDS
-Hallmark: Rag Doll appearance
-floppy
-Head sag
-Large tongue
aka Cretinism

A

CONGENITAL HYPOTHYROIDISM

52
Q

MANAGEMENT FOR CONGENITAL HYPOTHYROIDISM?

A

Within 10 days give Levothyroxine (synthroid, levothroid)

Mix with milk

53
Q

NEWBORN SCREENING

Problem: Reflective Adrenal Cortex
↓Sugar(Cortisol)
↓Aldosterone (Hypovolemia)
Normal: Testosterone

APG: ↑ ACTH due to defected steroid synthesis
Adrenocorticotropic Hormones)
↓
Stimulates Adrenal Cortex =Hyperplasia
↓
↑sex

A

CAH : CONGENITAL ADRENAL HYPERPLASIA

54
Q

CAH has increased mortality because of?

A

Increase mortality in first 7 hours because of
1st: shock,
2nd: Hypoglycemia,
3rd: Hypovolemia.

55
Q

S/sx of CAH

A

MALE:
-early puberty
-enlarged penis, masculine voice, pubic hair
-4ft .

FEMALE:
-no menarche
-virilisation (loss of feminity)
-deep voice
-hirsutism
-flat chested
-enlarged clitoris

56
Q

MANAGEMENT FOR CAH

A

Hydrocortisone: synthetic cortisol
Medication is effective when:
-↑ Breastfeeding time
-↓ engorgement breast of mother
Fuducortisone: Synthetic aldosterone
-Effective: Weight Gain

57
Q

NEWBORN SCREENING

-Lactose intolerance
-Dissacharide (glucose +galactose)
Problem: GI symptoms
-Diarrhea & vomiting
-Liver damage

A

GALACTOSEMIA

58
Q

Management for Galactosemia:

A

No breastfeeding
Formula milk —> Lactose free
NEUTRAMIGEN (Milk for galactosemia)
*soy milk as alternative

59
Q

NEWBORN SCREENING

-Glucose 6 phosphate dehydrogenase
-RBC health/life
Problem: Hemolytic Anemia
-Oddly shaped RBC

Triggers: Hemolytic Anemia
Drugs: Aspirin, Chloramphenicol, quinine, quinidine, chloroquine, sulfa drugs, cotrimoxazole.
Foods: Ampalaya, Soya, Nuts, Beans, Mints
Substance: Mentol, Naphthalene (moth balls)

A

GGP6

60
Q

MANAGEMENT for G6PG during hemolysis?

A

RBC transfusion: Chronic
Risk for: Iron Toxicity
-First sign: Iron fist Sign or Pain on knuckles
-Liver Damage (LFT check)
7-56 u/l : SGPT (ALT)
10-50 u/l : SGOT (AST)
-Abdominal pain
S/sx: V-A-N-D-A
-Antidote: Chelation Therapy: removal of excess minerals
-Agent: Deferoxamine (Desferral)
-Urination
-CI: kidney failure
-Agent:Deferasirox
-feces
-Last resort: Surgery (Spleenectomy)

61
Q

S/sx of g6pd

A

V-A-N-D-A

62
Q

G6PD Has a lot of triggers, therefore?

Triggers: Hemolytic Anemia
Drugs: Aspirin, Chloramphenicol, quinine, quinidine, chloroquine, sulfa drugs, cotrimoxazole.
Foods: Ampalaya, Soya, Nuts, Beans, Mints
Substance: Mentol, Naphthalene (moth balls)

A

Put it all in a medic Alert Drugs

63
Q

First sign of G6PD?

A

Iron fist or pain in knuckles

64
Q

What s/sx is seen only in pt with galactesemia?

A

CATARACT

65
Q

Milk for galactesemia?

A

NEUTRAMIGEN

66
Q

Hallmark for Congenital Hypothyroidism?

A

Hallmark: Rag Doll appearance
-floppy
-Head sag
-Large tongue

67
Q

Medical term to child with hypothyroidism?

A

Cretenism

68
Q

choice of milk for PKU?

A

LOFENALAC

69
Q
A

NP 2- TOP 8 (12 decks)

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