Pediatric Exam 2

RBC & Hbg

Anemia is the most common hematologic disorder in children and is characterized by decreased:

Ventricular septal defect

Abnormal opening between L & R ventricles

**Acyanotic

90 & 70

If giving digoxin for heart failure, hold if a babies apical pulse is <_____ & a childs is <_____

Kawasaki disease

(inflammation of blood vessles, hence the strawberry tongue) causes coronary artery aneurysms
S&S: relentless fever, strawberry tongue, hand/foot redness, conjunctivits

HLHS

Underdeveloped left side of heart with aortic atresia

**Cyanotic

Incompatible for life w/o other defects

Knee to chest

What position should you put a baby in during a Tet spell

Tetrology of fallot

Pulmonic stenosis, right ventricular hypertrophy, overriding aorta, ventricular septal defect

Coarctation of the aorta

Narrowing of aorta near ductus arteriosus increases upper extremity pressure & decreases lower extremity pressure

**Acyanotic

Aortic stenosis

Narrowing of aortic valve caused by decreased cardiac output **Acyanotic

Left sternal boarder

In pulmonary stenosis, a systolic ejection murmur would be heard at:

Pulmonary stenosis

Narrowing at entrance of pulmonary artery leads to obstruction of blood flow from ventricles

**Acyanotic but may be cyanotic

Right ventricle hypertrophy

Pulmonary congestion in patent ductus arteriosus lead to:

Machine like murmur

Sound hear in patent ductus arteriosus

Patent ductus arteriosus

Failure of the fetal arteriosus to close within the 1st week

--> left to right shunt

**Acyanotic

Systolic murmur with split S2

Sound hear in atrial septal defect

Atrial septal defect

Abnormal opening between L & R atria

**Acyanotic

Holosystolic murmur

Sound heard in ventricular septal defect

Sickle cell

Destructive autosomal disorder characterized by misshaped RBC that clump together

6 months

Sickle cell symptoms don't occur until what age

PenVK & hydroxyurea

Treatment for sickle cell crisis

Iron chelation

Due to frequent blood transfusions required with sickle cell disease, ________ _________ therapy is needed to remove extra iron

Hemophilia

Group of hereditary bleeding disorders characterized by deficiencies in clotting factor

8

Hemophilia A is a deficiency in factor ____

9

Hemophilia B is a deficiency in factor ___

Hemarthrosis

Characteristic of hemophilia with bleeding into the joint spaces that is painful & decreases mobility

Prolonged

Patients with hemophilia will have a __________ PTT/INR time

Contact sports

Patients with hemophilia should be educated to avoid

Neutropenic

Patients with iron deficient anemia should be on ______________ precautions

Thalassemia

Inherited defect in ability to produce hemoglobin

Delayed growth, bone abnormalities, enlarged spleen

Characteristics of thalassemia

Transfusion

Treatment for thalassemia

Idiopathic thrombocytopenia purpura

Hypocoagulation resulting from an autoimmune destruction of platelets

Bruises, nosebleeds, gingival bleeds

Charectoristics of idiopathic thrombocytopenia purpura

Steroids & IVIGs

Treatment for idiopathic thrombocytopenia purpura

50,000

Patients with idiopathic thrombocytopenia purpura should avoid contact sports if platelet count is less than __________

Spleen

Children with sickle cell may loose function in their _______ due to atrophy

Acute chest syndrome

Decreased oxygen to the lung tissue causing chest or back pain, fever, cough, & tachypnea

2

Preterm and low birth weight infants should be given iron supplements at ____ months

4-6

Full term infants should be given iron supplements at ___-___ months

Breast milk & fortified cereals

Sources of iron for infants

12

Universal anemia screens occur at _____ months

Tarry green

What color should stool turn if iron dose is adequate

Brush teeth

Education for patients taking iron as it may stain mouth

Hodgkins lymphoma

Cancer with painless enlarged lymph nodes that are firm and moveable

Non-hodgkins lymphoma

Cancer that involves diffuse lymph and distribution is early and rapid

Femur

Most common location of a tumor in osteosarcoma

Wilms tumor

Painless swelling or mass on ONE side of the abdomen

Don't palpate

Sign that should be placed on the door of a child with a Wilms tumor

Neuroblastoma

Mass that is firm, nontender, and crosses the midline of the abdomen

**Considered a "silent tumor"

Retinoblastoma

Tumor arising from a developing retinal cell

Leukoria

"cats eye" found in retinoblastoma

**Abnormal white reflection from the retina

Red

In retinoblastoma, the ______ reflex is missing

Acute glomerulonephritis

Inflammation of the kidney typically occurring after a strep infection

Hematuria & mild proteinuria

Urine content with acute glomerulonephritis

Tea/ smoky

Color or urine with acute glomerulonephritis

Face

With acute glomerulonephritis, patients may have EDEMA in the ________ in the morning

Increased BUN & creatinine

Labs associated with acute glomerulonephritis

Protein

Nephrotic syndrome is charectorized by major urine excretion of ___

Hypoalbuminemia & hyperlipidemia

Labs associated with nephrotic syndrome

Hydrocele

Fluid in scrotum

Hypospadia

Opening on ventral surface

Phimosis

Narrow or stenosis of penis opening

Chordee

Curvature of the penis

Cryptorchidism

Undescended teste

VCUG

Patients with reccurent UTIs will get what test

Precocious puberty

Sexual development before 9 in boys and 7 in girls

Lupron

Hormone agonist used to treat precocious puberty

Prolonged jaundice, hoarse cry, low tone

Symptoms of juvenile hypothyroidism

Growth hormone

Pituitary hyperfunction leads to an increase in

Diabetes insipidus

Posterior pituitary malfuntion with decreased levels of ADH hormoe

Polyuria & polydipsia

Cardinal signs of diabetes insipidus

Vasopression

Treatment for diabetes insipidus

SIADH

Body retains water that should be excreted leading to diluted electrolytes

Morning

JIA is worsen in the ____________

NSAIDs, corticosteroids, antirheumatic drugs

Pharmacological treatment of JIA

Osteomyeltis

Inflammation and infection of the bony tissue

6

Newborns to ____ months with a congenital hip dysplasia require a Pavlik harness

6-18

Babies from ___- ____ months require a spica cast

Shortened limbs & unsymmetrical gluteal folds

Signs of hip dysplasia

Barlow sign

Popping sound heard in hip indicating a hip dysplasia

Ortolani

Click in hip indicating hip dysplasia

Lateral

Scoliosis is a _________ curvature of the spine

Osteogenesis imperfecta

Inherited disorder with excessively fragile bones