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peds #3 Flashcards

1
Q

paroxysmal abdominal pain or cramping

A

colic

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2
Q

S/Sx of colic

A

sudden, dibilitating pain, cries, pulls legs up, red faced, fist clenched
usually lasts 3 hours at least 3 times a week

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3
Q

management of colic

A

antiflatulent, parental support

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4
Q

passive transfer of gastric contents into the esophagus, starts witin the 1st week of birth

A

gastroesophageal reflux

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5
Q

patho of gastroesophageal refulx

A

neurimuscular distrubance

(kids at risk: CP, neuro involvement

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6
Q

S/Sx of gastroesophageal reflux

A

passive regurgitation or emesis, poor weight gain, irritability, gagging

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7
Q

Dx for gastroesophageal reflux

A

h&p, barium swallow, upper GI, pH monitoring

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8
Q

Rx for gastroesophageal reflux

A

antacids (decrease acid production)

H2 blockers

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9
Q

nissen fundoplication

A

tightens esophagus for gas. reflux

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10
Q

hardening or thickening of pyloric

A

pyloric stenosis

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11
Q

S/sx of pyloric stenosis

A

forceful vomiting, sour smelling, hungry, dehydration, visible peristalsis

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12
Q

Dx of pyloric stenosis

A

h&p, u/s, barium swallow

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13
Q

pyloromyotomy

A

surgical tx for pyloric stenosis, RUQ incision, post op clear liquids, hear bowel sounds (4-6 hours)

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14
Q

telescoping of one portion of the intestines into another

A

intussusception (MEDICAL EMERGENCY)

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15
Q

complication of intussusception

A

ischemia

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16
Q

S.Sx of intussusception

A

heatlhy child who suddenly has episode of acute colicky, abdominal pain, N/V, jelly like stool

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17
Q

how will you know if the intussusception is fixed

A

you will have normal stools

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18
Q

remnant of fetal omphalomesenteric duct that conntects yolk sac with primitive mid-gut during fetal lifecan lead to intussusception

A

meckel diverticulum

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19
Q

S/sx of meckel diverticulum

A

abdominal pain, bloody stool, anemia (possible)

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20
Q

Dx of meckel diverticulum

A

history, radionucleotide scintigraphy (meckle scan)

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21
Q

Tx for meckel diverticulum

A

surgical removal,

if left untx hemorrhage and bowel obstruction

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22
Q

absence of hanglionic innervation to the muscle of a section of the bowel, usually the sigmoid colon, abnormal gene on chromosome 10

A

hirsprung disease

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23
Q

s/sx hirsprung disease

A

newborn: failure to pass meconium within 24-48 hours after birth, infant: constipation, distention, childhood: constipation, impaction

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24
Q

what will a child with hirsprung disease die from

A

interocolitis

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25
Q

Dx of hirsprung disease

A

history, digital rectal exam, barium enema, rectal biopsy, anorectal menometry

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26
Q

Tx for hirsprung

A

surgery

post op: assess for abdominal distention

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27
Q

when is surgery done for hernias

A

age 2-5

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28
Q

S/sx for hernias

A

lump in groin, asymptomatic, pain

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29
Q

intolerance for gluten, causes malnutrition in children

A

celiac disease

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30
Q

when is celiac disease first noted

A

after several months after introduction of cereals (usually age 1-5)

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31
Q

S.sx of celiac disease

A

fatty stool, impaired fat absorption, N/V, watery stools

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32
Q

Dx of celiac disase

A

jejunal biopsy, gluten free diet, d-xylose absorption test

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33
Q

complication of celic disease

A

malignant lymphoma of small intestine (or other GI malignancies)

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34
Q

forceful ejection of gastric contents through the mouth

A

vomiting

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35
Q

Tx for vomiting

A

NPO for short time (3-8 hours)

ice chips, water/clear liquids in small amounts

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36
Q

most pathogens are spread by fecal oral route through contaminated food or water or spread from person to person

A

etiology of diarrhea

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37
Q

what is the most common pathogen in diarrhea

A

rotavirus

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38
Q

acute diarrhea lasts for

A

7-14 days

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39
Q

chronic diarrhea (IBS) lasts how long

A

beyond 2-3 weeks

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40
Q

Tx for diarrhea

A

BRAT diet

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41
Q

water and sodium lost in proportin to each other

A

isotonic

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42
Q

water loss in excess of electrolyte loss

A

hypertonic

MOST dangerous type

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43
Q

total output exceeds input

A

dehydration

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44
Q

S/Sx of isotonic dehydration

A

turgor poor, membranes dry, rapid pulse, irritable or lethargic

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45
Q

S.sx of hypotonic dehydration

A

very poor skin turgor, clammy, slightly moist membranes, very rapid pulse, lethargic, convulsions possible

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46
Q

s/sx of hypertonic

A

fair turgor, membranes parched, moderatly rapid pulse, marked lethargy, extreme hyperirritability on stimulation

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47
Q

mild dehydration

A

3-5% weight loss, cap refil more than 2 seconds, urine specific gravity less 1.020

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48
Q

moderate dehydration

A

6-10% weight loss, cap refill 2-4 seconds, urine specific gravity less 1.020 or oliguria

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49
Q

severe dehydration

A

10-15 % weight loss, cap refill more 4 seconds, tenting, oliguria or anuria, sunken anterior fontanel

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50
Q

alteration in freqency consistency or ease of passing stool

A

constipation

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51
Q

reasons for constipation

A

structural, systemic, medications (opids, iron)

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52
Q

Tx for constipation

A 
increase fiber and fluids
CRAP diet (cherries, raisins, apricots, prunes)
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53
Q

child takes or has bottle of milk to bed for prolonged times

A

night bottle syndrome

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54
Q

deficiency of protein with an adequate supply of calories

A

kwashiorkor

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55
Q

S/sx of kwashiorkor

A

thin wasted eextremities, ascites, scaly skin, blindness

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56
Q

results from general malnutrition of both calories and proteins

A

marasmus

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57
Q

S.sx of marasmus

A

starts at age 6-18 months, no sub q tissue, look old,

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58
Q

deficit in vit D

A

rickets

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59
Q

deficit in vit C

A

scurvvey

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60
Q

Dx of parasites

A

stool specimens, string test

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61
Q

Tx for parasites

A

quinacrine, furozone, flagyl

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62
Q

deficit in vit A

A

blindness

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63
Q

deficit in vit B

A

beri beri, constipation, alcoholics

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64
Q

Prevention of parasites

A

hand washing

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65
Q

what is the most common parasite int he US

A

protozoa (guardisasis)

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66
Q

protozoa

A

transmission: person to person

S/sx: abd cramps, diarrhea, constipation

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67
Q

tx of protozoa

A

furoxone, most infections resolve on on in 4-6 weeks

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68
Q

caused by a nematode, most common helminthic infection in US, small thread like worm that live in the cecum

A

pinworms (enterobiasis)

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69
Q

Pinworms

A

transmission: touch, inhalation
Dx: flashlight, tape

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70
Q

Tx for pinworms

A

mebendazole or vermox, anti itch cream for anal area, wash all bed clothes, keep nails short, wash hands

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71
Q

prevalent in southen warm climates, lives in the intestines

A

roundworm

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72
Q

roundworm

A

mild Gi sx to obstruction,

transmission: fecal oral

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73
Q

lives in warm soil

A

hook worm

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74
Q

hookworm

A

transmission: skin contact with soil, S/sx: erythema papular erruptions, itching, burning

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75
Q

results from ingestion of worm larvae living in inadequately cooked beef for pork

A

tapeworm

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76
Q

Tx for tapeworm

A

antihelminthics (destroys worm)

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77
Q

renal malignancy that may involve one or both kidneys, most common malignant neoplasm of the kidney

A

wilm’s tumor (nephroblastoma)

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78
Q

wilm’s tumor

A

S/sx: mass appears overnight, abdominal pain, vomit, fever, hematuria

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79
Q

Tx for wilms tumor

A

DO NOT PALPATE, surgery, chemo, radiation

80
Q

failure of one or both testes to descnd fromthe abdominal cavity to the scrotum

A

cryptorchidism
occurs more in preterm males
have higher risk for testes cancer

81
Q

true undescended

A

can palpate, just hasnt dropped yet

82
Q

ectopic

A

cant palpate, in abdomen

83
Q

Tx cryptorchidism

A

if persists after one year, refer to surgeon, if ectopic test kidney function

84
Q

orchiopexy

A

surgery done for cryptorchidism

85
Q

involuntary voiding of urine beyond the expected age at which voluntary control should not be achieved after successful toilet training

A

enuresis (wetting bed)

86
Q

classifications of enuresis

A

primary: never achieved a peiod of dryness
secondary: dry for 3-6 months and then resumes wetting
diurnal: wetting occurs only during day
nocturnal: wetting occurs only at night

87
Q

VCUG

A

voiding cystourethrogram, xray visualize childs urinary tract and bladder

88
Q

Tx for enuresis

A

oxybutyin chloride, desmopressin, imipramine ydrocholoride

89
Q

passing of stools into underwear or Pjs past the normal time of toliet training

A

encopuresis

90
Q

Tx for encopuresis

A

increase fluids, fiber, decrease dairy, enemas, MOM, schedule

91
Q

clinical manifestation of a large # of distinct glomerular disorder (fluid shift)

A

nephrotic syndrome

damage to the basement membrane

92
Q

S.sx of nephrotic syndrome

A

proteinuria, edema, low serum albumin, increased blood lipid level, decrease output, weight losspuffiness

93
Q

Dx nephrotic syndrome

A

UA, serum, renal biopsy

94
Q

Tx for nephrotic syndrome

A

diet, prednisone, diuretics, I&O, daily weight, abdominal girth, rest, skin breakdown, no tight clothing

95
Q

complication of nephrotic syndrome

A

peritonitis

96
Q

inflammation of glomeruli

A

acute glomerulonehritis, by product of strep

97
Q

S/sx of acute glomerulonehritis

A

decrease of glomerular filtration rate, puffiness, dark colored urine, edema, pale, lethargy, HA

98
Q

Tx acute glomerulonehritis

A

abx, diretics, bed rest, limit competitive activity until normal kidney function, dont add electrolytes until after 1st void (dont want excess of potassium)

99
Q

hemolytic anemia, thrombocytopenia, acute renal failure

A

hemolytic uremic syndrome (HUS)

100
Q

S/Sx of HUS

A

hemorrhagic manifestations, oliguria or anuria, decreased renal function, CNS involvement (sezires)

101
Q

prevention of HUS

A

cook temp of meat to 160, no unpasterurized milk, wash raw veggies, dont swim where water can be contaminated

102
Q

acute encephalitis with accompanying fatty infiltration of the liver, brain, kidney, heart, lung, skeletal muscle. Viral illness (flu, varicella)

A

reyes syndrome

103
Q

when is reyes syndrome more likely to occur

A

Jan, Feb, March

104
Q

S/sx reye’s syndrome

A

anorexia, lethargy, vomiting, combativeness, normal to low grade fever (can look like drug intoxication)

105
Q

Dx of reye’s syndrome

A

liver enzymes, liver biopsy, WBC, CSF

106
Q

Prevention of Reye’s syndrome

A

no ASA, tylenol, no Peptobismal

107
Q

neurological condition resulting from damage to the motor cortex and resulting in impaired muscular control

A

cerebral palsy

108
Q

1 cause of Cp is

A

cerebral anoxia (head trauma, decrease of birth weight)

109
Q

spastic

A

hypertonicity

110
Q

dyskinetic

A

abnormal involuntary movement (jerky)

111
Q

athetosis

A

slow wormlike writhing movements

112
Q

atatic

A

awkward wide based gait

113
Q

primary goal of CP

A

early recognition and promote optimum development

114
Q

Tx for CP

A

braces, wheeled scooter boards, orthopedic surgery, Rx to decrease spasticity dantrolene, baclofen, robaxin, valium

115
Q

premature closing of one or more cranial sutures

A

craniosynotosis

116
Q

Tx for craniosynotosis

A

surgery to decrease pressure, correct deformity

recovery: assess nero, watch bleeding & infection

117
Q

inherited disorder, abnormal precollagen, bone has large areas of osseous tissue with no architectural pattern

A

osteogenesis imperfecta

“briddle bone”

118
Q

Type 1

A

MOST COMMON, blue sclera, after puberty femur fx

119
Q

type II

A

most severe, death occurs before infancy

120
Q

avascular necrosis of the femoral head (no blood supply), degenerative changes, flattening of upper surface of femoral head

A

legg-calve-perthes disease

121
Q

4 stages of legg-calves-perthes disease

A

avascular stage (degenerative changes)
fragmentation/revascularazation: mottled appearacnce on xray
reparative stage: trying to repair itsself
regenerative stage

122
Q

S/sx of legg-calves-perthes disease

A

intermittent appearacnce of limp on affected side, pain (increases in AM), limited ROM

123
Q

Tx of legg-calves-perthes disease

A

surgery

124
Q

slipping of the femur head posteriorly and inferiorly, occurs in pre-adolescence, obese or very tall & thin rapid growth

A

slipped femoral capital epiphysis

125
Q

lateral curvature of spine

A

scoliosis

no pain until severe, occurs around age 10

126
Q

Tx for scoliosis

A

observe, surgical, braces (slow progression of curve, boston brace & thoracic lumbar sacral orthotic TLSO)

127
Q

posterior wires are threaded beneath laminae of each vertebrae and tightened around rods resting along transverse processes so that spinal column is stabilized by transverse traction on each vertebrae

A

luque segmental spinal instrumentation (scoliosis)

128
Q

exaggeration of lumbar curvature

A

lordosis

129
Q

humpback

A

kyphosis

130
Q

chronic inflammation of synovium and joint effusion, S.Sx must begin before age of 16 and last longer than 6 weeks and in more thatn one joint

A

juvenile rheumatoid arthritis

131
Q

S.sx of juvenile rheumatoid arthritis

A

swelling, contractures, warm to touch, not red, stiffness increases in AM or with decrease of motion

132
Q

Rx for juvenile rheumatoid arthritis

A

ASA, NSAIDS, SAARDS, cytotozics, corticosteroids

133
Q

ability to spread to others

A

communicability

134
Q

time between the invasion of an organism and the onset of Sx of infection

A

incubation period

135
Q

time btwn the beginning of nonspecific Sx and specific Sx

A

prodromal period

136
Q

stage during which the specific Sx are evidnet

A

illness

137
Q

interval btwn when sx begin to fade and the return to full wellness

A

convalescent period

138
Q

how pathogen enters the body

A

portal of entry

139
Q

how organisms leave the body

A

portal of exit

140
Q

method by which the organisms are spread and enter a new individual to cause disease

A

chain of infection

141
Q

rash

A

exanthem

142
Q

how to relieve a itch or rash

A

dress in light cotton clothing, maintain hydration, fingernails short, press on itchy areas dont scratch, analgesics for comfort, antihistamines

143
Q

roseola infantum

A

human herpesvirus 6, high fever then rash, period of communicability is during febrile period

144
Q

rubella (german measles)

A

rash starts at face and goes down, joint stiffness, tx: Sx, transmission: droplet

145
Q

Measles (rubeola)

A

sore throat, enlarged lymph nodes, droplet transmission, classic sign: kopliks spots on mouth (bright red with blue center)

146
Q

chicken pox (varicella)

A

contagious one day before the rash

147
Q

erythema infectiosum (5th disease)

A

rash on cheek then goes to extremites “slap cheek”, droplet transmission, tx Sx

148
Q

poliomyelitis

A

encourage bed rest, direct and indirect contact

149
Q

mumps

A

ear ache, soft foods, direct and indirect contact

150
Q

scarlet fever

A

Tx PCN 7-10 days, large droplets and direct contact, fast progressivebeta hemolytic streptococci, group A

151
Q

diphtheria

A

bull neck, conjunctivitis, direct and indirect contact, ABx

152
Q

whooping cough (pertussis)

A

bordetella pertussis, direct and indirect contact, DtaP vaccine

153
Q

Type 1 DM

A

usually thin build, must inject exogenous insulin to survive, autoimmune destructive process, hyperglycemia progress to ketoacidosis, weight loss

154
Q

S.sx of type 1 dm

A

polyphagia, polydipsia, polyuria

155
Q

Tx for type 1

A

3 meals, 3 snacks, carb counting, insluin (long acting, fast acting)

156
Q

somogyi

A

rebound

157
Q

dawn phenm.

A

increase of BS in am due to hormones

158
Q

Type 2 Dm

A

strong genetic predispostion, overwight, inactive, HTN, hyperlipidemia, diet, excercise

159
Q

S.sx of type 2

A

3 p’s without weight loss, yeast infection, increase sleep, fatigue, dark mark on back of neck

160
Q

tx for type 2

A

educate, 3 meals, 1 snack, decrease carb intake/sodium/fat/calories, diet exercise, oral Rx or insulin

161
Q

chronic complications of DM

A

microvascular (eyes, kidneys) type 1

macrovascular (heart) type 2

162
Q

trisomy 21 defect

A

down syndrome

163
Q

S.sx of down syndrome

A

broad flat nose, asian appearance, brushfileds spots, back of head flat, congenital heart defects

164
Q

what issues can you have with feeding

A

large tounge, feed slowly

165
Q

missing portion of chormosome 5

A

cri-du-chat syndrome

166
Q

S.sx of cri-du-chat syndrome

A

distinctive weak high pitched cry (cat), microcephaly, eyes far apart, severe mental retardation

167
Q

presence of one or more X chromosomes

A

klinefelters syndrome

168
Q

clinical manifestations of klinefelters syndrome

A

no distinctive physical characteristics before onset of puberty, infertility, decreased 2ndary sex characteristics, mental impairment

169
Q

Tx for klinefelters syndrome

A

none, can give testosterone to increase male characteristics

170
Q

only one functional X chromosome

A

turners syndrome

99% females die inutero

171
Q

Tx for turners syndrome

A

growth hormone, estrogen

172
Q

lacks HexA enzyme necessary for lipid metabolism

A

tay sach’s disease

found in jewish population

173
Q

S/sx tay sach’s disease

A

normal for 1st 6 months, then regress, loss of head control, exaggerated moro, severe mental retardation, blind, seizures, live to 3-5 years die r/t cachezia, pneumonia

174
Q

disease of metabolism, phenylalanine is an essential amino acid necessary for growth and repair of body cells

A

PKU phenylketonuria

175
Q

PKU

A 
increased phenylanlanine (builds up in brain tissue) 
tyrosine (fair blond hair, blue eyes
176
Q

S.sx of PKU

A

seizure, exzema

177
Q

Dx for PKU

A

heal stick after 2 full days of mild feeding, then test again

178
Q

Tx for PKU

A

keep blood level below 8 (2-8)

stay away from milk, nuts, meats, eggs, cheese, bread, rice, corn, pasta

179
Q

inborn error of metabolism, autosomal recessive, child is deficient in the liver enzyme galactose 1 phostphate uridyl transferase

A

galactosemia
(build up of galactose in brain liver eyes)
cataracts seizure, lethargy

180
Q

S.sx of galactosemia

A

appear normal at birth, after start of feedings, vomit & have weight loss, E coli sepsis,

181
Q

Tx for galactosemia

A

NO BREAST FEEDINGs, formula feedings (lactose free),

182
Q

group of inherited blood disorders characterized by deficienceies in the rate of production of specific globin chains of Hgb

A

thalassemia

increase of incidence in ppl live near mediterranean sea

183
Q

S/sx

A

dont show until 6 months (fetal Hgb is replaced by adult Hgb), pale, tired, anorexia, Hgb less 5 g/100ml, epistaxis is common, bronzed skin

184
Q

tx for thalassemia

A

prevent heart failure, transfuse RBC every 2-4 weeks, iron chelating agent (removes excess iron stores), spleenectomy, cure is possible with bone marrow transplant, but usually die in adolesence due to cardiac failure

185
Q

gene level defect sex linked, deficiency of both T & B cells, unable to fight infection

A

severe combined immunodeficiency disorder (SCID)

186
Q

Dx of severe combined immunodeficiency disorder (SCID)

A

hx of infection, family hx, lymphocytopenia

187
Q

Tx for severe combined immunodeficiency disorder (SCID)

A

bone marrow transplant, gene therapy, if untx DIE

BUBBLE BOY

188
Q

group of muscle diseases in childhood lack of protein needed for muscle contraction, progressive weakness and wasting of skeletal muscle

A

muscular dystrophy

usually only live 20 years

189
Q

S.sx of muscular dystrophy

A

waddling gait, gowers sign (get up very slowly), progressive weakness and wasting of skeletal muscle

190
Q

Dx of muscluar dystrophy

A

muscle biopsy, EMG, serum CPK (elevated in skeletal muscle injury)

191
Q

groups of bleeding disorders in which there is a deficiency of one of the factors necessary for coagulation of the blood, sex linked X recessive

A

hemophila

female is carrier, males have disease

192
Q

which factor is the intrinsic factor of coagulation

A

factor VIII

193
Q

Dx of hemophillia

A

platelet cound WNL, prothrombin time WNL, thromboplastin abnormal, PTT abnormal

194
Q

S/sx of hemophilia

A

painful/swelling at joints, GI bleeds, nose bleeds,

195
Q

Tx for hemophilia

A

control bleeding, administer factor VIII, prevention is key

196
Q

if injury occurs

A

IV factor VIII, immpbilize joint, ice, avoid sutures

NO ASA!!!

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