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Peds-FINAL Flashcards

1
Q

GFR

A

A measure of the amount of plasma from which a given substance is totally cleared in one minute.

End product of protein metabolism

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2
Q

The most useful clinical estimation of GFR is

A

Creatinine

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3
Q

Cystoscopy

A

Provides a direct visualization of the bladder through a small scope

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4
Q

IVP

A

Intravenous pyelogram

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5
Q

KUB

A

kidney, ureter, bladder x-ray

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6
Q

Symptoms of Urinary tract disorders in NEONATES

A
  • Poor feeding, poor weight gain
  • Rapid RR, resp distress
  • Spontaneous pneumothorax or pneumomediastinum
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7
Q

Symptoms of Urinary tract disorders in INFANTS

A
  • Poor feeding
  • Vomiting
  • FTT
  • Excessive thirst
  • Straining or screaming w/urination
  • Foul-smelling urine
  • Pallor
  • Fever
  • Persistent diaper rash
  • Seizures
  • Dehydration
  • Enlarged Kidneys/bladder
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8
Q

Symptoms of Urinary tract disorder in CHILDREN

A
  • Poor appetite
  • Vomiting
  • Growth failure
  • Excessive thirst
  • Enuresis, incontinence
  • Frequent urination
  • Dysuria
  • Facial swelling
  • Pallor
  • Fatigue
  • Seizures
  • Hematuria
  • Abd/back pain
  • Edema
  • HTN
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9
Q

Enuresis

A

Difficulties with urinary control

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10
Q

RF for Enuresis

A

Underlying urinary tract abnormalities Neurologic alterations small bladder capacity obstructive sleep apnea Constipation (encoporesis) UTI Pinworms DM

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11
Q

Diurnal Enuresis

A
  • occurs during the day & night
  • Urgency, frequency, wetting during the day
  • Tight crossed legs or rush to potty
  • constant urine odor
  • difficulty sitting still
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12
Q

Nocturnal Enuresis

A
  • Occurs at night
  • cannot sense bladder fullness > deep sleeper
  • NOT A CONCERN UNITL AFTER AGE 6
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13
Q

Primary enuresis

A

Child had never had control of bladder

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14
Q

Secondary

A

Child has had control for 6-12 months

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15
Q

Treatment for Enuresis

A 
_	Limit evening fluids
_	Behavioral conditioning (bed alarms)
_	Waking child up to go to bathroom
_	Reward system (charts, big-boy underwear!)
_	Guided imagery
_	Medication: DDAVP, Imipramine
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16
Q

UTI

A

The 2nd leading cause of morbidity in children!!

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17
Q

Bacteriuria

A

presence of bacteria in the urine

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18
Q

Asymptomatic bacteriuria

A

Significant amount of bacteria w/o S/S

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19
Q

Cystitis

A

Inflammation of the bladder

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20
Q

Urethritis

A

Inflammation of the urethra

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21
Q

Pyelonephritis

A

Inflammation of the upper urinary tract & kidneys

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22
Q

Urosepsis

A

febrile UTI with systemic S/S (blood culture contains urinary pathogens)

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23
Q

UTI RF

A
  • VUR (vesicoureteral reflux)
  • Sexually active
  • Anatomic differences (females have shorter urethra)
  • Obstruction
  • Voiding dysfucntion/urinary stasis (constipation, neurogenic bladder, holding too long)
  • Bubble bath
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24
Q

UTI Prevention

A
  • Wipe front to back
  • Frequent emptying of bladder
  • Increased fluids
  • No tight clothing/diapers, wear cotton underwear
  • No bubble baths
  • Void after sex
  • Cranberry juice
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25
Hydronephrosis
obstruction in ureter, especially ureteropelvic junction > dilation of kideny **ASSOCIATED WITH VUR
26
Vesicoureteral Reflux
Retrograde flow of urine from the bladder into the ureters
27
Primary VUR
Congenital anomaly that affects ureterovesical junction - Ectopic or orthotopic implantation of the ureter - abn tunneling of the intramural ureteral segment - defects in configuration of ureteral orfice
28
Secondary VUR
Result of acquired condition such as UTI or dysfunctional voiding
29
VUR Classification
Grade I = reflux into ureter only w/o dilation | Grade V = Gross dilation of ureter, pelvis calyces
30
Cryptochoridism
Undescended or hidden testicles - Increased risk for testicular Cx - Premature infant have > occurrence - Intra-abdominal testis may require surgery
31
Orchiopexy
Testis brought down and sutured into place
32
Hypospadias
Congenital anomaly; meatus below normal placement on glans -Repair should be done before toilet training so child can urinate standing up
33
Epispadias
Meatus above normal placement
34
Chordee
Downward curvature of penile shaft; may accompany hypospadias
35
Nephrotic Syndrome
Kidney disorder characterized by proteinuria, hypoalbuminemia, edema
36
Primary Nephrotic Syndrome
**Most common type in children- a disorder in the glomerulus
37
Acquired Nephrotic Syndrome
Secondary to systemic diseases such as hepatitis, SLE, carcinoma
38
Polycythemia
Excess RBC production | -occurs secondary to hypoxemia
39
Screening for Iron-deficency anemia
- Once between 6-9mo - Early childhood 1-5yrs - Late childhood 5-12yrs - Adolescence 14-20yrs
40
Iron Administration
- Give in 3 divided doses BETWEEN meals - Give with Vit C rich foods - Use straw/dropper to put in back of mouth; brush or wipe off teeth - Expect black tarry stools - Milk, formula, cereal IMPEDE absorption
41
Sickle Cell Crisis precipitating factors
- Infection - Dehydration - Stress - Hypoxia - Trauma
42
Most common inherited bleeding disorder
Von Willebrand's disease
43
VWD
Underproduction or dysfunction of VW protein | Carrier protein for clotting factor VIII
44
ITP
Reduction of platelets that occurs after febrile viral illness Peak age 2-5yrs Sudden onset of bruising petechiae; most often in mucous membranes, sclerae
45
Neoplasm
any tumor arising from new abnormal growth
46
invasive spread
growth in unrestricted disorderly fashion at site of origin
47
Metastasis
cells grow at sites other than site of primary cancer
48
Cardinal signs of cancer - OVERT
- A mass or swelling - Purpura, bruising - Pallor weight loss - Absence of red reflex - Vomiting in early am - Recurrent fever
49
Cardinal signs of cancer - COVERT
- Bone pain - Headache - Persistent lymphadenopathy - Change in balance, gait, personality - Fatigue, malaise
50
Second leading cause of death in children (after accidents)
Cancer
51
Most common form of cancer in children less than 15 years
Leukemia
52
This CX known for painless enlargement of lymph nodes
Hodgkin's lymphoma
53
Manifestations of hodgkins
- Painless enlargment in cervical and supraclavicular region (MOST COMMON) - Fever - DRENCHING night swear - Weight loss - Hepatosplenomagaly
54
Most common bone cancer in children
Osteogenic Sarcoma
55
Functions of Skin
Protection Impermeability Heat regulation Sensation
56
Meds used for anti-itching with eczema
Hydroxazine (Atarax) Diphenhydramine (Benadryl) Loratadine (claritin)
57
Atopic Dermatitis
Eczema
58
Seborrheic Dermatitis
Cradle Cap
59
Contact Dermatitis
Diaper rash
60
Cellulitis
Infection/inflammation of skin, SC tissue and regional lymph nodes
61
Folliculitis
Hot tub folliculitis | Infection of hair follicle > can develop tender pus filled nodule
62
Verruca
Warts
63
Tinea Capitis
Ringworm of the scalp - Oral griseofulvin for 6-8wks - Topical antifungal agents, selenium shampoos
64
Tinea corporis
Ringworm of the body - Topical antifungal until 2wks after lesions clear - May need systemic tx
65
Tinea cruris
"Jock itch" | Ringworm of the groin
66
Tinea pedis
"Athletes foot'
67
Candidiasis
Beefy red rash with SATELITE lesions Thrush Yeast infection
68
Tx for candidiasis
Nystatin PO in each cheek Topical antifungal to diaper area Diflucan if resistant
69
Pediculosis
Lice
70
Scabies
Endemic- mite that burrows into skin | Tx: permethrin 5% (Elimite) applied to skin & rinsed off 8-14hrs later, treat ALL members of the family
71
Agent
organism (bacteria, virus, parasite)
72
Reservoir
Environment in which agent lives and multiplies
73
Host
organism from which agent receives nourishment
74
incubation period
time form exposure to appearance of symptoms
75
Prodromal period
Early symptoms prior to full-blown symptoms
76
Epidemic
spread of disease among a population
77
carrier
asymptomatic person that harbors agent
78
S/S of Neonatal sepsis
``` Temp instability Lethargy poor feeding change in muscle tone and reflexes Resp distress Tachy or bradycardia decreased perfusion mottling GI Symptoms jaundice jitteriness or decreased response to stimuli rashes- petechiae blood sugar changes ```
79
How many immunizations can a child receive in one visit?
5
80
How many immunizations can a child by age 2?
24
81
Assessing Immunization Status
1. Name of Disease vaccination is for 2. Number of injections given 3. Dates of injections 4. Dosage of injections 5. Age at time of dose 6. Occurrence of any reaction to immunization
82
What should be given if infant is at risk for HBV perinataly
Heb B immunoglobulin
83
What make up the DTaP
Diphtheria Tetanus Pertussis (acellular)
84
When is DTaP given
``` 2mo 4mo 6mo 15-18 mo (as early as 12mo if if 6mo have elapsed) 4-6yr 11-12yr ```
85
Dipththeria
Spread by respiratory secretions | Contagious up to 4wks
86
Pertussis
"Whooping Cough" | Many parents may opt out of pertussis vaccine bc hx of seizure complications
87
Pertussis Catarrhal stage
s/s similar to URI may last up to 2 weeks
88
Pertussis Paroxysmal stage
short rapid coughs followed by sudden insiration when characteristic whoop sound occurs
89
Rotavirus
First dose before 12wks Second dose before 32 wks (2mo & 4mo)
90
Leading cause of infant and child mortality world wide
Rotavirus
91
Vaccine that has decreased incidence of epiglottitis
Hib
92
Haemophilus influenza type B (HIB) given at
2mo | 4mo
93
Polio (IPV) given at
2mo, 4, mo, 6mo, 6-18mo, 4-6yrs
94
Polio transmitted by
feces, oral secretions
95
Virus causes nonspecific symptoms or may cause paralysis
Polio
96
When is MMR given
At or after 12 months second dose 4-6 yrs at least 4wks bt doses
97
Measles
Rubeola | Transmitted direct contact with respiratory droplets
98
S/S Rubeola
``` Prodromal = fever, cough coryza conjunctivitis, Koplik spots. Rash= maculopapular face & spreads down, blanches with pressure ```
99
Mumps
Tender/painful enlargement of parotid glands | can cause sensorineural deafness
100
Rubella
German Measles Rapid spread Greatest danger is teratogenic effect on developing fetus in first trimester
101
Varicella given
on or after 12mo
102
Chicken pox
Incubation period 10-21 days
103
Shingles
During primary infection virus enters dorsal root ganglion > latent infection
104
Most common complication of chicken pox is
Impetigo
105
Pneumococcal given
Given up to 24 mo | 2mo, 4mo, 6mo, 12-15mo
106
Hep A given
2 dose series given at least 6mo apart 12-15mo 12-23mo
107
HPV
first dose females 11-12 | series of 3 doses
108
Meningococcal
all children age of 11-12 | ALL college freshman living in dorms
109
RespiGam (RSV-IGIV)
RSV immunoglobulin given to high-risk infants in first year of life to prevent RSV. Given monthly NOT A VACCINE, DOES NOT PREVENT RSV
110
Roseola
Herpesvirus type 6
111
Scarlet Fever
Group A beta-hemolytic strep Strawberry tongue Rash feels like sandpaper
112
Mortality
death rate per 100,000 population
113
Morbidity
Number of ill people per 1000
114
Leading cause of infant MORTALITY
Congenital anomalies
115
Number one cause of childhood deaths
Unintentional injuries

Pediatrics (5 decks)

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