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Thp III Exam 1 > Pediatrics > Flashcards

Pediatrics Flashcards

0
Q

Increase in function

A

Development

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1
Q

Increase in size

A

Growth

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2
Q

Antenatal

A

Term for occurring before birth (maternal)

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3
Q

Term for 12th week gestation through 28th day of life after birth

A

Perinatal

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4
Q

Perinatal includes what time periods?

A

12th week gestation through 28th day after birth

Fetus - Neonate

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5
Q

Embryo

A

Term for 1st trimester stage of development

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6
Q

Fetus

A

Term for 12th week gestation through birth

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7
Q

Neonate

A

Term for birth through one month

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8
Q

Infant

A

Term for one month through beginning of walking (usually 10-14 months)

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9
Q

Toddler

A

Term for beginning of walking through 2 years

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10
Q

Child

A

Term for two years through 12 years

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11
Q

Pubescent / Adolescent

A

Term for 12 years through 18 years

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12
Q

Gestational age

A

Age of fetus in weeks
Using either:
Calculated from first day of last menstrual period
OR
Ultrasound measurement
OR
Ballard (Dubowitz) Scoring System based on physical assessment of newborn

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13
Q

Postnatal age

A

Age after birth

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14
Q

Full-term Neonate

A

38-42 weeks

Postnatal age < one month

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15
Q

Post-term Neonate

A

> =42 weeks

Postnatal age < one month

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16
Q

Postconceptional Age

A

Gestational Age + Postnatal Age
Ex: 25 wk gestation + 6 wk old = 31 wk
postconceptional age

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17
Q

APGAR Scoring System

A

Heart Rate >100 (<100 = 1)
Respiratory Effort - good and crying (irreg = 1)
Muscle Tone - active movements (some = 1)
Reflex Irritability - crying vigorously (crying = 1)
Color - pink all over (blue extr = 1)

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18
Q

Pre-term Neonate

A

Equal or less than 37 weeks

Postnatal age < one month

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19
Q

Average birth weight

A

3.4kg

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20
Q

Age at which birth weight doubles

A

~4-5 months

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21
Q

Fever in an infant

A

38.4 C

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22
Q

Severe otitis media

A

Mod-severe pain plus temp at least 39 C

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23
Q

Recurrent otitis media

A

3x in 6 mo OR

4x in 1 yr w/1 in last 6 mo

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24
Q

3 holes in fetal heart

A

Foramen ovale
Ductus arteriosis
Ductus venosus

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25
Q

Kinrix

A

DTap-IPV

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26
Q

Comvax

A

HBV-Hib

HBV: (Recombivax 5mcg)
PRP-OMP: (PedvaxHIB) = H.influenzae B

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27
Q

Pediarix

A

DTaP-HBV-IPV

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28
Q

ProQuad

A

MMR-V
(4 Live vax)

MMRii
Varivax

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29
Q

Twinrix

A

HBV-HAV

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30
Q

PENTACEL

A

Hib-DTaP-IPV

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31
Q

MenHibrix

A

Hib-MenCY

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32
Q

AOM tx

A

Amox 80-90 mg/kg/day

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33
Q

Hole separating RA & LA

A

Foramen ovale

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34
Q

Blood vessel connecting pulmonary artery to proximal descending aorta

A

Ductus arteriosis

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35
Q

Shunts blood flow from umbilical vein to inferior vena cava

A

Ductus venosis

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36
Q

Umbilical cord connects ____ to ____.

A

Fetus

Placenta

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37
Q

Fetal circulation flows through

A

1 umbilical vein (mom to fetus) MAIN VEIN

2 umbilical arteries (fetus to mom)

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38
Q

Age at which birth weight triples

A

1 year

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39
Q

A baby weighing 10 kg should be about how old?

A

1 year

(3 x 3.4kg)

40
Q

Of weight, height and head circumference, which will decrease first…last?

A

Weight first

Head circumference last

41
Q

After a baby dries up from birth, how long until they return to avg birth weight?

A

~10 days (1-2 weeks)

42
Q

Hole between pulmonary artery and aorta

A

Ductus arteriosis

43
Q

Hole in fetal inferior vena cava

A

Ductus venosis

44
Q

Why does fetus have holes in heart?

A

Lungs are filled with amniotic fluid, so must get oxygenated blood from mother. Holes prevent pushback and heart failure.

45
Q

When blood enters fetal RA, where does it go?

A

2/3 to LA (thru Foramen ovale) and 1/3 to RV

46
Q

Umbilical cord enters placenta through

A

Ductus venosis

47
Q

PVR in fetus

Why?

A

High b/c lungs are full of fluid and blood is shunted away

48
Q

SVR in fetus

Why?

A

Low

B/c open line between baby and mom

49
Q

How does PVR change after birth? Why?

A

Decreases because first breath fills lungs with oxygen

50
Q

How does SVR change after birth? Why?

A

Increases

B/c cord is cut and holes start to close up

51
Q

Term for bowel movement of newborn

A

Meconium

52
Q

Why is it important for a fetus to make it at least 20 weeks?

A

Surfactant begins to form at 20 weeks

53
Q

Fetus’s ability to produce surfactant has completely matured by ____ weeks.

A

34-36 weeks

54
Q

What happens at first breath?

A 
Decrease PVR
Increased SVR causes Foramen Ovale to close
Increase blood flow to lungs
Increase blood flow to LA
Oxygenation and decrease prostaglandins 
   causes PDA to close
55
Q

What keeps PDA open in utero?

A

Low oxygenation and prostaglandins that mom is giving baby

56
Q

What happens if PDA doesn’t close?

A

Blood going out to body is not as oxygenated and body thinks it needs to work harder. Low oxygenated blood shunts from PA into aorta and to body.
Causes pulmonary edema, enlarged heart, CHF, pulmonary HTN

57
Q

Tx for PDA that doesn’t close

A

Close via pharmacological means
Manage symptoms: digoxin and diuretics
Surgical closure

58
Q

Consequences of PDA remaining open

A

Pulmonary edema (retrograde flow)
Enlarged heart (L-sided failure)
CHF
Pulmonary Hypertension

59
Q

Drugs used to close PDA

A 
Prostaglandin Antagonists
  -NSAIDS
      Ibuprofen, Indomethacin***
  -Corticosteroids (inhibit PLP A2 prod)
  -COX-2 selective inhibition

***Indomethacin DOC - most studied
(only takes 1-2 doses)

60
Q

Tx for PPHN

A

Sildenafil (PDE-5 inhibitor) to allow smooth muscle relaxation and cause vasodilation of the blood vessels in the lungs

61
Q

Vital signs of infant vs adult

A

⬆️ RR
⬆️ HR
⬇️ BP

62
Q

What causes Foramen Ovale to close after birth?

A

Increased SVR due to removal of umbilical flow from mother

63
Q

How do you manage symptoms for a PDA closure failure?

A

Digoxin and Diuretics

64
Q

At what age can a child start to swallow a capsule?

A

5 years old

Never give tablet/capsules to children <5

65
Q

Septic meningitis

A

Bacterial

66
Q

Aseptic meningitis

A

Viral (HSV, HIV, etc.)

67
Q

Septic meningitis can lead to…

A

Cerebral edema
Increased ICP
Decreased CBF

SIADH
Cerebral ischemia
Disseminated intravascular coagulation
Death

68
Q

Classic s/s of meningitis

A 
Severe headache
Stiff neck
Dislike of bright lights
Fever / Vomiting
Drowsiness / Impaired consciousness 
Rash
69
Q

Two tests for signs of meningitis

A 
Brudzinski's Sign 
  (knees bend with raised neck and 
   legs raise together)
Kernig's Sign
  (Spasm when trying to extend knee)
70
Q

Initial mgmt of meningitis

A
  1. GET BLOOD CULTURES FIRST!
  2. Lumbar puncture (if pt. is stable)
  3. Start empiric tx +/- dexamethasone
71
Q

How to tell if CSF culture is bacterial or viral

A

Bacterial

  • Higher Protein
  • Low Glucose (bacteria need nutrition)
  • Very Elevated (>90% PMNs…polys+bands)

Viral
- 50% lymphocytes

72
Q

PMNs

A

aka Neutrophils

= Polys + Bands

73
Q

Meningitis pathogens for newborn to 1 month old

A

LEG
Listeria (unpasteurized dairy)
E. coli (vaginal canal)
Group B strep (GBS+)

74
Q

Meningitis pathogens if >1 month old

A

N. meningitidis

Strep. pneumoniae

75
Q

Empiric tx for meningitis in newborn to 1 month

A

Ampicillin + Aminoglycoside (gent.)
or
Ampicillin + Cefotaxime

76
Q

Empiric tx for meningitis if >1 month old

A

Cefotaxime or Ceftriaxone
AND
Vancomycin

77
Q

Evidence of nisseria meningitidis

A

Rash all over (esp limbs)

78
Q

Tx for neiserria meningitidis

A

DOC- Pen G (if PCN MIC <0.1)
or 3rd gen ceph (Cefotaxime or Ceftriaxone)

Alt- FQL, meropenem, chloramphenicol

DUR - 1 week

79
Q

Evidence of strep. pneumo meningitidis

A

Seizures and coma are common

80
Q

ADE from Augmentin

A

Diarrhea (from clav)

- try to maintain clav <10 mg / kg / day

81
Q

Twinrix min age

A

18 years

82
Q

Term describing inflammation of middle ear

A

Otitis media

83
Q

Rapid onset of signs and symptoms of inflammation in middle ear

A

Acute otitis media (AOM)

84
Q

Acute otitis media without otorrhea

A

Uncomplicated acute otitis media

85
Q

Discharge from ear, originating at 1 or more of the following sites: external auditory canal, middle ear, mastoid, inner ear, or intracranial cavity

A

Otorrhea

86
Q

AOM with presence of mod-severe otalgia or fever at or above 39 C

A

Sever AOM

87
Q

AOM wih the presence of mild otalgia and temp below 39 C

A

Nonsevere AOM

88
Q

Angle of eustachian tube in adult vs child

A

Adult - 45 degrees

Child - 10 degrees

89
Q

Common pathogens in AOM

A

Strep. pneumo
Nontypeable H. Influenzae
Moraxella catarrhalis

90
Q

Who should not be diagnosed with AOM?

A

Children without otorrhea in middle ear

91
Q

Concerts technology

A

OROS

92
Q

Immediate-release stimulants

A

Methylin

Ritalin

93
Q

Immediate-acting CNS stimulants

A

Metadate ER
Methylin ER
Ritalin SR

94
Q

Long-acting CNS stimulants

A 
Concerta
Metadate CD
Ritalin LA
Daytrana
Quillivant XR
95
Q

Tx of ADHD + depression

A

Stimulant and/or

Antidepressant (bupropion, imipramine, or atomoxetine)

96
Q

Tx ADHD + conduct oppositional/defiant

A

Stimulant plus
Mood stab (chlorpromazine and haloperidol)
or clonidine

97
Q

Tx ADHD + Tic Disorder

A 
Stimulant plus
Clonidine
Risperidone 
Pimozide
Haloperidol

Thp III Exam 1 (15 decks)

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