Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Peds Primary care 2 > Urinary, Cardio, anemia, endocrine > Flashcards

Urinary, Cardio, anemia, endocrine Flashcards

1
Q

biggest worry in kids with UTI?

A

hydronephrosis and renal scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is Vesicoureteral Reflux?

A

abnormal flow of urin from bladder into the upper urinary tract, is a congential anomaly and depends on the valve in the ureter that is supposed to prevent reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what relationship does the position of the ureter tunnel have to do with the likelihood of reflux?

A

the shorter the tunnel, the more likely reflux is

as children grow the tunnell elongates, so can grow out of VUR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what classifies severe VUR?

A

massive dialation of ureter, renal pelvis, and calyces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Grade I VUR

A

reflux into ureter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Grade II VUR

A

reflux to the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Grade III VUR

A

Reflux to kidney with dilation of ureter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Grade IV VUR

A

reflux with dilation of ureter and mild blunting of renal calyces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Grade V VUR

A

reflux with dilation of ureter and blunting of renal calyces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

visible anomalies known to be associated with renal anomalies

A

myelomeningocele
prune belly syndrome
vater syndrome
eat deformities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how does VUR almost always present?

A

as a UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

most common clinical presentation of VUR in ages 0-2

A

fever w/out obvious source of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is a marker of risk in URI of renal damage?

A

fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

clinical presentation/ symptoms of VUR in newborns

A 
irritability
fever (often the only thing)
jaundice
anorexia
vomiting
diarrhea
symptoms:
respiratory distress
renal failure
flank masses
urinary ascites
UTI
Failure to thrive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

clinical presenation/symptoms of VUR in infants, toddlers, and preschoolers

A 
Fever
vomiting
diarrhea
abdominal pain
symptoms:
URI
nocturnal enuresis
failure to thrive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

symptoms of VUR in children and adolescents

A

cystitis
dysuria
frequency
urgency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

symptoms of pyelonephritis

A 
fever (high in infants)
flank pain
abd pain
CVA tenderness
vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

symptoms of cystitis

A

usually afebrile or low grade
few systemic signs
dysuria, urinary incontinence or retention, hematuria
may have cloudy urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how is leukocyte esterase on urinalysis useful?

A

it helps distingush asympomatic bacteriuria from those with true UTI, if it is negative it is asymptomatic bacteruria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the key to distinguishing true UTI? from asymptomatic bacteriuria?

A

the presence of pyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

if positive nitrites in urinalysis what does it rule IN?

A

UTI, has few false positives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

in the new UTI guideline the CFUs required to diagnose UTI is now what?

A

50,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

usual choices of ABX for UTI?

what should guide the decision?

A

augmentin, cephalosporin, bactrim

local sensitivity patterns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

infants with fever and UTI need to have what done?

A

renal and bladder US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

when should a RBUS be performed on an infant with UTI (less than age 2)?

A

W/ in 1st two days of treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

when is VCUG indictated?

A

if RBUS shows hydronephrosis, scarring, findings that suggest high grade VUR r obstructive uropathy
OR if recurrence of febrile URI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what can a VCUG NOT evaluate?

A

obstruction of flow of urine from the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what appearance will a ureterocele have on a urogram in VUR?

A

cobra-head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

a VCUG should not be performed when?

A

there is an active, untreated UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What does a DSMA scan detect?

A

pyelonephritis, renal scarring, and thinning of the renal cortex
can give an estimation of the percentage of renal function of each kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what does an IVP detect? when is it usually done?

A

detects scarring and evaluates renal function

if VCUG positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

when can you treat UTI with bactrim (at what age?)

A

2mos (some say 3mo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

if suspicious of pyelonephritis what antibxs should be used?

A

3rd gen cephalosporins like rocephin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what anitbx is considered 1st line therapy for febrile child with UTI with pending culture

A

rocephin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

which fluorquinolone is allowed in kids and at what age?

A

cipro: age 6 and older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

duration of antibiotic therapy for:

  • cystitis:
  • pyleonephritis:
A
  • 10 days

* 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

when should follow up cultures for UTI be obtained?

A

2nd: 72 hours
3rd: 4-7 days after abx completed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what if VUR is determined on VCUG?

A

may be on prophylactic ABX for 6mos to 2 years

will have yearly VCUG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what does cranberry juice do for a UTI?

A

decreases bacterial adherence to bladder wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

when to refer to physician for UTI?

A 
child <2 years
elevated BP
febrile UTI
flank pain or CVA tenderness
evidence of sexual abuse or trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

when to refer to peds urologist

A

VUR noted or suspected on RUS or VCUG
suspicion of foreign body in urinary tract
boy or prepubertal girl w/ recurrent UTI or child having fist documented UTI when imaging sudies are unobtainable
hematuria persisting after resolution of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

definition of prehypertension in kids

A

systolic or diastolic BP between 90th and 95th [ercentiles for age, gender and height

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

definition of perhypertension after the age of 12

A

BP b/t 120/80 and the 95th percentile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

how is hypertension staged?

A

extent to which BP exceeds the 95th percentile , determines treatment, management, and urgency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

stage 1 hypertension?

A

BPs that range from the 95th percentile to 5mm hg above the 99th percentile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

stage 2 hypetension?

A

BPs that are higher then 5mm hg above the 99th percentile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

which type of hypertension is more common in adolescents?

A

primary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

which type of HTN is more common in preadolescents?

A

secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

lab studies/ tests for pt with HTN?

A 
Ambulatory BP
UA/ culture
CBC
serum electrolytes, BUN, Cr, Ca
uric acid
fasting lipids
maybe CXR, EKG
ECHO
renal ultrasound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Labs are normal in what type of HTN?

what is the exception?

A

primary

uric acid, usually elevated in kids with essential htn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what is the most common cause of HTN in children??

A

Renal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

the younger the child and the higher the BP what diagnosis of what type of HTN is mostly likely

A

secondary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what are indications for antihypertensive drug therapy in children?

A 
symptomatic hypertension
secondary hypertension
hypertensive target organ damage
diabetes 
persistent HTN after non pharmacologic tx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what are goals of treatment for HTN in children:
for those with uncomplicated primary:
for those with chronic renal disease, diabetes, or hypertensive target organ damage

A
  • less than 95th percentile for age, gender, and height

* less than 90th percentile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

TChol levels
normal
boarderline
elevated

A

< or = 170
170-199
>or = 200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

LDL levels
normal
boarderline
elevated

A

< or = 110
110-129
> or = 130

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

TTriglycerides levels
normal
boarderline
elevated

A

< or = 100
100-140
> 140

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what is Archus corneae?

A

physical finding in hyperlipidemia: depositis of cholesterol creating a thin white circular ring on the outer edge of the iris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what is tendon xanthoma?

A

thickened tissue due to fat deposits surrounding the achilles and extensor tendor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what is xnthelasma?

A

yellowish deposits of cholesterol surrounding the eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

palmar xantoma?

A

pale lines on creases of palms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

eruptive xanthomas?

A

papular yellowish lesions with red base that occur on bttocks, elbows, and knees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

how old must child be for statin treatment in hyperlididemia?

A

at lease 10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

when would you treat with statins in children?

A

if LDL> 160 and family hx of premature CAD

when LDL? 190 w/out family hx of premature CAD or if there are other risk factors for CHD like HTN or obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what is kawasaki’s disease?

A

an idiopathic, multisystem diesease in young children: characterized by vasulitis of small and medium sized blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what is required for diagnosis of kawasakis disease?

A

fever for more than 5 days despite antibx + 4 classic symptoms
OR
persistent fever + 3 classic symptoms and coronary artery abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

classic symptoms/ criteria for Kawasakis disease/

A
  • nonexudative conjunctival infection
    *polymorphous nonvesicular rash
    *mucosal involvement of upper respiratory tract
    *edema or erythema of hands and feet
    cervical adenopathy of at least 1.5cm in diameter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what classifies as mucosal involvement in the criteria for Kawasakis

A

erythemia, fissures of the lips, crusting of the lips and mouth, or strawberry tongue. rarely exudative pharyngitis and discrete oral lesions are rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

atypical Kawasakis:
presentation?
who is it more common in?

A

may have less than 4, but still may develop aneurysms
more common in children less than 1 year: will see: irritability, diarrhea, abd pain, vomiting w/ coronary artery disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

complications of KD?

A

aneurysms, these may thrombose and cause MI and death

pancarditis often present in 1st 10 days, pericardial effusions may accompany

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

when are aneurysms usually noted in KD?

A

12-28 days after onset, rare after 28 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

how can pancarditis in KD present?

A

as CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

kawasakis physcial exam findings

A 
red mouth and throat
strawberry tongue
red, swollen, racked lips
bulbar conjunctivitis w/ out exudate
at lease one cervical node 1.5cm or lardger
generalized polymorphous red rash
induration of hands and feet
periungual and groin desquamation may occur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

CBC findings in kawasakis

A

WBC usually elevated w a shift to the left

thrombocytosis usually in 2nd week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

tx of kawasakis

A

IVIG: one dose over 10 hours
high dose ASA 80-100mg of aspirain in 4 doses: continued until day 14 or when child has been afebrile for 48 hours, then is decreased and is d/c when platelet cont is normal (about 6- 8 weeks)
steroids (methylprednisolone may be useful can be given inconjunction with IVIG or those who dose respond to IVIG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

children typically show improvement how long after IVIG

A

2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

most common cause of anemia in children?

age groups and why?

A

iron deficiency
6-24month: loss of maternal iron stores, increased growth needs
adolescents: menstration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

what can temprarily decres HgB and WBC and increase platelets? so what should you do?

A

viral infections: postpone anemia testing for 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

absolute neutrophil counts of ______ significantly increases a childs risk of developing a life threatening infection

A

> 500

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

s/s of anemia

A

pallor, fatigue, heart failure, jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

s/s of polycythemia

A

irritability, cyanosis, seizures, jaundice, stroke, HA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

s/s of neutropenia

A

fever, pharyngitis, oral ulceration, cellulitis, lymphadenopathy, bacteremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

s/s of thrombocytopenia

A

petechiae, ecchymosis, GI bleeding, epistaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

s/s of coagulopathy

A

bruising, hemarthrosis, mucosal bleeding

85
Q

s/s of thrombosis

A

PE, DVT

86
Q

what is the only function of RBC’s?

A

to carry Hgb

87
Q

what are the two types of anemia?

A

anemia of Acute blood loss

grandual anemia w/ no loss of blood volume

88
Q

s/s of grandual anemia?

A

HA, dimmed vision, loss of appetitie, nausea, constipation, heart failure, pallor, tachycardia, murmurs, dyspnea, fatigability, dizziness and fainting , tinnitus

89
Q

“cytic” refers to RBC ______?

A

size

90
Q

“chromic” refers to RBC ______?

A

Hgb content

91
Q

what does hypochromic, microcytic anemai mean?

A

low hgn in the cell and the size is small

92
Q

what is normocytic anemia associated with?

A

systemic illness that impairs bone marrow sythesis of RBCs

93
Q

what is associated with macrocytic anemias?

A

Viramin B12 and folic acid dificiencies

94
Q

what causes hypochromic microcytic anemia?

A

inadequate production of Hgb

95
Q

which RBC indices is used to determine if cells are normocytic, microcytic, or macrocytic?

A

Mean corpuscular Volume

96
Q

what diseases cause decreased values of RBCs

A

Anemia, neoplastic disease, hemorrhage, lupus, addisons, theumatic fever, subactue endocarditis, chronic infection

97
Q

what diseases cause increased values of RBCs

A

erythrocytosis, renal disease, extra renal tumors, living in high altitudes, pulmonary disease, CVD, alveolar hypoventilation, tobacco use, and dehydration

98
Q

what does MCV tell you?

A

voume occupied by a single RBC

99
Q

what MCV values consider the RBCs normocytic?

A

82-98

although, higher in infants & newborns and elderly

100
Q

MCV values mean RBCs are microcytic?

A

< 82, more RBCs in a given volume

101
Q

MCV values mean RBCs are macrocytic?

A

> 100: less RBCs in a given volume

102
Q

decreased levels of Hgb found in what?

A 
anemias
hemorrhage
hemolytic anemias
hypothyroidism
liver disease
103
Q

increased levels of Hgb found in what?

A 
polycythemia
CHF
COPD
excessive fluid intake
extreme physical exercise
104
Q

what is the panic value for hemoglobin

A

5.0: heart failure and death

105
Q

what can hgb > 20 cause?

A

clogging of capillaries

106
Q

what does hematocrit measure?

A

the percentage by voume of packed RBCs in whole blood (packed cell volume PCV)

107
Q

what can cause decreased hematocrit?

A 
anemia
neopastic disease
hemolytic diseases
adrenal insufficiency
chronic disease
108
Q

what can cause increased hematocrit?

A

erythrocytosis
polycythemia vera
shock
living in high altitudes

109
Q

what can a HCT < 20 cause?

A

cardiac failure and death

110
Q

what can a HCT of > 60 cause?

A

spontaneous clotting

111
Q

what is mean corpuscular Hgb concentration?

A

average concentration of hgb in the RBC

112
Q

what is mean corpuscular hemoglobin?

A

a measure of the average weight of Hgb/ RBC

113
Q

what can Mean corpuscular hgb help measure?

A

response to therapy for anemia

114
Q

what can mean corpuscular hemoglobin help diagnose?

A

the severly anemic
increased in macrocytic anemia and newborns
decrased in microcytic anemia

115
Q

what does RDW meaasure?

A

the degree of abnormal variation in RBC size

116
Q

what is a reticulocyte count?

A

% of immature RBCs

117
Q

what can reticulocyte count help distinguish?

A

anemias cause by bone marrow failure from those caused by hemorrhage or hemolysis

118
Q

what is reticulocytosis?

what can it help recongnize?

A

increased RBC production as the bone marrow replaces cells lost of prematurely destroyed cells
otherwise occult disease like hidden chronic hemorrhage or unrecongnized hemolysis (sickle cell, thalassemia)

119
Q

what does a reduce reticulocyte count mean?

A

bone marrow is not producing enough RBCs

120
Q

what classification anemia involves low MCV and MCHC?

what anemias fall into this category?

A

microcytic, hypochromic: ie: cells are small cells are pale
IDA
thalassemia

121
Q

what classification of anemia involves high MCV and normal MCHC?
what anemias fall into this category?

A

Macrocytic, normochromic
cells are large, normal amount of Hgb: normal color
anemias of folate and vit B12 deficency
Refractory anemia

122
Q

what classification of anemia involves normal MCV and MCHC?

what anemias fall into this category?

A

normocytic, normochromic anemia
normal size and color/ volume of Hgb
a broad spectrum of anemias

123
Q

what classification is IDA?

A

hypochromic, microcytic

124
Q

what is most common type of anemia?

A

IDA

125
Q

what are the high risk groups of IDA in pediatric populations?

A

infants fed a high volume of cows milk

teenage girls menstruating

126
Q

no infant should consume more than how many oz of formula a day?

A

32oz

127
Q

when are premies’ maternal iron stores usually depleted Vs a normal, full term infant?

A

2mos vs 4-6 mos

128
Q

what is the most common age group for anemia to maifest?

A

9-24 months

129
Q

what is important to remember about iron deficiency and lead?

A

in iron deficiency, lead absoption occurs more easily

130
Q

what is the first value to fall in iron deficiency?

A

Ferritin

131
Q

What is Ferritin and what does it reflect?

A

a protein that bind iron for storage, it reflects the amount of iron stores

132
Q

what ferritin level indicates iron deficiency?

A

<10

133
Q

what is TfR1? what does it detect?

If it is elevated what does that mean?

A

serum transferrin receptor 1: detects iron deficiency at cellular level (is what trasfers iron into the cell)
there is a decrease in iron stores, there is an upregluation to better compete for iron

134
Q

what is CHr?

what does it do?

A

reticulocyte Hgb concentration
a measure of iron available to cells recently released from the bone marrow
has been shown to be strongest predictor of ID in kids

135
Q

when diagnosing IDA what labs need to be ordered? (if Hgb <11?
what about diagnosis of iron deficiency w/ out anemia?

A

same for both:
Ferritin + CRP
OR
CHr

136
Q

what is an alternative approach to diagnosing IDA if stable patient, mild anemia, cause seems dietary, compliance with therapy is likely and follow up is assured?

A

supplement with iron and monitor response

137
Q

what increase in HgB after 1 month of therapy with supplementation of iron signifies the presence of ID?

A

1g/dL

138
Q

treatment of IDA?

A

decrease milk intake to 16oz/day
3-6mg/kg/day in 2-3 doses of iron supplementation
transfusion only when Hgb <7
treat underlying cause

139
Q

SEs of iron supplementation

A 
temporary staining of teeth
contstipation or occausionally diarrhea
toxic in overdose
will cause greenish/ black stool discoloration
GI upset if taken on empy belly
140
Q

f/up in IDA?

A

CBC in 1 month

resolution in 3-6 months

141
Q

good food sources of iron
better sources
best sources

A

\tuna, oatmeal, apricots, spinach, kale, greens
better: beef, fish, poultry, raisins, eggyoks, legumes, apricots, spinach, kale, greens.
BEST: breast milk, formula with iron, infant cereals or other iron fortified cereals, liver, prune juice

142
Q

if MCV is low, what should you get to determine if its IDA?

A

ferritin

143
Q

IDA is associated with a _______ reticulocyte count

A

decreased

144
Q

if MCV is high what levels should you get next?

A

B12 and folate

145
Q

iron supplementation dose at 4 months if exclusively or partially breastfed infants?

A

1mg/kg

146
Q

recommended iron intake for 6-12mo of age?

A

11mg/day

147
Q

recommended iron intake for 1-3 years?

A

7mg/day

148
Q

supplementation for preterm infants with iron dose and duration
what is the exception?

A

2mg/kg/day until 12 months

infants who received multiple transfusions of packed RBCS

149
Q

what vitamins does poly vi sol contain?

A

A,B,C,D,E, iron and flouride

150
Q

what vitamins does tri Vi sol contain?

A

A,D,C, Iron, Flouride

151
Q

what are the most common vitamin deficiencies that result in anemia?

A

B12 and B9

152
Q

why is vit deficiency anemia also called megalobalstic?

A

with deficiency erythroblasts become big, So MCV is high, macrocytic

153
Q

lab values in megaloblastic anemia

A

hgb low
RBC disproportionately low
MCV is high (RBCs are large)
MCHC is normal

154
Q

what test with differentiate folate def vs B12?

A

serum B12, normal in folate, decreased in b12 deficiency

155
Q

good sources of folate

A 
liver
mushrooms
oatmeal
peanut butter
red beans
soy
156
Q

response to folate replacement should be evaluated when? what should you see?

A

reticulocytosis in 1 week
Hbg & HCt values increase in 1 week
HCT should be normal in 2 months

157
Q

importance of folate?

A

RBCs cant reproduce without folate

158
Q

what is pernicious anemia?

A

disoreder w/ failure to absorb B12, lack of intrinsic factor

159
Q

how can you distinguish anemia of chronic disease from iron deficiency anemia?

A

ferritin level: is normal or elevated in anemia of chronic disease

160
Q

what is type one diabetes also called?

A

autoimmune Type I DM

161
Q

pathology of type I diabtetes

A

in genetically susceptible people: an environmental trigger causes an autoimmune-mediated destruction of B pancreatic cells leading to absolute insulin deficiency

162
Q

what chromosome makes a person genetically susceptible to diabetes?

A

Chromosome 6

163
Q

characteristics of DKA

A

hyperglycemia, ketosis, acidosis, osmotic diuresis, dehydration, shock and death

164
Q

s/s of hypoglycemia

A 
trembling
diaphoresis
tachycardia
lethargy
mental staus change
seizures
coma
165
Q

what are the 3 P’s of diabetes, why do they happen?

A

polyuria: from high osmolality
polydypsia: from water loss resulting from polyuria
polyphagia is because low sugar from excessive secretion: makes them feel hungry

166
Q

s/s of type one diabetes

A

3 P’s, nocturia, weight loss or failure to gain, fatigue, possible blurred vision

167
Q

diagnosis of type I diabetes

A

FBS> or = 126
random blood sugar > or = 200
2 hour post prandial blood glucose > or = 200
also: glucosuria and ketonuria
anti insulin antibodies positive in > 90 %
HgB A1C > 6.5% (7 in kids)`

168
Q

diagnosis of prediabetes:

A

FBS> 100

2 hour GTT> 140

169
Q

D/D of polyuria in diabetes

A

URI, DI, renal glucouria, hypercalcemia

170
Q

D/D of DKA

A

sepsis, pneumonia, acute abdomen, ASA poisoning

171
Q

D/D of polydipsia

A

can be psychogenic

DI

172
Q

D/D of hyperglycemia

A

steroid use, stress or trauma

173
Q

D/D of hypercalcemia

A

weight loss, fatigue, lethargy

174
Q

what should you do in children presenting with vague symptoms especially during flu season?

A

urine dip

175
Q

goals of therapy in diabetes?

A

FBS 80-120
PP< 180
Hgb A1C < 7.0 %

176
Q

calorie requirments/ limitations in type I diabetes

A

infants and preschoolers: 1000 calories + 100 calories for each year of age
school age: 65cal/kg of ideal body weight

177
Q

sources of simple sugars diabetics should carry around

A 
need 15grams of fast acting CHO:
4 oz of OJ
5 life savers
3 glucose tabs
8 oz mnilk
4-6 oz of soda
2 tbsp raisins
178
Q

what is given for hypoglycemia in those unable to swallow or respond

A

glucagon

179
Q

glargine (lantis) is now approved down to what age?

A

6 years

180
Q

novolog is now approved down to what age?

A

2 years

181
Q

what is the dawn phenomenon?

A

fasting hyperglycemia due to release of growth hormone, cortisol, and adrenaline that occurs between 2 and 3 am

182
Q

when should you refer/ consult in diabetes?

A

any new case w/ signs of ketosis should be hospitalized
any new cases to endocrinologist
all newly diagnosed in diabetes education program
refer to opthalmologist for baseline exam

183
Q

yearly tests/ exams for diabetes?

A 
eye exams
urine samples
cholesterol profile
thyroid studies
comprehensive chemistries
184
Q

cause of type 2 diabetes

A

decreased insulin production
insulin resistance
hepatic glucose production
reduced glucose uptake by target tissue

185
Q

what is insulin resistance?

A

when muscle, fat, and liver cells resist the insulin molecule on the cell membrane and outside the cell, the insulin does not initiate the usually chain of enzymatic reactions causing glucose levels to rise
in other words:
glucose must enter the cell to be utilized, needs insulin to enter the cell, w/out cellular response to insulin glucose cannot enter the cells to be utilized, so it stays in the blood

186
Q

why is the onset of puberty an important factor in type II diabetes?

A

the release of pubertal hormones increases resistance to insulin and initiates hyperglycemia

187
Q

clinical presentation of type II diabetes

A 
BMI > or = 85th %tile
acanthosis nigricans
glycosuria
may have vagues sx like:
lethargy
fatigue
blurry vision
frequent urination
yeast infections
188
Q

what does acanthosis nigricans mean?

A

insulin resistance

189
Q

all children with BMI > or = 85th percentile should have what?

A

FBS

190
Q

when should you screen for type II diabetes?

A

obese or overweight
family hx of diabetes
high risk ethnic group
polycystic ovary syndrome

191
Q

what is critical in the treatment/management of type II diabetes?

A

regular aerobic activity

weight loss/ stabilization

192
Q

what age is metformin (glucophage) approved for?

A

> or = to 10 years

193
Q

what do sulfonylureas do in type II diabetes?

A

increase endogenous insulin production and release

194
Q

what do biguanides do in type II diabetes?

A

reduce hepatic glucose production

195
Q

what do thiazolidinediones do in type II diabetes

A

improve peripheral insulin insensitivity

196
Q

What do alpha glucosidase inhibitors do?

A

competitively inhibit intestinal glucose absorption

197
Q

what is most common side effect with metformin?

A

GI upset, gets better after one month of treatment

198
Q

what are the benefits of oral antidiabetic agents?

A

can reduce long term complications

added: weight loss

199
Q

what is Maturity onset diabetes in youth: MODY?

A

family of autosomal dominant syndromes caused by mutation of genes involved in the regluation of pancreatic dvmt or insulin secretion
onset before age of 25
has:
impaired insulin secretion but not total absence
variable degrees of insulin

200
Q

presentation of MODY?

A

begins with mild to moderate hyperglycemia w/out ketoacidosis, may progressively worsen, may eventually need insulin

201
Q

what is metabolic syndrome?

A

a consellation of metablolic characteristics that place one at higher risk for CV events: new guideline: having at least 3 of the 5 metabolic abnormalities

202
Q

what are the 5 metabolic abnormalities that one must have 3 of to be diagnosed with metabolic syndrome/

A 
central obesity (apple shape)
high BP
high triglycerides
low HDL cholesterol
insulin resistance
203
Q

what are thought to be the two most important metabolic disturbances in metabolic syndrome?

A

abdominal obesity and insulin resistance

204
Q

defining crieteria of abdominal obesity in metabolic syndrome by waist circumference:
Men:
Women:

A

Men: >40 in
Women: > 35in

205
Q

defining criteria for triglycerides in metabolic syndrome?

A

> 150

206
Q

defining criteria for HDL in metabolic syndrome?
Men:
Women?

A

Men: < 40

Women< 50

207
Q

defining criteria for BP in metabolic syndrome?

A

> or = 130/ > or = 85

208
Q

defining criteria for FBS in metabolic syndrome?

A

> or = 110

209
Q

what is the test for insulin resistance?

A

2 hour post prandial glucose tolerance test

Peds Primary care 2 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions