Peds - other

Question 1

kawasaki disease

Answer 1

acute systemic vasculitis; infectious agents triggers T cells

Question 2

kawasaki S&S

Answer 2

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

Question 3

kawasaki tx

Answer 3

aspirin, IVIG

Question 4

Reye syndrome

Answer 4

acute encephalopathy following viral illness, is dx with liver biopsy, is characterized by cerebral edema and fatty changes in liver, associated with aspirin use

Question 5

Reye syndrome S&S

Answer 5

viral illness, n/v, fever, sign of liver dysfunction (lethargy, jaundice), high ammonia levels in blood, altered mental status

Question 6

Reye syndrome tx

Answer 6

monitor: neuro status and signs of increase ICP, liver function, I&Os, impaired coagulopathy

rest and low stimulation

Question 7

Phenylketonuria (PKU)

Answer 7

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

Question 8

PKU S&S

Answer 8

newborn screening, GI problems and vomiting, growth failure, behaviour difficulties, seizures

Question 9

PKU tx

Answer 9

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

Question 10

rickets

Answer 10

softening and weakening of bones, extreme prolonged lack of vitamin D leading to bones not being able to absorb calcium

Question 11

Rickets S&S

Answer 11

delayed growth, bow legs, weakness, pain in spine, pelvis, legs

Question 12

Rickets tx

Answer 12

vitamin D and calcium, surgery to correct bow legs

Question 13

developmental dyplasia of the hip

Answer 13

abnormality in development of femoral head, acetabulum, or both; femur becomes displaced from hip

Question 14

developmental dyplasia of the hip S&S

Answer 14

Infant: ortolani and barlow tests

Toddler: limb length inequality, abnormal walking or gait

Question 15

developmental dyplasia of the hip tx

Answer 15

promote proper formation of hip; brace (Pavlik harness), cast (spica body cast), surgery

Question 16

osteogenesis imperfecta

Answer 16

brittle bone disease, body cannot make enough collagen and bones are weak, fracture easily often with no obvious cause

Question 17

osteogenesis imperfecta S&S

Answer 17

easily broken bones, deformities (barrel shaped chest, bow legs, curved spine, triangle shape face), loose joints, weak muscles, soft discolored teeth

Question 18

osteogenesis imperfecta tx

Answer 18

lifelong condition, prevent fractures, fracture care, biphosphonates (keep calcium in bones), prevent deformities (braces or splints), surgery, PT, OT, assistive devices

Question 19

Muscular dystrophy

Answer 19

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)

Question 20

muscular dystrophy S&S

Answer 20

trouble standing unsupported, poor posture, dysphagia, trouble walking, scoliosis, loss of reflexes, lungs are weak, heart is weak

Question 21

muscular dystrophy tx

Answer 21

no cure, median life expectancy duchenne = early 20s and Beckers = middle age, PT, OT, assistive devices (typically need a wheelchair in late childhood)

Question 22

Diaper Dermatitis and Tx

Answer 22

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

Question 23

Impetigo

Answer 23

contagious bacterial disease, caused by staphylococcus aureus, toxins from bacteria produce a weeping lesion with a honey colored crust

Question 24

impetigo tx

Answer 24

topical antibiotics, oral antibiotics

Question 25

non accidental trauma

Answer 25

changing or unclear story, margins are demarcared, uniform depth, non splash marks, pattern of object, skin creases spared

Question 26

accidental trauma

Answer 26

reasonable story, irregular margins, variable depth, multiple splash marks, initial point of contact is most severe and lessens further away from site

Question 27

children are at much greater risk for severe burns and complications due to their

Answer 27

think skin and large BSA

Question 28

the Lund and Browder’s TBSA pediatric chart account for the difference in

Answer 28

smaller the body, bigger the head

Question 29

in pediatrics >___% TBSA needs emergency treatment for fluid replacement

Answer 29

10%

Question 30

Pediatric Parkland burn formula

Answer 30

3ml x TBSA% x kg = Lactated ringers to be administered over 24 hrs

Question 31

adeqaute urine output

Answer 31

at least 0.5ml/kg/hr

Question 32

barlow test

Answer 32

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

Question 33

ortolani test

Answer 33

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