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Flashcards

Final Examino N304

Kate Caldwell N304-Peds English 249 cards

Cards in this deck (249)

  1. 1Which two things commonly cause Otitis Media?HIB and Pneumoniae
  2. 2Why are ear infections frequent in kids?Because of their short eustachian tube
  3. 3If a child is older than 6 months, how do we treat an ear infection?Wait 72 hours to see if it disappears, and if not, see an MD for Amoxicillin
  4. 4How does Otitis Externa symptomology differ from otitis media?Externa will have pain and redness, but NO fever
  5. 5What beverage should be avoided with viral tonsillitis?citrus!
  6. 6How do we treat bacterial tonsilitis?PCN
  7. 7What is the biggest risk post- tonsilectomy?bleeding! can occur up to 10 days after surgery
  8. 8What is a common sign of bleeding after a tonsilectomy?frequent swallowing
  9. 9How should a child be positioned after a tonsilectomy?Abdomen or side lying to promote secretions
  10. 10Laryngitis is AKA what?The midnight croup
  11. 11What are s/s of Midnight Croup?Barking cough with NO FEVER
  12. 12What med can help child with severe croup?Racemic Epi
  13. 13What are s/s of Acute Epiglottitis?Drooling, Dysphagia, Dysphonia, TRIPOD BREATHING
  14. 14What should not be done to a patient with acute epiglottitis?No throat examinations...can block airway
  15. 15Which vaccine prevents Acute Epiglottitis?HIB!
  16. 16Which virus causes Pertussis?Bordetella
  17. 17Which virus causes Vronchiolitis?RSV
  18. 18Which vaccines can prevent Bronchiolitis?Respigam/Synagis (given to premies or heart kids) and Ribaviron
  19. 19When coughing, if it hurts, what should be done?Splint the abdomen
  20. 20What classifies Apnea?cessation of breathing for > 20 seconds
  21. 21Who is susceptible to Bronchopulmonary Dysplasia?Premies or those on mechanical vents...AKA the Cronic Lung disease of the NEwborn
  22. 22How do we treat chronic lung disease of the newborn?O2 therapy and a high calorie, high fat diet
  23. 23Which drug may we also give chronic lung disease of the newborn patients to increase lung compliance?Caffeine
  24. 24What causes CF?atypical chloride secretion in the respiratory and exocrine systems
  25. 25How do we diagnose CF?sweat test....will have Na+ and Cl- in sweat
  26. 26What will stool of CF patient appear like?Frothy, greasy, and foul smelling
  27. 27What vitamins are deficient in CF kids?ADEK: they can't absorb fat well
  28. 28For CF patients, what needs to be given 30 minutes before each meal?Pancreatic Enzyme Replacement
  29. 29What is the best measure of kidney function?Creatinine
  30. 30How do we diagnose Enuresis?Bed wetting 2x per week for 3 months AND be 5 years old developmentally
  31. 31What is normal urine output?1-2 ml/kg/hour
  32. 32What is Vesicoureteral Reflex?When urine flows from the bladder back into the ureters and kidneys
  33. 33What is Obstructive Uropathy?Something is blocking urinary flow (stones, stenosis, etc), so urine backflows into the kidneys
  34. 34What is post-urethral valve?When urine flows from the urethra back into the bladder due to tissue blockage
  35. 35What are s/s of an obstructive uropathy?UTI, hematuria, incontinence
  36. 36What surgery can be done to help chronic obstructive uropathy?Illeal Conduit, where the ureters are removed from the bladder and connected to act as the bladder
  37. 37What is Cryptorchidism?Undescended testes
  38. 38How do we correct undescended testes?Orchiopexy...surgery to descend them
  39. 39When should testes descend in utero?7-9 months (so premies commonly aren't descended)
  40. 40What is Phimosis?Narrowing of the foreskin opening so it can't be retracted
  41. 41With hypospadias, when should circumsision be done?Later....may need foreskin for reconstruction surgery
  42. 42What do we detect Hydrocele?Transillumination of the testes to ID that it is JUST fluid and not a tumor
  43. 43How do we diaper a child with bladder exstrophy?Double diaper, so pee is separated from poop to prevent infection
  44. 44When does AGN occur?1-2 weeks after strep infection
  45. 45What are s/s of AGN?hematuria, edema, HTN
  46. 46How do we diagnose AGN?ASO antibody titer
  47. 47How do we treat AGN?diuretics to lower the BP and ACE inhibitors
  48. 48What happens with Nephrotic syndrome?Abnormal protein loss in the urine
  49. 49What are s/s of Nephrotic syndrome?Anascara, low albumin, protein in the urine, high cholesterol and DARK, froathy urine
  50. 50How do we treat nephrotic syndrome?Steroids and IV immuneglobulins
  51. 51Nephrotic syndrome kids will often need what done in the future?Kidney replacement
  52. 52When should all fetal shunts be closed?Within 24-48 hours after birth
  53. 53IN the womb, what side of the heart has higher pressure?Higher pressure on the right side in utero, but at birth, high pressure shifts to the left side
  54. 54What closes the foramen ovale and ductus arteriosis?Pressure change
  55. 55What closes the ductus venosus?lack of blood flow
  56. 56Which murmurs are associated with cyanosis?Pathological murmurs: graded on a scale of 1-6
  57. 57If a murmur is noted, what should be done?BP in all 4 extremities to rule out coarctation of the aora
  58. 58Post Op cardiac cath, how should child be positioned?Supine and flat with legs straight
  59. 59What are s/s of congestive heart failure?tachycardia, low urine, ascites, respiratory distress
  60. 60What two things are done to treat CHF?Diuretics and Digoxin
  61. 61What is a therapeutic Digoxin level?0.8-1.2 ng/ml
  62. 62If Dig Tox, what are s/s?Vomiting and low HR
  63. 63How is blood shunted with Cyanotic Heart Diseases?Right to Left shunt of blood flow (lungs not involved)
  64. 64How is blood shunted in Acyanotic Heart Diseases?Left to Right shunt of blood flow
  65. 65Which two classes of disorders fall under Cyanotic Heart Diseases?Those of decreases pulmonary blood flow and those of mixed blood flow
  66. 66Which two classes of disorders fall under ACYANOTIC heart diseases?Increased Pulmonary Blood Flow and Obstruction to Blood flow from ventricles
  67. 67Which two disorders involve DECREASED PULMONARY BLOOD FLOW?Tetralogy of Fallot and Tricuspid Atresia
  68. 68What are s/s of decreased pulmonary blood flow disorders?Cyanosis, polycythemia, low SpO2
  69. 69Which 3 disorders fall under MIXED BLOOD FLOW disorders?Transposition of the Great Arteries, Truncus Arteriosis, and Hypoplastic Left Heart Syndrome
  70. 70What are s/s of Mixed Blood Flow disorders?Cyanosis, HF, poor weight gain, and murmur
  71. 71Which 4 disorders fall under INCREASED PULMONARY BLOOD FLOW Disorders?Atrial septal defect, ventricular septal defect, patent ductus arteriosis, and atrioventricular canal
  72. 72What are s/s of Increased Pulmonary Blood Flow disorders?murmur, poor feeding, CHF, increased respiratory infections
  73. 73Which 3 disorders are OBSTRUCTION TO BLOOD FLOW FROM VENTRICLES conditions?coarctation of the aorta, aortic stenosis, and pulmonic stenosis
  74. 74What are s/s of obstruction to blood from the ventricles disorders?Increased pressure in the heart and increased workload
  75. 75What happens with Atrial Septal Defect?There is a hole in the wall that divides the atria because the Foramen Ovale didn't close: SO, the RA fills with mixed blood when it should be ALL deoxygenated
  76. 76What happens with Ventricular Septal Dfect?Hole between the two ventricles with a high risk for HF because the right ventricle can't handle this high pressure!
  77. 77With a Patent Ductus Arteriosis, what do we give to keep it open? What to close it?Prostaglandins to keep open, Indomethicin to close
  78. 78What is Atriocentricular Canal Septal Defect? What is commonly effected?A Large hole in the middle of the heart; commonly effected valves
  79. 79Which population of kids is Atrioventricular Canal common in?Down's Syndrome kiddos
  80. 80What hapens with Coarctatino of the Aorta?Aortic arch is narrowed, so more blood goes to the head and lower extremities have a weak blood flow
  81. 81How do we treat Coarctation of the Aorta?Closed heart surgery OR balloon angioplasty to expand the aorta
  82. 82What is Aortic Stenosis?Obstruction to blood flow from the left ventricle to the Aorta
  83. 83What is PUlmonary Stenosis?Obstruction to blood flow from the RV to the pulmonary artery
  84. 84Which FOUR conditions need to be present in order for a Tetrology of Fallot diagnosis?Right Ventricular Hypertrophy, Overriding Aorta, Ventricular Septal Defect, and Pulmonary Stenosis
  85. 85What position should child be placed in during a Tet spell?KNEE TO CHEST
  86. 86In order for a child with Tricuspid Atresia to remain alive, what two "holes" need to be open?Foramen Ovale and Ductus Arteriosis
  87. 87What is the size of the RV with tricuspid atresia?SMALL
  88. 88What is the size of the RV with Pulmonary Atresia?LARGE
  89. 89What occurs with Transposition of the great arteries?Aorta and Pulmonary Artery switch places!
  90. 90What is Truncus Arteriosis?Only ONE artery leaves the RV and LV, creating a mixing of blood
  91. 91Which heart chamber is really small with Hypoplastic heart syndrome?The LV, so not much blood is pumped to systemic circulation
  92. 92What is Jones Criteria?Major and Minor Criteria for Rheumatic Fever
  93. 93What are the two biggest concerns with Kawasaki Disease?MI and Coronary Aneurysm
  94. 94What are s/s of Kawasaki?Fever that is unresponsive to meds, Strawberry tongue, Conjuctivitis, and Edema of hands and feet
  95. 95Which vaccines should be avoided in Kawasaki patients?No Live vaccines (MMR, Varicella)
  96. 96Which 3 meds are used as Kawasaki treatment?IVIG, anti-platelets, and ASPIRIN (one of the only pediatric uses for it!)
  97. 97Which glasbow coma scale posture is WORSE?Decerebrate...hands and feet outward
  98. 98Which two "signs" are indicative of Meningitis?Kernig's and Brudzinski's
  99. 99If doing a lumbar puncture to assess the CSF, what will labs show if there is an infection?Decreased glucose, because it is being eaten by bacteria
  100. 100Partial seizures involve what area of the brain?Only one hemisphere
  101. 101What are post-dictal symtpoms of a Grand Mal seizure?Tiredness and confusion
  102. 102Which seizure is AKA a "drop and fall" attack?Atonic, when there is lack of muscle tone
  103. 103What is the first line of treatment for status epilepticus?Ativan
  104. 104What is the first line of treatment for a "normal" seizure?Dilantin
  105. 105What's the difference between a Tremor and a Seizure?Tremors stop with restraint, whereas seizures continue
  106. 106Since Spina Bifida Occulta is not visible except for a sacral dimple or hair tuft, what are the two visible forms of Spina Bifida Cystica?Meningocele and Myelomeningoele
  107. 107What is Meningocele?A protruding sac with CSF and meninges
  108. 108What is Myelomeningocele?Protruding sac with spinal cord and root
  109. 109The higher the defect is on the spinal cord...The worse the outcome
  110. 110Which bowel condition do Spina Bifida patients often also have?Neurogenic Colon
  111. 111How should temp be taken with Spina Bifida?NO RECTAL
  112. 112What allergy do NTD babies often have?LATEX: avoid bananas, kiwis, and berries (Trace elements in them)
  113. 113What are s/s of hydrocephalus in an infant?Enlarged head, bulging eyes (sunsetting eye), bulging fontanelles, MacEwen sign, and Opisthotonos
  114. 114What is Macewen sign?cracked pot sutures on the head of infants with hydrocephalus
  115. 115What is Opisthotonos?Arching of head and limbs back to relieve pressure: common in hydrocephalus infants
  116. 116What are s/s of hydrocephalus in kids?H/A, vomiting, behavior changes ,seizures
  117. 117Which surgical treatment treats hydrocpehalus if the child is > 5?VP shunt
  118. 118POst-Op VP shunt, what should be restricted?Fluids: also avoid contact sports!
  119. 119What are s/s of Meningitis?FEver, H/A, changed LOC, photophobia, nuchal rigidity, Kernig Sign (pain when legs are elevated), BRudzinski sign ( when head elevates, knees do too)
  120. 120Which pain meds should NEVER be given with meningitis?Opioids, because they mask s/s of increased ICP
  121. 121What are s/s of ataxic CP?Poor coordination, balance, and control of extremities
  122. 122What is the med of chioce for CP?Baclofen
  123. 123What are early s/s of CP?scissoring gait, toe walking ,early handedness
  124. 124What 'Ps" do we assess with fractures?Pain, Pallor, Pulselessness distal to fracture, Parathesia distale to fracture, Paralysis
  125. 125How long can swelling take to appear? What should be held off until this period?72 hours---dont' cast before this....can cause Compartment syndrome
  126. 126What is a Comminuted fracture?Basically a crush injury where there are tons of pieces of bone
  127. 127How do Casts help?Don't improve healing time, but help pain because there is no bone movement
  128. 128How does traction work?Decreases muscle spasms
  129. 129What is the Illizarov External Fixator?More common than traction---its those things you put on your legs to lengthen bones or aid in limb deformatinos
  130. 130How does the Illizarov External Fixator work?Wires are inserted through bone and a key turns them to separate bone---new bone forms to fill in the holes!
  131. 131What is Talipes Equinovarus?Clubfoot, where the foot goes down, then in
  132. 132What are s/s of Hip Dysplasia?Assymetrical gluteal folds, Ortalani's Click, Shorted femur, and Trendelenberg sign
  133. 133What is Trendenberg Sign?In kids with hip dysplasia: Stand on affected side to the unaffected side's hip drops
  134. 134Between birth and 6 months of age, how do we treat Hip Dysplasia?Pavlik Harness: helps to move the femoral head back into the socket and keep the legs abducted
  135. 135Is tummy time still allowed with a Pavlik Harness?yup
  136. 136What is Perthes Disease?Aseptic Necrosis of the femoral head
  137. 137Which age group is Perthes Disease common in?4-8
  138. 138What is the goal of treatment with Perthes Disease?To preserve femoral head roundness
  139. 139What is Slipped Capital Femoral Ephiphysis?Inferior and Posterior displacement of the femoral head
  140. 140Who is SCFE common in?9-16
  141. 141What is osteomyelitis?Bacterial infection of bone and soft tissue
  142. 142If the Sed rate decreases with antibiotic treatment for Osteomyelitis, what does this mean?treatment is working!
  143. 143With Osteogenesis Imperfecta, what will labs show?normal Ca+ and Phosphorus, but LOW pre-collagen levels (low collagen--> no connective tissue)
  144. 144What is evident in teens with OI?blue grey teeth and hearing loss
  145. 145Which two drugs help OI patients?Calcitonin to heal bone and Biphosphonates to increase bone mass
  146. 146If spinal curve is <20 degrees, how do we treat?watch and wait
  147. 147IF spinal curve is 20-50 degrees, how do we treat?Brace (wear over a t-shirt)
  148. 148If spinal curve is >50 degrees, how do we treat?Spinal fusion
  149. 149Post-Op spinal fusion, how should patient be positioned?Flat
  150. 150A sprain is an injury of what? Strain?Sprain is an injury of ligament; Strain is an injury of muscle
  151. 151What is the most common form of muscular dystrophy?Duchenne
  152. 152What is the creepy sign of Muscular Dystrophy?Gower Sign: exorcist movement using hands
  153. 153Kids with juvenille arthritis often have problems with what other part of body?Eyes
  154. 154What are s/s of concussion?NV, headache, SIADH, balance issues, anisacoria (constricted pupils)
  155. 155What is the best treatment for concussions?BRAIN REST
  156. 156Which organ creates clotting factors?Liver
  157. 157What does Reticulocyte look like with anemia?LOW
  158. 158Which food may be in excess and lead to development of iron deficiency?WHOLE MILK---it does NOT have enough iron
  159. 159What are side effects of iron pills?make poop dark
  160. 160What increases iron absorption?orange juice
  161. 161When do sickle cell crises commonly occur?During stress, infection, trauma, and high altitudes: any time oxygen need is increased
  162. 162Which sickle cell disease is the most common?Vaso-Occlusive
  163. 163how do we treat sickle cell crisis?hydration, oxygen, morphine, antibiotics prophylactically
  164. 164Which population commonly has Beta Thalassemia?Greeks and Italians
  165. 165Thalassemia Major (Cooley Anemia) will present with what s/s?protruding forehead, maxillary prominence, wide set eyes, and a flattened nose. Also jaundice and pathological fractures are common
  166. 166How and what does Hemosiderosis treat?Treats thalassemia and its iron overload: iron chelating drugs like Desferal bind to excess iron for excretion by the kidney
  167. 167Which factor is missing with Hemophilia A?VIII
  168. 168Which factor is missing with Hemophilia B?IX
  169. 169Which factor is missing wit hVon WIllebrand Hemophilia?Von Willebrand factor (carrier of factor VIII)
  170. 170Which two treatments help Hemophilia?Replacement of factor using FFP, and Vasopressin to increase factor VIII and Von Willebrand
  171. 171What are s/s of lead poisoning?Anemia, coagulation impairment ,encephalopathy, blindness and deafness
  172. 172If Iron is low, what happens to lead absorption?It is increased
  173. 173If lead levels are over >20, what do we do?Treat!: Chelation Therapy to bind to lead and remove it
  174. 174What are s/s of Impetigo?Honey colored crusted lesions with mega ooze
  175. 175Which med treats Impetigo?Bactroben
  176. 176What will skin look like with Cardidiasis?Beef red and shiny
  177. 177Where does candidiasis tend to proliferate?In creased areas of the skin
  178. 178Which drug treats Candidiasis?Nystatin
  179. 179Tinea Corporis is AKA???Ringworm
  180. 180what does ringworm look like?oval patches with central clearing and raised borders
  181. 181If child has ringworm, when can they go back to school?Once antifungals are started and areas are COVERED
  182. 182What is Tinea Capitis?ringworm of the head
  183. 183Which drug treats Tinea Capitis?Griseofulvin
  184. 184Which shampoo helps with Tinea Capitis?Selsun blue
  185. 185How should Griseofulvin be dosed?With a fatty meal!
  186. 186Which other 2 things does eczema commonly occur with?Asthma and Allergies
  187. 187How does an infant present with eczema?reddened vessicles on cheeks
  188. 188What kind of skin will a child with eczema have?Lichenification: leathery skin
  189. 189what are s/s of cradle cap?greasy, salmon colored scaling of face and scalp
  190. 190What kind of shampoo aids cradle cap?Antiseborrheic shampoo like Sebulex
  191. 191What will Eosinophills be with poison ivy?Increased Eosinophills
  192. 192What is treatment for neonatal acne?NONE
  193. 193When will itching be most intense with Scabies?at night
  194. 194Which two drugs treat scabies?Permethrin and Lindane
  195. 195Which drug treats Lice?Permethrin (Nix)...comb hair after to rid of nits
  196. 196What is an adverse side effect of Lindaine?Seizures
  197. 197What's another name for Rubeola?Red Measles
  198. 198What are the 3 C symtpoms of Rubeola?Cold, Cough, and Conjunctivitis
  199. 199What will appear 2 days before a Rubeola rash?Koplik's spots in the mouth
  200. 200What's another name for Rubella?German Measles
  201. 201Does Rubeola or Rubella have a high fever?HIGH FEVER WITH RUBEOLA
  202. 202What is a rash a sign of with Roseola?recovery
  203. 203With Fifth's disease, when are kids most infectious?BEFORE rash
  204. 204What can help kids with hand foot mouth disease to eat and drink?Magic Mouthwash: mouth may be sore with lesions
  205. 205What are s/s of Scarlet FEver?Strawberry tongue and beefy red tonsils
  206. 206What appears on creases of skin with Scarlet Fever?Pastia lines
  207. 207What happens to BS with GH deficiency?low blood sugar
  208. 208How do we treat low GH?Somatropin injections 3-4 times per week
  209. 209If congenital hypothyroidism is left untreated, what can it lead to?retardation
  210. 210What will thyroid levels look like with congenital hypothyroidism?LOW T4 and HIGH TSH
  211. 211When should thyroid levels be tested in newborns?At least 48 hours after birth to ensure a false high isn't received
  212. 212When dosing thyroid replacement meds, what should be done before and after?Taking pulse!
  213. 213With Salt Losing Congenital Adrenal Hyperplasia, what adrenal hormones are lacking?No Cortisol or Aldosterone
  214. 214What are s/s of Salt Losing CAHLow BS, salt and water loss, masculinization (from increased andreogens)
  215. 215How do we treat salt-losing CAH?Cortisone, Aldosterone, and Florinef replacements
  216. 216What occurs with PKU?Lack of enzyme, so phenylanine can't be converted to tyosine--> low tyrosine leads to melanin deficiency--->high phenylalanine leads to seizures, brain damage, and retardation
  217. 217What is the Mosaiacism of Down's?Some cells have tisomy, and some cells don't, so every Down's kid has different level of functioning
  218. 218What are physical s/s of Down's?low set ears, broad nose, simian crease, large tongue
  219. 219What are physical s/s of Fragile X?long face, high arched palatte, large ears
  220. 220What are physical s/s of FAS?Flat face, low nasal bridge, smooth philtrum, small upper lip
  221. 221What is the RED FLAT of autism?poor language development
  222. 222What are side effects of CNS stimulants used to treat ADHD?weight loss, insomnia, decreased appetite
  223. 223What age group are bruises uncommon?Those who are immobile (<1)
  224. 224A red bruise is how old?1-2 days
  225. 225A blue bruise is how old?2-5 days
  226. 226A brown bruise is how old?10-14 days
  227. 227most pediatric cancers are from which cells?Mesodermal
  228. 228What are s/s of Leukemia?pallor from anemia, bruising from low platelets, infection from low WBC, and bone pain
  229. 229What is the gold standard for leukemia diagnosis?Bone marrow aspiration
  230. 230What is the most common CNS tumor in kids?Brain tumor
  231. 231What is the 2nd most common CNS tumor in kids?Neuroblastoma
  232. 232With metastatis of neuroblastoma, what occurs?Raccoon eyes
  233. 233With neuroblastoma, which age group has the best prognosis?Those < 1 year
  234. 234With a bone or soft tissue tumor, what happens to alkaline phosphtase?increases
  235. 235Where is osteogenic sarcoma found?shaft of long bones
  236. 236What is treatment for osteogenic sarcoma?Amputation :(
  237. 237Where is Ewing's Sarcoma found?bone marrow spaces
  238. 238How do we treat Ewing's Sarcoma?Radiation and chemo
  239. 239What cells cause Rhabdomyosarcoma?Undifferentiated cells that SHOULD have become striated muscle
  240. 240What organ is effected by Wilm's tumor?Renal tumor, so kidneys
  241. 241Because WIlm's tumor is well encapsulated, what should NOT be done during assessment?palpation
  242. 242What is treatment for Wilm's tumor?nephrectomy
  243. 243What is the big s/s of Retinoblastoma?Cat's eye reflex (white reflexion on pupil)
  244. 244How do we treat retinoblastoma?Eunucleation (removal of eye)
  245. 245Kids are 0-2 are in what Piaget stage? How do they view death?Sensorimotor: View death as a loss of the caregiver
  246. 246Kids age 2-7 are in what Piaget stage? How do they view death?Preoperational stage: blame themselves for others' deaths, death is reversible, and are magical thinkers
  247. 247What stage are kids age 7-12 in? How do they view death?Concrete Operational: View death as sad and irreversible
  248. 248Teens are in what Piaget stage? How do they view death?Formal operations: Death is real but distant
  249. 249What are s/s that death is near?increased sleep, loss of appetite, Cheynee-Stokes respirations, weak slow pulse

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N304-Peds Flashcards on Final Examino N304, created by Kate Caldwell on 02/12/2013.
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