peds65

Question 1

scalding injuries

Answer 1

from hot liquids; most common types of burns

Question 2

glasgow coma scale assess what?

Answer 2

eye opening (1-4), best motor response (1-6), and best verbal response (1-5)

Question 3

eye opening

Answer 3

none, response to pain, response to voice, spontaneously

Question 4

motor

Answer 4

none, decerebrate, decorticate, flexion withdrawl, localizes pain, obeys commands

Question 5

verbal

Answer 5

none, incomprehensible, innapropriate words, disoriented conversation, oriented

Question 6

glasgow coma scores

Answer 6

13-15 mild head injury; 9-12 moderate; less than 8 severe

Question 7

first degree burns

Answer 7

involve only the epidermis; characterized by red, blanching, painful skin that heals without scarring

Question 8

second degree burns

Answer 8

involve the entire epidermis and part of the dermis; superficial or deep

Question 9

second degree superficial burn

Answer 9

partial thickness burns involve the entire epidermis and outer portion of the dermis; moist, painful and red; they blister but does not scar

Question 10

second degree deep partial thickness burns

Answer 10

involve destruction fo the entire epidermis and lower part of the dermis; burns are pale white. They may blister and they heal with scarring

Question 11

third degree burns

Answer 11

full thickness burns involve the complete destruction of the epidermis, dermis, and part of the subcutaneous tissue; bruns are dry, white, and leathery to the touch and skin grafts are needed

Question 12

skin grafts for third degree burns

Answer 12

yes right

Question 13

painful third degree burns?

Answer 13

no, usually victim is insens to pain

Question 14

management of burns

Answer 14

ABCs (endotracheal intub, assess oxygenation, IV access through nonburned skin)

Question 15

why is fluid resuscitation critical in management of burn victims

Answer 15

lots of fluid can be lost through the skin and leaky capillaries

Question 16

first degree burns management

Answer 16

moisturizers and analgesics

Question 17

second degree burns management

Answer 17

analgesics, debridement of dead skin to prevent infection; bullae (large blisters are not removed because forms barrier; ruptures bullae should be removed

Question 18

third degree burn management

Answer 18

skin grafting and hydrotherapy; escharotomy may be needed if burn restricts blood flow or chest expansion

Question 19

escharotomy

Answer 19

surgical removal of a constricting scar

Question 20

antibiotics are important in the treatment of scars

Answer 20

in second and third degree burns; topical 1 percent silver sulfadiazine

Question 21

what is a “near drowner”

Answer 21

victim who survives sometimes only temporarily, after asphyxia when submerged in a liquid

Question 22

how does death by drownign happen?

Answer 22

asphyxia by aspirating liquid (wet drowner) or from larygospasm (dry drowner)

Question 23

how does inhaling liquid hurt you?

Answer 23

denaturing of surfactant, alveolar instability and collapse and pulm edema

Question 24

respirations in a near drowner

Answer 24

absent or irreg; and the victim may cough up a pink frothy material;

Question 25

lungs in a drowner on physical exam

Answer 25

rales, rhonchi, or wheezes

Question 26

how does a drowner get pneumonia

Answer 26

aspiration of fluid containing mouth flora

Question 27

how does a drowner get neuro insult

Answer 27

hypoxia

Question 28

other features of near drowning

Answer 28

CV abnormalities, heamtologic abnormalities, renal failure

Question 29

management of near drowner

Answer 29

ABCs, cervical spine immobilization, removal of wet clothing, intubation and mechanical ventilation, rewarming of body core

Question 30

why do you do cervical spine immobilization

Answer 30

possibility of coexistent head trauma

Question 31

why removal of wet clothing in a near drowner?

Answer 31

to reduce heat loss

Question 32

how to rewarm a patient who has drowned

Answer 32

warm saline gastric lavage, bladder washings, or peritoneal lavag should be perforemd if needed. Resuscitation should continue until patient temp is 32 deg C

Question 33

prognosis in a near drowner

Answer 33

children have a better outcome than adults because their primitve dive reflex shunts blood to vital organs

Question 34

risk of child abuse is greatest in which kids?

Answer 34

less than 4 years old; mental retardation; history of premature birth; chornic illness

Question 35

bruises inflicted injury vs noninflicted trauma

Answer 35

inflicted in bruises on fleshy or protected areas; exposed areas are typically noninflicted

Question 36

accidental vs nonaccidental burns

Answer 36

accidental have irreg, splashlike config; nonaccidental have a clear line of demarcation (glovelike pattern suggests submersion)

Question 37

what fracturs are highly suggestive of abuse?

Answer 37

metaphyseal fractures (bucket or corner fractures); fractures of the posterior or first ribs, sternum, scapula, and vertebral spinous processes

Question 38

leading cause of death and morbidity due to child abuse

Answer 38

head injury

Question 39

shaken baby syndrome

Answer 39

kids les than 2 yo; head injury

Question 40

lab studies for suspected child abuse

Answer 40

within 72 hours of abuse; tests for STDs, incl HIV; pregnancy test and test vaginal fluid for sperm

Question 41

SIDS

Answer 41

death of an infeant younger than 1 year whose death remains unexplained after a thorough case eval

Question 42

most common cause of death in kids less than 1 years

Answer 42

SIDS

Question 43

peak incidence of SIDs

Answer 43

2-4 mos

Question 44

typical victim of SIDs

Answer 44

found dead in the morning in bed after being put to sleep at night

Question 45

most common autopsy finding in SIDS

Answer 45

intrathoracic petechiae (unknown cause), pulm congestion or edema, small airway inflamm and evidence of hypoxia

Question 46

how do most poisonings happen

Answer 46

kids less than 6 yo; 90 percent are accidental; at home when the childs caregiver is distracted; usually ingested; mortality less than 1 percent

Question 47

most common toxic exposures

Answer 47

cosmetics and personal care products; cleaning agents; cough and cold preparations; vitamins (iron); analgesics; plants, alcohols; carbon monoxide; prescription meds

Question 48

bitter almond

Answer 48

cyanide

Question 49

garlic smell on a kid that ingested a poison

Answer 49

arsenic or organophosphates