Peds - other Flashcards
kawasaki disease
acute systemic vasculitis; infectious agents triggers T cells
kawasaki S&S
strawberry tongue, rash, bilateral conjunctivitis, red cracked lips/mucous membranes, red swollen hands and feet, lymphadenopathy, arthralgia, high fever, abd pain, diarrhea, vomiting, anemia, elevated CRP, ESR, WBC, platelets
kawasaki tx
aspirin, IVIG
Reye syndrome
acute encephalopathy following viral illness, is dx with liver biopsy, is characterized by cerebral edema and fatty changes in liver, associated with aspirin use
Reye syndrome S&S
viral illness, n/v, fever, sign of liver dysfunction (lethargy, jaundice), high ammonia levels in blood, altered mental status
Reye syndrome tx
monitor: neuro status and signs of increase ICP, liver function, I&Os, impaired coagulopathy
rest and low stimulation
Phenylketonuria (PKU)
rare, inherited disorder where the body is unable to break down phenylalanine
normal phenylalanine is 0-2, PKU is >20; high levels cause damage to CNS if not treated
PKU S&S
newborn screening, GI problems and vomiting, growth failure, behaviour difficulties, seizures
PKU tx
avoid foods high in protein and phenylalanine (meats, dairy, aspartame), special preparation formulas, family needs education on importance of follow up appointments and tx, adhering to safe diet, and risks for future children
rickets
softening and weakening of bones, extreme prolonged lack of vitamin D leading to bones not being able to absorb calcium
Rickets S&S
delayed growth, bow legs, weakness, pain in spine, pelvis, legs
Rickets tx
vitamin D and calcium, surgery to correct bow legs
developmental dyplasia of the hip
abnormality in development of femoral head, acetabulum, or both; femur becomes displaced from hip
developmental dyplasia of the hip S&S
Infant: ortolani and barlow tests
Toddler: limb length inequality, abnormal walking or gait
developmental dyplasia of the hip tx
promote proper formation of hip; brace (Pavlik harness), cast (spica body cast), surgery
osteogenesis imperfecta
brittle bone disease, body cannot make enough collagen and bones are weak, fracture easily often with no obvious cause
osteogenesis imperfecta S&S
easily broken bones, deformities (barrel shaped chest, bow legs, curved spine, triangle shape face), loose joints, weak muscles, soft discolored teeth
osteogenesis imperfecta tx
lifelong condition, prevent fractures, fracture care, biphosphonates (keep calcium in bones), prevent deformities (braces or splints), surgery, PT, OT, assistive devices
Muscular dystrophy
lack of specific protein needed for muscle function, progressive atrophy of symmetrical groups of skeletal muscles, loss of strength, progressive disability and deformity, Duchenne and Becker (types)
muscular dystrophy S&S
trouble standing unsupported, poor posture, dysphagia, trouble walking, scoliosis, loss of reflexes, lungs are weak, heart is weak
muscular dystrophy tx
no cure, median life expectancy duchenne = early 20s and Beckers = middle age, PT, OT, assistive devices (typically need a wheelchair in late childhood)
Diaper Dermatitis and Tx
irritant contact dermatitis caused by prolonged exposure to a dirty diaper, can become infected
Tx: remove diaper, keep area clean and dry, zinc oxide cream
Impetigo
contagious bacterial disease, caused by staphylococcus aureus, toxins from bacteria produce a weeping lesion with a honey colored crust
impetigo tx
topical antibiotics, oral antibiotics
non accidental trauma
changing or unclear story, margins are demarcared, uniform depth, non splash marks, pattern of object, skin creases spared
accidental trauma
reasonable story, irregular margins, variable depth, multiple splash marks, initial point of contact is most severe and lessens further away from site
children are at much greater risk for severe burns and complications due to their
think skin and large BSA
the Lund and Browder’s TBSA pediatric chart account for the difference in
smaller the body, bigger the head
in pediatrics >___% TBSA needs emergency treatment for fluid replacement
10%
Pediatric Parkland burn formula
3ml x TBSA% x kg = Lactated ringers to be administered over 24 hrs
adeqaute urine output
at least 0.5ml/kg/hr
barlow test
test for developmental hip dysplasia, done before ortolani. Abduct hip while applying downward pressure on knee, if it pops the femur has come out of socket and this is a + test. If both barlow and ortolani are + then dx can be confirmed
ortolani test
done to test for developmental hip dysplasia, done after Barlow. Flex knee to 90 degrees and place index finger on anterior greater trochanter and apply pressure and use thumbs to abduct if you get clunk/pop the femur has popped back in. This is a + test. If both barlow and ortolani are + then dx can be confirmed
