peds #3 Flashcards Preview

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Flashcards in peds #3 Deck (196):
1

paroxysmal abdominal pain or cramping

colic

2

S/Sx of colic

sudden, dibilitating pain, cries, pulls legs up, red faced, fist clenched
usually lasts 3 hours at least 3 times a week

3

management of colic

antiflatulent, parental support

4

passive transfer of gastric contents into the esophagus, starts witin the 1st week of birth

gastroesophageal reflux

5

patho of gastroesophageal refulx

neurimuscular distrubance
(kids at risk: CP, neuro involvement

6

S/Sx of gastroesophageal reflux

passive regurgitation or emesis, poor weight gain, irritability, gagging

7

Dx for gastroesophageal reflux

h&p, barium swallow, upper GI, pH monitoring

8

Rx for gastroesophageal reflux

antacids (decrease acid production)
H2 blockers

9

nissen fundoplication

tightens esophagus for gas. reflux

10

hardening or thickening of pyloric

pyloric stenosis

11

S/sx of pyloric stenosis

forceful vomiting, sour smelling, hungry, dehydration, visible peristalsis

12

Dx of pyloric stenosis

h&p, u/s, barium swallow

13

pyloromyotomy

surgical tx for pyloric stenosis, RUQ incision, post op clear liquids, hear bowel sounds (4-6 hours)

14

telescoping of one portion of the intestines into another

intussusception (MEDICAL EMERGENCY)

15

complication of intussusception

ischemia

16

S.Sx of intussusception

heatlhy child who suddenly has episode of acute colicky, abdominal pain, N/V, jelly like stool

17

how will you know if the intussusception is fixed

you will have normal stools

18

remnant of fetal omphalomesenteric duct that conntects yolk sac with primitive mid-gut during fetal lifecan lead to intussusception

meckel diverticulum

19

S/sx of meckel diverticulum

abdominal pain, bloody stool, anemia (possible)

20

Dx of meckel diverticulum

history, radionucleotide scintigraphy (meckle scan)

21

Tx for meckel diverticulum

surgical removal,
if left untx hemorrhage and bowel obstruction

22

absence of hanglionic innervation to the muscle of a section of the bowel, usually the sigmoid colon, abnormal gene on chromosome 10

hirsprung disease

23

s/sx hirsprung disease

newborn: failure to pass meconium within 24-48 hours after birth, infant: constipation, distention, childhood: constipation, impaction

24

what will a child with hirsprung disease die from

interocolitis

25

Dx of hirsprung disease

history, digital rectal exam, barium enema, rectal biopsy, anorectal menometry

26

Tx for hirsprung

surgery
post op: assess for abdominal distention

27

when is surgery done for hernias

age 2-5

28

S/sx for hernias

lump in groin, asymptomatic, pain

29

intolerance for gluten, causes malnutrition in children

celiac disease

30

when is celiac disease first noted

after several months after introduction of cereals (usually age 1-5)

31

S.sx of celiac disease

fatty stool, impaired fat absorption, N/V, watery stools

32

Dx of celiac disase

jejunal biopsy, gluten free diet, d-xylose absorption test

33

complication of celic disease

malignant lymphoma of small intestine (or other GI malignancies)

34

forceful ejection of gastric contents through the mouth

vomiting

35

Tx for vomiting

NPO for short time (3-8 hours)
ice chips, water/clear liquids in small amounts

36

most pathogens are spread by fecal oral route through contaminated food or water or spread from person to person

etiology of diarrhea

37

what is the most common pathogen in diarrhea

rotavirus

38

acute diarrhea lasts for

7-14 days

39

chronic diarrhea (IBS) lasts how long

beyond 2-3 weeks

40

Tx for diarrhea

BRAT diet

41

water and sodium lost in proportin to each other

isotonic

42

water loss in excess of electrolyte loss

hypertonic
MOST dangerous type

43

total output exceeds input

dehydration

44

S/Sx of isotonic dehydration

turgor poor, membranes dry, rapid pulse, irritable or lethargic

45

S.sx of hypotonic dehydration

very poor skin turgor, clammy, slightly moist membranes, very rapid pulse, lethargic, convulsions possible

46

s/sx of hypertonic

fair turgor, membranes parched, moderatly rapid pulse, marked lethargy, extreme hyperirritability on stimulation

47

mild dehydration

3-5% weight loss, cap refil more than 2 seconds, urine specific gravity less 1.020

48

moderate dehydration

6-10% weight loss, cap refill 2-4 seconds, urine specific gravity less 1.020 or oliguria

49

severe dehydration

10-15 % weight loss, cap refill more 4 seconds, tenting, oliguria or anuria, sunken anterior fontanel

50

alteration in freqency consistency or ease of passing stool

constipation

51

reasons for constipation

structural, systemic, medications (opids, iron)

52

Tx for constipation

increase fiber and fluids
CRAP diet (cherries, raisins, apricots, prunes)

53

child takes or has bottle of milk to bed for prolonged times

night bottle syndrome

54

deficiency of protein with an adequate supply of calories

kwashiorkor

55

S/sx of kwashiorkor

thin wasted eextremities, ascites, scaly skin, blindness

56

results from general malnutrition of both calories and proteins

marasmus

57

S.sx of marasmus

starts at age 6-18 months, no sub q tissue, look old,

58

deficit in vit D

rickets

59

deficit in vit C

scurvvey

60

Dx of parasites

stool specimens, string test

61

Tx for parasites

quinacrine, furozone, flagyl

62

deficit in vit A

blindness

63

deficit in vit B

beri beri, constipation, alcoholics

64

Prevention of parasites

hand washing

65

what is the most common parasite int he US

protozoa (guardisasis)

66

protozoa

transmission: person to person
S/sx: abd cramps, diarrhea, constipation

67

tx of protozoa

furoxone, most infections resolve on on in 4-6 weeks

68

caused by a nematode, most common helminthic infection in US, small thread like worm that live in the cecum

pinworms (enterobiasis)

69

Pinworms

transmission: touch, inhalation
Dx: flashlight, tape

70

Tx for pinworms

mebendazole or vermox, anti itch cream for anal area, wash all bed clothes, keep nails short, wash hands

71

prevalent in southen warm climates, lives in the intestines

roundworm

72

roundworm

mild Gi sx to obstruction,
transmission: fecal oral

73

lives in warm soil

hook worm

74

hookworm

transmission: skin contact with soil, S/sx: erythema papular erruptions, itching, burning

75

results from ingestion of worm larvae living in inadequately cooked beef for pork

tapeworm

76

Tx for tapeworm

antihelminthics (destroys worm)

77

renal malignancy that may involve one or both kidneys, most common malignant neoplasm of the kidney

wilm's tumor (nephroblastoma)

78

wilm's tumor

S/sx: mass appears overnight, abdominal pain, vomit, fever, hematuria

79

Tx for wilms tumor

DO NOT PALPATE, surgery, chemo, radiation

80

failure of one or both testes to descnd fromthe abdominal cavity to the scrotum

cryptorchidism
occurs more in preterm males
have higher risk for testes cancer

81

true undescended

can palpate, just hasnt dropped yet

82

ectopic

cant palpate, in abdomen

83

Tx cryptorchidism

if persists after one year, refer to surgeon, if ectopic test kidney function

84

orchiopexy

surgery done for cryptorchidism

85

involuntary voiding of urine beyond the expected age at which voluntary control should not be achieved after successful toilet training

enuresis (wetting bed)

86

classifications of enuresis

primary: never achieved a peiod of dryness
secondary: dry for 3-6 months and then resumes wetting
diurnal: wetting occurs only during day
nocturnal: wetting occurs only at night

87

VCUG

voiding cystourethrogram, xray visualize childs urinary tract and bladder

88

Tx for enuresis

oxybutyin chloride, desmopressin, imipramine ydrocholoride

89

passing of stools into underwear or Pjs past the normal time of toliet training

encopuresis

90

Tx for encopuresis

increase fluids, fiber, decrease dairy, enemas, MOM, schedule

91

clinical manifestation of a large # of distinct glomerular disorder (fluid shift)

nephrotic syndrome
damage to the basement membrane

92

S.sx of nephrotic syndrome

proteinuria, edema, low serum albumin, increased blood lipid level, decrease output, weight losspuffiness

93

Dx nephrotic syndrome

UA, serum, renal biopsy

94

Tx for nephrotic syndrome

diet, prednisone, diuretics, I&O, daily weight, abdominal girth, rest, skin breakdown, no tight clothing

95

complication of nephrotic syndrome

peritonitis

96

inflammation of glomeruli

acute glomerulonehritis, by product of strep

97

S/sx of acute glomerulonehritis

decrease of glomerular filtration rate, puffiness, dark colored urine, edema, pale, lethargy, HA

98

Tx acute glomerulonehritis

abx, diretics, bed rest, limit competitive activity until normal kidney function, dont add electrolytes until after 1st void (dont want excess of potassium)

99

hemolytic anemia, thrombocytopenia, acute renal failure

hemolytic uremic syndrome (HUS)

100

S/Sx of HUS

hemorrhagic manifestations, oliguria or anuria, decreased renal function, CNS involvement (sezires)

101

prevention of HUS

cook temp of meat to 160, no unpasterurized milk, wash raw veggies, dont swim where water can be contaminated

102

acute encephalitis with accompanying fatty infiltration of the liver, brain, kidney, heart, lung, skeletal muscle. Viral illness (flu, varicella)

reyes syndrome

103

when is reyes syndrome more likely to occur

Jan, Feb, March

104

S/sx reye's syndrome

anorexia, lethargy, vomiting, combativeness, normal to low grade fever (can look like drug intoxication)

105

Dx of reye's syndrome

liver enzymes, liver biopsy, WBC, CSF

106

Prevention of Reye's syndrome

no ASA, tylenol, no Peptobismal

107

neurological condition resulting from damage to the motor cortex and resulting in impaired muscular control

cerebral palsy

108

#1 cause of Cp is

cerebral anoxia (head trauma, decrease of birth weight)

109

spastic

hypertonicity

110

dyskinetic

abnormal involuntary movement (jerky)

111

athetosis

slow wormlike writhing movements

112

atatic

awkward wide based gait

113

primary goal of CP

early recognition and promote optimum development

114

Tx for CP

braces, wheeled scooter boards, orthopedic surgery, Rx to decrease spasticity dantrolene, baclofen, robaxin, valium

115

premature closing of one or more cranial sutures

craniosynotosis

116

Tx for craniosynotosis

surgery to decrease pressure, correct deformity
recovery: assess nero, watch bleeding & infection

117

inherited disorder, abnormal precollagen, bone has large areas of osseous tissue with no architectural pattern

osteogenesis imperfecta
"briddle bone"

118

Type 1

MOST COMMON, blue sclera, after puberty femur fx

119

type II

most severe, death occurs before infancy

120

avascular necrosis of the femoral head (no blood supply), degenerative changes, flattening of upper surface of femoral head

legg-calve-perthes disease

121

4 stages of legg-calves-perthes disease

avascular stage (degenerative changes)
fragmentation/revascularazation: mottled appearacnce on xray
reparative stage: trying to repair itsself
regenerative stage

122

S/sx of legg-calves-perthes disease

intermittent appearacnce of limp on affected side, pain (increases in AM), limited ROM

123

Tx of legg-calves-perthes disease

surgery

124

slipping of the femur head posteriorly and inferiorly, occurs in pre-adolescence, obese or very tall & thin rapid growth

slipped femoral capital epiphysis

125

lateral curvature of spine

scoliosis
no pain until severe, occurs around age 10

126

Tx for scoliosis

observe, surgical, braces (slow progression of curve, boston brace & thoracic lumbar sacral orthotic TLSO)

127

posterior wires are threaded beneath laminae of each vertebrae and tightened around rods resting along transverse processes so that spinal column is stabilized by transverse traction on each vertebrae

luque segmental spinal instrumentation (scoliosis)

128

exaggeration of lumbar curvature

lordosis

129

humpback

kyphosis

130

chronic inflammation of synovium and joint effusion, S.Sx must begin before age of 16 and last longer than 6 weeks and in more thatn one joint

juvenile rheumatoid arthritis

131

S.sx of juvenile rheumatoid arthritis

swelling, contractures, warm to touch, not red, stiffness increases in AM or with decrease of motion

132

Rx for juvenile rheumatoid arthritis

ASA, NSAIDS, SAARDS, cytotozics, corticosteroids

133

ability to spread to others

communicability

134

time between the invasion of an organism and the onset of Sx of infection

incubation period

135

time btwn the beginning of nonspecific Sx and specific Sx

prodromal period

136

stage during which the specific Sx are evidnet

illness

137

interval btwn when sx begin to fade and the return to full wellness

convalescent period

138

how pathogen enters the body

portal of entry

139

how organisms leave the body

portal of exit

140

method by which the organisms are spread and enter a new individual to cause disease

chain of infection

141

rash

exanthem

142

how to relieve a itch or rash

dress in light cotton clothing, maintain hydration, fingernails short, press on itchy areas dont scratch, analgesics for comfort, antihistamines

143

roseola infantum

human herpesvirus 6, high fever then rash, period of communicability is during febrile period

144

rubella (german measles)

rash starts at face and goes down, joint stiffness, tx: Sx, transmission: droplet

145

Measles (rubeola)

sore throat, enlarged lymph nodes, droplet transmission, classic sign: kopliks spots on mouth (bright red with blue center)

146

chicken pox (varicella)

contagious one day before the rash

147

erythema infectiosum (5th disease)

rash on cheek then goes to extremites "slap cheek", droplet transmission, tx Sx

148

poliomyelitis

encourage bed rest, direct and indirect contact

149

mumps

ear ache, soft foods, direct and indirect contact

150

scarlet fever

Tx PCN 7-10 days, large droplets and direct contact, fast progressivebeta hemolytic streptococci, group A

151

diphtheria

bull neck, conjunctivitis, direct and indirect contact, ABx

152

whooping cough (pertussis)

bordetella pertussis, direct and indirect contact, DtaP vaccine

153

Type 1 DM

usually thin build, must inject exogenous insulin to survive, autoimmune destructive process, hyperglycemia progress to ketoacidosis, weight loss

154

S.sx of type 1 dm

polyphagia, polydipsia, polyuria

155

Tx for type 1

3 meals, 3 snacks, carb counting, insluin (long acting, fast acting)

156

somogyi

rebound

157

dawn phenm.

increase of BS in am due to hormones

158

Type 2 Dm

strong genetic predispostion, overwight, inactive, HTN, hyperlipidemia, diet, excercise

159

S.sx of type 2

3 p's without weight loss, yeast infection, increase sleep, fatigue, dark mark on back of neck

160

tx for type 2

educate, 3 meals, 1 snack, decrease carb intake/sodium/fat/calories, diet exercise, oral Rx or insulin

161

chronic complications of DM

microvascular (eyes, kidneys) type 1
macrovascular (heart) type 2

162

trisomy 21 defect

down syndrome

163

S.sx of down syndrome

broad flat nose, asian appearance, brushfileds spots, back of head flat, congenital heart defects

164

what issues can you have with feeding

large tounge, feed slowly

165

missing portion of chormosome 5

cri-du-chat syndrome

166

S.sx of cri-du-chat syndrome

distinctive weak high pitched cry (cat), microcephaly, eyes far apart, severe mental retardation

167

presence of one or more X chromosomes

klinefelters syndrome

168

clinical manifestations of klinefelters syndrome

no distinctive physical characteristics before onset of puberty, infertility, decreased 2ndary sex characteristics, mental impairment

169

Tx for klinefelters syndrome

none, can give testosterone to increase male characteristics

170

only one functional X chromosome

turners syndrome
99% females die inutero

171

Tx for turners syndrome

growth hormone, estrogen

172

lacks HexA enzyme necessary for lipid metabolism

tay sach's disease
found in jewish population

173

S/sx tay sach's disease

normal for 1st 6 months, then regress, loss of head control, exaggerated moro, severe mental retardation, blind, seizures, live to 3-5 years die r/t cachezia, pneumonia

174

disease of metabolism, phenylalanine is an essential amino acid necessary for growth and repair of body cells

PKU phenylketonuria

175

PKU

increased phenylanlanine (builds up in brain tissue)
tyrosine (fair blond hair, blue eyes

176

S.sx of PKU

seizure, exzema

177

Dx for PKU

heal stick after 2 full days of mild feeding, then test again

178

Tx for PKU

keep blood level below 8 (2-8)
stay away from milk, nuts, meats, eggs, cheese, bread, rice, corn, pasta

179

inborn error of metabolism, autosomal recessive, child is deficient in the liver enzyme galactose 1 phostphate uridyl transferase

galactosemia
(build up of galactose in brain liver eyes)
cataracts seizure, lethargy

180

S.sx of galactosemia

appear normal at birth, after start of feedings, vomit & have weight loss, E coli sepsis,

181

Tx for galactosemia

NO BREAST FEEDINGs, formula feedings (lactose free),

182

group of inherited blood disorders characterized by deficienceies in the rate of production of specific globin chains of Hgb

thalassemia
increase of incidence in ppl live near mediterranean sea

183

S/sx

dont show until 6 months (fetal Hgb is replaced by adult Hgb), pale, tired, anorexia, Hgb less 5 g/100ml, epistaxis is common, bronzed skin

184

tx for thalassemia

prevent heart failure, transfuse RBC every 2-4 weeks, iron chelating agent (removes excess iron stores), spleenectomy, cure is possible with bone marrow transplant, but usually die in adolesence due to cardiac failure

185

gene level defect sex linked, deficiency of both T & B cells, unable to fight infection

severe combined immunodeficiency disorder (SCID)

186

Dx of severe combined immunodeficiency disorder (SCID)

hx of infection, family hx, lymphocytopenia

187

Tx for severe combined immunodeficiency disorder (SCID)

bone marrow transplant, gene therapy, if untx DIE
BUBBLE BOY

188

group of muscle diseases in childhood lack of protein needed for muscle contraction, progressive weakness and wasting of skeletal muscle

muscular dystrophy
usually only live 20 years

189

S.sx of muscular dystrophy

waddling gait, gowers sign (get up very slowly), progressive weakness and wasting of skeletal muscle

190

Dx of muscluar dystrophy

muscle biopsy, EMG, serum CPK (elevated in skeletal muscle injury)

191

groups of bleeding disorders in which there is a deficiency of one of the factors necessary for coagulation of the blood, sex linked X recessive

hemophila
female is carrier, males have disease

192

which factor is the intrinsic factor of coagulation

factor VIII

193

Dx of hemophillia

platelet cound WNL, prothrombin time WNL, thromboplastin abnormal, PTT abnormal

194

S/sx of hemophilia

painful/swelling at joints, GI bleeds, nose bleeds,

195

Tx for hemophilia

control bleeding, administer factor VIII, prevention is key

196

if injury occurs

IV factor VIII, immpbilize joint, ice, avoid sutures
NO ASA!!!