PEDIATRIC ABNORMALS Flashcards
Refresher Course (116 cards)
1
Q
Causative agent of Pertussis
A
Bordatella Pertussis
2
Q
Mode of Transmission of Petussis
A
Direct and indirect
3
Q
Incubation period of pertussis
A
5-21 days
4
Q
Pertussis most communicable when?
A
Catarrhal stage 1-2 weeks
5
Q
Active artificial immunity of Pertussis
A
DPT or DTaP - 2,4,6 months of age
then 4-6 yrs old then 11-12
6
Q
What stage is like a common cold or mild rhinitis
A
Catarrhal Stage 1-2 weeks
7
Q
What stage is with whooping cough and 5-10 short rapid cough with deep inspiration
A
Paroxysmal stageq
8
Q
What stage is gradual cessation of pertussis symptoms
A
Convalescent
9
Q
MGT for Pertussis
MSHANO
A
Macrolide - Azith
Suction PRN
Hydration
Avoid cough triggers
Nutrition
O2
10
Q
WOF (Pertussis)
PEDAS
A
Pneumonia
Emphysema or Epistaxis
Dehydration
Alkalosis, Atelectasis
Subarachnoid bleeding / Seizure
11
Q
Pharyngitis occurs at what age?
A
5-15 y.o
12
Q
Pharyngitis Causative agent:
A
Group A Beta Hemolytics (GABHS)
13
Q
WOF (pharyngitis) complications
A
rheumatic fever
Glumerulonephritis
14
Q
Classical signs of Pharyngitis
THROAT
A
Temp high
Headache
Rash: Scarla Tiniform rash
Optics
Appears ill
Throat inflamed
15
Q
Signs and symptoms of viral pharyngitis
A
Mild, enlarged lymph nodes
Tx. only oral analgesis and gargling with warm H2O for dec. inflamm
16
Q
Pus formation at the back of the throat that impacts airway and is a medical emergency
A
Retropharyngeal Abscess
17
Q
S/Sx of Retropha Abscess
A
Fever
Refusal to eat
Swelling in the one side of the neck
18
Q
What to avoid in Retropha Abscess
A
Don’t initiate gag reflex
And no tongue dep
19
Q
Diagnostics for Retropha Abscess
A
Radiograph
20
Q
Treatment for Retropha Abscess
A
IV Antibiotic
Hydration
Respi status: O2, RR
21
Q
Corrective treatment for Retropha abscess
A
Tonsillectomy laser or ligation
21
Q
Laser ton sillectomy no suture causes?
A
Hemorrhage
21
Q
WOF for tonsillectomy (report)
3S
A
Severe pain
Swallong frequently -
Signs of Bleeding (High HR)
21
Q
Risks for tonsillectomy
AHA
A
Aspiration
Hemorrhage
Anesthetic effect
22
Avoid after tonsillectomy
SCAR
Sports: Competitive
Carbonated drink
Acid
Red foods
22
Allowed after tonsillectomy
PIE
Popsicles
Ice chips
Ear pain (mild) for 1 weak
23
Inability of the heart to pump adequate O2 in blood
Heart Failure
24
Causes of Heart Failure
4D's
Defects
Diseases (GABHS, Kawasaki)
Disorder
Dysfunction
25
Right sided heart failure
5E's
Edema
Extremities
Eye
Enlarged Liver
Engorged JV
26
Left sided heart failure
"LUNGS RRR"
Lung symptoms
Use accessory muscles
Nasal flaring
Grunting
SOB
Rales
Retractions
Resp. rate (inc)
27
Treatment for Heart Failure
DAB Triad
Digoxin
ACE inhibitors
Betablockers
28
Sign and Symptoms of Digoxin toxicity (DDD)
Dizziness
Diarrhea
Decrease RR
29
If oral Digoxin was vomited?
No food, if vomited dont repeat
If vomit again, REPORT
30
When to take oral Digoxin
1 hr pre meal or 2 hrs post meal
31
Effect of Digoxin
+ Inotropic = High contract
- Chronotropic = Low HR
32
ACE inhibitors with diuretics WOF?
Low BP and hypovolemia
33
Left to right delivery of O2 blood
Acyanotic HD
34
Cyanotic heart dx mechanism
Right to Left O2 blood
Poor delivery of O2
More severe
35
Assessment of CHD
"Ang PET Mo"
Diaphgram then Bell
Aortic, Pulmonic, Erbs point, Tricuspid, Mitral
36
A congenital heart disease that Aorta with O2 blood from the lungs
Patent Ductus Arteriosus
37
Signs and Symptoms of PDA
PDS
Pulmonary Congestion: rales
DOB (feeding)
Systolic murmur
38
Where can systolic murmur be heard?
2nd ICS Left upper sternal border
39
Treatment of PDA
Prostaglandin = Indomethacin
Diuretics
Surgery - Cardiac cath
40
Atrial Septal Defect (Acyanotic)
Assessment: "ASD"
Asymptomatic: Activity intolerance
Systolic murmur
DOB: feeding
41
Diagnostic tests for ASD
Echocardiogram
42
Management for ASD
Diuretics
Device place
Defect closure (Median sternotomy with cardio pulmo bypass)
43
Most common congenital heart defect
VSD
44
VSD closes at?
First 2 years of life
45
Assessment of VSD
"2H2T"
Heart Failure
Harsh/ Holosystolic Murmur
Tachypnea
Thriving failure
46
Diagnostic test for VSD
Echocardiogram
47
MGT for VSD
Diuretics
Diet: High calorie
Defect closure
Dacron Patch (?)
48
A combination of ASD and VSD, most common defect in trisomy 21
Atrioventricular Septal Defect
49
More severe signs of heart failure
AVSD
50
Mgt for AVSD
"ABCD"
ACE inhibitors
Band (In pulmonary artery)
Closure
Digoxin/Diuretics
51
2nd most prevalent congenital heart disease
Transposition of the Great Arteries (ToGA)
52
ToGA management?
Emergent! Cyanotic
53
Mgt for ToGA
Give Prostaglandin E1 - IV
(Give patent ductus arteriosus)
Balloon atrial septostomy
Arterial Switch
54
balloon atrial septostomy can be done after?
14 days or 2 weeks
55
Arterial switch for ToGA is also called?
Jatene Procedure
56
What to watch out for ToGA
Apnea
Low bp
in the first 2 hours of life
57
Management ToGA
Nursing int
Room air
Spontaneous breathing
Initiate ventilator PRN
58
4 hallmark signs of Tetralogy of Fallot
Pulmonic Stenosis
Overriding aorta
VSD
Right ventricular hypertrop
59
Assessment of ToF
Systolic murmur
Hypercyanotic spell (tet)
60
Tet spells are?
irritates the infant
Seizure that leads to death
61
Primary intervention for TOF
Knee chest position = Increase systemic vascular resistance
62
If not resolved by knee chest position
Go to ER while on knee chest
63
Management on ER for ToF
Max O2
Alpha Adrenergic Agonist
(Phenylprine)
Repair
64
Repair of ToF when?
3-6 months
65
narrowing of the aorta
Coarctation of the Aorta
66
CoAo is more common in?
Male
67
hallmark signs of CoAo
Higher blood pressure in right arm
Unequal BP up to 10mmHg
68
Assessment of CoAo
RUM
Right arm (>BP)
Unequal PR
Males
69
Mgt for CoAo
and its incision site
Balloon/ stent angioplasty
thru cath lab
Left thoracostomy
70
Mucutaneous lymph node syndrome that is prominent in Asian Males
5 yrs old below an inflammatory blood vessels
Kawasaki Dx
71
WOF Kawasaki Dx
3
Coronary Aneurysm
Thrombus formation
Myocardial Infarction
72
Treatment of Kawasaki dx
IV - Immunoglobulin
that triggers immune system
73
IV immunoglobulin must be administered when?
7-10 days acute phase
74
Important health teaching for Kawasaki
Delay vaccines, Continuous echocardiogram to look for aneurysm
75
Acute phase of Kawasaki Dx
High constant fever of 39 for more than 5 days and can be relieved only by ibuprofen
76
Subacute phase of Kawasaki
(2-3 weeks)
Edema
Erhythema - Feets, hands and eyes
Tongue - Strawberry
77
Rasher of Kawasaki can be found in?
Trunk, extremity with red eyes
78
Inflammation of joints, heart and vessels
And what is its causative agent?
Rheumatic fever
CA: GABHS
79
Rheumatic fever can be at age?
6-15 years old,
10 days after pharyngitis
80
Assessment for Rheumatic fever
Major: JONES
Minor: TAPES
Joint pains
O: Carditis
Nodules (SC)
Erythema Marginatum
Sydenham Chorea
Temp (38.5)
ASO titer high
PR interval prolonged
ESR, CRP
81
Definitive sign of RF
Erythema Marginatum
82
Most serious symptom of RF
Carditis
83
Mgt for RF
IM/Oral Penicillin for 10 days
NSAID: Phenobarbital
For chorea: Diazepam
84
AGE is a viral or bacterial?
viral
85
A complication from which body tries to excrete vomiting or diarrhea
AGE
86
Vomiting with no stomach content also called?
Dry retching
87
MGT for AGE
"SOAPI"
SFF
ORS
Anti emetic
Pedialyte
IVF
88
IVF for pedia
24 yellow
89
Timing of breastfeeding
1. Per demand
2. 2-3 hrs
3. if SFF, q30 mins for 10 mins
90
Assessment of Dehydration for Infant "FES"
Fontanelle: Sunken
Eyes: Sunken
Skin turgor: Poor
N- 2-3 secs
91
skin turgor must be done in which part of the infant?
Abdomen area
92
Bulging fontanelle can also be caused by?
Hydrocephalus
Increase ICP
93
Diarrhea caused by infection can be caused by
Protozoa
Virus
Bacteria
94
Pyloric Stenosis can be caused
Hypertrophy
Hyperplasia
95
Assessment of Pyloric stenosis
"STENOSIS"
Sign of Dehydration
TEtany
No bile vomitus
Olive sized lump
Sour smelling
Immediately after feeding (vomit)
Strong/Forceful vomit
96
TEtany in pyloric stenosis can be caused by?
Low calcium
97
Olived size lump in pyloric can be found in
upper central region of abdomen
palpated while eating
98
Strong forceful vomiting projectile how far?
3-4 ft
99
Diagnostic tool for pyloric stenosis
UTZ and Endoscopy
100
Mgt for Pyloric stenosis
NPO but give pacifier
IV: D5Nss
Give Ca and K
Pylorotomy
101
WOF when giving Ca and K
Ensure that child has voided
102
Post op health teaching for Pylorotomy
Infection, incision on the diaper area
103
telecoscoping of one portion of the intestine
Intussusception
104
Intussusception can be found most in?
Distal ileum and proximal colon
105
Intussusception is at ages?
6 months to 2 yrs
106
Cause of intussusception
75% idiopathic
Lead point - diverticulum, hypertrophy
107
Assessment for Intussy
DDD RR
Distended abdomen
Draw up legs
Disappears then reappear
Red currant jelly like stool
Reappear in 15 mins
108
Mgt of Intussy
Surgical emergency
Water soluble/barium enema
air instillation
109
Air instillation is for?
pneumatic insuffocation to reduce necrosis
110
Hirschsprungs dx hallmark signs
Aganglionic
Mega colon
Ribbon like stools
111
Assessment for Hirsch
6-12 mos
Undernourished
No Bowel movement for 1 week
112
Dx for Hirsch
Rectal exam - No stool
UTZ
Barium Enema - w/ caution
