Sick School-Aged Children

Question 1

a disorder in which blood sugar (glucose) levels are abnormally high because the body does not produce enough insulin or fails to respond normally to the insulin produced.

Answer 1

diabetes mellitus

Question 2

a group of conditions with high blood glucose levels (hyperglycemia) caused by decreased insulin production, decreased effect of insulin, or both.

Answer 2

diabetes mellitus

Question 3

types of diabetes (3)

Answer 3

• prediabetes
• type 1 diabetes
• type 2 diabetes

Question 4

type of DM in which blood glucose levels are too high to be considered normal but not high enough to be considered diabetes.

Answer 4

prediabetes

Question 5

type of DM that is more common among obese adolescents.

Answer 5

prediabetes

Question 6

type of DM that occurs when the pancreas produces little or no insulin.

Answer 6

type 1 diabetes

Question 7

most common type of DM among children, causing about two thirds of all cases of diabetes.

Answer 7

type 1 diabetes

Question 8

type 1 diabetes can develop at any time during childhood, even during infancy, but it usually begins between _ or between ages _.

Answer 8

type 1 diabetes can develop at any time during childhood, even during infancy, but it usually begins between ages 4 years and 6 years or between ages 10 years and 14 years.

Question 9

signs and symptoms of type 1 DM (8): FIB FIB EU

Answer 9

• frequent urination
• increased thirst
• bed-wetting in children
• fatigue and weakness
• irritability and other mood changes
• blurred vision
• extreme hunger
• unintended weight loss

Question 10

treatment for type 1 DM

Answer 10

• injections of insulin
• fluids (to treat dehydration) and insulin
• children who do not have DKA at diagnosis typically receive two or more daily injections of insulin

Question 11

DKA

Answer 11

diabetes ketoacidosis

Question 12

types of insulin regimens (3)

Answer 12

• basal-bolus insulin regimen
• multiple daily injections regimen
• premixed insulin regimens

Question 13

insulin regimen that involves taking one or two injections of longer-acting insulin (basal dose) every day and then separate supplemental injections (bolus dose) of a short-acting insulin immediately before meals.

Answer 13

basal-bolus insulin regimen

Question 14

insulin regimen that can be used if the basal–bolus regimen is not an option. In this regimen, children usually receive a form of insulin works quickly before eating breakfast and dinner and at bedtime.

Answer 14

multiple daily injections regimen

Question 15

insulin regimen that use a fixed mixture of two forms of insulin: one that works quickly and lasts for only a few
hours, and one that takes longer to work but lasts longer.

Answer 15

premixed insulin regimens

Question 16

insulin can be injected in several ways (3): IVI

Answer 16

• insulin pen
• vial and syringe
• insulin pump

Question 17

a problem with the body that causes blood glucose (sugar) levels to rise higher than normal.

Answer 17

type 2 diabetes

Question 18

this is also called hyperglycemia. it is the most common form of diabetes.

Answer 18

type 2 diabetes

Question 19

children with _ usually are not treated in the hospital unless the diabetes is severe.

Answer 19

type 2 diabetes

Question 20

treatments for type 2 DM (2): MI

Answer 20

• metformin
• insulin

Question 21

treatment for type 2 DM: the main drug given orally for children and adolescents. it is started at a low dose
and often increased over several weeks to higher doses. it can be taken with food to prevent nausea and abdominal pain.

Answer 21

metformin

Question 22

treatment for type 2 DM: given to children who are hospitalized with severe diabetes. it can often be stopped
after several weeks once glucose levels return to normal after treatment with metformin. children whose type 2 diabetes is not controlled by metformin alone need to take it. about
half of adolescents with type 2 diabetes ultimately require it.

Answer 22

insulin

Question 23

a few children who _ (3) may be able to stop taking the drugs or treatment for type 2 DM.

Answer 23

• lose weight
• improve diet
• exercise regularly

Question 24

an inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever.

Answer 24

rheumatic fever

Question 25

rheumatic fever is most common in ages _ children, though it can develop in younger children and adult.

Answer 25

5-15 years old

Question 26

can cause permanent damage to the heart, including damaged heart valves and heart failure.

Answer 26

rheumatic fever

Question 27

the onset of rheumatic fever usually occurs about _ after a strep throat infection.

Answer 27

2-4 weeks

Question 28

signs and symptoms of rheumatic fever results from inflammation of (4)

Answer 28

• heart • joints • skin • CNS

Question 29

signs and symptoms of rheumatic fever (10): FOPPS CHJFF

Answer 29

• fever • outbursts of unusual behavior, such as crying or inappropriate laughing • painful, swollen and tender joints - knees, ankles, elbows, wrists • pain in one joint that migrates to another joint • small, painless bumps (nodules) beneath the skin • chest pain • heart murmur • jerky, uncontrollable body movements — hands, feet and face • fatigue • flat or slightly raised, painless rash with a ragged edge (erythema marginatum)

Question 30

risk factors of rheumatic fever (3): FTE

Answer 30

• family history • type of strep bacteria • environmental factors - overcrowding - poor sanitation - and other conditions that can easily result in the rapid transmission or multiple exposures to strep bacteria

Question 31

diagnosis of rheumatic fever (3): EBE

Answer 31

• electrocardiogram (ECG) • blood tests • echocardiogram

Question 32

treatment for rheumatic fever (3): AAA

Answer 32

• antibiotics • anti-inflammatory • anticonvulsant

Question 33

treatment for rheumatic fever: what antibiotics are used to eliminate remaining strep bacteria?

Answer 33

penicillin

Question 34

treatment for rheumatic fever: anti-inflammatory drugs to reduce inflammation, fever, and pain (2).

Answer 34

• aspirin • naproxen

Question 35

treatment for rheumatic fever: anticonvulsants for severe involuntary movements (2).

Answer 35

• valproic acid • carbamazepine

Question 36

formerly known as juvenile rheumatoid arthritis, is the most common type of arthritis in children under the age of 16.

Answer 36

rheumatic arthritis or juvenile idiopathic arthritis

Question 37

symptoms of rheumatic arthritis (4): PSSF

Answer 37

• pain - limps, especially in the morning or after a nap. • swelling - common but is often first noticed in larger joints such as the knee. • stiffness - child appears clumsier than usual, particularly in the morning or after naps. • fever, swollen lymph nodes and rash - rash on the trunk may occur, which usually worsens in the evenings.

Question 38

diagnosis for rheumatic arthritis (7): BT (ERAC) ; I (XM)

Answer 38

• blood test - erythrocyte sedimentation rate (ESR) - rheumatoid factor - anti-nuclear antibody - cyclic citrullinated peptide (CCP) • imaging scans - x-rays or MRI

Question 39

complications for rheumatic arthritis (2): EG

Answer 39

• eye problems • growth problems

Question 40

diagnosis for rheumatic arthritis: the sedimentation rate is the speed at which the RBCs settle to the bottom of the tube of blood.

Answer 40

erythrocyte sedimentation rate (ESR)

Question 41

diagnosis for rheumatic arthritis: proteins commonly produced by the immune systems of people with certain autoimmune diseases, including arthritis.

Answer 41

anti-nuclear antibody

Question 42

diagnosis for rheumatic arthritis: this antibody is occasionally found in the blood of children with juvenile idiopathic arthritis.

Answer 42

rheumatoid factor

Question 43

diagnosis for rheumatic arthritis: like the rheumatoid factor, it is another antibody that may be found in the blood of children with juvenile idiopathic arthritis.

Answer 43

cyclic citrullinated peptide (CCP)

Question 44

diagnosis for rheumatic arthritis: may be taken to exclude other conditions, such as fractures, tumors, infection or congenital defects.

Answer 44

x-rays or magnetic resonance imaging (MRI)

Question 45

eye inflammation

Answer 45

uveitis

Question 46

if uveitis is left untreated, it may result in (3): CBG

Answer 46

• cataracts • blindness • glaucoma

Question 47

medication used for treatment of rheumatic arthritis that can inhibit growth

Answer 47

corticosteroid

Question 48

treatment for rheumatic arthritis (2): ND

Answer 48

• nonsteroidal anti-inflammatory drugs (NSAIDs) • disease-modifying antirheumatic drugs (DMARDs)

Question 49

treatment for rheumatic arthritis: these medications, such as ibuprofen and naproxen sodium, reduce pain and swelling. side effects include stomach upset and liver problems.

Answer 49

NSAIDs

Question 50

treatment for rheumatic arthritis: used when NSAIDs alone fail to relieve symptoms of joint pain and swelling or if there is a high risk of damage in the future.

Answer 50

disease-modifying anti-rheumatic drugs (DMARDs)

Question 51

also known as seven-year itch, a contagious skin infestation by a tiny burrowing mite called sarcoptes scabiei.

Answer 51

scabies

Question 52

what mite causes scabies?

Answer 52

sarcoptes scabiei

Question 53

it is contagious and can spread quickly through close physical contact in a family, child care group, school class, nursing home, or prison.

Answer 53

scabies

Question 54

signs and symptoms of scabies typically appears _ after infestation for individuals never before exposed to scabies.

Answer 54

2-6 weeks

Question 55

signs and symptoms of scabies (2): IR

Answer 55

• itching • rash/thin, irregular burrow tracks

Question 56

rash / thin, irregular burrow tracks made up of tiny blisters or bumps, typically appear in folds of the skin. though may appear in almost any part of the body, it is most often found (9)

Answer 56

• finger webs • soles of the feet • ventral wrists • inner elbow • back • buttocks • external genitalia • armpits • male genital area

Question 57

in infants and young children, common sites of infestation in scabies usually include the (3):

Answer 57

• skin of the face • scalp • acropustulosis

Question 58

blisters and pustules on the palms and soles of the feet, are characteristic symptoms of scabies in infants.

Answer 58

acropustulosis