pediatrics Flashcards
Kawasaki disease diagnostic criteria
fever > or = 5 days AND 4 of 5 findings
1) bilateral conjunctival injection, non-purulent
2) oral change : cracked erythematous lips and strawberry tongue
3) cervical lymphadenopathy (most likely > 1.5 cm in diameter, general unilateral)
4) extremity change : erythema or palm and sole desquamation
5) polymorphous rash: maculopapular, erythema multiforme–like or scarlatiniform rash, involving extremities, trunk, and perineal regions
diagnostic criteria of atypical (incomplete) Kawasaki disease
fever > or = 5 days AND 2-3 of 5 findings
1) bilateral conjunctival injection
2) oral change : cracked erythematous lips and strawberry tongue
3) cervical lymphadenopathy
4) extremity change : erythema or palm and sole desquamation
5) polymorphous rash
the diagnostic imaging modality of choice of Kawasaki disease
Transthoracic echocardiography to rule out coronary artery aneurysm
ER management of child poisoning - initial info from the mother on the phone (old SAMP question)
- child weight
- child past medical history/ allergy/ current medications
- time of ingestion
- type of exposure/ name of the product ingested
- amount of ingestion
method to reduce poison absorption
administration of active charcoal
methods to enhance poison excretion
- forced diuresis
- hemodialysis
- hemoperfusion (over activated charcoal or resin)
- acidification/ alkalization of the urine
How long after the ingestion will you be able to assess the severity of acetaminophen poisoning adequately?
4 - 24 hours after ingestion
Antidote of acetaminophen poisoning
N-acetylcysteine (NAC)
What laboratory tests are important for determining whether N-acetylcystine treatment is effective for acetaminophen poisoning?
- Aspartate tramsaminase testing (AST)
- Alanine transaminase testing (ALT)
- Bilirubin testing
- measurement of prothrombin time (PT) / measurement of International Normalized Ra`tio (INR)
management of croup
- Dexamethasone 0.6mg/kg po x1 max 10mg
- consider blow-by O2
- benulized epinephrine
Rourke milestone - 2 months old
- Follows movement with eyes
- Coos – throaty, gurgling sounds - Lifts head up while lying on tummy
- Can be comforted & calmed by touching/rocking
Rourke milestone - 4 months old
- holds head steady when supported at the chest or waist in a sitting position
- Laughs/smiles responsively
Rourke milestone - 6 months old
- Sits with support (e.g. pillows) *** No head lag
- Reaches/grasps objects with both hands equally, no persistent closed/fisted hands
- Rolls from back to side
- Turns head toward sounds
- ** introduction of solids
- ** teeth/Caries risk assessment
Rourke milestone - 9 months old
- Plays social games (pee-a-boo)
- babbles
- Cries or shouts for attention
- Sits without support - Stands with support when helped into standing position
Rourke milestone - 12 mo
- Responds to own name
- Understands simple requests - Says 3 or more words
- Crawls or ‘bum’ shuffles
- Pulls to stand/walks holding on
- Has pincer grasp to pick up and eat finger foods (8 mo)
- Shows distress when separated from parent/caregiver (separation anxiety)
- Follows your gaze to jointly reference an object
