Peds Flashcards
Assessment of a child with intussuption
Colicky abdominal pain that causes the child to scream and draw the knees to the Abdomen
Vomiting of gastric contents
Bile stained fecal emesis
Current jelly like stools containing blood and mucus
Hypo active or hyperactive bowel sounds
Tender distended abdomen possible with a palpable sausage shaped mass in the URQ
What is PKU
Genetic disorder - autosomal recessive
Results in CNS damage from toxic levels of phenylalanine in the blood
Levels greater than 20 mg/dL (normal - 1.2-3.4)
Pku assessment symptoms in young children
Digestive problems and vomiting
Seizures
Musty odour of the urine
Mental retardation
PKU symptoms in older children
Eczema
Hypertonic
Hypo pigmentation of the hair skin and irises
Hyperactive behaviour
Before testing during infancy the infant will have been started on what
Bottle feeding or breast milk
What if the first test is positive
Repeat test
And further diagnostics
1- @ 48hrs
2 @ 14 days of age
What if the child has a definitive diagnosis
Restrict phenylalanine intake high protein foods - meat and dairy products
Avoid aspartame as there is a high concentration of phenylalanine
What is sickle cell anemia
Hemoglobin A is partially or completely replaced with hemoglobin s
The inheritance of a gene for structurally abnormal portion of the hemoglobin chain
What are the risk factors for sickle cell anemia
Having parents heterozygous for hemoglobin S or being African American descent
What is the screening test used for sickle cell
Sickle turbidity test - finger stick blood and yields accurate results in 3 minutes
What happens if the sickledex test is positive
Hemoglobin electrophoresis is necessary to distinguish between children with the trait and those with the disease
What is hemoglobin S sensitive to
Changes in the oxygen content of the red blood cell
What are the precipitating factors of sickling
Fever
Dehydration
Emotional or physical stress
Any condition that increases the need for oxygen or alters the transport of oxygen can result in a crisis
What is sickle cell crisis
Acute exacerbations of the disease
Varied in severity and frequency
- vaso-occlusive crisis, splenic sequestration, hyperhemolytic crisis and aplastic crisis
Cause of vaso-occlusive crisis
Stasis of blood with clumping of cells in the microcirculation ischemia and infarction
Symptoms of Vaso-occlusive crisis
Fever
Painful swelling of hands feet and joints and abdominal pain
Hat is splenic sequestration caused by
Pooling and clumping of blood in the spleen hypersplenism
Symptoms of splenic sequestration
Profound anemia,hypovolemic and shock
Causes of hyperhemolytic crisis
An accelerated rate of red blood cell destruction.
Signs of hyperhemolytic crisis
Anemia
Jaundice
Reticulocytosis
What is aplastic crisis caused by
Diminished production and increased destruction of RBCs triggered by a viral infection or depletion of folic acid
Symptoms of aplastic crisis
Profound anemia and pallor
What is aplastic anemia
Deficiency of circulating erythrocytes and all other formed element of blood resulting from the arrested development of cells within the bone marrow
Primary at birth or secondary which is acquired
How do you diagnosis aplastic anemia
Bone marrow aspiration _ shows conversion of red bone marrow to fatty bone marrow
What is the therapeutic management aimed at for aplastic anemia
Restoring function to the bone marrow
Immunosuppressive therapy
Bon marrow transplant
Assessment symptoms of aplastic anemia
Pancytopenia - deficiency of erythrocytes leukocytes and thrombocytes
Petechia purpura bleeding pallor weakness tachycardia and fatigue
What is pernicious anemia
Results from deficiency of intrinsic factor necessary for intestinal absorption of vitamins b 12
What can cause pernicious anemia
Gastric disease
Surgery
What is intussuption
Telescoping of one portion of the bowel into another portion
Results in obstruction to the passage of intestinal contents
