PEDIA Flashcards

(241 cards)

1
Q

what is the disorder that have pressure inside the cranium

A

INCREASE ICP

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2
Q

normal ICP

A

5-15 mmHg

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3
Q

what indicated if >15 ICP

A

increased ICP

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3
Q

what indicates if more than 20 ICP

A

life threatening

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4
Q

what disease in neurologic disorder that has cushing’s triad

A

Increase ICP

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5
Q

how do you determine the widen pulse pressure

A

Subtract Diastolic from Systolic

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6
Q

what is the shape of anterior

A

diamond

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6
Q

what are the 2 fontanels

A

anterior and posterior

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7
Q

what is the shape of posterior

A

triangular

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7
Q

Anterior fontanel closes at

A

12-18 months

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8
Q

posterior fontanel closes at

A

2-3 months

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8
Q

What aggravate fontanels

A

by crying

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9
Q

what is the early sign of ICP

A

High pitched Cry/Shrill Cry

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10
Q

early sign of ICP in the age of child

A

irritability and agitation

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10
Q

early sign of ICP in the age of adult

A

restlessness

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11
Q

early sign of ICP in the age of geria

A

confusion

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12
Q

Initial sign of increased ICP

A

headache

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12
Q

vomiting center of the body

A

Chemoreceptor Trigger Zone

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13
Q

what is anisocoria and what it represents

A

-uneven pupils
-represents f brain damage

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14
Q

what does dilated pupil indicates in increase ICP

A

shock

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15
Q

what does constricted pupil indicates in increase ICP

A

narcotic overdose

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16
Q

how do you indicate normal pupil

A

PERRLA

(pupil equally round and reactive to light and accommodation)

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17
Q

why does sunset eyes occur in ICP

A

the pressure of the brain is pushing downwards

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17
Q

position if you have ICP

A

semi fowlers

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18
what does semi fowlers purpose in increase ICP
Drain CSF → decrease fluid → decrease pressure = Decrease ICP
19
what is avoided if you have increase ICP
coughing and sneezing
20
In ICP, limit fluid intake into ____
1,200-1,500 ml/day
21
what are the two diuretics in increase ICP
Lasix and mannitol
22
mannitol is what kind of diuretics
osmotic
22
Lasix is what kind of diuretics
loop
23
Lasix is localized or generalize
localized
24
mannitol is localized or generalize
generalized
25
Lasix and Mannitol is a potassium wasting diuretic. What do you need to monitor?
Monitor hypokalemia
26
Decadron (Dexamethasone) is ____
-steroid, anti inflammatory -prevention of cerebral edema
27
Anticonvulsants is for
prevention of seizure episodes
28
In ICP, why are they acidic
Stress levels Using Decadron → GI irritants
29
What are the two antacids
Mg Hydroxide and Aluminum hydroxide
29
side effect of Mg Hydroxide
Diarrhea (Mag tatae)
30
side effect of Aluminum hydroxide
Constipation (Ala tae)
31
what is the purpose of anti coagulants
to prevent complication of thrombosis
32
what are the two anti coagulants
heparin and warfarin
33
what are the medications contraindicated in increased ICP
opiates and sedatives
34
opiates and sedatives can occur
Severe cardiac/Respiratory depression
35
what do you call the type of seizure that is generalized (mula ulo hanggang paa)
Grand Mal Seizure
35
Mental clouding and intoxication seziure
Psychomotor Seizure
36
type of seizure that is absent, blank facial expression, automatisms, lip smacking
petit mal
37
Tonic clonic of a group of muscle → progresses to grand mal seizure
Jacksonian Seizure
38
type of seizure that is high temp and wide flactuations due to
febrile seizure
39
what is the most dangerous type of seizure
status epilepticus
40
what does occur in status epilepticus
30 mins → brain damage could occur (on and off)
41
what is the main management in seizure
medication
42
last resort management for seizure
surgery
43
what to WOF in phenytoin
gingival hyperplasia and pinking red urine
44
Benzodiazepines indication
Prevents seizure episodes
44
medication needed when you have Refractory Seizures
→ Iminostilbenes: Carbamazepine
44
why does Valproates: Valproic Acid is the last resort medication
due to hepatotoxicity
45
Valproates: Valproic Acid is not given to pregnant women due to _____
it will cause Neural tube defects
46
In children with bacterial meningitis, affect yung movement because
because meninges supports and nourishes the brain
47
in CSF analysis, why there is cloudy urine
because of elevate WBC, protein
48
Pathognomonic sign in bacterial meningitis
Kernig's and Brudzinski sign
49
what is the difference between Kernig's and Brudzinski sign
Kernig's: (K)nee → Flex → Pain in the hamstring, back, neck = (+) Kernigs Brudzinski: (B)atok → flex → pain the back and neck = (+)brudzinski
50
type of head trauma wherein there is Structural alteration brought by extravasation of blood
contusion
50
what is the important to emphasize in Antibiotic therapy
Finish Duration to prevent drug resistance
51
what should be the position in opisthotonos
side lying
51
type of head trauma wherein there is Jarring of the brain → sudden forceful contact in a rigid skull
concussion
51
what position in car if <3 y/o
rear facing
52
what position in car if >3 y/o
Front facing/ Forward facing booster seat
53
Most important prognostic indicator in head trauma
assessing LOC
54
what to do if there is (+) cervical injury
do not move the client → Immobilize
55
(-) cervical injury:
Height of the bed - 30 degrees to decrease ICP
56
Two way in the blood flow in the heart indicates
regurgitation
57
Point of Intersection of aorta and pulmonary artery
ductus arteriosus
58
if there is one problem in the heart
acyanotic
58
if there is two problem in the heart
cyanotic
59
why there is Machinery like murmur in PATENT DUCTUS ARTERIOSUS (PDA)
Nagbabanggaan ang tunog kasi naka bukas ung ductuss arteriosus
60
sign of cerebral hypoxia
irritability
61
DOC for PATENT DUCTUS ARTERIOSUS (PDA)
INDOMETHACIN
62
Indication of indomethacin
facilitates closure of PDA
63
secondary drug for PDA
ibuprofen
64
what happens in septal defect
→ Na bybypass ung lungs kasi may butas
65
signs and symptoms in septal defect
-Fatigue → poor feeding -Dyspnea on exertion → activity intolerance -Failure to thrive (delayed milestones) -signs and symptoms of heart failure
66
In management, suture is use when ________
hole is small
67
if hole is big, what is the managemet
dacron patch
68
In dacron patch, the tissue is the ___
Decrease rejection rate and favorable
69
In dacron patch, the plastic is the ___
Increase rejection rate and use when tissue is fading
70
in COARCTATION OF AORTA, in upper extremities - the BP is
increase
71
in COARCTATION OF AORTA, in lower extremities - the BP is
decrease
72
in COARCTATION OF AORTA, in upper extremities - the pulse is
bounding
73
in COARCTATION OF AORTA, in lower extremities - the pulse is
weak sometimes absent
74
management in coarctation in aorta
Balloon Angioplasty with coronary stenting
75
is stent for lifetime yes or no
YES
76
how may problems in tetralogy of fallot
4 problems
77
what is the primary problem in tetralogy of fallot
pulmonary stenosis
78
What allows mixing of blood in TOF
overriding of aorta
78
What is the compensatory mechanism in TOF?
Right ventricular hypertrophy
79
how does the patient with TOF keeps alive in VSD
narerelieve yung pressure kasi dahil may butas sa septum pumupunta ung blood sa left galing sa RV kasi kung sarado, sa RV lang napupunta lahat
79
What keeps the patient alive in TOF
VSD
80
why does squatting is allowed in TOF
-Decrease venous return → decrease cardiac workload → promoting cardiac rest -Conserve oxygen in the upper body
80
What is the pathognomonic sign in TOF
Tet spells
80
what can manifest in TET spells
-Group of s/sx that represents decrease oxygenation -Irritability -Convulsions -Blackouts -Pallor (hypoxemia)
80
diagnostic in TOF
2D ECHO
81
WHAT CAN SEEN IN 2D ECHO IN PATIENT WITH TOF
BOOT SHAPED HEART
82
TOF: WHAT IS THE SURGERY IN CURATIVE
INTRACARDIAC SURGERY/BROCKS PROCEDURE
82
TOF: WHAT IS THE PROCEDURE IN PALLIATIVE SURGERY AND HOW
Blalock Taussig Shunt -Anastomosis (padudugtungin) of pulmonary artery and aorta using subclavian artery
83
TOF: WHAT IS THE GOAL IN PALLIATIVE SURGERY
Mas maraming oxygenated compared to unoxygenated
83
WHAT IS THE TWO SURGERY IN TOF
PALLIATIVE AND CURATIVE SURGERY
84
WHAT DOES BALLOON ANGIOPLASTY SOLVE IN TOF
PULMONARY STENOSIS RIGHT VENTRICULAR HYPERTROPHY
84
WHAT DOES DACRON PATCH SOLVE IN TOF
REMOVAL OF VSD AND OVERRIDING OF AORTA
84
TOF: WHAT IS THE TWO PROCEDURE IN BROCKS
1. BALLOON ANGIOPLASTY 2. DACRON PATCH
85
ACYANOTIC vs. CYANOTIC WHERE DOES THE MORE OXYGENATED BLOOD
ACYANOTIC
86
ACYANOTIC vs. CYANOTIC WHERE DOES THE MORE UNOXYGENATED BLOOD
CYANOTIC
86
WHAT HAPPENS IN TOGA
Right Ventricle connected to aorta Left Ventricle connected to pulmonary artery
86
WHAT MEDICATION CAN MAINTAINS AND KEEP THE PDA OPEN
PROSTAGLANDIN E
86
WHAT KEEPS THE PT ALIVE IN TOGA
PDA
87
ARTERIAL SWITCH/JATENE SURGERY IS DONE DURING __________
1ST WEEK OF LIFE
87
WHAT IS THE SURGERY IN TOGA
ARTERIAL SWITCH/JATENE SURGERY
88
WHAT IS THE LIFESPAN OF PDA INFANT
1-2 WEEKS
89
WHAT IS THE CAUSE IN RHEUMATIC HEART FEVER
BACTERIA
90
WHAT IS THE BACTER CALLED IN RHF
GABHS (Group A Beta Hemolytic Streptococcus)
91
WHAT ARE THE MAJOR CRITERIA IN JONES
JONES J - Polyarthritis (Multiple joint inflammation) O - carditis N - Subcutaneous Nodules E - Erythema Marginatum S - Sydenham Chorea
91
WHAT TO CONSIDER IN JONES CRITERIA
2 Major + Hx of GABHS 1 major + 2 minor + Hx of GABHS
92
what is Sydenham chorea
(St. Vidus Dance - Worm like movement of fingers and arms)
93
where does Subcutaneous Nodules occur
Bony prominence (Knuckles, Knees, Elbow)
94
DOC FOR RHEUMATIC HEART FEVER
PENICILLIN
94
what is Erythema Marginatum
redness in trunk
95
WHAT ARE THE MINOR CRITERIA IN JONES
- Low grade fever - Arthralgia - painful joints w/o swelling - Elevation of ASO titers (Antistreptolysin O titer) - Elevation of inflammatory markers (vague lab result kaya minor lang) >ESR (erythrocyte sedimentation rate) >CRP (C-reactive CHON)
96
IF ALLERGY TO PENICILLIN, WHAT YOU WILL GIVE
ERYTHROMYCIN
97
PENICILLIN IS GIVEN HOW MANY DAYS
5-10 DAYS
98
If there’s exacerbation and remission of RHF, THE ___________
Treatment is continued up to 10 years
99
MEDICATION USE IF THERE IS PAIN AND SWELLING IN RHEUMATIC HEART FEVER
SALICYLATES
99
WHAT TO MONITOR IF GIVING ASPIRIN
BLEEDING
99
WHAT MEDICATION USE THAT CAN RELIEVE CARDITIS IN RHEUMATIC HEART FEVER
CORTICOSTEROIDS
99
IF SYSTEMIC MANIFESTATIONS, LSHF OR RSHF
RSHF
99
What aspirin use in RHF:
ANALGESIC AND ANTI INFLAMMATORY
99
IF PULMONARY MANIFESTATIONS, LSHF OR RSHF
LSHF
99
Peripheral/Dependent/Pitting Edema
RSHF
99
Orthopnea
LSHF
99
Distended Neck Veins (JVD)
RSHF
99
Hepatomegaly
RSHF
99
Crackles, Rales
LSHF
99
LSHF OR RSHF: COUGH
LSHF
99
RSHF or LSHF: WEIGHT GAIN
RSHF
99
WHAT Measures the pressure in left side of the heart
Pulmonary Capillary Wedge Pressure (PCWP)
99
WHAT IS THE FORM OF COMPENSATION IN BOTH RSHF AND LSHF
TACHYCARDIA
99
R HF or L HF: BODY WEAKNESS, ANOREXIA, NAUSEA
RSHF
99
WHAT IS THE EARLY SIGN IN BOTH RSHF AND LSHF
TACHYCARDIA
99
IN HEART FAILURE, WHAT CAN BE SEEN IN CHEST XRAY
PRESENCE OF CARDIOMAEGALY
99
IN HEART FAILURE, WHAT CAN BE SEEN IN 2D ECHO
Hypokinetic heart
99
WHAT IS THE LATE SIGN IN HEART FAILURE
Hypokinetic heart
99
what measure the pressure in the right side of the heart
Central Venous Pressure (CVP)
99
normal Pulmonary Capillary Wedge Pressure (PCWP)
4-12 mmHg
99
what is the normal Central Venous Pressure (CVP)
12 mmHg
99
what is the position for heart failure
fowlers
99
what type of oxygen use in heart failure and why
venturi because its precise and accurate
99
what is the effect of inotropic drugs in heart failure
strengthens contraction → increases cardiac output
99
what indicates Lanoxin/Digoxin in heart failure
Maximize Cardiac Output
100
Signs of Digoxin Toxicity
N - nausea A - anorexia V - visual disturbances/vomiting D - diarrhea A - abdominal cramps
101
antidote for digoxin
digibind
102
What occurs in Kawasaki disease
-Mucocutaneous Lymph Nodes Syndrome (altered immune response) -Multisystemic Vasculitis (inflammation of blood vessels)
102
Pathognomonic sign in Kawasaki disease
Strawberry Red Tongue
103
Signs and Symptoms in kawasaki disease
High Spiking Fever Strawberry red tongue Photophobia Polymorphous rash Palmar desquamation
104
what to remember in Palmar desquamation
KAWASAKI IS ONLY IN PALMAR NOT IN THE SKIN BC IF SKIN BUONG KATAWAN YON
105
WHAT CAN BE SEEN IN DIGNOSTIC IN KAWASAKI
ELEVATED ESR
105
diet for kawasaki
clear liquid diet
105
what antibodies given in kawasaki
immunoglobulins
105
what type of aspirin given in kawasaki
antipyretic anti inflammatory analgesic
106
cleft lip vs. cleft palate tuwid mag salita
cleft lip
106
what to remember in clear liquid diet
clear liquid diet is considered if there's opacity to light
107
cleft lip vs. cleft palate have speech problem
cleft palate
108
why does cleft palate has the one with speech problem and not the cleft lip
because when we are talking, it is touching to the palate, so, if there's clef
109
cleft lip is common in
lalaki
109
cleft palate is common in
females
110
why does large nipples is needed in cleft lip
to be easy to suck
111
what should be the cut of nipple if have child having cleft lip
Criss Cross cut of nipple
112
the one using Training cup, Medicine dropper
Cleft palate
113
surgery for cleft lip
cheiloplasty
114
surgery for cleft palate
Palatoplasty/ Palatorrhaphy
115
rule in cheiloplasty
rule of 10 10 wks 10 lbs 10k WBC 10g/dl hgb
116
in Palatoplasty/ Palatorrhaphy, why does it should not be too early
it will re open
117
in Palatoplasty/ Palatorrhaphy, why does it should not be too late
it will have speech problem
117
when should perform Palatoplasty/ Palatorrhaphy
18-24 months (this is when child starts to talk)
118
what is the post op position in Cheiloplasty
Turn on the unaffected side
119
if the patient has bilateral cleft lip, the POST OP position is _____
HOB ELEVATED
120
what is the post op position in Palatoplasty/ Palatorrhaphy and why
Prone - to drain secretions to prevent aspriation
120
MAIN PROBLEM IN GERD
Incompetent Lower Esophageal Sphincter (LES)
121
GERD IS ALSO KNOWN AS
CHALASIA
122
WHAT HAPPENS IF BARIUM SWALLOW IS MORE THAN 2 DAYS IN YOUR BODY
OBSTRUCTION
122
DIAGNOSTICS IN GERD
BARIUM SWALLOW
122
BARIUM SWALLOW LAST WITHIN
2 DAYS
122
OTHER TERM FOR Lower Esophageal Sphincter (LES)
CARDIAC SPHINCTER
122
WHAT TO DO IN ORDER TO EXCRETE THE BARIUM
Increase OFI laxatives as ordered
123
DIET FOR GERD
LOW FAT HIGH PRIBER
123
FOODS TO AVOID IN GERD
SPICY FOODS CAFFEINE ALCOHOL TOBACCO
123
WHAT IS THE MOST EFFECTIVE DRUGS IN GERD AND WHY
PPI Because it blocks HCL production + protective covering to prevent further damage in linings
123
IN GERD, WHY DOES HIGH FIBER IS GIVEN
BECAUSE IT DECREASES PERISTALSIS
123
IN GERD, WHY DOES HIGH FAT IS AVOIDED
IT CAN CAUSE VOMIT
124
IN PYLORIC STENOSIS: PRESENCE OF WHAT IN ABDOMINAL
OLIVE SHAPED MASS
125
IN PYLORIC STENOSIS: IS THERE VOMITUS WITH BILE OR NON
WITHOUT BILE
126
IN PYLORIC STENOSIS: WHAT CAN HELP TO HASTEN DIGESTION
INCREASE OFI
127
WHAT DOES IT MEAN IF THERE'S BILE IN VOMITUS
THERE IS OBSTRUCTION
128
CELIAC DISEASE: REVERSIBLE OR IREVERSIBLE
IREVERSIBLE
129
CAUSE OF CELIAC DISEASE
MALABSORPTION OF GLUTEN
130
WHAT HAPPENS IN MALABSORPTION OF GLUTEN
The body can’t process gluten so it will remove the gluten through diarrhea
130
CONFIRMATORY DIAGNOSIS FOR CELIAC DISEASE
BOWEL BIOPSY
130
CELIAC DISEASE: foods allowed
Meat, Eggs, Milk products (milk, cheese, cream), all fruits and vegetables, rice, corn, corn flakes
131
CELIAC DISEASE: WHAT TO AVOID
BROW barley rye oats wheat
132
WHAT IS THE RESPONSIBLE OF GANGLIONIC
RESPONSIBLE FOR PERISTALSIS
132
HIRSCHSPRUNGS DISEASE: cause
AGANGLIONIC
133
PATHONOMONIC SIGN IN HIRSCHSPRUNGS DISEASE:
RIBBON LIKE STOOLS
134
HIRSCHSPRUNGS DISEASE: DIAGNOSTICS OF ENEMA, WHAT CAN BE SEEN
PRESENCE OF MEGACOLON
134
MAIN PROBLEM IN HIRSCHSPRUNGS DISEASE
FAILURE TO PASS MECONIUM FOR FIRST 24-48 HRS
135
HIRSCHSPRUNGS DISEASE: DIAGNOSTIC CONFIRMATORY TEST
RECTAL BIOPSY
136
SURGERY FOR HIRSCHSPRUNGS DISEASE:
SWENSON PULL THROUGH
137
NORMAL COLOR OF STOMA
PINKISH
138
BLUISH STOMA INDICATES
LACK CIRCULATION
139
Avoid foods that can obstruct the stoma
GAS FORMING FOODS -CABBAGE, POTATO
140
FOODS ALLOWED IN HIRSCHSPRUNGS DISEASE
SPINACH PARSLEY YOGURT BROCCOLI
141
WHAT DOES ABDOMEN LOOK LIKE IN INTUSSUSCEPTION
SAUSAGE SHAPE MASS
142
WHAT DOES STOOL LOOK LIKE IN INTUSSUSCEPTION
CURRANT JELLY LIKE STOOL (BLOODY MUCOID STOOL)
142
IN GUIAC TEST/OCCULT BLOOD TEST, DCF IS AVOID DUE TO
IT WILL BE FALSE POSITIVE
143
IN GUIAC TEST/OCCULT BLOOD, VIT C IS AVOIDED DUE TO
IT WILL BE FALSE NEGATIVE
143
IN GUIAC TEST/OCCULT BLOOD, WHAT IS THE AGENT USE
HYDROGEN PEROXIDE
144
IN USING HYDROGEN PEROXIFE, FORMATION OF BLUE RING INDICATES
BLEEDING
145
FUNCTIONS OF NGT
FIDME Feeding Irrigation Decompression - decompress the abdominal distention Medication
146
WHAT IS COUP DIESEASE
NARROWING OF AIRWAY DUE TO VIRAL INFLAMMATION
147
Pathognomonic sign IN CROUP
Barking seal like cough
148
IN CROUP, WHAT ARE SIGNS OF EPIGLOTITIS
Dooling Nasal Flaring Use of accessory muscles while breathing
149
IN CROUP, WHAT SHOULD BE THE ROOM TEMP AND WHY
COOL - INCREASE GAS EXCHANGE AND BRONCHODILATION
150
IN CROUP, WHAT SHOULD BE IN THE BEDSIDE AND WHY
TRACHEOSTOMY CARE - ANYTIME PWEDE MAG CLOSE AND AIRWAY
150
MEDS FOR CROUP
Antivirals: “vir” (main drug) Antibiotics: Prophylaxis (preventing bacterial as well) Bronchodilators: SE - TACHY
151
DISORDER THAT Blockage of exocrine glands (MUCUS)
CYSTIC FIBROSIS
152
IN CYSTIC FIBROSIS, WHAT IS SEEN IN SWEAT CHLORIDE TEST
INCREASE CHLORIDE LEVELS IN SWEAT
152
ORGANS AFFECTED IN CYSTIC FIBROSIS
PANCREAS, LUNGS, INTESTINES, SWEAT GLANDS
153
DIAGNOSTIC FOR CYSTIC FIBROSIS
SWEAT CHLORIDE TEST
154
process of removing mucus in the lungs
CHEST PHYSIOTHERAPY
155
IN CYSTIC FIBROSIS, AFTER POSTURAL DRAINAGE, WHAT WILL YOU TEACH PT
ORAL CARE
156
MEDS FOR CYSTIC FIBROSIS
pancreatic enzyme
157
NURSING CONSIDERATION IN PANCREATIC ENZYME
GIVEN W/ NO EMALS, NEVER DOUBLE THE DOSAGE
158
IS ASTHMA, REVERSIBLE OR IREVERSIBLE
REVERSIBLE
159
CAUSE OF ASTHMA
ALLERGENS
159
IN ASTHMA, WHEEZES IS HEARD IN ___
Expiratory