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Advanced Med Surg > Test #4 > Flashcards

Test #4 Flashcards

1
Q

results from the failure of a fetal duct in the intestine to fuse normally in utero

A

Meckel’s diverticulum

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1
Q

baseline tests to get before scoliosis surgery

A

x-rays, PFTs, ABGs

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2
Q

complications of chronic vaso-occlusive crisis

A

increased r/f URI osteomyelitis retinal detachment liver and renal failure

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2
Q

Duchenne MD

A

mutation in gene for dystrophin protein that maintains muscle fibers; muscle wasting that begins in pelvis and hips

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2
Q

antidote for iron OD

A

Deferoxamine

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3
Q

Failure to Thrive diagnosed when weight is

A

below the 3rd percentile

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3
Q

first 24-48h after a burn injury

A

Emergent (Resuscitative) Phase Fast fluid resus

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4
Q

s/s Vaso-occlusive crisis

A

**pain; swollen joints; hematuria; fever

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5
Q

complications of infant GER

A

can injure esophageal mucosa, lead to FTT, bleeding, dysphagia; can trigger RAD; stricures; aspiration PNA; esophagitis

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6
Q

Post op care for Hirschprung’s correction

A

ng tube, NPO to decompress ostomy care monitor abd girth

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7
Q

aplastic crisis

A

worsening of baseline anemia in SCA; viral trigger

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7
Q

s/s child abuse

A

inconsistency between injuries and story; chip/spiral Fx; child withdraws or is fearful of parents; behavior changes, sleep disturbances

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8
Q

s/s TEF

A

excessive drooling; 3Cs after feeding: coughing, choking, and cyanosis

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9
Q

Meckel’s diverticulum s/s

A

Painless bloody stools with bright red mucus

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9
Q

tylenol antidote

A

large dose Mucomyst

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10
Q

congenital aganglionic megacolon

A

Hirschprung’s disease–missing nerves at the end of the colon, obstruction results from inadequate motility

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11
Q

treatment for imperforate anus or fistula

A

surgical reconstruction and temporary colostomy

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11
Q

complications of Hirschprung’s disease

A

Enterocolitis (fever and explosive diarrhea) that can lead to sepsis, peritonitis, or shock of bowel perfs; anal stricture/incontinence; fussy eating/manipulation with meals

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12
Q

Meckel’s diverticulum Dx

A

radionucleotide scan

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13
Q

surgery to fix pyloric stenosis

A

pyloromyotomy

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14
Q

non-surgical treatment for intussusception

A

enema or air inflation; successful if brown stool passes but can often recur

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15
Q

noninvasive, keeps hips abducted and in socket in a child with DDH

A

Pavlik harness (6 mos)

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16
Q

with hemophilia its important to monitor for

A

brain bleed: HA, slurred speech, decreased LOC

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16
Q

Pre op most babies with TEF have

A

aspiration pneumonia

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17
Q

cleft palate repair

A

palatoplasty; performed between 12-18 mos; only cup liquids and soft foods 4-6 weeks postop

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17
Q

three zones of burns

A

Zone of Coagulation (non-viable); Zone of Stasis (tissue can be salvaged by fluid resus and reducing edema); Zone of Hyperemia (usually heals spontaneously)

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18
Q

severe GER causing FTT or tracheomalacia treat with

A

Nissan fundoplication: stomach wrapped around esophagus to increase LES tone

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19
Q

sickle cell anemia s/s

A

pain; SOB/fatigue/tachycardia; pallor or jaundice; nail bed deformities; Hand Foot syndrome=symmetric painful swelling; low fever; FTT

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20
Q

sickle cell pts need this test yearly to monitor for CVA from ages 2-16

A

transcranial doppler

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21
Q

screening tool for sickle cell anemia

A

SickleDex

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22
Q

RFs for sickle cell crisis

A

hypoxemia; infection; dehydration; fever

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23
Q

s/s hemophilia

A

bleeding episodes; joint pain and stiffness (hemoarthrosis), can lead to deformities; activity intolerance, prolonged PTT

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23
Q

inheritance pattern of Duchenne MD

A

X-linked recessive

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25
Q

Complications of cleft lip/palate

A

Aspiration, sinus infections; ear infections, hearing loss; speech delay; dental delay; feeding aversions

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26
Q

pinworm dx

A

Tape test

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28
Q

TEF diagnosis

A

X-ray with ng/og tube and air injection to show pouch

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29
Q

s/s tylenol OD

A

n/v; jaundice; RUQ pain; bleeding; coma

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31
Q

Leukemia Dx

A

Bone marrow biopsy showing immature leukemic blast cells

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32
Q

s/s tracheomalacia

A

barky cough and intermittent stridor; may outgrow or need trach temporarily

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32
Q

post op for scoliosis surgery

A

ICU; ng tube, foley, blood transfusions (autologous if possible), log rolling

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33
Q

s/s narcotic OD

A

decreased LOC, pinpoint pupils

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35
Q

risk factors for leukemia

A

family history; Down’s syndrome; chemical exposure; maternal smoking

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36
Q

often first sign of Duchenne MD

A

difficulty climbing stairs, riding a bike

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37
Q

RFs for DDH

A

Family history; uterine position, especially breech presentation

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38
Q

position to avoid GER

A

feed upright; prone HOB elevated 30 deg after feeding; thicken feeding, avoid overfeeding

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39
Q

s/s Hirschprung’s disease

A

bilious vomiting, refusal to feed; no meconium 48h after birth, abd distention; Child: ribbon-like stool, visible peristalsis

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40
Q

group of genetic diseases with progressive weakness and degeneration of skeletal muscles.

A

Muscular Dystrophy

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42
Q

best way to prevent sickle cell crisis

A

adequate hydration

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44
Q

most common childhood cancer

A

leukemia; 60% ALL, 38% AML

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45
Q

s/s intussusception

A

sudden colicky abd pain, knees to chest; currant jelly-like stools; palpable sausage-shape in RUQ; vomiting, abd distention

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46
Q

s/s rotavirus

A

mild/mod fever and vomiting for 2 days, followed by frequent watery foul-smelling stools for 5-7 days

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47
Q

frostbite treatment (white waxy areas)

A

water bath 38-41 deg; pain meds, Td

48
Q

leukemia: Early s/s

A

low grade fever; recurrent infections; pallor; bruising; enlarged lymph nodes; joint pain

49
Q

RFs for cleft lip/palate

A

heredity; maternal intake of dilantin, alcohol, smoking; maternal infection; Vitamin B/folate deficiency

50
Q

cyanide antidote

A

amyl nitrate or IV sodium nitrate

51
Q

goal of fluid admin in emergent phase of burn

A

good urine output (30-50 mL/hr)

52
Q

an infant may have an imperforate anus or fistula if they haven’t passed stool in the first

A

24 hours of birth

53
Q

MD Dx

A

muscle biopsy

54
Q

purpose of traction in DDH treatment

A

stretch soft tissues to allow femoral head to return to socket

56
Q

inheritance pattern of sickle cell anemia

A

autosomal recessive (both parents must be carriers)

57
Q

this applied after closed reduction for DDH

A

spica cast for 3-6 mos, then a brace

58
Q

s/s infant GER

A

excessive non-bilious vomiting; wt loss, FTT; chronic cough;

60
Q

post op position for pyloromyotomy

A

head up and on side to aid stomach emptying

61
Q

sickle cell anemia usually dosn’t present until 4-6 months of age because

A

before that babies have fetal hemoglobin from mother

62
Q

after leukemia there is high risk for

A

secondary malignancy

62
Q

thickened pyloric sphincter; surgical emergency

A

Pyloric stenosis

64
Q

s/s DDH

A

“click” in hips; asymmetrical gluteal/thigh folds; shorter leg on affected side, turned outward

65
Q

hypothermia s/s

A
67
Q

pinworm treatment

A

Vermox or Pyrantel; treat family; stool precautions–wash linen in hot water, T/L hygeine

69
Q

abnormal, uncontrolled and destructive proliferation of one type of white blood cell and its precursors.

A

Leukemia

70
Q

hemophilia severity depends on

A

% of clotting factor missing

71
Q

inheritance pattern of hemophilia

A

X-linked recessive

73
Q

definitive diagnosis for sickle cell anemia

A

Hgb electrophoresis

74
Q

complications to watch for after TEF repair

A

Pleural effusion, pneumothorax; Feeding aversions (may need Gtube); Strictures (may need future eso dilations)

75
Q

Hirschprung’s Dx

A

rectal biopsy to see aganglionic cells

75
Q

burn extends into dermis, painful scalds, blisters can form; edema, pain, and moistness

A

second degree: superficial or deep partial thickness

76
Q

acute painful splenomegaly due to trapped sickled rbcs; decreased Hgb, can lead to shock; medical emergency

A

splenic sequestration

77
Q

cleft lip repair

A

cheiloplasty; performed at 6-12 weeks, use staggered sutures to prevent scar

78
Q

s/s acute chest syndrome

A

pulmonary infiltrates, dyspnea, tachypnea, congested cough

79
Q

palmar surface rule for burn estimation

A

the patient’s palmar surface is equal to 1% of their BSA

80
Q

RFs for esophageal atresia/ TEF

A

maternal: Vit A, riboflavin deficiency, polyhydramnios

81
Q

treatment for ethylene glycol poisoning

A

activated charcoal and gastric lavage

83
Q

MD complications

A

contractures; disuse atrophy; infections; obesity; CP problems

84
Q

Dx of infant GER

A

esophagus pH monitoring

85
Q

s/s pyloric stenosis

A

Projectile vomiting, especially 30-60 min after eating, non-bilious; constant hunger with FTT and dehydration; Olive-shaped mass in epigastric area

86
Q

pre op for intussusception monitor for this complication

A

peritonitis

87
Q

rotavirus transmission

A

fecal-oral

87
Q

edema in a burn can convert partial thickness burns into full thickness burns because of

A

decreased perfusion to the area–therefore, decrease edema and admin fluids quickly

89
Q

s/s smoke inhalation damage

A

singed nasal hairs and brows, sooty sputum, hoarseness, wheezing and increased secretions; can be delayed 24-48h

90
Q

third degree burn=full thickness burn

A

dry, non-edematous, and painless; no residual epidermal cells so no healing possible; tissue is called eschar; may be waxy white or black; elasticity is lost so escharotomy may be necessary to restore blood flow

91
Q

s/s Heat Stroke

A

HoTN, tachypnea, tachycardia, anxiety and confusion/AMS, weakness, thirst, leading to seizures and coma

92
Q

painful burn, pink to red skin; only epidermis affected, skin function intact; no systemic response

A

superficial (first degree)

93
Q

leukemia: Late s/s

A

Pain; hematuria; mouth ulcerations; enlarged kidneys and testicles; IICP

94
Q

eye disorder associated with DM

A

cataracts

95
Q

Rett disorder

A

mostly in females; initially normal development, then around 18 mos: deceleration of head growth, loss of speech and hand control, eventual dementia

96
Q
A
97
Q

very rare dev. disorder, regression in multiple areas on function after 2 years of normal development

A

Child Disintegrative Disorder

98
Q

social disorder with increased verbal and cognitive ability and social interaction compared with other forms of social disorder, especially concerning the child’s current obsessive preoccupation

A

Aperger’s disorder

99
Q

to diagnose autism, s/s must present by

A

3 years of age

100
Q

hallmark of autism

A

impaired social interaction–nonverbals, attention, and social reciprocity. Impairments in socialization, communication, and behavior

101
Q
A
102
Q

loss of lens elasticity with age

A

presbyopia

103
Q

light rays focus on two differrnt points on retina due to vurvature abnormality of cornea or lens

A

astigmatism

104
Q

blunt trauma causes bloor in anterior chamber of eye; red color on lower iris as blood pools

A

hyphema

105
Q

Tx for chemicals in eye

A

rinse with cool tap water 20 minutes

106
Q

with eye impalement, cover both eyes initially to

A

stop movement of the affected eye–eyes move together

107
Q

treatment for corneal abrasion or tearing

A

steriod eye drops`

108
Q

RFs for retinal tear/detachment

A

Age; Cataract surgery; DM

109
Q

s/s retinal tear/detachment

A

light flashes, floaters; ring in field of vision

110
Q

edema of optic disc

A

papilledema; can be caused by severe HTN

111
Q

normal IOP

A

10-21 mmHg

112
Q

Increased pressure in eye causes atrophy of optic disc and retinal cells, with loss of peripheral vision first, then central if untreated; also visual halos and blurred vision

A

glaucoma

113
Q

normally aqueous humor flows

A

from posterior chamber to anterior chamber and is absorbed by the veins of the trabecular network

114
Q

aqueous humor cannot drain well from anterior chamber through trabecular meshwork; insidious development

A

open angle glaucoma; chronic glaucoma

;IOP 22-32

115
Q

iris bows forward and completely blocks fluid access to trabecular meshwork, causing pressure buildup, leading to more bowing and pressure; emergency with severe eye pain and fast vision loss

A

closed angle glaucoma; acute glaucoma; IOP>50

116
Q

treatment for open angle glaucoma

A

laser trabeculoplasty–holes made in meshwork to accomodate fluid movement; meds: BBs, cholinergics, miotics to decreased IOP

117
Q

clouding of eye lens resulting in nighttime glare, reduced color perception, and image distortion

A

cataracts

118
Q

most common cause of vision loss >55 yrs

A

age related macular degeneration

119
Q

Tx for closed angle glaucoma

A

laser iridectomy

120
Q

eye drops to treat cataracts before surgery

A

mydriatics-cycloplegic agents to temporarily paralyze IO muscles

121
Q

light sensing cells are damaged in the macula–area in the retina specialized for high acuity vision

A

macular degeneration

122
Q

RFs for macular degeneration

A

aging; smoking; alcohol; UV exposure; heredity

123
Q

macular degeneration is diagnosed when this is observed with the opthalmoscope

A

drusen: yellow exudate of extracellular debris

124
Q

two forms of macular degeneration

A

Dry (atrophic)–drused accumulates between choroid and retina, can cause detachment; gradual vision loss;

Wet (exudative)–rapid progression, BVs grow between choroid and retina; distinctly darkened or blurred vision

125
Q

sensorineural hearing loss involves

A

cranial nerve 8–vestibulocochlear nerve

126
Q

vertigo and nystagmus caused by calcium carbonate accumulation

A

benign paroxysmal positional vertigo (BPPV)

127
Q

endolymph buildup in inner ear causes fullness, tinnitus, and vertigo that can last 30-60 minutes and be accompanied by nystagmus

A

Meniere’s disease

128
Q

Meniere’s disease

A

Head trauma, URI, chronic aspirin use, smoking and alcohol use

129
Q

meniere’s disease lifestyle treatment

A

los sodium diet to prevent fluid retention; diuretics, avoid caffeine and nicotine

Advanced Med Surg (6 decks)

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