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Pathopharm > Peds exam 3 > Flashcards

Peds exam 3 Flashcards

1
Q

Outpouching of lower small intestine, Symptoms appear at age 1-2 years (i.e., painless rectal bleeding)

A

meckel diverticulum

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2
Q

Internal organs eviscerate through sac in umbilical cord, Dress with saline soaked gauze and impermeable dressing at delivery, Protect the sac, prevent hypothermia and infection, and provide comfort measures and nutritional support.

A

omphalocele

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3
Q

Intestines are outside the body through a hole in the abdominal wall near umbilicus; no sac covering organs, may have resp distress

A

gastroschisis

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4
Q

Tissues in lip and/or palate do not fuse, Feeding, ontological, dental, and speech complications.

A

cleft lip and palate

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5
Q

t/f: An infant with an omphalocele has evisceration of the intestines and other abdominal contents
through a sac in the umbilical cord.

A

true

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6
Q

Communication between thoracic and abdominal cavities, Severe respiratory distress; auscultatory changes

A

Congenital diaphragmatic hernia

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7
Q

Stenosis, prolapse, or atresia; Dilation or surgical intervention are commonly used, May have temporary colostomy to allow for healing, Avoid placing anything in the rectum.

A

Anorectal malformations

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8
Q

Upper and lower portions of esophagus are
disconnected.

A

Esophageal atresia

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9
Q

Connection between trachea and esophagus.

A

Tracheoesophageal fistula:

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10
Q

Pediatric patients are more vulnerable to this, Can be isotonic, hypotonic, or hypertonic

A

dehydration

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11
Q

nausea, retching, and expulsion of stomach contents.

A

vomiting

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12
Q

Acute diarrhea, Infection, food sensitivity, or environmental.

A

gastroenteritis

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13
Q

Elongation and thickening of the pylorus muscle, Projectile and forceful vomiting without nausea, Typically presents 3 to 6 weeks after birth, Signs of malnutrition and dehydration.

A

Hypertrophic pyloric stenosis

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14
Q

Mucosal and transmural necrosis in the intestine, most lethal, Air in the abdominal wall present on x-ray

A

Necrotizing enterocolitis (NEC):

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15
Q

One portion of the intestine prolapses and telescopes, Currant jelly (red) stools and nausea and vomiting, enema to reduce defect

A

Intussusception

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16
Q

A 4-week-old infant presents to the emergency
room with nonbilious projectile vomiting
immediately after eating. What conditions does the infant most likely have?

A

Hypertrophic pyloric stenosis

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17
Q

Inflammation of the appendix, Obstruction of appendiceal lumen.

A

appendicitis

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18
Q

Presents with cramping around the umbilicus, pain
at McBurney point, rebound tenderness, fever,
vomiting, guarding, and rigidity.

A

appendicitis

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19
Q

Erosion of mucosal tissue in the stomach, esophagus, or duodenum, Proton pump inhibitors and antibiotics used for treatment.

A

peptic ulcer disease

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20
Q

If failure to gain weight or respiratory symptoms present, may have

A

gastroesophageal reflux disease (GERD) .

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21
Q

Infrequent bowel movements, hard or large stools

A

constipation

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22
Q

Voluntary or involuntary passage of stool, Usually associated with constipation (retentive), toilet training/high fiber diet

A

Encopresis

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23
Q

Absence of ganglion cells and peristalsis, Also known as congenital megacolon, Distended abdomen; failure to pass meconium.

A

Hirschsprung disease

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24
Q

Occurs after bowel removal, Severe diarrhea, signs of electrolyte imbalances, and dehydration.

A

short bowel syndrome

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25
Q

Causes wall thickening, Involves small and large bowel (intermittent normal bowel segments).

A

crohns disease

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26
Q

Causes wall thinning, Involves large bowel only

A

Ulcerative colitis

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27
Q

Gluten-sensitive enteropathy, autoimmune reaction to gluten such as Intestinal inflammation, Villous atrophy, Malabsorption

A

celiac disease

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28
Q

Chronic, irreversible disease with impaired fat absorption (steatorrhea)

A

celiac disease

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29
Q

Yellow discoloration of skin, sclera, and mucous membrane, Establish regular feeding patterns to prevent jaundice, treat with phototherapy with blue light.

A

Hyperbilirubinemia (jaundice):

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30
Q

Progressive obstruction of the extrahepatic bile ducts, Presents with jaundice 2 to 3 weeks after birth, abdominal distension, bruising, bleeding, itching, and clay-colored stools

A

biliary atresia

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31
Q

Inflammation of the liver, viral cause, Presents with jaundice, fever, fatigue, and abdominal pain.

A

hepatitis

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32
Q

Scarring of the liver, Chronic cholestasis, inborn errors of metabolism, and chronic hepatitis are common causes.

A

cirrhosis

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33
Q

Which hepatobiliary disorder is treated with the
Kasai procedure?

A

Biliary atresia

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34
Q

t/f: Caregivers should manage all aspects of disease management until the adolescent stage.

A

false

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35
Q

Hormones: growth, thyroid-stimulating, adrenocorticotropic, prolactin, follicle-stimulating, and luteinizing

A

Anterior pituitary

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36
Q

Hormones: Antidiuretic and oxytocin

A

posterior pituitary

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37
Q

Hormones: Thyroxine, triiodothyronine, and calcitonin

A

thyroid

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38
Q

Hormones: Epinephrine and norepinephrine

A

adrenal medulla

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39
Q

Hormones: Cortisol and aldosterone

A

adrenal cortex

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40
Q

Hormones: Insulin and glucagon

A

pancreas

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41
Q

Hormones: Testosterone

A

testes

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42
Q

Hormones: Estrogens and progesterone

A

ovaries

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43
Q

Hormones: Thymosin

A

thymus

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44
Q

Hormones: Melatonin

A

pineal

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45
Q

(hypopituitarism) Results in children being smaller than other children of the same age and gender, Normal height and weight at birth, but percentiles decrease with age; puberty is delayed.

A

Growth Hormone Deficiency (anterior pituitary)

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46
Q

Excess of growth hormone, also known as
hyperpituitarism

A

Growth Hormone Excess Excess (anterior pituitary)

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47
Q

Puberty before age 9 in boys and 8 in girls, CNS abnormality (too early! must be treated)

A

precocious (early puberty)

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48
Q

Puberty does not occur by age 12 in girls or 14 in boys

A

delayed puberty

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49
Q

diabetes indipidus: Kidneys cannot concentrate urine because of decreased or lack of the hormone ______ (antidiuretic hormone [ADH]).

A

vasopressin

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50
Q

manifestations of diabetes insipidus

A

polyuria, dehydration, polydipsia

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51
Q

treatment for diabetes insipidus

A

intranasal or oral desmopressin; low sodium and protein diet

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52
Q

t/f: Healthcare providers should encourage a child
with diabetes insipidus to increase their fluid
intake.

A

true

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53
Q

inability to suppress antidiuretic hormone (ADH,
vasopressin), resulting in its excessive secretion

A

Syndrome of Inappropriate Antidiuretic Hormone
(SIADH) (posterior pituitary)

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54
Q

Deficient production of thyroid hormones, congenital, autosomal recessive

A

Congenital Hypothyroidism (thyroid)

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55
Q

Can occur because of an autoimmune disorder, late-onset thyroid dysfunction, drugs*, iodine deficiency, and/or isolated thyroid stimulating hormone (TSH) deficiency.

A

acquired hypothyroidism

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56
Q

Also known as thyrotoxicosis (too much thyroid
hormone).

A

hyperthyroidism

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57
Q

Adrenal insufficiency resulting in a deficiency of
cortisol and aldosterone.

A

addison disease

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58
Q

Autosomal recessive disorder (genetic), Insufficient enzymes for synthesis of cortisol and
aldosterone, adrenal glands become hyperplastic due to continued adrenocorticotropic hormone (ACTH) secretion.

A

Congenital Adrenal Hyperplasia (adrenal cortex)

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59
Q

Overproduction of cortisol by the adrenal cortex, Caused by small ACTH-secreting pituitary tumor or prolonged exposure to corticosteroid therapy.

A

Cushing syndrome

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60
Q

what is not a clinical
manifestation of Cushing syndrome?

A

excessive hair loss

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61
Q

Autoimmune condition resulting in pancreatic damage and lack of insulin.

A

Type 1 Diabetes Mellitus (pancreas)

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62
Q

May occur in teenage and school-aged children
due to the increase in childhood obesity.
- Pancreas produces insulin, but it is unable to
be used by the body (insulin resistance).

A

Type 2 Diabetes Mellitus (pancreas)

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63
Q

Deficient secretion of parathyroid hormone (PTH), Usually caused by the accidental removal of the
parathyroid glands during surgery.

A

hypoparathyroidism (parathyroid)

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64
Q

Excess secretion of parathyroid hormone (PTH), Most commonly caused by parathyroid
adenoma or chronic renal failure.

A

Hyperparathyroidism

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65
Q

Newborns enter the world with the brain and its
structures intact but ______, and brain development
really begins to take hold after birth.

A

immature

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66
Q

Significant adversity can impair cognitive, language,
and emotional development in the first __ years of life.

A

3

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67
Q

________ defects of the neurological system include
defects in which brain, cerebral spinal fluid tracts,
spinal cord, or skull are malformed, incompletely
developed, or, in some cases, absent.

A

structural

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68
Q

_______ defects involve the skull bones and cranial
sutures and can range from major defects that are
incompatible with life, to defects that are insignificant
and do not require intervention.

A

cranial

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69
Q

Cranial defects can be caused by _____ _____ of
the cranial sutures, a skull that grows too quickly in
relation to how fast the brain is growing, or absence
of the bones that make up the skull.

A

premature closure

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70
Q

Premature fusion of one or more of the cranial sutures, at or before birth, increased ICP and head malformations

A

Craniosynostosis

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71
Q

Asymmetry and flattening of head from external forces (mattress), Skull deformation; affects right occiput more than left occiput

A

Deformational plagiocephaly (DP)

72
Q

An abnormally small head

A

microcephaly

73
Q

Primary, due to a genetic, chromosomal, or hereditary cause; or secondary, as a result of exposure to irradiation, maternal infection with toxoplasmosis, rubella, Zika
virus, or cytomegalovirus; or maternal use of alcohol or tobacco. cognitive and motor development delays from birth

A

microcephaly

74
Q

Buildup of cerebrospinal fluid (CSF) in the brain, Increased CSF production, decreased CSF absorption, or flow
obstruction – the effect is increased intracranial pressure (ICP)

A

hydrocephalus

75
Q

Dilated scalp veins, bulging fontanel, apnea, irritability,
headaches, sunset eyes, and vomiting, Lethargy, irritability, a decline in school performance, and gait disturbances

A

hydrocephalus

76
Q

A tangle of arteries and veins in the brain that disrupt the normal flow of blood; blood travels directly from the arteries to the veins instead of moving through the capillaries first

A

Intracranial Arteriovenous Malformation (AVM)

77
Q

Infection of the meninges (membranes protecting the
brain); cause may be viral, or bacterial (septic)

A

meningitis

78
Q

Infection of meninges with cerebral edema, similar to viral
(aseptic) meningitis

A

Encephalitis

79
Q

Typically viral, but can occur from toxins, fungi, bacteria, or
parasites; Usually associated with vector-borne viruses
(mosquitoes); Increased risk for seizures, flaccid paralysis, headaches, photophobia, lethargy, and stiff neck

A

encephalitis

80
Q

Rapid progression of multiorgan failure with poor outcomes

A

reye syndrome

81
Q

often misdiagnosed as meningitis or encephalitis; associated with aspirin during viral illness

A

reye syndrome

82
Q

May involve one hemisphere (focal) or
both hemispheres (generalized)

A

seizures

83
Q

seizure that may have impaired awareness or be unconscious; with or without motor activity

A

focal

84
Q

seizure; unconscious; with or
without motor activity

A

generalized

85
Q

Recurrent, unprovoked seizures; Two unprovoked seizures more than 24 hours apart, Or one, with high probability of repetition over the next 10 years (abnormal EEG)

A

epilepsy

86
Q

Prolonged seizure or series of seizures without
recovery in between (more than 5 minutes), EMERGENCY, Convulsive or nonconvulsive based on movement activities

A

Status Epilepticus

87
Q

Use IV fluids, oxygen, and IV medications to stop
seizure, Medically-induced coma to stop seizures if necessary

A

status epilepticus

88
Q

Acute seizures triggered by high fever in children
younger than 7 years of age (above 101.2)

A

Febrile Seizures

89
Q

occurs after a blow or jolt to the head, Classified as primary (skull fracture, bleeding) or secondary (cerebral edema, tissue ischemia)

A

TBI

90
Q

Infants and toddlers are at greatest risk
due to ____ _____; adolescents are at
risk for their ________

A

large head, recklessness

91
Q

Occurs when an infant or a small child has been
shaken or beaten, #1 cause of brain
damage in infants and the most common form of
non-accidental head trauma in infants in the U.S.

A

shaken baby syndrome (abusive head trauma)

92
Q

Pain in the nerves, blood vessels, and muscles that cover the head and neck

A

headache

93
Q

Unequal refractory curvatures

A

Astigmatism

94
Q

Abnormal movement of eyes

A

nystagmus

95
Q

“Cross eye”, treat with occlusion therapy

A

strabismus

96
Q

Increase in intraocular pressure

A

infantile glaucoma

97
Q

Cloudiness over corneal lens

A

congenital cataracts

98
Q

Obstruction of tear duct and excessive tearing, Failure of canalization of the opening between the nose
and nasolacrimal duct, red/swollen eyelids (looks like conjunctivits

A

Nasolacrimal Duct Obstruction

99
Q

Infection of eyelid and orbital tissues surrounding the eye, distinct swelling of eyelid, decreased
vision, elevated intraocular pressures

A

Periorbital Cellulitis

100
Q

An inflammation of the conjunctiva of the eye - the membrane that lines the inside of the eyelids and covers the eyeball

A

conjunctivitis

101
Q

Suspect hearing loss if startle reflex is absent, or no turn to voice or noise, or babbling at __ to __ months

A

6-7

102
Q

“State of well-being in which every individual
realizes his or her own potential, can cope with the
normal stresses of life, can work productively and
fruitfully, and is able to make a contribution to his
or her community”
- Disorders result from genetics, physiological
changes, and environmental exposures

A

mental health

103
Q

“The process of thought and knowing that is
acquired through experiences and maturation”

A

cognition

104
Q

a form of psychotherapy that encourages
children to express feelings and emotions through play, for 3-12yo

A

play therapy

105
Q

a technique employed by child life specialists for hospitalized children.

A

therapeutic play

106
Q

incorporates creativity in healing and expressing childhood emotions (all ages).

A

art therapy

107
Q

Difficulties in receiving and processing information and
generating appropriate responses.

A

learning disabilities

108
Q

is a disorder of receptive language that creates difficulty using letters to decode written language

A

dyslexia

109
Q

A continuum of neurobiological symptoms that result in
difficulty with communication, behavior, and social
interaction that are usually present by age 3.

A

Autism Spectrum Disorder (ASD)

110
Q

is Autism Spectrum Disorder (ASD) increased in boys or girls

A

boys

111
Q

Manifestations of ________ include : stereotypy (repetitive movements), obsessive behavior, difficulty with sensory integration, echolalia (repetition of words without meaning), and avoidance of eye contact.

A

autism spectrum disorder

112
Q

Neurobehavioral disorder characterized by
inattentiveness with or without hyperactivity and
impulsivity; short attention span, impulsivity, movement difficulties

A

Attention Deficit Hyperactivity Disorder (ADHD)

113
Q

Worry, fear, and anxiety extend past normal adaptive
coping mechanisms and cause stress and significant
impairment.

A

anxiety disorders

114
Q

Eating disorder characterized by fear of gaining weight or
becoming overweight

A

Anorexia Nervosa

115
Q

Eating disorder characterized by periods of binge
eating followed by periods of purging; self induced vomiting, diuretics or laxatives

A

Nervosa Bulimia

116
Q

Use a forensic medical team to
collect evidence of _____ abuse
and a Sexual Assault Nurse
Examiner to collect evidence of
_____ abuse.

A

physical, sexual

117
Q

Misinterpretation or presentation of exaggerated or
absent symptoms in a child to gain entry into the medical
setting, imposer often is mother

A

Factitious disorder imposed on another (FDIA),
(formerly Munchausen syndrome by proxy (MSP))

118
Q

uncontrolled proliferation of (malignant) cells

A

growth rate

119
Q

malignant cells: Exhibit Independent Behavior

A

anaplasia

120
Q

malignant cells compressing all normal
functioning cells in the area and competing
for oxygen, nutrients

A

expansion

121
Q

malignant cells taking over and occupying/replacing normal cells

A

invasion

122
Q

long term effects of radiation:

A

skeletal, neurological, secondary malignancies

123
Q

_____ effects of radiation:
- dental
- skin (radiation dermatitis)
- salivary glands
- alopecia

A

local

124
Q

All __________ drugs are immunosuppressive – they
interfere with function of normal as well as
malignant cells – especially the white blood
cells.

A

chemotherapy

125
Q

decreased production of all normal blood cells (RBCs, WBCs, PLTs)

A

myelosuppression

126
Q

normal RBC level:

A

4.5 – 5.5 million/mm3

127
Q

normal Hgb level:

A

12-14

128
Q

normal Hct level:

A

36-40%

129
Q

normal WBC level:

A

5,000 – 10,000

130
Q

normal PLT count:

A

150,000 – 400,000

131
Q

decreased RBC (myelosuppression)
-(activity intolerance)

A

anemia

132
Q

decreased WBC (myelosuppression)
-(prone to infection)

A

neutropenia

133
Q

decreased PLT (myelosuppression)
(protect from injury)

A

thrombocytopenia

134
Q

Chemo SE

A

N/V, anorexia (altered nutrition), mucosal irritations (impaired tissue integrity), alopecia (self-concept, body-image disturbance), tumor lysis syndrome, anaphylaxis

135
Q

SE of chemo drug vincristine

A

Peripheral Neuropathy

136
Q

SE of chemo drug Cytoxan

A

Hemorrhagic cystitis

137
Q

An uncontrolled production of abnormal
WBCs called lymphoblasts, “liquid tumor”

A

Acute Lymphoblastic Leukemia

138
Q

most common malignancy and type of leukymia in children

A

Acute Lymphoblastic Leukemia

139
Q

infection, often respiratory; pale d/t anemia, may complain of belly pain (due to inflamed bowel wall from
decreased WBCs), bone/joint pain, Lymphadenopathy/hepatosplenomegaly, Headaches, irritability, nerve palsies, hypermetabolism

A

Acute lymphoblastic leukemia

140
Q

ALL can infiltrate into:

A

testicles, ovaries, lungs, CNS

141
Q

ALL lab studies:

A

Complete Blood Count, Bone Marrow Aspiration, Lumbar Puncture

142
Q

Excess number of immature nonfunctioning
myeloid cells (Myeloblasts), not as responsive to treatments as ALL

A

acute myelogenous leukemia

143
Q

types of stem cell transplants: autologus

A

from self

144
Q

types of stem cell transplants: allogenic

A

from someone else

145
Q

types of stem cell transplants: Syngeneic

A

from identical twin

146
Q

Approximately __-__% of all pediatric
patients have some type of GVHD [Graft vs.
Host Disease]

A

40-70

147
Q

Typical history for ______: headache, visual problems,
nausea, and early morning vomiting, Balance problems/clumsiness (if cerebellum
involved)

A

brain tumor

148
Q

Obstructed CSF flow (4th ventricle blocked)

A

brain tumor

149
Q

(too much ADH) –decreased urine
output, decreased serum sodium, increased
urine specific gravity

A

SIADH

150
Q

(suppression of ADH) – increased urine output, increased serum sodium, decreased urine specific gravity

A

diabetes insipidus

151
Q

Develops in cells of fetus called the “neural crest” –
these become the adrenal glands and sympathetic
ganglion (head- pelvis)

A

neuroblastoma

152
Q

Common sites/related symptoms of ________ : weight loss, feeding problems, FTT, diarrhea, tumor may secrete
catecholamines (HTN, sweating, flushing, diarrhea)

A

neuroblastoma

153
Q

Multimodal Treatment because it’s so aggressive;
surgery to excise tumor and stage, irradiation and
chemo

A

neuroblastoma treatment

154
Q

cure rate for neuroblastoma : diagnosed under 1 year – ___% survival

A

75%

155
Q

cure rate for neuroblastoma: diagnosed over 1 year – __% survival

A

12%

156
Q

Most common malignancy affecting the renal
system (can be bilateral or unilateral), often genetic, child with painless mass

A

Wilm’s tumor (Nephroblastoma)

157
Q

do NOT palpate ____ tumor

A

Wilm’s

158
Q

If unilateral – nephrectomy; If bilateral –
nephrectomy on worse affected kidney and
partial nephrectomy on the other kidney

A

Wilm’s tumor

159
Q

Malignant tumor of the retina, diagnosed by 17 months, Cat’s eye reflex (leukokoria),

A

retinoblastoma

160
Q

cancers of the lymph system

A

lymphoma

161
Q

Reed-Sternberg cells, painless, swollen
lymph nodes, fever, night sweats
- RX: chemo/radiation

A

Hodgkin Lymphoma

162
Q

Uncontrolled proliferation of abnormal lymphocytes, fever, wt loss, night sweats, tumors outside of lymph system,
RX: chemo
- common 15-19 (adolescents)

A

Non-Hodgkin Lymphoma

163
Q

Occurs near growth plates (metaphyses) of long bones, peak during adol growth spurt
- Pain, soft tissue edema, limp
RX: chemo/ tumor removal (amputate vs limb salvage)

A

osteosarcoma

164
Q

Occurs in diaphysis of long bones, peak adolescents, small round blue cells on stain
-Pain, soft tissue edema, wt loss, fever, fatigue
RX: chemo, before and after surgery; avoid wt bearing until all Rx complete

A

Ewing Sarcoma

165
Q

Tumors arising from muscle tissue, peak under 6yo, common places: head and neck, GU
tracts, extremities, and orbits

A

Rhabdomyosarcoma

166
Q

Kills malignant cells and normal (squamous) cells surrounding the radiation site, assess skin for redness, scales, breakdown, Avoid fragranced soap or moisturizers, skin is more photosensitive

A

radiation therapy

167
Q

SE of radiation

A

N/V, fatigue, appetite changes

168
Q

Metabolic abnormalities from release of intracellular contents after malignant cells are destroyed, IV fluids before chemo, Treat with allopurinol

A

Tumor lysis syndrome

169
Q

Progression of infection in children with neutropenia, Absolute neutrophil count less than 500 are at higher risk; prevention is key, confirm with positive blood cultures, fluid admin, abx, ventilatory support

A

sepsis

170
Q

Compression of superior vena cava from mediastinal
mass, Dyspnea, cough, headache, pleural effusion, and edema in neck and upper extremities, confirm with chest x-ray/ CT, Treat tumor to reduce pressure; may require intubation.

A

superior vena cava syndrome

171
Q

From primary tumor, metastases, or surgical procedures, – vomiting, vision changes, altered mental
status, headaches, and behavior changes.
- May result in herniation of brainstem without prompt
intervention.

A

increased ICP

172
Q

chemo treatment phase 1: Induction phase (4 weeks)

A

induce remission

173
Q

chemo treatment phase 2: Consolidation phase

A

strengthen remission and CNS prophylaxis with intrathecal chemotherapy

174
Q

chemo treatment phase 3: maintenance phase (2-3 years)

A

eliminate residual cancer cells with intermittent chemotherapy.

175
Q

Arise from embryonal cells of peripheral nervous system, SNS but common in medulla and adrenal gland,

A

Pathopharm (8 decks)

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