Peds Flashcards

1
Q

What is the number one cause of death in children?

A

trauma

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2
Q

What is the best indicator of shock in pediatric patients?

A

tachycardia

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3
Q

What is a tachycardic for kids?

A
  • neonates > 150
  • 1-6 years old > 120
  • 6-12 years old > 110
  • over thirteen > 90
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4
Q

What is the preferred strategy for fluid resuscitation in pediatric trauma?

A
  • start with a 20cc/kg bolus x2
  • then move to a 10cc/kg blood transfusion
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5
Q

What is the target UOP for pediatric patients?

A
  • neonates are 2-3 cc/kg/hr
  • toddlers and older are 1cc/kg/hr
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6
Q

Which pediatric trauma patients get an uncuffed tube?

A

neonates

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7
Q

What is the differential for emesis in a neonate?

A
  • medical: infectious, allergy, metabolic disorder
  • surgical: GERD, pyloric stenosis, intestinal obstruction, atresia
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8
Q

What is the differential for emesis in toddlers and infants?

A
  • medical: infectious, neurologic/psychologic, gastroparesis
  • surgical: intussussception
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9
Q

What is the differential for emesis in an adolescent?

A
  • medical: functional, psychologic, IBD
  • surgical: appendicitis
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10
Q

What metabolic disturbance is seen in those with pyloric stenosis?

A
  • hypochloremic hypokalemia
  • metabolic alkalosis
  • paradoxic aciduria
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11
Q

How is a diagnosis of pyloric stenosis made?

A

based on an US with thickness > 4mm and length > 14mm

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12
Q

What should guide the fluid resuscitation in a patient with hypertrophic pyloric stenosis?

A
  • use a dextrose containing fluid
  • target bicarb < 30 and chloride > 100
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13
Q

What is the difference between a type A and type C TEF?

A
  • A: second most common, just esophageal atresia
  • C: most common, esophageal atresia and distal TEF
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14
Q

What other screening should those with a TEF undergo?

A

look for VACTRL anamolies
- V: vertebral anomalies - sacral US
- A: anorectal - imperforate anus/rectal exam
- C: cardiac - echo
- T: TEF
- R: renal - renal US
- L: limb - physical exam

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15
Q

What tests are used to look for VACTRL anomalies?

A
  • sacral US
  • rectal exam
  • echo
  • AXR
  • renal US
  • physical exam of limbs
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16
Q

How is a TEF treated?

A
  • resuscitate with areplogle
  • place a G-tube and perform a primary repair through a right extra pleural thoracotomy
17
Q

What is the preferred method to treat an ileocolic intussusception in adults?

A

surgical since they most likely have a pathologic lead point requiring diagnostic laparoscopy

18
Q

What is the best first test for bilious emesis?

A

an upper GI series to evaluate for malrotation

19
Q

Most patients with malrotation present with volvulus by what age?

A

one year

20
Q

Malrotation is associated with what two other abnormalities?

A

CDH and omphalocele

21
Q

Where should the bowel lie when you finish a Ladd’s procedure?

A

the small intestine on the right and the large intestine on the left (turn back time with a counterclockwise rotation)

22
Q

What procedure should you perform along with a Ladd’s procedure?

A

an appendectomy

23
Q

Duodenal atresia has what associations?

A
  • Down’s syndrome
  • cardiac, renal, and GI anomalies
24
Q

How is duodenal atresia diagnosed?

A

with AXR and an UGI series

25
Q

What is different about the etiology of duodenal and other intestinal atresias?

A

others are due to vascular accidents while duodenal atresia is not