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NP 2- TOP 8 > PEDIATRIC 1: ASSESMENT HEAD TO TOE > Flashcards

PEDIATRIC 1: ASSESMENT HEAD TO TOE Flashcards

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1
Q

ASSESSMENT: Head to Toe
VITAL SIGNS

A

HR: 120-160 bpm
RR: 30-60 cpm
BP: Sytole: 60-80 mmhg
Diastole: 40-50 mmhg
Temperature:
-1st rectal: imperforated anus
-2nd axillary
-36-5- 37.2
SaO2: >95%

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2
Q

HEAD/FONTANELS
“BAD TEACHER (LPT)”

A

B-A-D
-Bregma-Anterior-Diamond
-Size: 3x4
-Closure: 12-18 months

            L-P-T -Lambda-Posterior-Traingle -Size: 1x1 -Closure: 2-3 months
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3
Q

-Swelling made of fuids
-Vaguely outlined :crosses suture line
-Disappears: 1 week

A

CAPPUT SUCCEEDANEUM

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4
Q

-Swelling made of blood
-Well outlined swelling :doesn’t cross the suture line
-Disappears: weeks- months
-Causes jaundice

A

CEPHALHEMATOMA

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5
Q

Head is Sunken/Depressed

A

Dehydration (↑BP,↓ HR& ↓RR)

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6
Q

Head is bulging/swelling

A

-↑ ICP (N: 0-15 mmhg)
-Narrow pulse pressure <30 mmhg
-Cushing Triad (Hyper, Brady, Brady)

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7
Q

Neural Tube defects:
-protusion of sac in occipital area that contains CSF & Meninges
-1-10 weeks of life: occurrence

A

ENCEPHALOCELE (back)

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8
Q

Neural Tube defects:
-Absence of cranial bone
-Brain is visible = death
-breech presentation :
↓ head weight= cannot move

A

Anencephaly

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9
Q

Neural Tube defects:
-Abnormal early closure of suture line= can’t moulding

A

CRANIOSYNOSTOSIS

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10
Q

NOSE:ABNORMAL
-closure of nasal passage
-Both nostrils: Immediate cyanosis after birth

A

Choanal Atresia

Assessment done by:
-Alternately Pinching/occluding each nostrils that leads to cyanosis.
Management:
-Surgery

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11
Q

NOSE:ABNORMAL
Down syndrome (Trisomy 21)

A

Flat nasal bridge

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12
Q

EAR: ABNORMAL

A

Hearing loss: No startle Reflex

Low set ears: Down syndrome

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13
Q

NECK: ABNORMAL
Short neck:

A

Down syndrome

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14
Q

NECK: ABNORMAL
-Overstreched fascia
-missing x chromosomes (23rd)

A

Webbed neck/Turner Syndrome:

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15
Q

NECK: ABNORMAL
-weakness of SCM
-Breasfeeding baby should lean on affected side; to exercise

A

Torticollis (Wry neck)

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16
Q

CHEST:
-Normal
-DUE TO: ↑Estrogen & ↑Prolactin

A

Witch Milk

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17
Q

chest: Abnormal
-Protusion & displacement of sternum
-Seen in pt with Marfan syndrome

A

Pigeon’s Chest

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18
Q

chest: Abnormal
-See-saw respiration (in-in)
-Sign of respiratory distress

A

Chest indrawing/ Chest retraction

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19
Q

ABDOMEN: ABNORMAL

A

↑abdominal diameter
-necrotizing enterocolitis: inflammed large & small intestines

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20
Q

closure of membrane

A

7-10 weeks

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21
Q

ABDOMEN: ABNORMAL

Protrusions: Immediate surgery within 24 hours
↓
(-) sac : (+) sac:
Raw intestines Small <4cm
(lumabas) Umbilical Hernia
↓ Large >4cm
↓ ↓
Gastroschisis Omphalecele

A

MANAGEMENT: Gastroschisis (-) sac
-NPO
-No Breastfeeding
-IV
-Moist Pnss

MANAGEMENT: Umbilical Hernia
-allow breastfeeding
-Moist: PNSS

MANAGEMENT: Stomach, liver,
Intestine
:Omphalocele
-NPO
-No breastfeeding
-Moist: PNSS

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22
Q

BACK: ABNORMAL

divided/split spinal cord

A

Spina Bifida

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23
Q

BACK: ABNORMAL

-“dumpling”; lumbar sacral
-Hair tuft or dimple at site.
-common in 1 out of 20
-most common & least serious

A

Occulta

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24
Q

BACK: ABNORMAL

Protrusion: sac of Meninges + CSF

A

Meningocele

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25
BACK: ABNORMAL -Protrusion: sac of Meninges +CSF+ Spinal cord -Incontinence & paralysis -Most serious
MyelomeningoceLe
26
absence of extremity
Amelia
27
Incomplete extremity
Phocomelia
28
Small extremity
Micromelia
29
Medication that cause loss of extremities:
Thalidomide/ Anti-emetic
30
fusion of digits
Syndactyly
31
Excess digits
Polydactyly
32
Talipes Disorders: Foot abnormal flexion of foot (plantar flexion)
Clubfoot
33
Talipes Disorders: Foot Turned inward
Varus deviation:
34
Talipes Disorders: Foot Turned outward
Valgus deviation
35
Talipes Disorders: Foot Forefoot (toes) lower than the heel
Equinus/horse foot:
36
Talipes Disorders: Foot Heel first
Calcaneus
37
Management for Talipes
Management: Casting Corrective Boots Danger: -Always check toes -Neurovascular compromised
38
GENITALS -Normal -Exposure to maternal hormones -↑ Estrogen & Progesterone
Normal: Pseudomenstruation **Abnormal : Pseudohermaphroditism
39
GENITALS -Undescended testis -Expected in premature baby
Cryptorchidism
40
DOC for Cryptorchidism
HCG hormone
41
GENITALS unretracted foreskin/prepuce
Phimosis
42
Management for Phimosis:
Circumcision at birth
43
Genitals Urethral opening : Upper/Dorsal aspect
Epispadias (UpEpiDor)
44
Genitals Urethral opening: Lower/Ventral aspect
Hypospadias LoHyVen
45
Management for Hypospadias
Hooding (Surgery)
46
Republic act about newborn screening -after 24 hours to 3 days -6 disorders Expanded Newborn screening 6 to 28 disorders
RA 9288
47
NEWBORN SCREENING -inability to metabolize protein -Valine -isoleucia -leucin Hallmark sign: Maple syrup urine odor Complications: -Brain damage & Kidney failure
MSUD (Maple Syrup Urine Disease)
48
MANAGEMENT FOR MSUD (Maple Syrup Urine Disease)?
↓ animal protein B-complex (IM)(IV)
49
NEWBORN SCREENING Inability to metabolize protein Phenylalamine ↓ Precursor: Melanin (skin Thyroxine (heat; t4) Epinephrine (Fight-Flight Toxic: Brain= brain damage (Pround=IQ; Mental Retardation)
PKU (Phenylketonuria)
50
Management for PKU
Phenylalanine Free milk: LOFENALAC Diet: low animal protein ↑fruits & Vegetables
51
NEWBORN SCREENING Etiology: Mother has Hyperthyroidism -Common In girls Problem: at Birth -Hypothermia/Hypoglycemia -Bradycardia, Apnea -WOF: SIDS -Hallmark: Rag Doll appearance -floppy -Head sag -Large tongue aka Cretinism
CONGENITAL HYPOTHYROIDISM
52
MANAGEMENT FOR CONGENITAL HYPOTHYROIDISM?
Within 10 days give Levothyroxine (synthroid, levothroid) Mix with milk
53
NEWBORN SCREENING Problem: Reflective Adrenal Cortex ↓Sugar(Cortisol) ↓Aldosterone (Hypovolemia) Normal: Testosterone APG: ↑ ACTH due to defected steroid synthesis Adrenocorticotropic Hormones) ↓ Stimulates Adrenal Cortex =Hyperplasia ↓ ↑sex
CAH : CONGENITAL ADRENAL HYPERPLASIA
54
CAH has increased mortality because of?
Increase mortality in first 7 hours because of 1st: shock, 2nd: Hypoglycemia, 3rd: Hypovolemia.
55
S/sx of CAH
MALE: -early puberty -enlarged penis, masculine voice, pubic hair -4ft . FEMALE: -no menarche -virilisation (loss of feminity) -deep voice -hirsutism -flat chested -enlarged clitoris
56
MANAGEMENT FOR CAH
Hydrocortisone: synthetic cortisol Medication is effective when: -↑ Breastfeeding time -↓ engorgement breast of mother Fuducortisone: Synthetic aldosterone -Effective: Weight Gain
57
NEWBORN SCREENING -Lactose intolerance -Dissacharide (glucose +galactose) Problem: GI symptoms -Diarrhea & vomiting -Liver damage
GALACTOSEMIA
58
Management for Galactosemia:
No breastfeeding Formula milk ---> Lactose free NEUTRAMIGEN (Milk for galactosemia) *soy milk as alternative
59
NEWBORN SCREENING -Glucose 6 phosphate dehydrogenase -RBC health/life Problem: Hemolytic Anemia -Oddly shaped RBC Triggers: Hemolytic Anemia Drugs: Aspirin, Chloramphenicol, quinine, quinidine, chloroquine, sulfa drugs, cotrimoxazole. Foods: Ampalaya, Soya, Nuts, Beans, Mints Substance: Mentol, Naphthalene (moth balls)
GGP6
60
MANAGEMENT for G6PG during hemolysis?
RBC transfusion: Chronic Risk for: Iron Toxicity -First sign: Iron fist Sign or Pain on knuckles -Liver Damage (LFT check) 7-56 u/l : SGPT (ALT) 10-50 u/l : SGOT (AST) -Abdominal pain S/sx: V-A-N-D-A -Antidote: Chelation Therapy: removal of excess minerals -Agent: Deferoxamine (Desferral) -Urination -CI: kidney failure -Agent:Deferasirox -feces -Last resort: Surgery (Spleenectomy)
61
S/sx of g6pd
V-A-N-D-A
62
G6PD Has a lot of triggers, therefore? Triggers: Hemolytic Anemia Drugs: Aspirin, Chloramphenicol, quinine, quinidine, chloroquine, sulfa drugs, cotrimoxazole. Foods: Ampalaya, Soya, Nuts, Beans, Mints Substance: Mentol, Naphthalene (moth balls)
Put it all in a medic Alert Drugs
63
First sign of G6PD?
Iron fist or pain in knuckles
64
What s/sx is seen only in pt with galactesemia?
CATARACT
65
Milk for galactesemia?
NEUTRAMIGEN
66
Hallmark for Congenital Hypothyroidism?
Hallmark: Rag Doll appearance -floppy -Head sag -Large tongue
67
Medical term to child with hypothyroidism?
Cretenism
68
choice of milk for PKU?
LOFENALAC
69

NP 2- TOP 8 (12 decks)

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