Falcon Review Pediatrics 2 Flashcards Preview

Med School Rotations > Falcon Review Pediatrics 2 > Flashcards

Flashcards in Falcon Review Pediatrics 2 Deck (128):
1

Activated charcoals is ineffective against what type of poisonings

Hydrocarbons
cyanide
metals
Li
acids and bases

2

What are the stages of acetaminophen toxicity

Stage 1: 1st 24 hours
- Nausea, vomiting, diaphoresis

Stage 2: 24-48 hours
- clinical improvement

Stage 3: 72-96 hours
- peak liver functional abnormalities

Stage 4: 4 days - 2 weeks
- hepatitis resolves

3

How do you diagnose acetaminophen tox

measure plasma level 4 hours after ingestion.

Use Rumack-matthew Nomogram to plot level and predict hepatoxicity

4

What is the treatment for acetaminophen tox

Consider activated charcoal with in 1 hour of ingestion

Antidote: N-acetylcysteine (mucomyst)

5

What are the signs and symptoms of amphetamine toxicity

Diarrhea, palpitations, arrhythmia, syncope, hyper pyrexia, hyperreflexia, may progress to convulsions

6

What are the signs and symptoms of anti-histamine toxicity

It ranges from drowsiness to restlessness and seizures
anticholinergic effects such as hot as here; blind as a bat; reticent beat; dries the bone; mad as a Hatter.

7

What is the treatment for antihistamine overdose

Consider activated charcoal within the first hour

8

What is the most common cause of drug poisoning

Aspirin overdose

9

Where the signs and symptoms of aspirin overdose

mild: vomiting, fever, lethargy, mental confusion, hyperpnea

Severe: convulsions, coma, respiratory / cardiovascular collapse

chronic: hyperventilation, dehydration, bleeding disorders, seizures, coma

10

What are the three phases of aspirin toxicity

Phase 1 for 12 hours.
Respiratory alkalosis, sodium and potassium excretion urine.

Phase II within 12 to 24 hours.
Paradoxical acid urea.

Phase III
Metabolic acidosis with dehydration and hypokalemia.

11

How is salicylate toxicity level determined

Clinical course is predicted by measuring salicylate levels at six hours after ingestion

12

What is the treatment for salicylate toxicity

Alkalinization of urine to increase excretion

13

What is the affinity of carbon monoxide

250 times that of oxygen

14

Greater than what percentage of carbon monoxide is lethal

70%

15

How effective is using a pulse ox symmetry to determine carbon monoxide poisoning

Poor

Pulse oximetry just measures saturation of hemoglobin whether it is oxygen or carbon monoxide

16

What are the complications of carbon monoxide poisoning

Behavior change.
Memory loss.
Blindness may occur in 10 to 30% of cases

17

What are the signs and symptoms of caustics ingestion

burns of mucous membranes and drooling often refusing to swallow

18

What are the steps to diagnose caustic ingestion

First ensure airway patency then endoscopy to evaluate the extent of damage

19

Should you treat the caustic ingestion with

No

The burns on the way down then it will burn on the way back up

20

What are the signs and symptoms of cocaine use

Perforated nasal septum.
Euphoria,
CNS stimulation.
Myocardial infarction

21

How long may the symptoms be delayed for hydrocarbon ingestion

Up to six hours

22

What are the signs and symptoms of iron toxicity

Stage one: 30 minutes to six hours.
-After ingestion nausea vomiting diarrhea abdominal pain hemorrhagic gastroenteritis.

Stage II: six to 12 hours.
The honeymoon phase shows improvement.

Stage III.
24 to 48 hours progressive circulatory collapse, hepatorenal failure, bleeding, metabolic acidosis, Coma

Stage IV
1-2 months with G.I. scoring in obstruction

23

What level of serum iron is considered severe

Greater than 500 mcg/dL

24

What is the anecdote for iron toxicity

Deferoxamine

25

What will a peripheral blood smear show for lead toxicity

anemia with basophilic stippling

26

What is the treatment for lead toxicity

Mild: decrease environmental exposure

Moderate: oral succimer

Severe: intravenous calcium EDTA

27

What are the signs and symptoms of opiates

Respiratory depression, constricted pupils, bradycardia, hypertension, hypothermia, hyperreflexia, coma

28

What are the signs and symptoms of organophosphate ingestion

Multi system affect

Muscarinic
Salvation, lacrimation, urination defecation

Nicotinic
Cramps, fasciculations, twitching, weakness, areflexia, paralysis of voluntary muscles

CNS
Anxiety, ataxia, dizziness, headache, convulsions, coma

29

What is the treatment for organophosphate ingestion

Atropine
Pralidoxime

30

The signs and symptoms of tricyclic antidepressant overdose

Drowsiness, delirium, was nation, seizure coma, hypertension, arrhythmias including QRS widening and QTc prolongation

31

What are the treatment options for tricyclic antidepressant overdose

Consider activated charcoal within the first hour

Sodium bicarbonates decreased cardiac toxicity by decreasing free fraction of drug

32

The most common causes of non-organic failure to thrive

P. A. I. D.

Poverty
Abuse
Ignorance
Depression

33

What IQ was determined mental retardation

IQ of 70 or less

34

Defined learning disorder

Academic functioning below what would be appropriate for age, IQ and education

Discrepancy between achievement test and cognitive test

35

What is the difference between conduct disorder and oppositional defiant disorder

A conduct disorder is more associated with actions; show aggressive behavior towards others, animals, and property

Oppositional defiant disorder is more associated with the attitude they lose control they have negativity, hostility, defiance

36

What is required to diagnose Tourette's syndrome

Disorder of multiple severe tics both vocal and motor

Must be before the age of 18 for one year nearly daily without a tic free period Greater than three months

Highly associated with ADHD

37

What are the signs and symptoms of depression

SIG E CAPS

S leep
I nterest (loss):
G uilt (worthless):
E nergy (lack):
C ognition/C oncentration:
A ppetite (wt. loss);
P sychomotor: agitation (anxiety) or retardations (lethargic)
S uicide/death preocp.

38

What are the signs and symptoms of schizophrenia

Positive symptoms which are treatable include delusions, hallucinations, disorganized speech and behavior

Negative symptoms which are difficult to treat include flat affect, apathy, anhedonia

39

What is anorexia nervosa

Condition of weight loss resulting from disturbed body image and fear of obesity

40

What are the signs and symptoms of anorexia nervosa

Weight loss, amenorrhea, bradycardia, hypotension, hypothermia, lanugo hair growth, cardiac fluid and electrolyte disturbances

41

What is bulimia

Eating disorder characterized by binge eating, induced vomiting, laxative abuse

42

What are the signs and symptoms of ADHD

Inattention, hyperactivity, impulsivity, symptoms must be present by age 7 and last for six months and occur in more than one setting and impair function

43

What is autism

Impaired social, communication language, and behavior

Develops before 30 months

44

What is aspergbers syndrome

Type of autism with more communication and appear more socially aware

45

What is Rett syndrome

Neurodegenerative disorder affecting females. X-linked dominant

46

What are the signs and symptoms of Rett syndrome

Loss of milestones.

Acquired microcephaly onset of one year of age

47

What is Munchhausen by proxy

Patient fabricates or induces an illness in the child. They may be in the healthcare profession or regarded as a model parent

48

What is strabismus

Misalignment of the eyes "lazy eye"

49

Transient strabismus is common up to what age

Four months

50

How is strabismus diagnosed

1. Hirschberg test: look for asymmetric corneal reflex

2. covered test: movement of affected eye. With strabismus the eye will wonder when the cover is removed

51

What is amblyopia

Decreased visual acuity resulting from an unclear image falling on the retina

52

What are the risk factors for amblyopia

Strabismus or deprivation (opacity in visual axis) such as congenital cataract

53

What is the treatment for amblyopia

Put a patch over the good to strengthen the bad

Surgery for congenital cataract

54

What are concerning signs and symptoms of pediatric headache

Awakens the patient from sleep or early-morning headaches, focal neurologic findings

55

What is the most common cause of recurrent headaches in childhood

Migraines

56

What are the risk factors for migraines

Stress,
exercise,
head trauma,
food,
menstruation

57

What are the signs and symptoms of migraine

Throbbing headache, photophobia, photophobia, aura, nausea and vomiting

58

What is the first-line treatment for pediatric migraines

NSAIDs

59

What is a pseudotumor cerebri

Also known as idiopathic intracranial hypertension

Is increased intracranial pressure in the absence of intracranial lesion or infection

60

Where the signs and symptoms of a pseudotumor cerebri

Headache,
diplopia,
nausea vomiting
papilledema

61

What is the treatment for a pseudotumor cerebri

Therapeutic lumbar puncture to decreased fluid levels.
Acetazolamide

62

What are the major types of neural tube defects

Spina bifida occulta
Meningocele
Myelomeningocele

63

What are the signs and symptoms of spina bifida occulta.

May have sinus dental or hair over the defects often asymptomatic

May develop bladder incontinence to the tethering of the cord

64

One of the signs and symptoms meningocele

The meninges herniate through defective posterior vertebral arches
Fluctuant Midline mass along the vertebral column does not contain spinal cord

Highly associated with hydrocephalus

65

What is used for definitive diagnosis of meningocele

MRIs definitive but ultrasounds maybe use first in the newborn

66

What is a myelomeningocele

Note to defect with protrusion of the spinal cord usually in the lumbosacral region

67

What are the risk factors to a myelomeningocele

Inadequate folate intake during pregnancy
Celiac disease

68

Is the biochemical marker for a myelomeningocele

AFP is a Biochemical Marker

69

What is a complication of a myelomeningocele

80% will have hydrocephalus. May require a VP shunt

70

What is the most common seizure disorder pediatrics

Febrile seizures

71

What are the signs and symptoms of febrile seizures

Generally occur from six months to five years of age. Generalized, tonic clonic, less than 15 minutes, normal neuro exam and return to baseline

Atypical seizures: are focal, greater than 15 minutes, or multiple seizures, and have an abnormal neuro exam

72

What are the signs and symptoms of an infantile spasm

Brief symmetric contractions of the neck, talk and extremities in infancy
Associated with tuberous sclerosis.

73

What will an EEG show for infantile spasms

hypsarrhythmia (bilateral asynchronous slow wave activity)

74

What are absence seizures

Sudden cessation of motor activity, blank staring, no aura or postictal state, occurring for less than 30 seconds.

Greater than five years, maybe provoked with hyperventilation

75

Want to limit EEG reveal for absence seizures

3 Hz spike and wave pattern

76

What is the treatment for absence seizures

ethosuximide

77

What are the signs and symptoms of a generalized tonic clonic seizure

Tonic clonic movements with loss of consciousness
Associated with aura
Postictal period

78

What is the treatment for generalized tonic clonic seizures

Phenytoin
Valproic acid
Phenobarbital

79

What are pseudoseizures

They are not true seizures.
It's thrashing. Consider sexual abuse

80

What is myoclonic epilepsy

Brief symmetric contractions with loss of tone.
patients will often slump or fall forward

81

What is the treatment for myoclonic epilepsy

Valproic acid

82

What are signs and symptoms of partial seizures

Simple
-10 to 20 seconds maybe conducive text
-Motor activity
-consciousness not impaired

Complex
-May have auras, automatism, EEG- temporal lobe waves and spikes

83

What is cerebral palsy

Static and nonprogressive impairment of motor function and posture.
Prenatal complications are the most common cause

84

What are the types of cerebral palsy

-Spastic diplegia
-Spastic quadriplegia
-Spastic hemiplegia
-Extrapyramidal
-Ataxia

85

What is spastic diplegia cerebral palsy

Increased muscle tone, increase DTR, contractures, lower extremities worse, may have seizures

86

What is spastic quadriplegia cerebral palsy

4 extremities are equally involved: scoliosis is more common

87

What is spastic hemiplegia cerebral palsy

-Involves one side of the body

88

What is extrapyramidal cerebral palsy

-Hypotonia, choreoathetosis, dystonia

89

What is ataxic cerebral palsy

-Hypotonia, brisk reflexes, cognitive delays

90

What is an Arnold Chiari type I malformation

Displacement of the cerebellar tonsils below the foramen magnum causing obstruction of caudal portion of the fourth ventricle.

91

What is an Arnold-Chiari type II malformation

Displacement of cerebellar tissue below the foramen magnum
- progressive hydrocephalus

92

What is Friedrichs ataxia

Is a defect in Alpha tocopherol transfer protein causing intracellular deficiency of vitamin E

Autosomal recessive is more common.

93

What are the signs and symptoms of Friedrichs ataxia

Neurologically: ataxia before 10 years, explosive dysarthria and nystagmus, absent DTRs, loss of vibration and position sense.
Skeletal: scoliosis and foot deformities

94

What is a major complication of Friedrich ataxia

Hypertrophic cardiomyopathy in 90%

95

What is leukodystrophy

Abnormal white matter or abnormal myelin

96

What is Krabbe leukodystrophy

Deficiency of lysosomal hydrolase galactosylceramide beta-galactosidase (GALC) resulting in myelin destruction

97

What causes the pathology of Krabbé leukodystrophy

Buildup of galctosylceramides

98

What are the signs and symptoms of Krabbé leukodystrophy

Will present in the first few months of life
Irritability, hypertonia, feeding problems, opisthotonus-followed quickly by rapid deterioration

99

What is opisthotonus

Hyperextension or specificity of the head and neck for me and arching position

100

What is adrenoleukodystrophy

X-linked
Adrenocortical insufficiency and demyelination the presents later in life typically between five and 15 years
Will develop abnormal skin pigmentation from adrenocortical insufficiency

101

What is the treatment of adrenoleukodystrophy

Mixture of MCG's or Lorenzo's oil to prevent body's production of VLCFAs

102

What is the problem of having a buildup of VLCFAs

Buildup of VLCFAs leads to demyelination

103

What is mucopolysaccharidoses

Deficiency of lysosomal enzymes needed for the degradation of glycosaminoglycans resulting in accumulations of GAGS

104

What are three major types of mucopolysaccharidoses

Hurler
SanFillippo
Hunter (X-linked)

105

What are the signs and symptoms of mucopolysaccharidoses

Course facies is the biggest clue
Skeletal abnormalities, mental retardation, visceromegaly

Hurlers and Sanfilippo will have corneal clouding. Not seen with hunters

106

What is the pathology behind Tay-Sachs disease

Lysosomal accumulation of GM2 gangliosides in the nervous system due to a deficiency of hexoseamidase A

107

What are the signs and symptoms of Tay-Sachs disease

Developmental regression at six months, seizures, hypotonia, blindness (macular cherry red spot)

108

What is the prognosis for Tay-Sachs disease

Death between three and four years of age

109

What is Werdnig Hoffman disease

Infantile spinal muscular atrophy
A degenerative disease of motor neurons causing atrophy of the anterior horn cells

110

What are the signs and symptoms of Werdnig Hoffman disease

On set before two years
Generalized weakness hypertonia, Frog leg position, tongue fasciculations, normal IQ

111

What is the prognosis of Werdnig Hoffman disease

Death by two

112

What's kind of pediatric patient history would be suggestive of hypotonia due to botulism

Recent ingestion of honey
Associated with spores in the soil that can be dug up a new construction site
Constipation

113

What is Guillain Barre

Postinfection polyneuropathy with demyelination usually associated with a viral infection or Campylobacter or Mycoplasma

114

What are the signs and symptoms of Guillain Barre

Ascending weakness or paralysis 10 days after nonspecific viral infection, absent DTRs, may compromise cardiorespiratory status

115

What's for a lumbar puncture demonstrate suggested of Guillain Barre

CSF protein elevated,
CSF WBC less than 10
Normal glucose

116

What is the treatment Guillain Barre

Supportive care only follow the negative inspiratory force to determine the time or need for intubation

117

What is the area affected for Guillain Barre

Peripheral neuron is the most often affected

118

What are the signs and symptoms of Duchenne muscular dystrophy

The most common hereditary neuromuscular disease, X-linked
Dystrophin absent
Proximal muscle weakness and depressed reflexes
Pseudohypertrophy of the calf
Positive Gower sign

119

How's Duchenne muscular dystrophy diagnosed

The gold standard is genetic testing

120

What inheritance pattern is suggested if the mothers brother is affected

Consider X-linked

121

What is needed to diagnose type I neurofibromatosis

Need to of the following seven
- Greater than six café au lait spots greater than 5 mm prepubertal or six café au lait spots greater than 15 mm post pubertal
-Axillary / inguinal freckling
-Greater than two iris lisch nodules
- Greater than 2 neurofibromas
-First-degree relative with NF 1
-Optic Glioma
-Osseous lesion

122

What is needed to diagnose type II neurofibromatosis

Need one of the following
-Bilateral acoustic neuromas
-Positive family history and unilateral acoustic neuroma

123

What is a hamartoma

Tissue that is in the correct location but growing in a disorganized fashion

124

Type one neurofibromatosis are at a greater risk for developing what

Optic glioma
Pheochromocytoma

125

What is tuberous sclerosis

Neurocutaneous syndromes of Facial fibroangiomas, hypopigmentation, seizures/infantile spasms and high incidence of MR

126

One of the classic cutaneous findings of tuberous sclerosis

Ash leaf spots
Shagreen patches
Sebaceous adenomas

127

What are the clinical features of tuberous sclerosis

Benign CNS tumors (tubers)
Angiomyolipoma's kidneys
Rhabdomyomas myocardium
Depigmented nevi

128

What are the signs and symptoms of Sturge-Weber

Portwine stain facial nevus on trigeminal region (V1) of the face
MR and seizures possible
Glaucoma on ipsilateral side