Pediatrics Flashcards
(98 cards)
0
Q
Increase in function
A
Development
1
Q
Increase in size
A
Growth
2
Q
Antenatal
A
Term for occurring before birth (maternal)
3
Q
Term for 12th week gestation through 28th day of life after birth
A
Perinatal
4
Q
Perinatal includes what time periods?
A
12th week gestation through 28th day after birth
Fetus - Neonate
5
Q
Embryo
A
Term for 1st trimester stage of development
6
Q
Fetus
A
Term for 12th week gestation through birth
7
Q
Neonate
A
Term for birth through one month
8
Q
Infant
A
Term for one month through beginning of walking (usually 10-14 months)
9
Q
Toddler
A
Term for beginning of walking through 2 years
10
Q
Child
A
Term for two years through 12 years
11
Q
Pubescent / Adolescent
A
Term for 12 years through 18 years
12
Q
Gestational age
A
Age of fetus in weeks
Using either:
Calculated from first day of last menstrual period
OR
Ultrasound measurement
OR
Ballard (Dubowitz) Scoring System based on physical assessment of newborn
13
Q
Postnatal age
A
Age after birth
14
Q
Full-term Neonate
A
38-42 weeks
Postnatal age < one month
15
Q
Post-term Neonate
A
> =42 weeks
Postnatal age < one month
16
Q
Postconceptional Age
A
Gestational Age + Postnatal Age
Ex: 25 wk gestation + 6 wk old = 31 wk
postconceptional age
17
Q
APGAR Scoring System
A
Heart Rate >100 (<100 = 1)
Respiratory Effort - good and crying (irreg = 1)
Muscle Tone - active movements (some = 1)
Reflex Irritability - crying vigorously (crying = 1)
Color - pink all over (blue extr = 1)
18
Q
Pre-term Neonate
A
Equal or less than 37 weeks
Postnatal age < one month
19
Q
Average birth weight
A
3.4kg
20
Q
Age at which birth weight doubles
A
~4-5 months
21
Q
Fever in an infant
A
38.4 C
22
Q
Severe otitis media
A
Mod-severe pain plus temp at least 39 C
23
Q
Recurrent otitis media
A
3x in 6 mo OR
4x in 1 yr w/1 in last 6 mo
24
3 holes in fetal heart
Foramen ovale
Ductus arteriosis
Ductus venosus
25
Kinrix
DTap-IPV
26
Comvax
HBV-Hib
HBV: (Recombivax 5mcg)
PRP-OMP: (PedvaxHIB) = H.influenzae B
27
Pediarix
DTaP-HBV-IPV
28
ProQuad
MMR-V
(4 Live vax)
MMRii
Varivax
29
Twinrix
HBV-HAV
30
PENTACEL
Hib-DTaP-IPV
31
MenHibrix
Hib-MenCY
32
AOM tx
Amox 80-90 mg/kg/day
33
Hole separating RA & LA
Foramen ovale
34
Blood vessel connecting pulmonary artery to proximal descending aorta
Ductus arteriosis
35
Shunts blood flow from umbilical vein to inferior vena cava
Ductus venosis
36
Umbilical cord connects ____ to ____.
Fetus
| Placenta
37
Fetal circulation flows through
1 umbilical vein (mom to fetus) MAIN VEIN
| 2 umbilical arteries (fetus to mom)
38
Age at which birth weight triples
1 year
39
A baby weighing 10 kg should be about how old?
1 year
| (3 x 3.4kg)
40
Of weight, height and head circumference, which will decrease first...last?
Weight first
| Head circumference last
41
After a baby dries up from birth, how long until they return to avg birth weight?
~10 days (1-2 weeks)
42
Hole between pulmonary artery and aorta
Ductus arteriosis
43
Hole in fetal inferior vena cava
Ductus venosis
44
Why does fetus have holes in heart?
Lungs are filled with amniotic fluid, so must get oxygenated blood from mother. Holes prevent pushback and heart failure.
45
When blood enters fetal RA, where does it go?
2/3 to LA (thru Foramen ovale) and 1/3 to RV
46
Umbilical cord enters placenta through
Ductus venosis
47
PVR in fetus
| Why?
High b/c lungs are full of fluid and blood is shunted away
48
SVR in fetus
| Why?
Low
| B/c open line between baby and mom
49
How does PVR change after birth? Why?
Decreases because first breath fills lungs with oxygen
50
How does SVR change after birth? Why?
Increases
| B/c cord is cut and holes start to close up
51
Term for bowel movement of newborn
Meconium
52
Why is it important for a fetus to make it at least 20 weeks?
Surfactant begins to form at 20 weeks
53
Fetus's ability to produce surfactant has completely matured by ____ weeks.
34-36 weeks
54
What happens at first breath?
```
Decrease PVR
Increased SVR causes Foramen Ovale to close
Increase blood flow to lungs
Increase blood flow to LA
Oxygenation and decrease prostaglandins
causes PDA to close
```
55
What keeps PDA open in utero?
Low oxygenation and prostaglandins that mom is giving baby
56
What happens if PDA doesn't close?
Blood going out to body is not as oxygenated and body thinks it needs to work harder. Low oxygenated blood shunts from PA into aorta and to body.
Causes pulmonary edema, enlarged heart, CHF, pulmonary HTN
57
Tx for PDA that doesn't close
Close via pharmacological means
Manage symptoms: digoxin and diuretics
Surgical closure
58
Consequences of PDA remaining open
Pulmonary edema (retrograde flow)
Enlarged heart (L-sided failure)
CHF
Pulmonary Hypertension
59
Drugs used to close PDA
```
Prostaglandin Antagonists
-NSAIDS
Ibuprofen, Indomethacin***
-Corticosteroids (inhibit PLP A2 prod)
-COX-2 selective inhibition
```
***Indomethacin DOC - most studied
(only takes 1-2 doses)
60
Tx for PPHN
Sildenafil (PDE-5 inhibitor) to allow smooth muscle relaxation and cause vasodilation of the blood vessels in the lungs
61
Vital signs of infant vs adult
⬆️ RR
⬆️ HR
⬇️ BP
62
What causes Foramen Ovale to close after birth?
Increased SVR due to removal of umbilical flow from mother
63
How do you manage symptoms for a PDA closure failure?
Digoxin and Diuretics
64
At what age can a child start to swallow a capsule?
5 years old
| Never give tablet/capsules to children <5
65
Septic meningitis
Bacterial
66
Aseptic meningitis
Viral (HSV, HIV, etc.)
67
Septic meningitis can lead to...
Cerebral edema
Increased ICP
Decreased CBF
SIADH
Cerebral ischemia
Disseminated intravascular coagulation
Death
68
Classic s/s of meningitis
```
Severe headache
Stiff neck
Dislike of bright lights
Fever / Vomiting
Drowsiness / Impaired consciousness
Rash
```
69
Two tests for signs of meningitis
```
Brudzinski's Sign
(knees bend with raised neck and
legs raise together)
Kernig's Sign
(Spasm when trying to extend knee)
```
70
Initial mgmt of meningitis
1. GET BLOOD CULTURES FIRST!
2. Lumbar puncture (if pt. is stable)
3. Start empiric tx +/- dexamethasone
71
How to tell if CSF culture is bacterial or viral
Bacterial
- Higher Protein
- Low Glucose (bacteria need nutrition)
- Very Elevated (>90% PMNs...polys+bands)
Viral
- 50% lymphocytes
72
PMNs
aka Neutrophils
= Polys + Bands
73
Meningitis pathogens for newborn to 1 month old
LEG
Listeria (unpasteurized dairy)
E. coli (vaginal canal)
Group B strep (GBS+)
74
Meningitis pathogens if >1 month old
N. meningitidis
| Strep. pneumoniae
75
Empiric tx for meningitis in newborn to 1 month
Ampicillin + Aminoglycoside (gent.)
or
Ampicillin + Cefotaxime
76
Empiric tx for meningitis if >1 month old
Cefotaxime or Ceftriaxone
AND
Vancomycin
77
Evidence of nisseria meningitidis
Rash all over (esp limbs)
78
Tx for neiserria meningitidis
DOC- Pen G (if PCN MIC <0.1)
or 3rd gen ceph (Cefotaxime or Ceftriaxone)
Alt- FQL, meropenem, chloramphenicol
DUR - 1 week
79
Evidence of strep. pneumo meningitidis
Seizures and coma are common
80
ADE from Augmentin
Diarrhea (from clav)
| - try to maintain clav <10 mg / kg / day
81
Twinrix min age
18 years
82
Term describing inflammation of middle ear
Otitis media
83
Rapid onset of signs and symptoms of inflammation in middle ear
Acute otitis media (AOM)
84
Acute otitis media without otorrhea
Uncomplicated acute otitis media
85
Discharge from ear, originating at 1 or more of the following sites: external auditory canal, middle ear, mastoid, inner ear, or intracranial cavity
Otorrhea
86
AOM with presence of mod-severe otalgia or fever at or above 39 C
Sever AOM
87
AOM wih the presence of mild otalgia and temp below 39 C
Nonsevere AOM
88
Angle of eustachian tube in adult vs child
Adult - 45 degrees
| Child - 10 degrees
89
Common pathogens in AOM
Strep. pneumo
Nontypeable H. Influenzae
Moraxella catarrhalis
90
Who should not be diagnosed with AOM?
Children without otorrhea in middle ear
91
Concerts technology
OROS
92
Immediate-release stimulants
Methylin
| Ritalin
93
Immediate-acting CNS stimulants
Metadate ER
Methylin ER
Ritalin SR
94
Long-acting CNS stimulants
```
Concerta
Metadate CD
Ritalin LA
Daytrana
Quillivant XR
```
95
Tx of ADHD + depression
Stimulant and/or
| Antidepressant (bupropion, imipramine, or atomoxetine)
96
Tx ADHD + conduct oppositional/defiant
Stimulant plus
Mood stab (chlorpromazine and haloperidol)
or clonidine
97
Tx ADHD + Tic Disorder
```
Stimulant plus
Clonidine
Risperidone
Pimozide
Haloperidol
```
