Peds Final Flashcards
RBC, Carry oxygen and carbon dioxide through hemoglobin (Hgb)
erythrocytes
WBC, Infection control and immunological reactions, Granulocytes and agranulocytes
leukocytes
platelets, blood clotting
thrombocytes
liquid portion, other coag. factors
plasma
fetal __ to __ months of life
4 to 6
hematological assessment
complete blood count analysis, assess for tachypnea, tachycardia, hypoxia, differential of blood count, coag studies and clotting times
Administer oxygen if _______ or _______ _______ low
Hgb or oxygen saturation
_____ increases metabolic and oxygen demands
Cold
under functioning immunity
Immunodeficiency
overfunctioning immunity
(hypersensitivity reactions)
Autoimmune disorder
nonspecific immune functions
inflammation and phagocytosis
specific immune functions
humoral and cell-mediated
_________ immunity involves B cells, which recognize specific antigens and secrete antibodies.
humoral
________ immunity involves T cells, which attack the antigens marked by the B cells.
cellular
The infant’s ________ organs are large at birth, in
proportion to the rest of the body.
lymphoid
The ______ shrinks in size at puberty.
thymus
Peyer’s patches increase in number until they peak between the ages of __ and __, then they decline.
15 and 25
_______ is smaller at birth and does not reach full size until adulthood.
Spleen
Children’s abdomens have less ___ to protect
immune organs; they are at higher risk for splenic rupture.
fat
Children have decreased amounts of
_________, so their immune system is less effective.
immunoglobulins
t/f: children have higher risk for sepsis
true
Which of the following immunoglobulins provide
primary protection against bacteria, viruses, and
fungi?
A. IgA
B. IgD
C. IgE
D. IgG
D IgG
Defects in development of immune system
components, repeated and persistent infections, opportunistic infections, and frequent skin lesions, rash/skin condition is one of first signs, May cure with hematopoietic stem cell transplantation.
primary immunodeficiency disorders
X-linked recessive disorder and a form of congenital thrombocytopenia
wiskott-aldrich syndrome
Thrombocytopenia and small platelets, Eczema, Immunodeficiency involving selective functions
of B and T lymphocytes
wiskott-aldrich syndrome
treatment for wiskott-aldrich syndrome
stem cell transplant is only cure, IV immune globulin, splenectomy to correct thrombocytopenia, infection prevention methods
Which of the following is not a manifestation of
Wiskott–Aldrich Syndrome?
A. Jaundice
B. Eczema
C. Recurrent infections
D. Increased bleeding
A. jaundice
Absent T-cell and B-cell function presented within first 6 months of life, potentially fatal and requires emergency treatment with stem cell transplant at time of diagnosis
severe combined immune deficiency (SCID)
SCID types of infections
bacterial, viral, fungal
treatment before stem cell transplant for SCID
long-term Abx therapy and IVIG
for SCID, only use _______ -________ blood in transufsions
cytomegalovirus- negative
Group of B-cell disorders in which immunoglobulins are inadequate or absent, could occur in infancy
Hypogammaglobulinemia
Symptoms begin around 3 months of age when maternal antibodies disappear.
hypogammaglobulinemia
Secondary immunodeficiency (acquired), types 1 and 2
Human Immunodeficiency Virus (HIV)
-Acquired vertically (transmission from mother) or horizontally (transmission from unprotected sex and nonsterile needles).
-Infants often have vertical transmission and adolescents have horizontal transmission.
Human Immunodeficiency Virus (HIV)
HIV-1 is presented ________
worldwide
HIV-2 is primarily _______ ______ only
West- Africa
manifestations of HIV
chronic diarrhea, failure to thrive, delayed development, and frequent infections
HIV treatment from HIV positive mothers
prevent prenatal transmission by avoiding breastfeeding, contact with fluids during delivery, clean right after delivery
HIV treatments include:
Nucleoside analog reverse transcriptase
inhibitors (NRTIs), Protease inhibitors, Nonnucleoside analog reverse transcriptase
inhibitors (NNRTIs)
Chronic autoimmune disease consisting of remissions and exacerbations.
Systemic Lupus Erythematosus
butterfly rash on bridge of nose and cheeks, fever, joint inflammation, fatigue, weight loss, splenic enlargement, vasculitis, leukopenia, anemia, nephrotic syndrome, and Raynaud phenomenon
Systemic Lupus Erythematosus
protection for Systemic Lupus Erythematosus
rest during flare-ups, protect against cold weather and UV light
Autoimmune disorder characterized by inflammation primarily affecting joints, autoantibodies primarily target synovial joints
Juvenile Idiopathic Arthritis
3 types of Juvenile Idiopathic Arthritis
pauciarticular, polyarticular, and systemic.
juvenile idiopathic arthritis manifestations:
joint symptoms (redness, pain, warmth, swelling, and stiffness) that are increased by inactivity, and system manifestations in some types (pericarditis, anemia, pleuritis).
Juvenile Idiopathic Arthritis treatment:
nonsteroidal anti-inflammatory drugs, corticosteroids, and antirheumatic medications, activities that maintain joint mobility
Result from exposure to environmental or food allergens, Caused by cell damage from antigen–antibody reactions that release histamine and causes allergic symptoms.
allergies
_____ allergies can be IgE-mediated or non-IgE-mediated.
food
______ indicates edema is occurring in the airway and is a sign of respiratory complication.
Wheezing
Three types of reactions to natural latex:
IgE mediated, Cell-mediated contact dermatitis, Irritant dermatitis
t/f: Food allergies can be diagnosed only by challenge testing.
false
Acute, immediate, and severe IgE-mediated
response to an allergen.
Anaphylaxis #1
common triggers for Anaphylaxis #1
nuts, shellfish, eggs, insect stings, penicillin, NSAIDs, radipaque dyes, latex
Anaphylaxis #1 usually occurs within __ to __ minutes of contact with the allergen.
5 to 10
Support the airway with intubation and ventilation if lip and tongue swelling and airway compromise, Assess circulation and administer IV fluids to provide volume expansion, monitor for 2 hours after
anaphylaxis #2
Abnormal Hgb gene, sickle shaped RBCs, autosomal recessive disorder, asymptomatic carriers
sickle cell disease #1
HgB F is protectant for the first 4 to 6 months of life, occlusion/hemolysis, premature RBC death
sickle cell disease #1
Triggered by hypoxia, acidosis, dehydration, fever, and hypothermia, vasoocclusive, Splenic sequestration, Silent cerebral infarct, Acute chest syndrome
sickle cell crisis
occluding vascular circulation: Severe pain from ischemia, Dactylitis
vasoocclusive
increased infections; requires splenectomy
splenic sequestration
Neuro assessments, Stroke or silent cerebral infarct
silent cerebral infarct
Pulmonary vessel occlusion, Mimics pneumonia but infarcts and not infiltrations
acute chest syndrome
increases the level of fetal Hgb, Reduces amount of crisis and promotes splenic function, Can cause neutropenia.
Hydroxyurea
Used if hemolysis results in high levels of free iron, Subcutaneous infusion: chelating agent to bind iron, Use with vitamin C, Monitor for side effects.
Deferoxamine
t/f: Deferoxamine should be administered with vitamin D to increase efficacy.
false, vitamin C
Autosomal recessive condition, Abnormal Hgb beta chains lead to rapid RBC destruction, Hemolytic anemia with bone marrow hyperplasia due to erythropoiesis
Beta-Thalassemia (Cooley’s Anemia) #1
Characteristics of the Cooley’s Anemia:
severe anemia, cell damage, free iron buildup
-Bone malformations (maxillary, frontal lobe)
-Osteoporosis and osteopenia
-Splenomegaly and hepatomegaly
-Cardiomyopathy
-Short statures
-Yellow or bronze skin pigmentation
cooleys anemia
treatment for cooleys anemia
chelation therapy to reduce free iron, BM transplant, frequent blood transfusions to replace RBCs
All three blood cellular components low or absent
pancytopenia
Complete bone marrow suppression or failure
-Rich, red marrow replaced with fatty yellow substance
-Congenital (autosomal recessive) or acquired (bone marrow destruction)
aplastic anemia (fanconi anemia)
-Skeletal defects and genitourinary deformities
-Sensory dysfunctions
-Café au lait spots
-Cardiac defects
-Delayed growth and short stature
-Microcephaly and intellectual disability
congenital aplastic anemia
-Excessive fatigue and weakness with behavior changes
-Recurrent infections and febrile episodes
-Petechia, bruising, epistaxis, and excessive bleeding
acquired aplastic anemia
Induces puberty in males
androgen therapy for aplastic anemia
Aplastic anemia is associated with which missing
component(s) in the blood?
RBC, WBC, platelets (all 3= panycytopenia)
Bleeding disorder resulting in deficits of coagulation factors, typically inherited by sons of moms who carry trait
hemophilia 1
classic hemophilia, factor VIII deficiency, X-linked recessive disorder, most common
Hemophilia A
Christmas disease, Factor IX disorder
Hemophilia B
manifestations of hemophilia
spontaneous/traumatic bleeding, external or internal bleeding, can be within tissues or joints from normal activity
treatment for hemophilia
RICE< intranasal desmopressin, monitor clotting and coag times/studies, factor replacement
A 4-month-old infant is diagnosed with hemophilia A after a prolonged nosebleed. Which clotting factor is
this child missing?
factor VIII
Autosomal dominant, Link between subendothelial collagen and platelets, Binds to factor VIII in circulation to prevent
premature clearing
Von Willebrand Disease #1
vWF deficiency
type 1 von Willebrand dx
quality of vWF is poor
type 2 von Willebrand dx
total absence of vWF
type 3 von Willebrand dx
von Willebrand dx manifestations
mucosal bleeding, epistaxis, large bruising, menorrhagia
Prophylactic and scheduled desmopressin doses, factor VIII replacement therapy, epistaxis control, avoid IM injections and rectal temp, birth control
treatment for von willebrand dx
Systemic coagulation due to thrombosis from stimulated thrombin, hemorrhage d/t fibrinolysis stimulated by plasmin, secondary, widespread clot formation occurs first
Disseminated Intravascular Coagulation (DIC)
