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Mock Exams 2016 > Pediatrics Final > Flashcards

Pediatrics Final Flashcards

1
Q
  1. Cardiovascular diseases of Children

Cerebral Palsy

A

1.

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2
Q
  1. Cardiovascular diseases of Children

ADD/ADHD, define it

A
  1. It is defined as a group of syndrome, occurring
    during childhood, clinically marked by inattention, hyperactivity, impulsiveness.
    According to international criteria, should have three characters:
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3
Q
  1. Cardiovascular diseases of Children

ADD/ADHD, basic facts:

A
  1. ○ It affects 5% children,4% adults.
    ○ It affects 2.9% male university students, 3.9% female one.
    ○ Co-exist learning disability, poor outcome of school.
    ○ Cause mental health problem: low self esteem, high level anxiety, even oppositional defiant behaviour.
    ○ It is the most common children’s mental disorder.
    ○ Reduced slightly after childhood, remain high morbidity in adulthood.
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4
Q
  1. Cardiovascular diseases of Children

ADD/ADHD, define the three criteria:

A
  1. Inattention: 1. not able complete a task. 2. Easily distracted. 3. Difficulty listening in school, or focus on homework, thinking, or planning in mind which may take a longer than normal time.

Hyperactivity: 1. Fidgety, squirming on seat 2. Often unreasonable restlessly running. 3. Difficulty being quiet in classroom. 4. Even tosses and turns while lying in bed. 5. Always looks busy. 6. Onset before school
age, last for more than 6 months.

Impulsiveness: 1. Act impetuously and erratically 2. Frequently shift activity 3. Not able do things in organized way. 4. Supervision always needed. 5. Often interrupting or shouting in classroom. 5. Impatient wait
for his turn at games and such.

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5
Q
  1. Cardiovascular diseases of Children

ADD/ADHD, Etiology and pathology.

A
  1. ADD/ADHD Etiology:
    a. Etio: Poor congenital leads to LV and KI (Yin Yang imbalance), Path: KI and LV imbalance lead to LV Yang hyper active which caused inattention, hyperactivity and impulsiveness.
    b. Etio: Improper diet impairs the SP and ST resulting phlegm and damp obstructions lead to Qi and Blood disorders which caused inattentive, forgetfulness, tiredness
    c. Etio: Trauma in birth or after birth resulting Qi and Blood stagnation lead to meridian blockage lead to inattentive and forgetfulness
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6
Q 
6. Cardiovascular diseases of Children
ADD/ADHD,  Characterized by:
LV disorder due to Kid yin D : Overactive, angry, overact, impatient, impulsive, inattentive/ feverish feeling, malar flush, night sweating etc.
a. What is the Pattern Diff'n
b. TxP
c. Formula and Points
A
  1. a. HYPERACTIVE OF LIVER YANG DUE TO KIDNEY YIN DEFICIENCY
    b. n. Yin and suppress Yang and calm the mind
    c. Zuo Gui Yin. KI3, UB23, HT9, YinTang, UB20, DU20
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7
Q
  1. Cardiovascular diseases of Children
    ADD/ADHD, Characterized by:
    ○ Mostly have improper diet or improper nursing. history.
    ○ Mostly showing ADD, lassitude, inattention, forgetfulness, act aimlessly, insomnia , learning problem, depression etc. predominate.
    a. What is the Pattern Diff’n
    b. TxP
    c. Formula and Points
A
  1. a. LACK OF NOURISHMENT OF MIND DUE TO YIN DEFICIENCY OF HEART AND SPLEEN
    b. Tonifying Heart & Spleen and calm the mind
    c. Gan Mai Da Zao Tang. UB15, UB20, SP6, UB17, DU20, HT7, PC6, Si Shen Cong
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8
Q
  1. Cardiovascular diseases of Children
    ADD/ADHD, Characterized by:
    ○ Mostly fatty, have overeating or improper diet history.
    ○ Fire characters: Hyperactive, Difficulty self control, impatient, impulsive.
    ○ Phlegm characters: Heavy feeling, headache, dizziness .
    a. What is the Pattern Diff’n
    b. TxP
    c. Formula and Points
A

8.

a. PHLEGM AND FIRE DISTURBING HEART DUE TO INTERNAL ACCUMULATION OF DAMPNESSHEAT
b. Clean damp-heat, Remove Phlegm Eliminate wind, calm the mind
c. Huang Lian Wen Dan Tang. HT7, PC6, UB20, ST40, SP6, DU20, Si Shen Cong

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9
Q
  1. Cardiovascular diseases of Children

Cerebral Palsy. Define it

A 
9. Cerebral Palsy is defined as a disorder of motor
function due to a non-progressive (static) lesion of
the developing brain.
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10
Q
  1. Cardiovascular diseases of Children

Cerebral Palsy. Basic facts:

A 
10. ○ Severe condition: 
31% I.Q ‹50
21% active seizure
20% not walking
11% Blindness
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11
Q
  1. Cardiovascular diseases of Children
    Cerebral Palsy. What are the causes of CP:
C.Postnatal (10%)
Preterm birth
.hypoxic-ischaemic encephalapath
Hyperbilirubinaemia
Hypoglycemia
Head injury
Intracranial infection
.Meningitis
.Encephalitis
A 
11. 
A. Pre-natal (80%) 
cerebral dysgenesis 
congenital infection: 
1. Rubella .intraventricular hemorrhage
2. CMV 
3. Toxoplasmosis 
B. Intrapartum : (10%)
. Birth asphyxia
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12
Q
  1. Cardiovascular diseases of Children

Cerebral Palsy. What are the classifications?

A 
12.
Spastic(70%)Hemiplegics
1. Paraplegic
2. Quadriplegic
Dyskinetic (10%)
1. Athetoid
2. Dystonic (both hyper and hypotonic)
Ataxic (10%) hypotonic
Mixed (10%)
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13
Q
  1. Cardiovascular diseases of Children

Cerebral Palsy. What are the Etio and pathology?

A
  1. A. Poor congenital, Dysgensis, Preterm birth, retardation, Multiple-birth, Twins, Asphyxia
    Hypoglycemia, etc. –> KiD essence D –> Mental
    B. Warm evil invade –> KI, LV Yin Df –> Hypermytonia
    C. Newborn intracranial bleeding, and head injury –> Phlegm and blood stan’n –> Hypomytonia
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14
Q
  1. Cardiovascular diseases of Children

Cerebral Palsy. TREATMENT & DIFFERENTIATION

A
  1. ○ No special method for cure.
    ○ Treatment focus on symptomatic.
    ○ Aim at as much as possible for development: Physique, Intellect, verbal ability, social ability, independent skills.
    ○ A comprehensive treatment include: orthopaedic & physiotherapy, surgery, Acupuncture ,massage, Chinese Medicine, social work, psychological treatment are needed.
    ○ The treatment may be life-time long.
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15
Q
  1. Cardiovascular diseases of Children

Cerebral Palsy. ADVANTAGES FROM TCM TREATMENT

A

15.
○ Improve capillary circulation of brain, improve nutrients supplement to location of lesion, limit lesion, reduce sequela, prevent further damage.
○ Reduce epilepsy-like convulsion.
○ Reduced muscular tone from hypermytonia.
○ Improved muscular tone from hypomytonia.
○ Promote Skeletal, mental, verbal development,improve
vision,hearing etc.

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16
Q
  1. Cardiovascular diseases of Children

Cerebral Palsy. Various patterns of diff’n

A
  1. a. KID D OF ESSENCE (Zuo Gui Wan)
    b. YIN D OF LIV&KID (Da Ding Feng Zhu or Great Peral for Wind)
    c. SP Qi Df (Bu Zhong Yi Qi Tang)
    d. Deficiency of Qi And Blood (Chang Pu Wan)
    e. BLOOD STASIS OBSTRUCTING CEREBRAL COLLATERALS (Tong Qiao Huo Xue Tang) Open Orifice Move Blood
    f. INTERNAL STAGNATION OF PHLEGM AND DAMPNESS (Hung Lian Wen Dan Tang, Ban Xia Bai Zhu Tian Ma Tang Mod’n)
17
Q
  1. Cardiovascular diseases of Children

Cerebral Palsy. Treatment by Acu, Moxa and Mx

A 
17
○ Highly recommended.
○ Main Points: DU14 UB23 GB20 ST36
Upper limbs : LI15 LI11 LI4
Lower Limbs: GB30 SP10 UB40 UB57 UB34
Back & Waist: UB43 UB52 DU3,4
Lock Jaw: ST4,5
Salivation: CV24
Extension tongue: CV23 UB15
Massage: Manipulation-Pushing, Grasping & Kneading,
Rubbing, Trundling
18
Q
  1. Cardiovascular diseases of Children

Cerebral Palsy. PROGNOSIS

A

18.
○ No cure method.
○ Though non-progressive lesion, since brain develop, showing spread damage.
○ A comprehensive and life long treatment is expected.
○ Treatments are helpful on life quality, development both physically and mentally, Training is helpful on independent skills.
○ Mostly can reach average life expectancy.
○ Some without reproduction damage may have children.
○ Only 2% show obvious hereditary tredence, no enough evidence show giving to lower generation.

19
Q
  1. Respiratory System Diseases

Asthma. OUTLINE

A

i. Definition
ii. Diagnoses
iii. Treatment- acute attack period
1. Cold asthma
2. Heat asthma
3. Lung qi deficiency with hidden phlegm
iv. Treatment- Remission period
1. Spleen qi deficiency with hidden phlegm
2. Kidney deficiency with hidden phlegm
v. Treatment- Topic Application of Drugs

20
Q
  1. Respiratory System Diseases

Asthma. Define it

A
  1. Asthma mostly is a genetic disease since the poor
    constitution (lung, spleen and kidney deficiency), lead hidden phlegm in deep lung and diaphragm , which may goes upward and blocks airway, causes asthma attack since qi movement disorder by triggers ( URI, improper diet, drugs, sports, emotional disorder, allergens like pollen, waste gas, pollution, odor, pets)
21
Q
  1. Respiratory System Diseases

Asthma. DIAGNOSES

A
  2. More than three times night choking cough, difficulty breathing, wheezing with chest tightness.
  3. Wheezing can be relieved by inhalation of bronchial dilator.( Like Ventolin)
  4. Personal history of allergy ( Eczema, dermatitis, rhinitis, drug or food allergic)
  5. Family history of allergy.
22
Q
  1. Respiratory System Diseases
    Asthma. Various patterns of diff’n and periods

What about TOPIC APPLICATION OF DRUGS:
○ Bai JieZi7, Yan Hu Shou7, Gan Xu4, Xi Xin4
○ For attack: with ginger juice UB13, B12, Tian Tu, Lu1
○ For prevention: with garlic juice UB13, 20, 23, 43

A
  2. ACUTE ATTACK PERIOD - COLD ASTHMA (Xiao Qing Long Tang)
  3. ACUTE ATTACK PERIOD - HEAT ASTHMA (Ding Chuan Tang) OR asthma-eliminating tang
  4. REMISSION PERIOD - Lung Qi Deficiency with hidden phlegm (Yu Ping Feng San) or Jade Screen Powder
  5. REMISSION PERIOD - Spleen qi deficiency with hidden phlegm (Six gentle men decoction)
  6. REMISSION PERIOD - Kidney deficiency with hidden phlegm (Jin Shui Liu Jun Jian) or Golden and Water six
    gentle men decoction
23
Q
  1. DIGESTIVE SYSTEM DISEASES
    General Etio and Pathology

○ When stomach qi goes rebelliously upward cause vomiting
○ When stomach qi stagnated, or lack of nourishment cause stomachache.
○ When spleen dysfunction, turbid and clear go in intestine cause diarrhea.
○ When spleen heart heat flame up, cause aphtha.
○ When moods disturb spleen, cause eating disorder.
○ When dysfunction of spleen results dampness and phlegm cause obesity

A
  1. ○ External pathogen: wind-cold, damp-heat
    ○ Over eating, improper eating, food stagnation
    ○ Emotional stress: liver qi, heart heat, heart and gallbladder deficiency
    ○ Poor constitution or prolonged illness
    ○ Lung and defensive qi is weak, easily get external pathogen attack directly.
    ○ Spleen weak, and not control food, easily causes sp/st dysfunction.
    ○ Spirit fragile, heart and liver excessive, easily damaged by mood.
24
Q
  1. DIGESTIVE SYSTEM DISEASES

VOMITING. Define it:

A 
24. ○ Definition: it is a forceful expulsion of stomach contents through the mouth, because of food, cold, or heat accumulate in stomach, or frighten invade stomach, cause stomach qi rebelliously goes upward.
○ Baby milk regurgitation
○ Bile-stained
○ Blood-stained
○ Frothy, mucoid
25
Q
  1. DIGESTIVE SYSTEM DISEASES

VOMITING. TREATMENT

A

25.
○ Acupoints: Pc6, Rn12, St36 add Liv3, St45
○ Ginger Moxa: St25, Rn4, 6
○ Navel therapy: Fresh Ginger juice 3ml, Ban Xia 1.5g (or garlic juice 3ml)

26
Q
  1. DIGESTIVE SYSTEM DISEASES

VOMITING. Various Patterns of Diff’n

A
  1. a. FOOD STAGNATION (Bao He Wan) or peace guarantying pill
    b. STOMACH HEAT VOMITING (Huang Lian Wen Dan Tang) or Huang Lian Warm Gallbladder decoction
    c. STOMACH COLD VOMITING (Ding Yu li Zhong Tang) or DingYu middle jiao ordered decoction
    d. LIVER QI INVADE STOMACH (Jie Gan Jian) or Liberate liver decoction
    e. FEAR AND FRIGHT DISTURB STOMACH (Ding Tu Wan) or arrest vomiting pill
27
Q
  1. DIGESTIVE SYSTEM DISEASES

DIARRHEA. Define it:

A
  1. It is a common encountered gastric disorder, marked by increased frequency of defecation with loose, thin or watery stool.
    DEFINITION
    ○ It pertains to indigestion, infantile enteritis.
    ○ Common in summer and autumn, easy being epidemic in winter and autumn.
    ○ Mostly less than 3 yr.
    ○ Favourable prognosis.
    ○ Easily causes qi and yin deficiency (dehydration), death may happen with severe diarrhea and dehydration.
    ○ Chronic diarrhea easily causes malnutrition, which can lead to delayed development.
28
Q
  1. DIGESTIVE SYSTEM DISEASES

DIARRHEA. TREATMENT

A

28.
○ Acupoints: St25, St36, Sp3, Sp4, UB20, UB23 + Moxa
○ Navel therapy: Wu Zhu Yu30g, Ding Xiang3, White pepper 10g+ vinegar
○ Rice soup infusion add Shan Yao, Ge Gen

29
Q
  1. DIGESTIVE SYSTEM DISEASES

DIARRHEA. Various Patterns of Diff’n

A
  1. a. WIND-COLD DIARRHEA (Huo Xiang Zheng Qi San) or Huo Xiang fixing spleen qi powder
    b. DAMP HEAT DIARRHEA (Ge Gen Qin Lian Tang)
    c. FOOD STAGNATION DIARRHEA (Bao He wan)
    d. Spleen deficiency (Shen Ling Bai Zhu San)
    e. Spleen and Kidney yang deficiency (Fu Zi Li Zhong Tang and Si Shen Wan)
30
Q
  1. ESSENTIALS FOR DIAGNOSIS

Observation of the finger vein. What can you differentiate?

A

30.

a. Differentiation of exterior and interior syndrome according to the superficial and deep finger vein
b. Differentiation of heat and cold according to the reddish and purplish finger vein
c. Differentiation of excess and deficiency according to the pale and dark finger vein
d. Determining the conditions of diseases according to the three passes

31
Q
  1. ESSENTIALS FOR DIAGNOSIS
    Observation of the finger vein.
    Finger Vessel Inspection.
    Within what age this is effective?
A
  1. ” For children up to 3 years of age. “ Three bars at
    the tiger’s mouth.” The three bars are the three
    joints of the index finger.
32
Q
  1. ESSENTIALS FOR DIAGNOSIS
    Observation of the finger vein.
    Finger Vessel Inspection.

The three bars are the three joints of the index finger. What do they represent?

A

32.
a. Metacarpal-phalangeal joint - “Wind Bar”
b. 1st inter-phalangeal joint - “Qi Bar”
c. 2nd inter-phalangeal joint - “Life Bar”
d. Observing the vessel for depth, colour, size, and
location

33
Q
  1. Finger organ correspondence?
A 
thumb=lung=metal
index=liver=wood
middle=spleen=earth
ring=kidney=water
pinky=heart=fire
34
Q

34.Stages of DEVELOPMENT.

Often divided into six stages:

A
  1. a. Foetus (during pregnant)
    b. Newborn (birth-28 days)
    c. Infant (1month –1year)
    d. Toddler (1 year-3 year)
    e. Pre-school (3-7 year)
    f. Pre-adolescent (7-12 years)
35
Q
  1. Herbal bath for wind cold. List the herbs (9):
A 
35.
Qiang Hou- 30 g
Du Huo - 30 g
Xi Xin - 15 g
Fang Feng - 30 g
Su Ye - 30 g
Bai Zhi - 30 g
Gui Zhi - 20 g
Cong Bai - 30 g
Sheng Jiang - 20 g
Decoct 3000 ml, bath child twice a day in warm
decoction
36
Q
  1. Herbal bath for wind heat. List the herbs (8):
A 
36.
Jin Yin Hua - 30 g
Lian Qiao - 30 g
Chai Hu - 15 g
Sang Ye - 30 g
Da Qing Ye - 30 g
Bo He - 20 g
Chan Tui - 30 g
Zhi Zi - 30 g
Decoct 3000ml and bath the child twice daily in warm decoction
37
Q
  1. FLU. Add which herbs?
A

37.
Da Qing Ye 15,- clears heat relieve toxins
Ban Lan Gen 15, - Drains heat, resolves toxins, cools the blood, and benefits the throat;
Ge Gen 12, - release the ext., nourish fluids and stop diarrhea
Qing Hao 12 - clears summerheat

38
Q
  1. TREATMENT FOR COMPLICATIONS
    Which herbs?

Otitis media: Long Dan Xue Gan Tang add Tiger ear cao, or Huang Lian ear drop. Chronic one strengthen spleen, eliminate Dampness.
Sinusitis - add Cang Er Zi 9, Xin Yi Hua 12, Shi Gao 12, Long Dan Xie Gan Tang. Chronic one, tonify lung and spleen, open orifice.
Nephritis—Fu Ling 9, Zhu Ling 9, Bai Zhu 9, Ze Xie 9, Chi Xiao Dou 9, Ma Huang 9
Mycarditis —Qi and Yin Deficiency add Sheng Mai San
Qi and Yang Collape add Shen Fu Tang
Phlegm heat with blood stagnation add Huang
Lian 9, Guo Lou 12, Ban Xia 9,Dan Shen 15
Arthritis–Qiang Huo 12, Du Huo 12, Gui Zhi 12, Sang Zhi 12, Fang Ji 12, Hai Tong pi 12

A

With Vomit, diarrhea, - He Xiang 9, Pei Lan 6, Fang Feng 6, Chan Tui 6, Che Qian Zi 6 Ban Xia 6, Shen Jiang 3
With food stagnation - add Shan Za 12, Shen Qu 9, Mai Ya 9
Febrile convulsion - Niu Huang 9, Da Qing Ye 12, Gou Teng 6, Chan Tui 9, Di Long 12
Meningitis, Encephalitis – Add Zi Bao Dan, An Gong Niu
Huang Wan or Zhi Xue Dan
Tonsillitis – Add Ma Bo 9, She Gan 12, Shan Dou Gen 9 and Huang Lian Jian Du Tang
Wu Wei Xiao Du Yin if there is laryngitis and abscess.

Mock Exams 2016 (3 decks)

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