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Pediatrics > Peds Lectures 14, 15, and 17 > Flashcards

Peds Lectures 14, 15, and 17 Flashcards

1
Q

Fourth-leading cause of child death

A

Poisoning

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2
Q

peak age of poisoning accidents

A

2 years

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3
Q

What information do you need to obtain when someone calls in to report a poisoning?

A
  • Name of substance
  • time taken
  • amount
  • patient’s condition
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4
Q

What should you give when an acid or alkaline agent is ingested?

A

Milk or water

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5
Q

Contraindications to vomiting induction

A
  • Corrosives
  • Volatile hydrocarbons
  • Absent gag reflex (comatose)
  • > 2 hours after ingestion
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6
Q

How do you know when you’ve performed a gastric lavage long enough?

A

-Clear fluid will return

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7
Q

You only want to give Ipecac if the poison has been ingested within what time frame?

A

30-60 minutes

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8
Q

What’s a narcotic poison antidote?

A

Naloxone (Narcan)

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9
Q

How common are fatal poisonings caused by iron?

A

20-25% of poison deaths

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10
Q

How many phases does a child experienced who’s been poisoned with iron?

A

5

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11
Q

What are the 5 phases of iron poisoning?

A
  • Hemorrhagic gastroenteritis starting 30-60 mins after ingestion, lasting 4-6 hours
  • Patient feels better for 2-12 hours
  • Hypotension from blood loss, metabolic acidosis, shock
  • Liver damage with hepatic failure
  • Pyloric stenosis 3-4 weeks post ingestion
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12
Q

What color might the urine be of a child with iron poisoning?

A

Red

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13
Q

Drug tx for iron poisoning

A

Deferoxamine

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14
Q

How many stages are involved in acetaminophen poisoning?

A

3

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15
Q

What are the 3 stages of acetaminophen poisoning?

A

2-24 hours: N/V, malaise, diaphoresis
24-48 hrs: looks/feels better, but hepatotoxic effects are starting
48+ hrs: hepatic necrosis, jaundice, coagulopathy, hypoglycemia, coma, encephalopathy

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16
Q

Acetaminophen poisoning tx

A
  • Acetyl Cysteine- lessens liver damage
  • Ipecac or lavage
  • Charcoal
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17
Q

Child presents with N/V, fever, lethargy, sweating, and is hyperventilating. Suspicion?

A

-Salicylate poisoning

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18
Q

What lab tests will be significant in a child with salicylate poisoning?

A
  • hypokalemia
  • hypoglycemia
  • metabolic acidosis
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19
Q

Does lead poisoning have a rapid or an insidious onset?

A

Lead poisoning

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20
Q

How do you treat lead poisoning?

A

-Succimer, which is a lead chelator

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21
Q

How do you treat CO poisoning?

A

100% oxygen by mask or hyperbaric oxygen

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22
Q

How do you treat methanol or ethylene glycol (antifreeze)?

A

-Fomepizole

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23
Q

What do we need to know about petroleum distillate hydrocarbon poisoning tx?

A

Normal saline or ringers IV for 1 hour

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24
Q

What triggers anaphylactic shock?

A

Antigens (medications, tree nuts, eggs, etc.)

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25
Q

What immunoglobulin is responsible for mediating anaphylaxis?

A

IgE

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26
Q

Anaphylaxis tx

A
  • ABC’s
  • oxygen
  • epinephrine
  • saline bolus for hypovolemia
  • nebulized beta-agonists
  • Diphenhydramine
  • corticosteroids
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27
Q

First line drug for symptomatic bradycardia in children

A

Epinephrine

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28
Q

At what age range does the incidence of SIDS peak?

A

2-4 months

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29
Q

How should you position a child when laying them down to prevent SIDS?

A

-On their back

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30
Q

What are the 4 major risks factors that can be modified to reduce the risk of SIDS?

A
  • sleep in supine position
  • no cigarette smoking
  • keep sleeping environment safe
  • breast feeding, rather than bottle-feeding
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31
Q

How should you treat open bite wounds?

A
  • DTaP booster if > 5 years since last one
  • Consider TIG if tetanus status uncertain
  • Copious wound irrigation
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32
Q

Where should you refer patients with significant hand bits?

A

Ortho

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33
Q

Most common pathogen in cat bites

A

Pasteurella multocida

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34
Q

Most common pathogens in dog bits

A
  • P. multocida
  • strep
  • staph
  • anaerobes
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35
Q

Most common pathogens in human bits

A
  • strep
  • staph
  • anaerobes
  • eikenella corrodens
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36
Q

Treatment for bites

A
  • Augmentin

- Cephalosporins for penicillin allergy patients

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37
Q

Brown recluse bite tx

A
  • cold compress
  • tetanus prophylaxis
  • total wound excision to the fascia
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38
Q

Black widow spider bit tx

A
  • cold compress
  • tatanus prophylaxis
  • IV calcium gluconate
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39
Q

Which age group is most affected by burns?

A

Toddlers

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40
Q

When should you refer a child to a burn center?

A
  • superficial burn > 10% of BSA

- Full thickness burn > 2% BSA

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41
Q

How do early CXR findings differ from late findings of aspirated foreign bodies?

A
  • Early: hyperinflation and mediastinal shift away from affected side
  • Later findings: atelectasis, pneumonia, abscess
42
Q

When should you consult a surgeon for re: a foreign body?

A
  • Causing GI symptoms
  • Remains in GI tract > 5 days
  • Remains in esophagus
43
Q

When is “bag and mask” ventilation indicated?

A
  • apnea
  • HR < 100
  • central cyanosis on continued O2
  • gasping or inadequate respirations
44
Q

When is endotracheal intubation indicated?

A
  • prolonged or ineffective Bag and mask oxygenation
  • to deliver meds
  • if transport is anticipated
45
Q

What is the #1 best drug for neonatal resuscitation?

A

Oxygen

46
Q

Common cause of congenital amputations

A

Amniotic bands

47
Q

In what kind of delivery presentation is hip dysplasia more common?

A

Breach presentation

48
Q

Is developmental dysplasia of the hip more common in girls or boys?

A

Girls

49
Q

Signs of DDH in older children

A
  • Asymmetric abduction of the hips

- Galeazzi’s sign

50
Q

What kind of treatment is usually required for DDH of young infants?

A

Pavlik harness

51
Q

What kind of tx is usually required for DDH in older children?

A
  • Traction
  • Casting
  • Osteotomy
52
Q

What is another name for avascular necrosis of the proximal femoral head?

A

Legg-Calve-Perthes disease

53
Q

What’s the most common symptoms of Legg-Calve-Perthes disease?

A
  • Persistent pain
  • limp
  • limited ROM
54
Q

In what patient population is a slipped capital femoral epiphysis more common?

A

-Obese adolescent males

55
Q

How does the acute stage of a slipped capital femoral epiphysis present?

A

Pain and limp with referred pain to the knee

56
Q

How do you treat a slipped capital femoral epiphysis?

A
  • Pin in place if diagnosed early enough

- If necessary, internally fix, and then pin

57
Q

What are the primary causes of painless limps in children up to 5 years of age?

A
  • DDH
  • leg length discrepancy
  • cerebral palsy
58
Q

What are the primary causes of painless limps in children 5-10 years of age?

A
  • DDH
  • Cerebral palsy
  • leg length discrepancy
  • muscular dystrophy
  • chronic stage of legg-calve-perthes disease
59
Q

Torticollis tx

A
  • passive stretching

- massage

60
Q

Bone infection caused by bacteria or other germs

A

-Acute osteomyelitis

61
Q

What part of the bone is usually affected by acute osteomyelitis?

A

Metaphysis of long bone

62
Q

In what bones does acute osteomyelitis most often occur?

A

Long bones of the lower extremities

63
Q

Most common pathogen responsible for acute osteomyelitis

A

Staph aureus

64
Q

Acute osteomyelitis tx

A

IV antibiotics

65
Q

Most common pathogen responsible for septic arthritis

A

Staph aureus

66
Q

Which joint is most often affected by septic arthritis?

A

Hip

67
Q

Which joint is second-most affected by septic arthritis?

A

Knee

68
Q

How will an infant present with septic arthritis?

A
  • Irritable

- Hip will be held in flexion and external rotation

69
Q

What should you look for on x-ray if septic arthritis is suspected?

A

Widening of the joint space

70
Q

Septic arthritis tx

A
  • IV antibiotics, then oral antibiotics

- surgical drainage/aspiration

71
Q

Most common cause of limping and pain in children in the US

A

Transient (toxic) synovitis

72
Q

Acute, self-limiting inflammation of a joint

A

Transient (toxic) synovitis

73
Q

Transient (toxic) synovitis tx

A
  • Rest

- NSAIDs

74
Q

Patient presents with low-grade fever, back pain, irritability, and a reluctance to flex their back. Suspicion?

A

Intervertebral diskitis

75
Q

Joint inflammation in a child of at least 6 weeks duration

A

Juvenile RA

76
Q

Most common rheumatic disease in children

A

Juvenile RA

77
Q

Three main types of juvenile RA

A
  • Systemic onset
  • Pauciarticular
  • Polyarticular
78
Q

Patient presents with high fever x2 weeks with a macular rash and joint inflammation. Suspicion?

A

Systemic onset JRA

79
Q

What percentage of JRA cases are systemic onset?

A

20%

80
Q

What percentage of JRA cases are pauciarticular?

A

40%

81
Q

What lab result will make you think of pauciarticular JRA?

A

Presence of ANA

82
Q

What percentage of JRA cases are polyarticular?

A

40%

83
Q

JRA treatment

A
  • NSAIDs
  • Hydroxychloroquine
  • Methotrexate
84
Q

Where will a child with Osgood-Schlatter disease feel pain?

A

At the tibial tuberosity

85
Q

10yo female presents with arthritic pain, malar rash, and hair loss. Suspicion?

A

SLE

86
Q

What types of injuries are battered children usually brought in with?

A

Orthopedic

87
Q

What should you suspect if you find a fx in a non-ambulatory infant?

A

Child-battering syndrome

88
Q

How do you treat nursemaid’s elbow?

A

-Supination of hand, full extension, full flexion

89
Q

How do you define scoliosis?

A

Lateral curvature of the spine greater than 10 degrees, accompanied by vertebral rotation

90
Q

What percentage of adolescents diagnosed with scoliosis have curves that progress and require medical attention?

A

10%

91
Q

Risk factors for scoliosis curve progression

A
  • Large curve magnitude
  • Skeletal immaturity
  • Female gender
92
Q

Test that can illustrate the spinal curvature of scoliosis

A

Adam’s forward bend test

93
Q

Patient presents with dull, aching pains in both arms that occur in the evening time. Suspicion?

A

Growing pains

94
Q

Growing pain treatment

A
  • Massage

- ASA, NSAIDs

95
Q

SH Type I fx

A

Fx through the physis

96
Q

SH Type II fx

A

FX through the physis and into the metaphysis

97
Q

SH Type III fx

A

Fx through the physis and into the epiphysis

98
Q

SH Type IV fx

A

Fx through the physis and into both the metaphysis and the epiphysis

99
Q

SH Type V fx

A

Crushing fx of the physis

100
Q

With what types of orthopedic injuries/diseases should you refer to orthopedics?

A
  • Acute osteomyelitis
  • Septic arthritis
  • Legg-calve-perthes disease
  • Slipped capital femoral epiphysis
  • All fractures

Pediatrics (16 decks)

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