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APEA - Pre predictor > Peds CE 6 > Flashcards

Peds CE 6 Flashcards

1
Q

ADHD core sx
3

A

hyperactivity
impulsivity
inattention

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2
Q

ADHA - what always occurs together

A

hyperactivity and impulsivity

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3
Q

ADHA - hyperactivity and impulsivity course - observed, peak, decline
4

A
  1. observed by age 4
  2. peak over 3-4 yrs
  3. hyperactive symptoms begin to decline after age 8
  4. not usually observable by adolescence
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4
Q

ADHA - inattention is not usually apparent before what age

A

8-9 years

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5
Q

ADHA DSM 5 criteria includes
3

A
  1. sx must be present prior to age 12
  2. sx last > 6 months
  3. sx evident in 2 different settings
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6
Q

ADHD when to start meds

A

meds are first line for children >6

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7
Q

ADHA rx
2

A

methylphenidate
amphetamines

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8
Q

ASD routine screening at what ages

A

9, 18, 24, 30 month visits

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9
Q

HAs - what imaging if preferred

A

MRI is preferred unless something is rapidly developing

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10
Q

HA red flags
5

A
  1. awakens child
  2. thunderclap HA
  3. associated with neuro findings - n/v, AMS
  4. age < 3
  5. absent family hx of migraines
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11
Q

most common acute recurrent HA in children

A

migraines

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12
Q

migraine HA med

A

topiramate 12 years and older

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13
Q

lead toxicity can masquerade as what

A

iron def anemia

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14
Q

lead toxicity exposure
6

A
  1. dust from old house paint
  2. water
  3. food
  4. lead pipes
  5. sucking on toys
  6. jewelry
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15
Q

lead toxicity sx
5

A
  1. fatigue
  2. GI - stomach ache, constipation
  3. irritability
  4. renal changes
  5. cognitive/behavior changes (irreversible)
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16
Q

what percent of newborns will have phsiologic jaundice

A

60%

17
Q

how does bilirubin develop

A

Hepatocyte enzymes conjugate bilirubin for excretion through the GI tract but the immature liver can’t get rid of bilirubin fast enough (not enough enzymes) so levels increase

18
Q

bilirubin clearance pattern in newborns

A
  1. bilirubin usually peaks in full term neonates on 3-4 days
  2. premature neonates, usually peaks on days 5-7
19
Q

tx for hyperbilirubinemia

A

phototherapy

20
Q

pathologic jaundice value

A

TB >25-35

21
Q

pathologic jaundice - elevated TB increases risk of what

A

neurologic dysfunction from free bilirubin that can cross the BBB

22
Q

pathologic jaundice can be caused by
3

A
  1. increased production due to hemolysis (ABO incompatibility, sepsis)
  2. decreased removal of bilirubin due to enzyme deficit or maternal/fetal endocrine problems
  3. poor feeding
23
Q

SCD - high risk of infection due to what

A

functional asplenia - spleen quits working due to occlusion of vessels

24
Q

SCD - what are major parts of care plan

A

prevention of infection and good nutrition

25
Q

SCD prevention
3

A
  1. prophylactic PNC BID in children
  2. infection can precipitate SC crisis
  3. fever can be life-threatening
26
Q

child with SCD - immunization

A

do not defer, get them immunized

27
Q

when WBC, RBC, and plts are all low - think what

A

bone marrow

28
Q

cancer of the bone marrow =

A

leukemia

29
Q

most common form of cancer in children

A

leukemia

30
Q

leukemia age

A

msot common 2-8 years
peaks 4 years
can occur at any age

31
Q

two types of leukemias

A
  1. acute lymphocytic leukemia ALL 70%
  2. acute myelogenous leukemia AML 11%
32
Q

leukemia s/sx
6

A
  1. anorexia, weight loss
  2. hepatosplenomegaly (60%+)
  3. fever
  4. bleeding, plt <100k
  5. persistent bone pain, long bones
  6. lymphadenopathy (50%)
33
Q

leukemia - lymph node rules
4

A
  1. > 10 mm = enlarged
  2. epitrochlear enlarged if > 5mm
  3. inguinal enlarged if > 15 mm
  4. cervical enlarged if > 20 mm
34
Q

leukemia - nodes, consider malignancy if they feel like what

A

nontender, firm, rubbery, matted nodes that are fixed to tissue

35
Q

leukemia diagnostic tests
3

A
  1. CBC w/ diff
  2. peripheral smear: malignant cells
  3. bone marrow aspirate: infiltration with blast cells
36
Q

leukemia CBC w/ diff
3

A
  1. thrombocytopenia present 85% of time
  2. WBC may be normal or elevated, lymphoblasts
  3. anemia is common

APEA - Pre predictor (38 decks)

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