Pediatric Diseases - Block 4 Flashcards
Describe the categories of pre-term neonates?
Late: 34-37 W
Moderate: 32-34 W
Very: 28-32 W
Extremely: less than 28 W
What is gestational age?
Time between last mentrual period and day of birth
What is postnatal age?
Time sinse birth
What is postmenstrual age?
GA plus chronological age
What is very low BW? extremely?
1500 g
1000 g
Examples of preterm complications?
- Respiratory distress
- Congenital heart defects
- Intraventricular hemorrhage
- SZ
- Necrotizing entercolitis
- Hypoglycemia
- Jaundice
- Sepsis
How do assess neonatal cardiopulmonary resuscitation?
Tone, RR, cry, HR
Target lungs not heart
How do you treat Neonatal cardiopulmonary Resuscitation?
- Initiation of positive pressure ventilation, positioning airway, clearing secretions, intubation
- Chest compression if HR <60
- Epinephrine <60 for 30 seconds
Routes of epinephrine use?
IV (umbilical)
IO/endotracheal (longer onset)
What is the difference between EOS and LOS?
EOS: withing 3 days of birth and risk factors originate from mother
LOS: after 3 days of life and risk factors from hospitalization, NEC
What are the sites of infection?
- Pneumonia
- UTI/pyelonephritis
- Menangitis
- Bacteriemia
What are the clincal prensentations of spesis in neonates?
Temp instability, feeding intolerance, lethargy, grunting, flaring, retractions, apnea
Meningitis -> bulging fontanelle and sz
What are the clincal prensentations of spesis in children?
Fever, loos of appetite, emesis, myalgia
Meningitis -> Nuchal, back pain, Kernig, Bruzinski, HA, photophobia, sz, altered mental status
Recommend temperature route for <4YO?
Rectall
Low grade fever?
100-102
High fever?
104
Normal body temp?
98.6
Temperature that qualifies for antipyretics?
101
What is the diagnosis for infection?
In serum:
↓ WBC
↓ ANC
↑ I:T
↑ CRP
Diagnosis for meningitis?
In CSF:
↑ WBC
↑ Protein
↓ Glucose
What is the tx for sepsis?
Abx based on culture
What are the types of congenital heart defects?
Acyanotic: artial and ventricular septum defects, patent ductus arteriosus
Cyanotic: tetralogy of fallots, hypoplastic left heart syndrome, transposition of the great arteries
What is paten ductus arteriosus?
High prostaglandin -> failure of ductus closure -> right to left shunt
Tx for patent ductus arteriosus
Prophylaxisis (24H of birth)
Eary sx (1-3 days)
Late sx (7-10 days) - surgery
Indomethacin
Ibuprofen
APAP
Monitoring for Indomethacin and IBU?
UO
Monitoring for APAP?
LFTs
WHo are more prone to patency?
Preterm infants who have:
1. Incomplete metabolism of PG
2. Increased sensitivity of PG
3. Increased ductus tone
4. Decreased muscle fibers of the ductus
What are the alterations of tetralogy of fallots?
- Override of aorta
- Hypertrophy of right ventricle
- Pulmonary stenosis
- Intraventricular septal defect (right to left shunt)
What are the alteration of hypoplastic left heart syndrome?
- Hypoplastic left ventricle
- Hypoplastic ascending aorta
- ASD
What are the alterations of transposisition of great arteries
Pulmonary arteries and aorta are switched