Pedriatric Exam Flashcards
What should a 8 month be able to do
Bears weight on legs when supported
Sits unsupported
Releases objects at will
Reaches persistently for toys out of reach
Increasing anxiety over loss of parent
Combines syllables bit, does not ascribe meaning to them ( dada)
When does a infant develop object permanence
Between 7-9 months
What is true of diabetes 1
No insulin is produced
Goal of HGbA1C of 7
What are the 3 most common signs of newly diagnosed diabetes
Polyuria
Polydipsia
Polyphagia
What is DKA
The most severe manifestation of metabolic de compensation induced by insulin deficiency
It develops as a consequence of the failure to recognize and treat early signs of diabetes
What are signs and symptoms of DKA
As the clinical manifestations of untreated diabetes progresses from weight loss, polyuria, polyphagia, polydipsia, weight loss and dehydration, additional late signs such as kussmaul respirations, neuron status changes including increased intracranial pressure, dry mucous membranes, sunken eyes and fontanelles may also be observed.
How Is DKA treated
Keep NPO
2 ivs one for insulin to reduce elevated blood sugar, the other a fluid to overcome dehydration and electrolyte imbalance
They patient will be on a monitor
How is acidosis stopped
By IV regular insulin
What is the normal behavior for 3 yr olds
Can ride a tricycle, stand on one foot for a few seconds and broad jump at age 3
What are signs of hypoglycemia
Early- sweating and trembling, anxious
Mild- difficulty concentrating, dizziness, lightheadness, slurred speech
Late- seizures, coma, possible death
What are Hirschsprung’s disease clinical manifestations in a newborn
Failure to pass meconium within 24-48 hours
Refusal to feed
Bilious vomiting
Abdominal distention
What are signs and symptoms of hirschsprungs disease in infancy
Growth failure Constipation Abdominal distention Diarrhea and vomiting Signs of enterocolitis such as expoplosive watery stools and fever
What are the clinical manifestations of Hirschsprung’s disease in childhood
Constipation Ribbonlike foul smelling stools Abdominal distention Visible peristalsis Easily palpable fecal mass Undernourished, anemic appearance
What is treatment for Hirschsprung’s disease
Barium enema
Rectal biopsy
What is Hirschsprung’s disease
Absence of ganglia tic cells in the distal bowel.
It is a congenital anomaly
The length of the affected bowel varies
Accounts for 1/4 of all cases of neonatal obstruction
What is the patho on UC
It involves the colon and rectum only
It affects 2 layers of bowel the mucosa and sub mucosa
What are the clinical manifestations of UC
FLARE UPS
watery diarrhea, bloody diarrhea, cramping, weight loss, fever
What is Crohn’s disease
Inflammation that can involve any part of the GI tract from the mouth to the anus. It affects all layers of the bowel wall
The inflammation of crohns diseases results in what
Ulcerations
Fibrosis
Adhesions
Strictures and fistulas
What are clinical manifestations of Crohn’s disease
Diarrhea Abdominal cramping Fever Weight loss Skin lesions Joint arthritis Mouth ulcers
What is celiac disease
It is known as the gluten induced enteropathy
Atrophy of the villi in the upper small intestine and malabsorption of most nutrients in the presence of gluten
It is autoimmune related to igA defiency
What are clinical manifestations of celiac disease
Failure to thrive Chronic diarrhea Abdominal distention Anorexia Muscle wasting
What is celiac crisis
Infections, especially of the GI
Prolonged fluid and electrolyte depletion
Emotional disturbances
What is treatment of celiac disease
Provide gluten free diet.
Clients can not consume grains of wheat and rye, barley and oats.
Corn and rice are substituted for grains
What is biliary intresia
It is a rare congenital malformation characterized by the absence or obstruction of intra hepatic or extra hepatic bile ducts.
It can cause liver failure or death
What are the clinical manifestations of biliary intresia
JAUNDICE is the earliest and most striking feature pale stools Dark urine Swollen abdomen Large hardened liver Poor metabolism, poor weight gain
What are diagnostic tests of biliary intresia
LFT
TOTAL BILI
ALK PHOS
LIVER BIOPSY
What is treatment of biliary intresia
Fat soluble vitamins Kasai procedure ( buys time only) Liver transplant ( long term therapy)
What is atresia
Congenital absence or closure of a normal body opening or tubular structure
What is the clinical presentation of tracheoesophageal fistula
Polyhedral noise in the mother
Copious, fine, white, sometimes frothy bubbles of mucus in mouth and sometime nose
Rattling respirations with episodes of choking, coughing, and cyanosis
Abdominal distention with tracheoesophageal fistula
When should milk be introduced to the diet
Switch to whole milk at 12 months of age until 2 yrs of age, the brain needs the fat for development
How much milk should a kid drink per day
No more than 24 ounces
What grows the fastest on a newborn
Head
How long is the growth chart implemented on kids
From Birth to 36 months
The parameters measured includes weight, height, head circumference. Values are plotted on a percentile chart compared with those of the population.
Who weighs more bottle fed or breast fed babies
Breast fed
What predictable pattern do toddlers follow
Trunk grows the fastest, they are bow legged due to leg muscles bearing the weight of the large trunk
What predictable growth pattern do preschoolers follow
Slower growth period, trunk grows the fastest, the healthy preschooler is slender with good posture.
During school age who grows faster boys or girls
Girls grow faster
Limbs grow faster
What is the onset of puberty for girls
8-14
What is the onset of puberty for boys
9-16
Who developed the moral development stages
Kohlberg
What are post conventional stages
It occurs in adolescence, they adapt there own values and moral principles
What is the #1 cause of death and disabilities in kids
Head injuries
What are febrile seizures
Seizures accompanied by a fever of 38
Occurs mostly between 6 months and 5 years of age
What are risk factors for a febrile seizure
Viral infections
Familial history
What is med is indicated for a febrile seizure
Antipyretics
For a febrile seizure that lasts longer than 5 min, call 911
Seizure interventions
1. AIRWAY- suction, oxygen, turn pt on side if they begin to vomit or drool. Do not place anything in mouth or attempt to restrain.
What are seizure interventions
To control the seizures or reduce the frequency and severity, discover and correct the cause and help the child live a normal life as possible.
Ketone of diet ( high fat, low carb, adequate protein)
vagus nerve stimulator
Surgical therapy
What is Reye’s syndrome caused from
Viral infections
It is a disorder defines as toxic encephalopathy associated with damage to the brain, kidneys, and liver.
There is a assoc between kids who have a viral infection and take aspirin.
What age group is most commonly affected by Reye’s syndrome
4-12 years
What are the age ranges of aspirin
Adults 18 and older only
What babies sometimes have hip dysplasia
Breech babies
Name the 3 types of immunizations
Live attenuated ( live virus given intranasallly)
Inactivated ( flu, IM route)
Immunoglobulins
What is the age range for HEP A
Do not give to children under 1 year old
When is the MMR vaccination first given
At 12-15 months for the 1st dose, 4-6 years for the 2nd dose
Children are not protected until they are at least 12 months
At what age can the flu vaccine be given IM
Older than 6 yrs.
