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ABSN Cohort 19 > Peds Exam 3 > Flashcards

Peds Exam 3 Flashcards

1
Q

4 Types of ▲ in blood flow patterns ♥

A

↑ pulmonary flow
↓ pulmonary flow
Obstruction
Mixed

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2
Q

3 ↑ ♥ pulmonary flow Disorders

A

Ventricular Septal Defect (VSD)
Atrial Septal Defect (ASD)
Patent Ductus Arteriosus (PDA)

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3
Q

VSD S/S and 3 Tx

A

loud harsh murmur on L sternal border

CC, banding, patch

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4
Q

ASD S/S and Tx

A

loud harsh murmur fixed by split second ♥ sound, MAY BE ASYMPTOMATIC
CC, patch

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5
Q

PDA 3 S/S wnth 3 Tx

A

Machine hum murmur, wide BP, bounding pulses

Indomethacin, coil insertion, thoracoscopic rapair

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6
Q

2 ↓ ♥ pulmonary flow Disorders

A

Tetraology of Fallot

Tricuspid Atresia

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7
Q

Tetraology of Fallot 4 included Dz, 2 S/S, and TX

A

pulmonary stenosis
Overriding Aorta
VSD
R Ventricular dystrophy

Cyanosis @ birth, systolic murmur
Shunt w/ surgery

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8
Q

Tricuspid of Atresia What? 2 S/S in infants vs. children. 3 step Tx

A

complete closure of tricuspid valve
infants = cyanosis and dypsnea
children = hypoxemia and clubbing

3 Step surgery (shunt, glenn, fontan)

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9
Q

3 ♥ Obstruction flow Disorders

A

Pulmonary stenosis
Aortic Stenosis
Coarctation of the Aorta

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10
Q

Pulmonary Stenosis 2 S/S. Tx infants vs. children

A

systolic ejection murmur and cyanosis that worsens w/ narrowing
infant - Brocks
children - Valvotomy

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11
Q

Aortic Stenosis 2 S/S infant vs. children and Tx

A

infant = faint pulses and HypoTN
child = dizziness, possible ejection murmur
valvotomy and Norwood

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12
Q

Coarctation of the Aorta 2 S/S

A

↑ BP arms w/ bounding pulses

↓ BP legs w/ cool skin

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13
Q

3 ♥ Mixed blood flow disorders

A

Transposition of Great arteries
Truncus Arteriosus
Hypoplastic Left ♥ Syndrome

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14
Q

Trans. of Great Arteries What? Oxygenation needs? Tx

A

Aorta connect to R vent instead of L
P. artery connect to L vent instead of R
Requires PDA for O2
Surgery w/in 2 weeks life

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15
Q

Truncus Arteriosis What? 3 S/S? Tx

A

Failure of septum formation
Delayed growth, lethargy, poor eating habits
Surgery w/in 1 month life

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16
Q

Hypoplastic Left ♥ Syndrome What? Oxygenation needs? Development of? Tx?

A

Underdeveloped L ♥
ASD and foramen ovale
Mild cyanosis regresses as PDA closes
Norwood, Glenn, and Fontan procedure @ birth

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17
Q

Kawasaki Disease

A

Acute systemi vasculitis w/ fever > 5 days that Ø respond to antipyretics

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18
Q

Kawasaki Disease 3 Types
Acute
Subacute
Convalescent

A

red eyes, rashes, strawberry tongue
irritable w/ peeling skin around nails
ØS/S except abnormal labs (6 - 8 weeks onset)

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19
Q

Kawasaki Disease Labs (4)

A

CBC, CRP, ESR, serum albumin

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20
Q

Kawasaki 2 Dx and Tx (g/kg/time/of fever)

A

Chest Xray and echocardiogram

IVGG (Gamma globulin) 2g/kg/10-12hrs w/in 7 days of fever

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21
Q 
♥ Medications function/look out for..
Digoxin
Captopril/Enalapril
Metoprolol/Carvedilol
Furosemide/Chlorothiaszide
A

↓ HR ↑ contractility, infant hold ↓ 90 HR, child hold ↓ 80 HR
ACE inhibitor, vasodilates to ↓ resistance, Hyperkalemia
Beta Blocker, ↓ HR, ↓ BP, vasodilates, HypoTN
Diuretic, wastes Na. K, H2O, Hypokalemia

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22
Q

♥ Transplant 2 S/S of rejection. Dx with. 2 Medications.

A

Low grade fever and ↑ resting HR
Endomyocardial biopsy
Calcineurin inhibitors and corticosteroids

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23
Q

Infective Endocarditis What? 3 S/S. 2 Dx. 2 Tx.

A

injured endocardium by blood flow infected r/in platlet/fibrin deposition r/in vegetation
diaphoresis
splinter hemorrhages under nails
Osler nodes
Blood culture and tran/esophageal/thoracic endocardiography
Antibiotics and surgery in case of embolism

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24
Q

Rheumatic Fever What? 2 S/S. Dx. Tx

A 
inflammatory dz r/t Group A B-hemolytic Streptococus (GABHS) infection in throat
non-tender nodules over joints
pin rash
antistreptolysin-O titer
chorea safety/education
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25
Q

Hyperlipidemia can r/in 2

A

atherosclerosis and coronary ♥ dz

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26
Q

Blood Disorders in Children (4)

A

Epistaxis
Iron Deficiency Anemia
Sickle Cell Anemia
Hemophillia

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27
Q

Epistaxis What? 3 Tx? If > 30 min?

A

nose bleed
sit up, lean forward. pressure 10 min
Possible hemorrhage, seek medical care.

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28
Q

Iron Deficiency Anemia cause in children 12 - 36 months (1) vs. adolescents (3

A

↑ cow’s milk intake w/out enough iron

Poor diet, menses, obesity

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29
Q

Iron Deficiency Anemia 3 S/S

A

SoB, pallor, brittle fingernails

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30
Q

Expected HH ranges
2 months
6 - 12 years
12 - 18 years (♂/♀)

A

9 - 14 / 28 - 42
11.5 - 15.5 / 35 - 45
♂ 13 - 16 / 37 - 49
♀ 12 - 16 / 36 -46

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31
Q

Iron Deficiency Anemia iron supplement timing preterm vs. exclusively breastfed

A

2 months

4 months

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32
Q

Iron Supplement 5 Notes

A

1 -2 hrs before milk/antacid prevents malabsoprtion
INJ with Z-track
Drink via straw for teeth
Take w/ VitC/protein

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33
Q

Food sources of Iron (7)

A

cereal, formula, beans, peanut butter, greens, poultry, red meat

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34
Q

Sickle Cell Anemia What? 3 S/S.

A

Abnormal HbS instead of HgbA r/in sickling
↑ viscocity
obstruction of blood flow
hypoxia

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35
Q

Sickle Cell Anemia 4 Crisis’

A

Vaso-occlusive (painful episode)
Sequestration
Asplastic
Hyperhemolytic

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36
Q

SCD - Vaso-occlusive

2 Acute v. 3 Chronic

A

4 - 6 days
Severe pain w/ swollen joints

respiratory infx, retinal detachment, and skeletal deformities

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37
Q

SCD - Sequestriation What? 2 S/S.

A

Pooling of blood in spleen/liver

Hypovolemia -> shock with irritability

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38
Q

SCD - Aplastic Crisis

A

Extreme anemia triggered by infx

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39
Q

SCD - Hyperhemolytic

A

RBC destruction

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40
Q

Sickle Cell Crisis ↑ 5 Labs

A

↑ Hgb, WBC, Bili, Reticulocytes

Sickle cells in peripheral blood smear

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41
Q

Definitive Dx Sickle Cell Anemia

A

Hemoglobin Elctrophoresis

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42
Q

How to test for CVa with SCD

A

Transcranial Doppler Test (TSD)

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43
Q

Vaccines that Counter SDC 3

A

PCV, MCV4, and Flu

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44
Q

Hemophilia What is? A v B?

A

Excessive bleeding
A = ↓ Factor VIII, classic
B = ↓Factor IX, christmas

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45
Q

Hemophilia Lab ▲ 4

A

↑ aPTT
Factors
Platlets/Prothrombin WITHIN range
Whole blood clotting WITHIN or PROLONGED

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46
Q

Hemophilia 4 Medications and Rationales ea.

A

1-deamino-8-d-arginine vasopressin (DDVAP) ↑ factor VII for mild cases
Factor VIII for hemorrhage
Corticosteroids for hematuria
NSAIDS for chronic synovitis

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47
Q

Hemophilia RICE Control

A

Rest, Ice, Compression, Elevation

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48
Q

Beta-Thalassemias What? 3 Types

A

Inherited blood disorder of Hgb synthesis r/in anemia
Trait = mild anemia
Intermdia = moderate
Major = req. transfusion

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49
Q

Post-Bone Marrow Transplant Hematopoietic Stem Cell Transplantation What? Timing of chemo, infusion, cell formation.

A

Killing bone tumor w/ chemo 7 - 10 days prior to…
histocompatible stem cell donor to infuse immediately
cells form in 2 - 8 weeks

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50
Q

Disseminated Intravascular Coagulation. What? S/S? Timed? 2 monitor Tx?

A

abnormal activation of clotting r/in formation in small vessels which bleed/hemorrhage
Observe breaks q1-2hrs
Assess IV sites q15min

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51
Q

Hypoglycemia BgL vs. Hyperglycemia BgL

A

↓ 60 mg/dL v. ↑ 250 mg/dL

52
Q

Hypoglycemia 3 S/S vs. Hyperglycemia S/S

A

hunger, shallow respirations, ↓LoC

thirst, polyuria -> oliguria, weakness

53
Q

4 Diabetes Self-Tx

A

Self monitoring q3hrs
Foot care
Check eyes YEARLY
Diet control and Exercise

54
Q

Diabetes 3 Dx levels
8hr fasting
Random
Oral BgL

A

↑ 126 mg/dL
↑ 200 mg/dL
↑ 200 mg/dL post fast and consumed glucosre

55
Q 
Types of Insulin Identifiers
Rapid
Short/Regular
Intermediate/NPH
Long
Which do you draw first when mixing?
A

simple name
Ends w/ “R”
Ends w/ “N”
Starts with “L…”

Draw short acting first

56
Q

Diabetic Ketoacidosis is defined by… and 3 Tx

A

↑ 300 mg/dL BgL
RAPID 0.9% NaCl
follow w/ 1/2 NSS
add glucose to fluides once BgL down to 250 mg/dL

57
Q

Human Growth Hormone 4 related hormones

A

ACTH
TSH
FSH
LG

58
Q

Reason for GH deficiency?

A

idiopathic

59
Q

3 S/S GH deficiency

A

short, insulin sensitivity, premature aging

60
Q

Meauring time for GH deficient ↓ 3 y/o vs ↑ 3 y/o

A

↓ 3 y/o q6months

↑ qYEAR

61
Q

GH deficiency 3 Dx

A

GH stimulation test at 0600 - 0800, FAST BEFORE
Radiologic/CT assessment
Evaluation vs. Growth curve

62
Q

GH related labs (2)

A

Insulin-like growth factor 1 (IGF-1) and IFG binding protein 3 (IGFBP-3)

63
Q

GH Replacement medication, route, qDaysPerweek, continue until what age? S/fx?

A 
Somatropin
SubQ
6 - 7 days/week
16♂/14♀
NO S/FX
64
Q

Neuroblastoma vs. Nephroblastoma (AKA)

where, % cases are, metastasis rate, age range

A

in adrenal gland, head area, 95% cases and 1/2 metastasized, ↓ 10 yrs/o
in kidneys/abdomen (Wilms Tumor), 10% bilateral, metastasis rare, 3 - 5 yrs/o

65
Q

Tumor General Tx 3

A

Chemo (ask for iodine/shellfish allergies)
Radiation (loose clothing/protect from sun)
Seek medical care for tender skin

66
Q

Neuroblastoma vs. Nepohroblastoma S/S + Metastasized S/S (2ea)

A

few, when metastasized = look ill (racoon ecchymoses) w/ pain
firm, non-tender mass in abdomen, when metastasized = dyspnea, SoB

67
Q

Neuroblastoma 2 vs. 4 Nephroblastoma Labs

A

CBC, urine catecholamines

BUN, Creatinine, CBC, urinanalysis

68
Q

Neuroblastoma vs. Nephroblastoma Dx + 2 Nephro rule outs

A

MIBG scan of marrow/soft tissue development
Abdominal Ultrasonography
Venacvogram for involvement vena cava
Bone marrow aspiration for metastasis

69
Q

Neuroblastoma vs. Nephroblastoma specific Tx notes

A

PICC may be inserted

DO NOT PALPATE ABDOMEN

70
Q

Neuroblastoma vs. Nephroblastoma Medications

2 Med enders vs. 1 specific

A

-ides/-ines

Dactinomycin (Cosmogen)

71
Q

Blood Neoplasms What? 2 Types? Primary result/issue?

A 
leukemia b/c malignancy in bone marrow
Acute Lymphoid (ALL)
Acute myelogenous (AML)

Production of immature WBC’s which crowd

72
Q

Leukemia 3 WBC crowding areas and S/S

A

Bone marrow = ↓ RBC, WBC, Platelets
Endocrine = tissue fibrosis
CNS = ↑ ICP

73
Q

Leukemia 3 Chemotherapies Fx and 1 Tx all
Induction
CNS prophylactic
Maintenance

A

remission of 5%
prevent invasion of leukemic cells
sustain remission phase

Tx N/V

74
Q

Leukemia Early vs. Late manifesations (3 ea)

A

low grade fever
unsteady gait
constipation

pain
ulcers in mouth
-megalies

75
Q

Leukemia 4 expected Labs

A

↓ CBC, platelets, neutrophils

+Leukemic Blasts (immature WBCS)

76
Q

Leukemia 2 Dx

A

Bone marrow biopsy w/ Eutetic mixture of local anesthetic ELMA unless unconscious General sedation (pressure site for 5 - 10 min)
CSF analysis
Side lying lumbar puncture (remain for 4 - 8hrs)

77
Q

Chemo Mucosal NO NO’s (4)

A

viscous lidocaine = aspiration
Hydrogen peroxide = ↓ healing
MoM = dries membranes
lemon glycerine = tooth/tissue decay

78
Q

When to complete chemo and bladder protection drug

A

Early in the day

Mesna (Mesnex)

79
Q

Hemapoietic Stem Cell Transplant (HCST)

What type, 1st/2nd remission, type of room, type filtration (acronym).

A

AML in 1st remission
ALL after 2nd remission

Positive pressure
HEPA filration

80
Q

Bone Cancers 2 vs. Soft Tissue malignancies

A

Osteosarcoma and Ewing’s (PNET)

Rhabdomyosarcoma

81
Q

Bone Cancer S/S vs. Rhabdomyosarcoma

A

Nonspecific pain relieved by flexing

Local pain r/t compression tumor MARBLE!!!

82
Q

Osteosarcoma, Ewings, Rhabdomyosarcoma medications + TCAs

A

methotrexate/doxorubicin
vinicristin/doxorubicin, alternating -ides
All above for 1 year
Tricyclic Antidepressants for phantom/neuropathic pain

83
Q

2 Bone Cancers + Rhabdomyosarcoma 4 Tx

A

localized radiation
surgical intervention
limb salvage (shrink tumor + joint replacement)
limb amputaiton

84
Q

Immunizations ORDER
HRD
HPIV
HMH

A

HepB…RV…DTaP…HiB…PCV…IPV…TIV…MMR…VAR…HepA…MCV4…HPV

85
Q

HepB Start + 3

Ø if..?

A

BIRTH
1 - 2 months
6 - 8 months
Allergic to bakers yeast

86
Q

RV Start + 2 (S/fx?)

Ø if…?

A

6 WEEKS - DIARRHEA
2 months
4 months
Intussusception/immunocompromise

87
Q

DTaP Start + 4

Ø if…?

A 
6 WEEKS
2 months
4 months
6 months
Encephalopathy, seizures, crying 3 hrs
88
Q

HiB Start + 3

A

6 WEEKS
2
4
12- 15

89
Q

PCV Start + 4

A

6 WEEKS
2
4
12 - 15

90
Q

IPV Start + 4

Ø if…?

A 
6 WEEKS
2 - 4
16 - 18
4 - 6 YEARS
Allergic to neomycin
91
Q

TIV Start + …?

Ø if…?

A

↑ 2 y/o for LIVE w/out other medical conditions
YEARLY (October)
Allergy to neomycin and eggs

92
Q

MMR Start + 2

A

12 MO
12 - 15 months
4 - 6 years/months if travelling internationally

93
Q

VAR Start + 2

Ø if…?

A

12 MO
12 - 15
4 - 6 years
Allergy to neomycin and corticosteroids

94
Q

HepA Start + 2

A

12 MO
12 mo - 2 yrs
6 - 18 months post first

95
Q

MCV4 Start
Prioritize what type of group? Booster needed when?
Ø if…?

A

9 months
high risk (African), if given ↓ 16 y/o
Hx Guilliane Barre Syndrome

96
Q

HPV Start + 3

Ø if…?

A

9 YEARS
2nd dose 1-2 months post first
3rd dose 6 months post first
Hypersensitive to yeast

97
Q

Epstein Barr/Mononucleosis 2 S/S and vector

A

severe fatigue and swelling

saliva

98
Q

Mumps/Paramyxovirus 2 S/S and 3 vectors

A

abd. pain and swollen salivary glands

direct contact, droplet, surfaces

99
Q

Rubella (German Measles) 2 S/S and 2 vectors

A

low-fever + rash for 2 - 3 days

direct contact, droplet

100
Q

Rubeola (Measles) 2 S/S + 3 vectors

A

Koplik spots on mucosa and reddish-brown rash from face down

direct contact, droplet, surfaces 2 hrs

101
Q

Conjunctivitis S/S + vector

A

red/dischargy eye

Direct contact

102
Q

Erythema Infectiosum (5ths disease) 2 S/S + vector

A

cold symptoms + face rash

blood droplet

103
Q

HFMD S/S + vector

A

rash on named parts

direct contact

104
Q

Pertussis/Bordetella 2 S/S + 2 vectors

A

cold symptoms + whooping cough

105
Q

Varicella Chicken pox S/S + 4 vectors

A

the pox!

direct contact, droplet, shingles, airborne

106
Q

Otitis Media AOM vs OME and 3 S/S ea

A

infection, no infection
tugging/pain ear w/ drainage and fever
full ear, orange tympanic membrane, hearing loss

107
Q

Pneumatic Otoscope strat for ↓ 3 yrs and ↑ 3 yrs

A

down back

up back

108
Q

Antibiotics r/t Otitis Media

A

wait 72 hours before starting

109
Q

HIV Infection Severities between ↓ 12 mo, 1 - 5 years, and 6 - 12 years.

NO, MODERATE, SEVERE

A

1500/25%, 1000/25%, 500/25%
740/15%, 500/15%, 200/15%
↓above ↓above ↓above

110
Q

HIV S/S NO SUP, MOD SUP, SEVERE SUP types of evidence

A

no sup = no evidence
mod = itis, opathy, onia, arcomas
severe = fancy names

111
Q

HIV name NABC 1,2,3 criteria

A 
N= no, A=mild, B=moderate, C=severe
1= no evi, 2 = evidence, 3 =severe evidence
112
Q

HIV Dx ↑ 18 months (2) vs ↓ 18 months

A

ELISA and Western Blot vs Polymerase Chaine Reaction (PCR)

113
Q

Tx 4 Bacterial Skin Dz and R/F

A

warm skin compress, PO/topical antibiotic, soap

immunosuppresion

114
Q

Tx 1 Viral Skin Dz and R/F

A

antiviral “-virs”

direct contact

115
Q

Tx 5 Bites/Stings and R/F

A

antipruritic, histamine, biotic, venom
cool compress
Geographic area

116
Q

Tx 3 Fungal Skin Dz and R/F

A 
Topicaal antifungal (clotrimazole) and Oral griseofulvin (except w/ candidiasis), warm compress
Geographic Area
117
Q

Folliculitis pimple, furuncle boil, carbuncle boil are caused by…

A

Staph A.

118
Q 
S/S Viral..
Human Papillo
HPV
HSV
Varicella
Molluscum
A 
gray-brown
same but on feet
1 = cold sores, 2 = genital
neurologi pain
asymptomatic papules
119
Q

Scabies S/S infant vs. Older children

A

widespread body pimples and blisters vs. head, wrists, genitals

120
Q

Lyme Dz 3 Stages S/S and times

A
  1. Erythema w/ Bull’s Eye Rash 3 - 31 days
  2. Paralysis, muscle/joint swelling, ♥ problems weeks
  3. SEVERE arthritis, tingling, speech problems
121
Q

Contact Dermatitis - 3 types, 3 tx
Atopic Dermatitis - infant vs older
Acne - Amnesteem

A

contact, diaper, seborrheic isopropyl alcohol/ zinc oxide w/ cornstarch
eczema infant = generalized erythema + vsicles, older = lichenification and keratosis in wrists/ankles
P. acnes - Amnesteem r/in behavioral ▲

122
Q

3 Types of Burns

A

Thermal
Chemical
Electrical

123
Q

5 Depths of Burns

A 
Superficial 1st
Superficial Partial 2nd
Deep Partial
     Ø blanching
Full thickness 3rd
     returning pain w/ leathery skin
Deep full thickness 4th
     no pain, charred
124
Q

3 Extents of Burns Definitions
Minor
Moderate
Major

A

tx in clinic
tx in hospital
req. medical services/burn center

125
Q

3 Tx burns and IV Tx

A

cool H2O BUT NO ICE!
nonadherent hydrocolloid dressing
Analgesia

0.9% NaCL 24 hr w/ LR
↓ 30 kg, urine output 1 -2 ml/kg/hr
↑ 30 kg, 30 ml/hr

126
Q

Burn
Allo
Xeno
Synthetic Grafts

A

from human partial/full
from animal partial
synthetic partial

127
Q

Burn Permanent autografts
sheet
mesh
artificatial

A

skin covers wound
skin + mesh for larger area
artificail heals better

ABSN Cohort 19 (28 decks)

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