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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

4

hypovolemia shock

shock causes by injury and dehydration. loss of blood volume.
Therapy - fluid replacement

5

cardiogenic shock

shock caused by pump (heart) not working. treat underlying cause. fluids don't help

6

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

7

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.

9

ventricaular septal defect

opening between ventricle. oxygenated blood from LV goes to RV. acyanotic

10

patent ductus arteriosis

blood from LV to aorta is being shunted back to pulmonary arteries and goes back to lungs. acyanotic.

11

pulmonic stenosis

pulmonary valve is stenosed. RV hypertrophy from trying to push blood through valve

12

tetralogy of fallot

4 defects. pulmonary stenosis, RV hypertrophy, ventricular septal defect and overiding aorta

13

overiding aorta

aorta is hooked to RV and LV. picks up blood from both sides of the heart (mixed blood)

14

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

16

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

20

hyperpituitarism

big, tall, joint problems. rare
causes: pituitary adenoma
Tx: surgery, radiation, sex hormones, meds (bromocriptine, glucosteroids)

21

primary amenrrohea

never had period/menses by age 14.5 and no secondary sex characteristics

22

secondary amenorrhea

started period and then stopped (absence of 3+ periods). most common cause is pregnancy

23

dysmenorrhea

painful menstrual cycles, affects 60-93% of girls

24

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.

25

causes of anemia

blood loss, malabsorption, diet, period of increased growth, lead ingestion, prematurity

26

anemia S/S

pallor, fatigue, irritabiity.
long term - HF, developmental delays, tachycardia

27

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

28

sickle cell crisis

caused by triggering event that causes cells to sickle. pain, fever, tissue engorgement (joints, hands and feet)

29

splenic sequestration

can happen in sickle cell crisis. high mortality, blood pools in spleen and CV collapse

30

aplastic crisis

can happen in sickle cell crisis. destruction of RBCs, anemia, pallor, fatigue

31

thalassemias

inherited blood disorders. most often Mediterranean, Asian and African populations. disorder of hemoglobin synthesis.

32

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

35

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

36

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

37

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

47

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

49

myoclonic seizures

repetitive jerks of motor muscles

50

tonic seizures

stiffen and fall like a tree

51

generalized seizures

absence, myoclonic and tonic sizures

52

tonic clonic seizures

jerking and relaxing seizure

53

atonic seizures

get pale and flops

54

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)

62

SIADH

excessive amount of ADH. excessive water reabsorption. causes hyponatremia, weight gain

63

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.

65

S/S of PDA, atrial septal defect or ventricular septal defect

increased HR, RR and BMR, difficulty feeding, diaphoresis, failure to thrive, CHF. if left untreated and severe: pulmonary artery HTN and RV hypertrophy