Flashcards in Exam 3 Deck (65)
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1
HR red flags
• Infant HR < 80 or > 220
• Child HR <60 or >180
2
BP red flags
• 0-1 month old systolic BP < 60
• 1 month-1yr old systolic BP < 70
• Older child systolic BP < 70 + (2x age in yrs)
3
shock state
not enough circulation to get blood where it needs to go
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hypovolemia shock
shock causes by injury and dehydration. loss of blood volume.
Therapy - fluid replacement
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cardiogenic shock
shock caused by pump (heart) not working. treat underlying cause. fluids don't help
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distributive shock
shock caused by blood volume not going where it is supposed to. caused by peripheral vasodilation so blood pools. happens in anaphylaxis, septic shock and neurogenic shock. treat the cause
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obstructive shock
shock caused by obstructed blood flow to and from heart. causes may be cardiac tamponade, tension pneumothorax, compression of vena cava
8
atrial septal defect
opening between atria. oxygenated from LA goes to RA. too much blood goes back to lungs. child is oxygenated but too much blood going to R side of heart. acyanotic heart disease.
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ventricaular septal defect
opening between ventricle. oxygenated blood from LV goes to RV. acyanotic
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patent ductus arteriosis
blood from LV to aorta is being shunted back to pulmonary arteries and goes back to lungs. acyanotic.
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pulmonic stenosis
pulmonary valve is stenosed. RV hypertrophy from trying to push blood through valve
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tetralogy of fallot
4 defects. pulmonary stenosis, RV hypertrophy, ventricular septal defect and overiding aorta
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overiding aorta
aorta is hooked to RV and LV. picks up blood from both sides of the heart (mixed blood)
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transportation of the great arteries
pulmonary artery hooked to LV and aorta is hooked to RV. 2 parallel circulations. incompatible with life unless mitigated by PDA. causes cyanosis, dyspnea, loud murmur, fatigue, hypoxia, finger clubbing, developmental delays, hypercyanotic spells
15
aortic stenosis
aortic valve is stenosed
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coarctation of the aorta
there is a big diff b/t BP in arms and legs. top half of body is getting better blood than bottom half of body. low cardiac output, poor peripheral pulses and cap refill. decreased urinary output. CHF and pulmonary edema r/t blood shunting L to R.
17
rheumatic heart disease
caused by autoimmune response to untreated strep. fever, joint pain, subcutaneous nodules, chorea. treated with antibiotics, aspirin, corticosteroids
18
Kawasaki disease
fever, conjunctivitis, buccal, erythema, dermatitis, cervical lymphadenopathy, joint pain
19
hypopituitarism
small and short in statue
causes: idiopathic, CNS infection, trauma, tumor
Meds: growth hormone injection
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hyperpituitarism
big, tall, joint problems. rare
causes: pituitary adenoma
Tx: surgery, radiation, sex hormones, meds (bromocriptine, glucosteroids)
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primary amenrrohea
never had period/menses by age 14.5 and no secondary sex characteristics
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secondary amenorrhea
started period and then stopped (absence of 3+ periods). most common cause is pregnancy
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dysmenorrhea
painful menstrual cycles, affects 60-93% of girls
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congenital hypothyroidism
gene mutation that causes thyroid gland to not work. thick tongue, lips, hypotonic, can't regulate temp well. treat with synthroid for rest of life.
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causes of anemia
blood loss, malabsorption, diet, period of increased growth, lead ingestion, prematurity
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anemia S/S
pallor, fatigue, irritabiity.
long term - HF, developmental delays, tachycardia
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sickle cell disease
autosomal recessive. more common i blacks and Mediterranean descent. C shaped blood cells caused by abnormal hemoglobin S. causes vaso-occlusion, ischemic tissue injury, chronic hemolytic anemia and impacts nearly every body system
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sickle cell crisis
caused by triggering event that causes cells to sickle. pain, fever, tissue engorgement (joints, hands and feet)
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splenic sequestration
can happen in sickle cell crisis. high mortality, blood pools in spleen and CV collapse
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aplastic crisis
can happen in sickle cell crisis. destruction of RBCs, anemia, pallor, fatigue
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thalassemias
inherited blood disorders. most often Mediterranean, Asian and African populations. disorder of hemoglobin synthesis.
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beta thalassemia / Cooley's anemia
structurally impaired RBCs (fragile, hemolyze easily and do not live long), chronic hypoxia. anemia symptoms, skeletal, cardiac and liver/gallbladder changes. splenomegaly, endocrine and skin issues.
33
ALL/AML S/S
fever, pallor, ecchymosis, petechiae, bleeding, bone/joint pain, lethargy, anorexia, lymphadenopathy, fatigue
34
medulloblastoma
brain tumor in external layer of cerebellum, peak incidence around 5 years. N/V, headache, ataxia, papilledema, highly sensitive to chemo and irradiation, 80% survival
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astrocytoma
35-45% of childhood brain tumors. above or below are between cerebellum and cerebrum. Seizures, visual disturbances, increased ICP, vomitting. prognosis depends on location and grading of tumor
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ependymomas
brain tumor that presents with hydrocephalus and increased ICP, seizures, motor and sensory complaints, only slightly more than half will be long-term survivors
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neuroblastoma
most common brain tumor outside cranium. commonly diagnosed b/t 17-22 months. s/s depends on location of tumor. treatment is chemo, radiation, surgery.
38
Hodgkin disease
disease of lymphatic system, adolescents and young adults. excellent prognosis. S/S are nontender firm lymphadenopathy, fever, night sweats, weight loss.
39
non-Hodgkin lymphoma
four types. metastasizes faster than Hodgkin's. good prognosis. S/S- fever, weight loss, lypmhadenopathy
40
retinoblastoma
cancer of retina. intraocular malignancy of retina. 40% hereditary. S/S - white pupil. often picked up on photograph
41
rhabdomyosarcoma
most common soft tissue tumor in children under 5. can involve muscles, tendons, vascular tissue or connective tissue.
42
osteogenic sarcoma
most bone cancer in kids, peak age in adolescence. found in long bones. pain, swelling, limp
43
ewing sarcoma
avg age of diagnosis is 14 yrs. cancer in femur, pelvis, tibia, fibula, ribs, humerus, scapula and clavicle. pain, swelling and fever.
44
Wilms tumor / nephroblastoma
rapidly growing, friable abdominal tumor found in children 2-3 yrs old. S/S - asymptomatic at first.increased abdominal girth, palpable abdominal mass. high BP, hematuria, abdominal pain. DO NOT PALPATE MASS (may dislodge it)
45
partial seizures
one part or one hemisphere of brain. can be simple or complex
46
simple seizure
type of partial seizure, person can respond. no loss of awareness
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complex seizure
type of partial seizure, person cannot respond. awareness is impaired
48
absence seizures
all over body. involved both sides of brain. blankness in face like daydreaming
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myoclonic seizures
repetitive jerks of motor muscles
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tonic seizures
stiffen and fall like a tree
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generalized seizures
absence, myoclonic and tonic sizures
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tonic clonic seizures
jerking and relaxing seizure
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atonic seizures
get pale and flops
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status epilepticus
seizure more than 5 minutes or two back to back
55
bacterial meningitis
virulent, often secondary to other infections, acutely ill child, diagnose with lumbar puncture and labs
56
viral meningitis
commonly preceded by enterovirus, B cells and protein in CSF (not bacteria), less acute than bacterial meningitis, resolves in 3-10 days, treat headache and other symptoms
57
encephaitis
inflammation/infection of the brain, caused by virus/bacteria/parasite/fungus, treat cause in ICU, sequelae develops
58
Reye syndrome
severe N/V, enlarged fatty liver, combative behavior, coma. treat in ICU. aspirin increases risk
59
gynecomastia
unilateral or bilateral breast development in male. caused by imbalance of estrogen vs testosterone. Usually takes care of itself and self limiting over 1-2 years
60
Addison disease
adrenal gland does not produce enough cortisone and aldosterone. caused by autoimmune, infection, metabolic disease. S/S - lethargy, weakness, fatigue, anorexia, emotional lability, cannot deal with stress/injury/illness and can go into crisis at any time
61
diabetes insipidus
disorder of posterior pituitary gland. inability of kidneys to concentrate urine (not holding onto water). not enough ADH or it is ineffective. S/S- polyuria and polydipsia (excessive thirst)
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SIADH
excessive amount of ADH. excessive water reabsorption. causes hyponatremia, weight gain
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DKA
build up of ketones causing metabolic acidosis. nausea, vomiting, dehydration, high blood glucose
64
hemophilia
missing factor 8. range of severity, spontaenous bleeding, hemarthrosis, deep tissue hemorrhage.
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