stuff I should have read sooner Flashcards
5 types of abuse
physical, neglect, mental, threat of harm, sexual/exploitation
AVN & ages
3-5 LCP 6 Kohlers 8-9 Severs 9-11 Panners (capitellum) 11-13 Osgood-Schlat 12-14 Freibergs 13-16 Scheurmanns
Discitis
3-5 = inflammation teens = infection MC @ T10-L5 \+ limp, + Lx, - hip not bacterial = rest & brace 2-4wks
septic hip arthritis
MC 0-2
holds hip in antalgic position (flex & ABd)
–X-ray unreliable takes 3 days to show up.
–**joint aspiration
13-16
pubertal growth spurt
17-19
pubertal development completed
children 6-9 & sports
MAY start team sports
- -balance is more automatic
- -small attention
- -canish do relevant Vs non stimuli
children 10-12 & sport
reaching puberty = (-) effect on balance.
- -team sports!!
- -respond well to competitive training & sports.
- SIZE not age
infants 0-2 & sport
unstructured play.
nocturnal enuresis
bed wetting
–symptom NOT disease
–no concern until ~6yrs
PRIMARY = never been dry = delayed neuronal maturation
SECONDARY = relapses after 3-4m dry = UTI, renal disease, motor disease, emotional, food allergy…
Management for bed wettign
- -counsel * reassure
- -condition w. urine sensitive pad/bell system
- -elimination diet
- -CMT
- -meds: imipramine (anti-depressant)
Asthma
MC chronic disease of kids
–nutrients = vit B6, Mg, Omega-3, Boswellia
accidental ingestion =
1 pediatric concern in 1-4yrs
cystic fibrosis =
–faulty transport of Na/Cl from epithelial cells of lungs & pancreas = thick mucous
~ live to 25
triad of symptoms of cystic fibrosis =
1) chronic pulmonary disease (cough, recurrent res infection, failure to thrive)
2) malabsorption 2degree to pancreatic insufficiency: stools freq & bulky
3) elevated sweat electrolytes
eval & tx for cystic fibrosis =
- -sweat test = for dx
- -postureal drainage/chest percuss to mobilize thick mucous
- -antibiotics for infections
- -vaporizers to thin mucous
- -enriched diets & pancreatic enzymes
- -oxygen therapy
- -lung transplant
cough
cough in infants are unusual & probably needs referral
viral croup
- -viral infection = obstruct upper airway (<4yoa)
- -most causes resolve some lead to fail respiratory
- -gradual onset 3-4days, fever, cough, hoarseness, sore throat, respiratory distress
- *croupy cough = short, sharp, barking, worse at night**
treatment of viral croup
r/o bacterial croup,
- -avoid sugar & dairy
- -increase fluids
- -steam inhalation kinds >6m
- -Vit A, C, E, bioflavinoids, Zn
- -CMT
- -lymph drainage
rheumatic fever
5-15
immune mediate reaction to group A beta hemolytic strep infection
–cardiac damage 40-50%
–polyarthritis (MC)
–chorea, erythema marginatum, sub-q nodules on extensor tendons of extremities
common cold (viral URTI)
- -viral infection of mucous membranes of nose/throat
- -kids 6m-5yrs may have 6-12 colds/year
complications/sequellae of a common cold =
- -otitis media
- -sinusitis
- -bronchitis & pneumonia (green sputum or blood, rales, rhonchi & remits)
meningitis
–vomiting or diarrhea
–infant = >100F OR kids >103
–meningeal irritation
–HA, fatigue, crying
–bulging anterior fontanelle
–purplish blue skin lesions
SEARCH SIGNS
Fever
> 99.6 in child who is acting ill
–look for SEARCH signs.
fever management
> 102 = tylenol or ibuprofen if uncomfortable & monitor temp 1-4h
> 103 = same, wait 30 mins & sponge bath for 10mins & recheck temp.
red flags for referral with fever
- > 104
- > 102F for >24h
- -any fever over 3 days
- -infant <3-6m & >1–F + SEARCH signs
- -stiff neck or skin lesions
- -child is irritable, drowsy, lethargic, acts/looks sick
febrile seizures/convulsions =
rising body temp = tonic-clonic contractions for 2-3min
–rare after 5
febrile seizures/convulsions management =
time seizure >5mins = emergency
–lumbar puncture IF: signs of meningeal irritation, signs of increased intracranial pressure, atypical seizure
Reyes Syndrome =
giving aspirin to kids until 18
- -assoc w. URTI or varicella
- -encephalopathy w. fatty degeneration of liver
- -may have increased liver enzymes and other bad things (personality change, confusion, delirium…)
subluxation of radial head
- -hold arm in pronated position
- -x-ray normal via pulled by hand
- -place elbow in supination & slowly extend arm
iron deficiency anemia (IDA)
MC nutritional deficiency in kids
- -pallor, anorexia, poor muscle tone
- -1.5mg/kg bid for 30 days WITH Vit. C**
- -decrease milk & dairy consumption
pes planus
<4 yrs = no tx
let them walk bare foot but don’t over due it & wait for muscles to develop
metatarsus varus (adductus)
kidney foot
- -more spontaneously resolve
- -some need casting & corrective shoes
talipes equinovarus
clubfoot
- -plantar flexion
- -varus/inversion deformity
- -forefoot varus
- *use manipulation to stretch contracted medial & posterior tissues + splinting
tibial torsion
> 16-18m = tx w/ ext splint
femoral anteversion
MC cause of toeing in after 2-3yrs
–usually resolves on its own
word comprehension @
9m
babbling @
12m
270 words & commands @
2 years
1600 words & intelligible speech & <5 word sentences @
4 years
