Chapter Two Flashcards
(182 cards)
1
Q
ADD PICTURE
A
Ligamentum venosum
2
Q
Mumps is a childhood disease that is best prevented by:
A
The MMR vaccine
3
Q
Nosocomial
A
originating in a hospital
4
Q
Phenylketonuria is an inborn error in the metabolism of amino acids that causes _ _ and _ _
A
brain damage, mental retardation
5
Q
If a baby is born with anencephaly, what is the prognosis?
A
Death
6
Q
Patent
A
open
7
Q
Antipyretic
A
drug or treatment that reduces or relieves fever
8
Q
ADD PICTURE
A
Aortic arch
9
Q
Asthma
A child has been examined for a severe episode of recurring asthma. The physician has prescribed a prophylactic inhalant to be used before exposure. In addition, the child has a prescription for a bronchodilator medication that he in inconsistent in taking. How do you handle this patient/parent-teaching opportunity?
A
Encourage parents to help the child remember to use prophylactic medications and to avoid known triggering allergens. In addition, reinforce the necessity of taking prescribed bronchodilating medications as prescribed. Advise caregivers about the importance of seeking medical help when an attack does not resolve quickly with normal intervention.
10
Q
Discuss the implications of children born with fetal alcohol syndrome on family, the healthcare system, and the educational system
A
These children usually are short and below average in weight and may have facial characteristics that include smaller eye openings with eyes spaced widely apart and a thin upper lip. They may experience growth deficiencies and central nervous system problems. In addition, heart defects including atrial septal defect and ventricular septal defect may be present. FAS also is associated with mental retardation. The infant may exhibit signs of alcohol withdrawal shortly after birth. These children often experience learning difficulties. Poor development of social skills may be present. As a result, these children may require special education classes.
As infants, the babies may have a poor sucking reflex requiring special adaptation devices and training necessary to ensure proper intake. Good nutrition is an important factor in development. The neurological damage cannot be reversed, so many adaptations for life may be necessary.
11
Q
ADD PICTURE
A
Inferior vena cava
12
Q
An infant with _ _ has episodes of projectile vomiting after feedings. The onset of symptoms usually begins within 2 to 3 weeks after birth
A
pyloric stenosis
13
Q
A common period for tetanus is _ to _ days, with onset commonly occurring at about _ days
A
3, 21, 8
14
Q
Anorexia
A
loss of appetite for food
15
Q
Hydrocephalus
A
increased cerebrospinal fluid around the brain
16
Q
Prenatal
A
before birth or from conception to birth
17
Q
What is the recommended schedule for Haemophilus influenzae type B immunizations?
A
12-18 months
18
Q
Arthritis
A
inflammation of a joint
19
Q
The most progressive form of muscular dystrophy is:
A
Duchenne’s
20
Q
Discuss the necessity of older individuals being current on pertussis immunizations
A
Many individuals, as they age, lose their immune status to pertussis allowing them to contract the disease. They may have contact with infants or young children who have not had the full immunization schedule allowing the child to be infected and develop the disease.
21
Q
Trace fetal circulation from umbilical vein through system to umbilical artery
A
The umbilical vein transports oxygen-rich blood and nutrients to the fetus. The umbilical vein enters the fetal body by passing through the umbilical ring and then goes on to the liver. Fifty percent of this blood passes into the liver, and the other 50% bypasses the liver by way of the ductus venosus. The ductus venosus soon joins the inferior vena cava, allowing the oxygenated placental blood to mix with the deoxygenated blood coming from the lower fetal body. This blood then travels to the right atrium through the vena cava.
Since fetal lungs are not functioning, this blood mostly bypasses the lungs. Most of the blood entering the right atrium by the inferior vena cava is shunted directly into the left atrium through the foramen ovale. The small valve on the left side of the atrial septum, the septum primum, keeps blood from going back into the right atrium. The remaining fetal blood that has entered the right atrium contains a large amount of oxygen-poor blood from the superior vena cava and travels to the right ventricle and into the pulmonary trunk. The pulmonary blood vessels have a high resistance to blood flow because of the collapsed state of the lungs and only allow a small amount of blood to enter the pulmonary circulation. This small amount is enough to nourish the pulmonary tissue.
The blood that has been shunted away from the pulmonary circulation bypasses the lungs through the fetal vessel, the ductus arteriosus. This vessel connects the pulmonary trunk to the descending area of the aortic arch. The ductus arteriosus allows the blood with low oxygen concentration to bypass the lungs and also prevents it from entering the arteries leading to the brain.
The blood that has a high oxygen concentration and has been shunted to the left atrium by way of the foramen ovale mixes with the small amount of blood returning from the pulmonary circulation by way of the pulmonary veins. This blood flows into the left ventricle and then into the aorta. From the aorta, some travels to the coronary and the carotid arteries. A portion travels on through the descending aorta to other parts of the fetal tissue. The remaining blood travels into the umbilical arteries and back to the placenta for exchange of gases, nutrients, and waste.
22
Q
Apnea
A
ceased breathing
23
Q
Explain the four abnormalities present in the heart of an infant who has tetralogy of Fallot
A
Ventricular septal defect, pulmonary stenosis, dextroposition of the aorta, right ventricular hypertrophy
24
Q
Dysphagia
A
difficulty in speaking, usually caused by a lesion in the central nervous system
25
Hypertension, hematuria, and pain are symptoms of:
Wilm's tumor
26
Compare cyanotic and acyanotic congenital cardiac defects
The acyanotic defects are serious, with many going undetected in infancy. Some are not detected until later in life as the individual grows. PDA may be closed by medication administration shortly after birth. Surgery may be required to correct the condition. Common symptoms include shortness of breath, fatigue, increased heart rate, and failure to thrive. Some may never require treatment intervention, but most will. The cyanotic defects are more serious, usually requiring surgical intervention. The cyanosis is indicative that atrial blood is not fully oxygenated. Tetralogy of Fallot and transposition of the great vessels are the two most frequently encountered cyanotic defects. Surgical intervention is usually required for the infant or child to survive.
27
Hemolysis
destruction of red blood cells with the release of hemoglobin
28
Treatment of hydrocephalus includes?
Starting surgical intervention to insert a shunt
29
ADD PICTURE
Umbilical arteries
30
ADD PICTURE
Transposition of the great arteries
31
ADD PICTURE
Ligamentum arteriosum
32
List examples of helminths that can live in the gastrointestinal tract
Roundworms, pinworms, hookworms, tapeworms
33
Electromyography
electrodiagnostic assessment of the activity of skeletal muscles
34
Name an example of an abnormality that may be detected by examination of amniotic fluid
Elevated alpha-fetoprotein (AFP) level
35
Ataxic
uncoordinated gait associated with pathology of the central nervous system
36
The mother of a 3-year-old boy calls to report that her child had the onset of vomiting and abdominal pain during the night and is now experiencing blood in his urine. She says that she just noticed a swelling on his left side towards his back. She requests an appointment. What is your response regarding to appointment?
Wilms Tumor
A child experiencing hematuria, pain, vomiting, and having a noticeable mass in the kidney region requires prompt assessment. Schedule for the next available appointment on day of call. If this is not possible, the mother and child are referred to another physician with a pediatric practice or to an urgent care center.
37
Tonsillitis
A child has just been diagnosed with tonsillitis. The physician has prescribed a round of antibiotics for the child. He has also made note to the parents to ensure that the child has adequate hydration. How do you handle this parent-teaching opportunity?
Instruct the patient and family concerning the importance of hydration during illness. It may be helpful to provide the parents with a list of beverages, including juices, Gatorade, and flavored water to encourage the child to drink. Suggest that they keep a written record of the amount of fluid the child drinks in the next 24-hour period. In addition, emphasize the importance of completing the entire recommended regimen of antibiotic therapy. Advise the parents that sharing drinking glasses and eating utensils should be discouraged. Old toothbrushes should be replaced.
38
Compare the symptoms of the three major types of cerebral palsy: spastic cerebral palsy, athetoid cerebral palsy, and ataxic cerebral palsy
Spastic cerebral palsy is the most common of the three categories, affecting 70% of patients with the diagnosis of cerebral palsy. The symptoms are hyperactive reflexes or rapid muscle contractions. Walking on toes and crossing one foot over the other when walking (scissor gait) is usually observed in older children.
The patient with athetoid cerebral palsy has symptoms of involuntary muscle movement and decreased muscle tone. The movements are usually more pronounced during times of stress. The child has difficulty speaking.
The patient with ataxic cerebral palsy has a lack of control over voluntary muscle movements, poor balance, and a wide gait.
39
Congenital _ defects are developmental abnormalities of the heart or _ of the heart
cardiac, great vessels
40
Just as the office is closing for the day, a mother calls about her child who just started experiencing signs and symptoms of respiratory distress including hoarseness, fever, a harsh, high-pitched cough, and a funny, high-pitched sound during inspiration. The physician has already left the office for the day. How do toy handle this call?
Possible Croup and Epiglottitis
Children experiencing respiratory difficulties require prompt if not immediate assessment and intervention. Refer to a 24-hour urgent care center or emergency department.
41
Cyanosis
bluish appearance of the skin and mucous membrane that usually indicates reduced hemoglobin levels in the blood
42
The condition where the foreskin of the penis does not have adequate opening to allow it to be pulled back over the end of the penis is called:
Phimosis
43
ADD PICTURE
Umbilical ligaments
44
The number one cause of death in children between the ages of 1 month and 1 year is:
SIDS
45
What occurs when there is a failure in the separation process of identical twins before the 13th day after fertilization?
Conjoined twins
46
What is the weight range for premature infants?
12 oz. or less at time of birth
47
The diagnosis of congenital abnormalities in a fetus can be accomplished by amniocentesis between the _ and _ week of pregnancy
15th, 18th
48
What are two forms of Robinow syndrome?
Dominant or recessive
49
One way to prevent epidemics of contagious disease:
Immunizations
50
Tachypnea
rapid and shallow respirations
51
Name the most common congenital cardiac disorder
Ventricular septal defect
52
ADD PICTURE
Ligamentum teres
53
Anastomosis
surgical or pathologic connection between two vessels or tubular structures
54
Contact a Shriner and ask about services provided to children with orthopedic or craniofacial abnormalities. Discuss how families may be made aware of the services
Using the Internet as a resource, explore Shriners Hospitals websites to ascertain locations and services provided by Shriners Hospitals. When possible locate a Shrine lodge and some members. Make an inquiry of these members about the services and costs. General information is that the hospitals care for children with orthopedic problems and craniofacial disorders and have specialized hospitals for treatment of burns.
55
Tachycardia
rapid heartbeat; more than 100 beats per minute
56
Hypoxia
decreased oxygen levels in the tissues
57
Anencephaly
gestation with failure of the cephalic aspect of the neural tube to close
58
ADD PICTURE
Ductus arteriosus
59
ADD PICTURE
Inferior vena cava
60
Erythroblastosis fetalis is a condition caused by:
Rh incompatability
61
Cystic fibrosis is considered a fatal disease. Discuss some of the feelings of parents and also of the individual when he/she is old enough to understand the implications of the disease
When a child is diagnosed with cystic fibrosis, he or she is essentially given a death sentence since at the present time there is no cure. The disease usually progresses with survival ages increasing with new treatment options. The individual will always require medication and specialized diet. The disease primarily attacks the lungs and the digestive system, producing copious thick and sticky mucus that accumulates and blocks glandular ducts. The clinical effects of CF can be immense, including a dry paroxysmal cough, exercise intolerance, pneumonia, bulky diarrhea, vomiting, and bowel obstruction. Pancreatic changes occur, with fat and fiber replacing normal tissue. Involvement of sweat glands causes increased concentrations of salt in sweat. Normal growth and ability to thrive are reduced. Sinus infections and diarrhea often accompany the other symptoms. Infertility is common.
The disease is not a friendly disease, resulting in the individual having some type of symptom most of the time.
62
At what age should a child receive the second MMR?
Before age 4 but at least 3 months after first shot
63
List the major clinical manifestations of cystic fibrosis
Manifestations of cystic fibrosis include that it is a multisystem disorder causing impaired function of exocrine glands. An important factor is the abnormally thick mucus secretions. Organs affected include the lungs, the intestines, the pancreas, and the liver. The lungs experience bronchial obstruction with stasis of secretions. In the intestines there is malabsorption of fat and protein. In the pancreas, there is obstruction of ducts. In the liver there is obstruction of bile ducts.
64
What treatment options are available to a baby born with patent ductus arteriosus (PDA)?
Closure by either drug therapy or surgical intervention
65
Explain the goal of treatment for cerebral palsy
The goal of treatment is to minimize the handicap by providing every opportunity for therapeutic measures to be used, which assists the child with techniques to help him or her reach full potential.
66
Cite possible causes of nongenetic congenital abnormalities that may be present in a child
Infection in the mother, drugs taken by mother, age of mother, radiographic examination made in early pregnancy, injury to pregnant mother or fetus
67
Klinefelter's syndrome and Turner's syndrome are both chromosomal disorders. Which on affects males, and which one affects females?
Klinefelter’s affects males; Turner’s affects females.
68
Stenosis
narrowing of an opening
69
The mother of a 3-year-old girl calls the office concerned that her daughter is experiencing abdominal pain. On checking her child she has noticed what she thinks is an abdominal mass. She says the skin around the girl's eyes is dark and looks like racoon eyes. How would you handle this call?
Neuroblastoma
A child whose parents report that the child has an abdominal mass or unexplained fever and weight loss should be evaluated promptly.
70
The failure of the testicle(s) to descend into the scrotum is called:
Cryptorchidism
71
Discuss possible conversations with parents about the necessity of having their children immunized according to the CDC recommended guidelines
School systems most often require compliance with the CDC schedule for protection of all students and educational workers. Parents can object for religious reasons. Essentially, smallpox has been eradicated from the world due to an aggressive immunization program. The risk of polio has been greatly reduced since polio vaccines have been included in the guidelines. The same is true of other contagious diseases covered by the suggested guidelines. Many children and adults are alive today thanks to the guidelines and the immunizations.
72
The mother of a 15-day-old infant son reports that he starting having episodes of vomiting, with the emesis "shooting out of his mouth" after feeding. She also reports that the infant appears hungry, continues to feed, and has not gained any weight. How do you respond to this phone call?
Possible Pyloric Stenosis
An infant with sudden onset of projectile vomiting requires prompt assessment. Schedule for the next available appointment on day of call. If this is not possible, the mother and child are referred to another physician with a pediatric practice or to an urgent care center.
73
The drug of choice to treat pertussis (whooping cough) is _
erythromycin
74
Necrosis
death of tissue
75
List cyanotic congenital cardiac defects
- Tetralogy of Fallot
- Transposition of the great vessels
- Coarctation of the aorta
76
What is considered to be the most common crippling condition of children?
Cerebral palsy
77
Amniocentesis
removal of amniotic fluid from the amniotic sac for testing
78
Medications that contain _ may mask the symptoms of Reye's syndrome and are generally avoided in the treatment of chickenpox
aspirin
79
List symptoms and signs of Downs syndrome
Typically, the infant has a small head with a flat back skull; a characteristic slant to the eyes; a flat nasal bridge; small, low-set ears; a small mouth with a protruding tongue; and small weak muscles. The hands are short, with stubby fingers and a deep horizontal crease across the palm (simian line). There is an exaggerated space between the big and little toes.
80
ADD PICTURE
Umbilicus
81
What are some of the characteristics that a child with Downs syndrome will exhibit?
Small head with flat-back skull, slant to eyes, flat nasal bridge, low-set ears, protruding tongue, small weak muscles, short and stubby hands, deep horizontal crease across the palm, exaggerated space between the big and little toes
82
ADD PICTURE
Abdominal aorta
83
Childhood obesity may be caused by:
The child eating too much food and not exercising enough
- fast-food restaurant type of food
- snacks, such as cookies, crackers, candy, and sodas high in calories
84
The mother of a 6-month-old infant calls the office requesting an appointment for her child. She advises that she thinks the child's head appears swollen and that there are areas that appear to be bulging. What is your response regarding the appointment?
Possible Hydrocephalus
Infants who have a possible increase in head size and bulging fontanels require prompt assessment. Schedule for the next available appointment, ideally within the next 24 hours. If immediate assessment is not possible, the mother and child are referred to another physician with a pediatric practice or to an urgent care center. If the mother suspects neurologic changes, immediate assessment is essential.
85
Acute tonsillitis (strep positive) is generally treated with _ to prevent rheumatic fever or rheumatic heart disease
Penicillin
86
The prognosis for cleft lip and cleft palate is _ with surgical repair
good
87
An atrial septal defect that is large would cause pronounced symptoms of _, _, and _
cyanosis, dyspnea, syncope
88
Bursitis
inflammation of a bursa
89
Identify the most serious form of spina bifida
Myelomeningocele
90
What is the method of transmission for lead poisoning?
Ingestion or breathing lead dust or particles
91
If a child is born with tetralogy of Fallot, how many actual heart defects are present?
Four
92
Lethargy
state of sluggishness or stupor
93
Transdermal
delivered through the skin
94
Discuss possible causes and prevention of SIDS
Sudden infant death syndrome (SIDS), formerly called crib death, is defined officially as the sudden death of an infant under the age of 1 year for which a cause cannot be established. It is the number one cause of death among infants from 1 to 12 months of age; 1 in 2000 infants dies mysteriously during the first year of life. Death occurs within seconds during sleep without sound or struggle, and the baby does not suffer. Most SIDS infants appeared healthy before death. When found, the dead infant may have a mottled complexion and cyanotic lips and fingertips.
Known causes and contributing factors for the sudden death of an infant are ruled out. These may include an immature respiratory control system, a susceptibility to deadly arrhythmias, congenital heart disease, and myocarditis.
The exact cause is uncertain. Research studies and autopsies point to certain pathologic findings in some SIDS infants that suggest more than one cause. Many maternal and infant risk factors are known: mother’s age less than 20 years, poor prenatal care, smoking and drug abuse during pregnancy, exposure of the infant to secondhand smoke, prematurity, recent upper respiratory tract infection in the infant, sleeping in the prone position, and a sibling with apnea. The incidence is higher in males and during the winter months likely. Parents are urged to put infants to sleep on their backs.
95
Foramen ovale
opening in the septum between the right and left atria of the fetal heart
96
Women of childbearing age are advised to increase their intake of _ to help prevent neural tube defects in their unborn child
Folic acid
97
ADD PICTURE
Umbilical vein
98
ADD PICTURE
Ventricular septal defect
99
ADD PICTURE
Fossa ovalis
100
Treatment for hydrocephalus usually includes placing a _ in the ventricular or subarachnoid spaces to drain off the excess cerebrospinal fluid (CSF)
shunt
101
ADD PICTURE
Pulmonary trunk
102
Is the condition of conjoined twins more prevalent in females or males?
Females
103
Reye's syndrome has been associated with the use of:
Aspirin
104
Define phimosis
Stenosis (narrowing) of the opening of the foreskin in the male
105
Pruritus
itching
106
List the symptoms associated with adenoid hyperplasia
Mouth breathing, snoring during sleep, nasal voice; recurrent otitis media and conductive hearing loss may also be factors.
107
Syncope
fainting, light-headedness
108
Closure of patent ductus arteriosus may be attempted by drug therapy using:
An antiprostaglandin
109
Posterior
toward the back
110
ADD PICTURE
Aortic arch
111
ADD PICTURE
Tetralogy of Fallot
112
Chickenpox
A child has just been diagnosed with chickenpox. How do you handle this parent-teaching opportunity?
Reinforce the necessity of good hand washing, along with the use of tissues during coughing or sneezing episodes and the proper handling and disposal of soiled tissues. Encourage parents to minimize contact these children may have with others during the contagious period (at least 6 days after the eruptions appear). This teaching concept can be applied to parents of children with any contagious childhood disease.
113
Spina Bifida
Parents have brought a previously diagnosed child to the office for a routine visit. They missed the last regularly scheduled appointment. During the intact assessment they told you that the child had no problems, so they did not come. How do you handle this parent-teaching opportunity?
In a nonjudgmental manner, it is important that the value of regular observation during the growth and development period should be stressed to both the child and the parent. In addition, the awareness of any neurologic symptoms and reporting of symptoms should also be stressed. The physician may have printed materials concerning neurologic symptoms to watch for. If so, present and discuss these with the parent.
114
ADD PICTURE
Coarctation of the aorta
115
Palpable
touchable
116
When should an infant receives the first in the series of hepatitis B immunizations?
1-2 months
117
Hypovolemia
decreased blood volume
118
Name the most common kidney tumor of childhood
Wilms tumor or nephroblastoma
119
Rheumatic fever, kidney complications, and rheumatic heart disease may be complications of untreated:
Spina bifida
120
Normal flora
normal bacteria and fungi adapted for living in, and characteristic of, the area considered (e.g., skin, intestine, vagina)
121
ADD PICTURE
Abdominal aorta
122
Cite the statistics for the occurrence of cleft palate
1 in 10,000 births
123
List the three major types of cerebral palsy
Spastic cerebral palsy, athetoid cerebral palsy, ataxic cerebral palsy
124
Tracheostomy
operation to open the trachea
125
Meconium
first stool of a newborn, greenish black and of a tarry consistency
126
ADD PICTURE
Foramen ovale
127
Postpartum
after childbirth
128
What is another name for infant respiratory distress syndrome?
Hyaline membrane disease
129
When a person is diagnosed with leukemia, there will be an:
Increase in white blood cells
130
Bicornuate
referring to a uterus that has two horns or horn-shaped branches
131
List symptoms and signs of hypertrophic cardiomyopathy
The first sign is often the collapse of a seemingly healthy young athlete during a strenuous sporting event or other period of stressful exercise. This collapse can be followed by cardiac arrest caused by a cardiac arrhythmia. Many have no symptoms until the collapse. Symptoms may include chest pain, syncope, hypertension, palpitations, or shortness of breath. Some report experiencing fatigue, shortness of breath when lying down, or reduced tolerance of activity.
132
A father calls the office inquiring about what he should do. His 6-year-old son has just come home from school and he noticed smell, reddened areas with tiny blisters on the boy's face, neck, arms, and now ches. He is asking about school attendance for the next day. How would you respond to this father?
Possible Chicken Pox
Contagious diseases present a challenge in the patient-screening process. Many physicians prefer not to have the contagious patient in the regular reception area. Many pediatricians have a “sick child” waiting room and a regular waiting room. At offices that have no “sick child” waiting area, the child is immediately placed in an examination room and the physician is notified. Some physicians prefer to have a telephone staff person obtain symptoms, body temperature information, and other pertinent information over the telephone, along with a telephone number where the parent can be reached. The physician reviews the information and calls the parent back to discuss the situation.
133
Which type of congenital disorders can be diagnosed by amniocentesis?
Potential genetic or neural tube defects
134
Explain the treatment measures that may be used if clubfoot is present
Cast application, the use of splints, or a combination of both; surgery if the casting and splinting are unsuccessful
135
Myopia
nearsightedness
136
Roundworms, pinworms, and tapeworms can be treated with which medication?
Mebendazole (Vermox)
137
List a few precautions women can take to help decrease the risk of abnormal fetal development
The pregnant woman is encouraged to refrain from smoking, consuming alcohol, or taking any form of medication or drugs without her physician’s knowledge. She should also avoid any situation that may expose the developing fetus to toxic substances.
138
Phototherapy
treatment of disease by exposure to light
139
Pyloric Stenosis
An infant has been seen on his or her first postoperative visit. How do you handle this parent-teaching opportunity?
Parents will need instruction in care of the incision. Usually the physician will have printed instructions regarding care of an incision. Review these instructions with the parents. If printed instructions are not available, instruct the parents to keep the incision clean and dry until it is completely healed. They should also be instructed to report to the physician any redness around or seepage from the incision. Reinforce the importance of postoperative visits.
140
Intracranial pressure is present when cerebrospinal fluid accumulates in the skull when the patient has:
Hydrocephalus
141
Adduction
movement toward the middle of body
142
Dyspnea
labored or difficult breathing
143
Childhood asthma can be treated with al of the following except:
-Albuterol (Proventil), Budesonide (Pulmicort), Tetracycline (Sumycin), Corticosteriods
Tetracycline (Sumycin)
144
Distinguish between croup and epiglottitis
Croup is an acute, severe inflammation and obstruction of the respiratory tract, whereas epiglottitis is an inflammation of the epiglottis, the thin, leaf-shaped structure that covers the entrance of the larynx during swallowing. The child experiencing croup may have had an upper respiratory tract infection. The symptoms include hoarseness, fever, a harsh, high-pitched cough, and stridor during inspiration caused by narrowing of the upper airways. The child may experience dyspnea (fast and difficult respirations) that may be accompanied by a grunting noise or wheezing. When the child is not receiving enough oxygen, the skin becomes pale with circumoral cyanosis (slight blue tinge around the mouth). It is possible for the bronchi and lungs to become involved with the infection. The child may be anxious and frightened by the respiratory distress. Epiglottitis typically strikes children between ages 3 and 7 years. The symptoms include a sore throat, croupy cough, fever, and respiratory distress caused by laryngeal obstruction. Visual inspection reveals a red and swollen epiglottis. Rapidly increasing dyspnea and drooling are the most significant signs of this critical respiratory emergency. Children experiencing any form of respiratory distress require immediate assessment and intervention. Instruct the parents not to place anything in the child’s mouth until the child is assessed by a health care professional, as airway spasm may result.
Croup is usually a viral disease that involves the larynx, trachea, and bronchi. The clinical manifestations are caused by edema and spasm of the vocal cords, creating varying degrees of obstruction.
Croup must be distinguished from epiglottitis. If necessary, blood or throat cultures may be performed to identify certain bacterial causes. Laryngoscopy may be performed. Radiographs of the airway may show a characteristic “steeple sign” or be necessary to rule out an obstruction by a foreign body. The patient with croup is treated symptomatically, with the administration of antipyretic agents, rest, increased fluid intake, cool humidification of air, and, if the cause is bacterial, antibiotic therapy. The hot steam from a shower may be beneficial. A dose of steroids may decrease airway edema. In severe cases, the patient is hospitalized for endotracheal intubation and oxygen therapy until the respiratory crisis passes. In most instances, the illness subsides in 3 to 4 days.
Epiglottitis may follow an upper respiratory tract infection. The most common cause is Haemophilus influenzae type B (Hib) bacteria. Other organisms that may be responsible for epiglottitis include Streptococcus pneumoniae, varicella-zoster, Haemophilus parainfluenzae, Staphylococcus aureus, and herpes simplex virus type 1. Another form of epiglottitis, thermal epiglottitis, may be caused by heat damage to the epiglottis from ingestion of very hot liquids or food.
Radiographic films of the neck may reveal the enlarged epiglottis. If the obstruction is not significant, the throat is examined to inspect the epiglottis. Nothing is placed in the child’s mouth until a health care professional with the capability, equipment, and supplies needed to perform endotracheal intubation and tracheostomy is present.
If the airway is obstructed, the child is hospitalized and given intensive care. The airway is established with tracheostomy or endotracheal intubation. Antibiotics, usually ampicillin, are given parenterally, and the patient is closely monitored.
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Patent ductus arteriosus
146
ADD PICTURE
Hepatic portal vein
147
Identify the organism responsible for causing chickenpox
Varicella-zoster
148
Diphtheria can be prevented by the administration of _ _ to produce active immunity
diphtheria toxoid
149
ADD PICTURE
Pulmonary arteries
150
The exact cause of spina bifida is unknown. However, _ and _ factors may play a role
genetic, environmental, vitamin A, folic acid
151
Hypertrophic
describing enlargement of an organ or structure
152
At what age should a child receive the first varicella immunization?
12-15 months
153
List three causes of prematurity
An incompetent cervix; bicornuate uterus; toxic conditions; maternal infection; trauma; premature rupture of the amniotic membranes; history of previous miscarriages; multiple gestation; intrauterine fetal growth retardation; and other physical conditions of the mother, such as pregnancy-induced or chronic hypertension. Diabetes, heart disease, kidney disease, poor nutrition, substance abuse, and lack of prenatal care also contribute to the incidence of the mother giving birth to a preterm infant.
154
The causative agent of mumps is an _ virus, which is spread by _ nuclei from the respiratory tract
airborne, droplet
155
What color is the skin of a baby born with tetralogy of Fallot?
Blue
156
An infant with cri du chat syndrome exhibits an abnormally _ head; and, if born alive, the infant will have a weak _ cry
small, catlike
157
At what age should a child receive influenza vaccine?
6 months and then annually
158
List causes of anemia
Iron deficiency, acute or chronic blood loss, decreased blood formation, nutritional deficiency disorders, hemolytic diseases, inhibition or loss of bone marrow, and sickle-cell disease
159
A common disease in infancy, bronchiolitis is usually caused by a _
virus
160
Muscular dystrophy is diagnosed by _, _, _
muscle biopsy, electromyography (EMG), elevated serum creatinine kinase (CK)
161
The test for cystic fibrosis that measures the levels of sodium and chloride is called what?
Sweat test
162
The umbilical cord contains _ and _
two arteries, one vessel
163
Describe patent ductus arteriosus (PDA)
The patent ductus arteriosus (PDA) is a congenital birth defect in which the ductus arteriosus fails to close after birth.
164
A mother calls to report that her three children have been complaining of being fatigued, having headaches, and having stomach, muscle, and joint pain for the past 2 weeks. She also states there has been a significant change in their behavior. How do you handle this?
Possible Lead Poisoning
Children exhibiting fatigue, headache, irritability, stomachache, muscle and joint pain, and changes in behavior require prompt assessment. Schedule for the next available appointment on day of call. If this is not possible, the mother and children are referred to another physician with a pediatric practice or to an urgent care center.
165
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Pulmonary veins
166
Congenital
describing a birth defect present at birth
167
The most common childhood malignancy is:
Leukemia
168
An infant with bronchopulmonary dysplasia (BPD) is very susceptible to respiratory infections, such as _ and _
Respiratory syncytial virus (RSV), pneumonia
169
Surgical intervention for myelomeningocele is recommended when?
Within the first 24 hours of life
170
What is the cause of cerebral palsy?
Cerebral palsy usually stems from inadequate blood or oxygen supply to the brain during fetal development, during the birth process, or in early childhood until about 9 years of age.
171
The leading cause of absenteeism in schoolchildren is:
Asthma
172
Photophobia
unusual sensitivity to light
173
Sensitivity to cow's milk may cause:
Infantile colic
174
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Umbilical cord
175
Acyanotic
absence of blue appearance of skin or mucous membrane
176
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Atrial septal defect
177
Dystrophy
progressive degenerative disorder causing weakening of tissue
178
Loss of appetite, vomiting, irritability, and ataxic gait are symptoms associated with:
Lead posioning
179
An electrocardiogram is suggested for athletes to identify those who may have:
Hypertrophic cardiomegaly
180
Explain how retinopathy of prematurity (retrolental fibroplasia) is diagnosed
Routine examination by an ophthalmologist
181
Postnatal
after birth
182
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Ductus venosus
