Exam II Flashcards
(283 cards)
Brittle bone disease is formally called what?
Osteogenesis imperfecta
Is Osteogenesis imperfecta autosomal dominant or recessive?
dominant
What disease involves mutation in alpha 1 and 2 chain of type 1 collagen?
Osteogenesis imperfecta
What type, I-IX of Osteogenesis imperfecta is most common?
Type I
What type, I-IX of Osteogenesis imperfecta is more severe?
Type II (prenatal lethal)
What types, I-IX, of Osteogenesis imperfecta are characterized by moderate-severe sx w/. characteristic of everything in between?
Type III-IX
Pt presents w/ blue sclerae, opalescent teeth, progressive hearing loss and excessive/atypical fractures. What disease are you concerned about?
Osteogenesis imperfecta
Other sx: short stature, bow legs, scoliosis (breathing difficulty), basilar skull deformity (spinal cord concerns)
Imaging for Osteogenesis imperfecta will show what?
- FX at various stages of healing (may be misdiagnosed as child abuse, so FHx is key!)
- Wormain bones (extra bones w/in suture bones)
- Codfish vertebrae (compression fx: bi-concave)
- Osteopenia
What is the leading cause of childhood death in the US?
Injuries
Large heads in comparison to body size, weak neck muscles, think skulls, physically uncoordinated, and lack of cognitive ability contributes to what peds injury?
Head injuries
Weak neck muscles place peds at risk for what specific type of head injury, and leading to what?
Acceleration-deceleration injuries
Lead to shearing forces, injury to neurons and vascular structures
What ages contribute to the bimodal distribution of head injuries?
> 8 yrs and < 1 yr
What are concerning signs/ hx for head injuries?
Excessively sleepy/ hard to arouse
Vomiting
Irritability
The primary survey on PE for head injuries includes what?
ABC’s (airway, breathing, circulation)
Neuro status (GCS)
Vital signs
What is Cushing’s triad with respect to head injuries?
Wide pulse pressure
Bradycardia
Abn respirations
What score on Glaslow Coma Scale (GCS) is indicative of good recovery? Poor prognosis?
8+ = good recovery 3-5 = poor prognosis
Checking for c-spine alignment, fundoscopic exam, hematomas, step-offs, crepitus, lacerations, fontanels, basilar skull fracture + eval of the rest of the body is included in what?
Secondary survey on PE for head injuries
Battle’s sign, periorbital ecchymosis, hemotympanum, and otorrhea/ rhinorrhea are indicative of what?
Basilar skull fracture
Decision rules for necessity of a CT for head injuries include what?
PECARN
CATCH
CHALICE
What diagnostic studies are used for head injuries?
X-ray and CT
What criteria typically indicate the necessity of a CT for head injuries? (9)
- GCS < 15, AMS
- Signs of skull fracture
- Vomiting > 3x
- Seizure
- < 2 yo
- Non frontal scalp hematoma
- LOC > 5 sec
- Severe mechanism
- “Not acting right”, lethargic
What is the prognosis for a pt with a subdural hematoma?
Poor
Parent presents w their child who has a hx of a head injury and has been experiencing LOC, with lingering sxs such as irritability, lethargy, bulging fontanelle and vomiting. What should you be concerned about?
Subdural hematoma
CT of a pt with a subdural hematoma will show what?
Crescent-shaped