Final Exam - general and head exam pt 2

- Acute pulmonary infection of viral or bacterial origin

- can develop as a complication of viral respiratory tract infections

pneumonia

fever, nonspecific symptoms such as rhinitis, nasal stuffiness, bronchitis

progression from upper to lower respiratory infection

respiratory syncytial virus

respiratory syncytial virus has ___ present 70% of the time

bronchioloitis

what are the clinical manifestations of RSV

dyspnea, severe respiratory distress

what is a normal pulse oximeter reading for peds

95-100%

what pulse oximeter reading indicates pediatric hypoxia

below 90%

a pulse ox reading between 90-05% should warrant what

trip to urgent care

how does the heart sound in a child

louder, higher pitch, shorter duration due to thinness of chest wall

the point of maximum impulse is at the 4th intercostal space until age ___ when it drops to the ___ intercostal space

7, 5th

- Occurs 2 to 6 weeks after streptococcal infection like pharyngitis

- New heart murmur

acute rheumatic fever

what does chronic rheumatic heart disease have

firm, nontender, movable subcutaneous nodules

- associated with history of rheumatic heart disease or preceding dental, urinary, or intestinal procedures

- not common in Peds

- splinter hemorrhages of nails, conjunctival hemorrhages, Janeway lesions (small, painless nodules)

- enlarged spleen, spiking fever

bacterial endocarditis

Part of the intestine folds into the section next to it, often blocking food and fluid from passing through. It's also known as "telescoping"

intussusception

what are c=some s/s of intussusception

initial screaming, progessing to whimper

colicky pain

vomit only at onset and then not again

what is the most frequent cause of bowel obstruction in first 2 years after newborn period

intussusception

is gastro. reflux common during infancy

yes

do infants with reflux usually require intervention

no

s/s of infants with reflux

delayed gastric emptying resulting in forceful vomiting

growth and weight gain are usually adversely affected

management of GER in pediatric patients

formula thickening, antacids

- Non-bilious vomiting, usually projectile, occurring after feeding.

- Starts around 3 weeks of age but can develop as early as first week or as late as 5th month.

hypertrophic pyloric stenosis

t/f

hypertrophic pyloric stenosis will most likely require surgery

true

do males or females get hypertrophic pyloric stenosis more often

males

- 1 to 2-day history of periumbilical crampy or dull pain.

- Followed by nausea and anorexia, with or without vomiting.

- Abdominal pain localized in lower right quadrant at McBurney point.

appendicitis

a child with normal WBC but a high fever between 100-102 is considered (typical or atypical?) this may represent what condition

atypical

appendicitis

infection with Rotavirus can lead to the acute onset of ____

acute gastritis

acute gastritis is concerning because of ___ risk

dehydration

t/f

most children recover from acute gastritis without developing dehydration

true

chronic constipation often results from what

painful defecation causing voluntary withholding

what is a drink that can help kids with constipation

apple juice

scoliosis with a curve

chiro care

periodic reassessment

scoliosis with a curve 20-40 degrees can be treated how?

conservative tx

bracing if progressing

co-management

scoliosis with a curve >40 degrees can be treated how?

bracing

surgery if needed

risk of cardiopulmonary and neuro issues

what is the most common neuromuscular disease

muscular dystrophy

muscular dystrophy is rarely ___ in infancy but may have possible mild hypotonia

symptomatic

a child with muscular dystrophy will begin showing ____ sign and ___ gait at ages 3-6

Gower's. Trendelenburg

ambulation is typically lost between ___-___ years with muscular dystrophy

10-14

Infectious process affecting long bones, typically at the metaphyseal region

osteomyelitis

Early Signs: Localized tenderness, pain on weight-bearing, erythema, warmth, swelling, fever, elevated pulse

Later Symptoms: Severe throbbing pain, limited joint motion

osteomyelitis

what is the organism that causes osteomyelitis

staph aureus

what are the radiographic findings of osteomyelitis

nothing in first 10 days

spotty rarefaction and periosteal new bone formation days 10-14

fever, urinary frequency, dyspuria, sharp pain, acute

recurrent episodes

urinary tract infection