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68 Cards in this Set
- Front
- Back
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what is the difference btw bronchiolitis and asthma
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bronchiolitis is a first time or isolated event
asthma is recurrent |
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what is the primary cause of bronchiolitis & hospitalizations in children
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RSV
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what are the clinical manifestations of RSV
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common cold progressing to
noisy, raspy breathing c audible wheezing within 1 week low grade fever and irritability prolonged expiratory phase use of accessory muscles |
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what might be your first sign of RSV in a young infant
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apnea
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when should you hosptalize a child with RSV
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if O2 sat drops below 92%
respiritory distress |
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how do you prevent RSV in infants
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only done if at increased risk (preme, born in autum or child under 2 c chronic lung disease)
monthly injections of Palivizumab |
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what is the pediatric approach to therapy for asthma
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rule of 2s
2 daytime episodes in a week 2 awakenings at night within a month go ahead and treat with daily anit-inflammatories |
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*what is a complication of asthma that requires hospitalization
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status asthmaticus
exasterbated asthma that does not respond to normal treatment |
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what does a normal PCO2 in a tachypnic child indicate
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impending respiratory arrest
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*where do foreign body aspirations tend to lodge*
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in the Right mainstem bronchus
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where do coins more typically lodge
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in the esophagus
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when should you suspect a foreign body aspiration
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cough, wheezing, stridor, unilateral abscence of breath sounds
does not respond to bronchiodilator therapy |
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*what do you order when you suspect a foreign body aspiration*
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expiratory & lateral decubitus CXR
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*what is the best way to remove a foreign body aspirate*
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rigid bronchoscopy
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* what is the standard diagnostic test for CF*
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sweat chloride test
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*what are the important "clinical pearls" to remember for Dx of CF*
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failure to thrive
cholestatic jaundice Chronic RTIs electrolyte abnormalities chronic GI sympt digital clubbing mechonium ileus in newborn |
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*what would you see during your HEENT of a child that would immediately lead you to test for CF*
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nasal polyps
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what is RDS
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resp distress from insufficient levels of surfactant
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if a baby is born prior to what week you should be concerned about RDS
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32 weeks
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what L/S ration is indicative of lung maturity
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2;1
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what are the clinical manifestations of RDS
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cyanosis
tachypnea nasal flaring sternal and intercostal retractions grunting |
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*what is the charicteristic sign of RDS on a CXR*
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atelectasis with GROUND GLASS haze in the lung surrounding air filled bronchi
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what are the complications of RDS
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PDA
pulmonary air leaks bronchopulmonary dysplasia retinopathy of prematurity |
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when do you see transient tachypnea of the newborn
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self limiting disease in larger premature or term infants born by C-section or precipitous delivery
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histocytosis X
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"bad skin"
hemorrhagic or petechial skin lesions |
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what are the 4 defects in tetrology of fallot
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VSD
Pulmonary stenosis Overriding aorta RV hypertrophy |
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clinical manifestations of tetrology of fallot
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murmur
hypoxic spells, cyanosis right axis deviation EKG boot shaped heart on CXR |
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clinical manifestations of transposition of the great vessels
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cyanosis
Right axis deviation and RV hypertrophy egg on string CXR |
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* how do you treat a transposition of the great vessels until you can get to surgery*
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PGE1 to maintain patent ductus arteriosis
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what is tricuspid atresia
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no tricuspid valve
RV hypoplasia |
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what are the clinical signs of tricuspid atresia
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severely cyanotic
superior axis on EKG LV hypertrophy |
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what is a persistant truncus arteriosus
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did not split to form the aorta and pulmonary artery
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* what are the clinical signs of a persistant truncus arteriosus*
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*systolic murmur at the left sternal border & a sys ejection click*
bi-ventricular hypertrophy |
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what is a Total Anomalous Pulmonary Venous Return (TAPVR)
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the pulmonary veins do not connect to the left atria
they return abnormally to the right side of the heart |
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what are the clinical manifestations of a TAPVR
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hyperactive RV impulse
widely split S2 systolic ejection murmur |
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what is the most common cause of deaths from cardiac defects in the first month of life
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hypoplastic left heart syndrome
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do you see cyanosis in left to right shunts?
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nope
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what is the most common congenital heart defect
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VSD
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what is the typical, clinical manifestation of a VSD
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pansystolic murmur @ left sternal border
pulmonary HTN |
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is surgical intervention always required with a VSD
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no, 30% close on their own
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clinical manifestations of an ASD
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RV impulse at the lower sternal border
Sys ejection murmur split S2 |
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clinical manifestation of PDA
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widened pulse pressure
Continuous, machine like, murmur |
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clinical manifestations of coarctation of the aorta*
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Rib notching**
femoral pulses weaker than radial pulses* S3 leg discomfort c exercise headache epistaxis HTN |
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what are the classic symptoms of DiGeorges synd
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CATCH 22
Cardiac defects Abnormal facial features Thymic hypoplasia Cleft palate Hypocalcemia 22q11.2 chromosome deletion |
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how many babies with trisomy 21 (downs) have heart problems
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40% have a heart defect
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what particular heart defect develops around adolescence in downs syndrome children
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MVP
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* what is a classic sign of a downs syndrome baby*
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hypotonia (floppy baby)
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what are the associated defects in trisomy 21 (downs)
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risk for leukemia
hypotonia congenital heart disease duodenal atresia |
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what is the clinical presentation of congenital rubella syndrome
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*Forchheimer spots- rose colored spots on the soft palate*
bluberry muffin rash cataracts, glaucome jaundice PDA deafness |
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key points for Turners syndrome
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"short, fat, web necked"
XO chromosome ovarian dysgenisis |
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what are the common heart complications in Turner syndrome
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coarctation of the aorta
aortic stenosis due to bicuspid aortic valve |
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general characteristics of Marfans
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Tall, lanky, and double jointed
pectus excavatum or carinatum hammer toes high palate early osteoarthritis |
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*what is a common defect of the eye in a marfans synd pt*
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lens dislocation- subluxation called ectopia lentis
80% |
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what are common cardiovascular complaints with Marfans pts
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fatigue
SOB palpitations angina poor circulation |
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*what is the major cardiac issue of concern with Marfans pts*
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dilated aorta or aortic aneurysm
resulting in death from aortic dissection tearing pain radiates to the back |
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what are the mild fetal effects in maternal DM
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Large babies "grow up to be the linebackers"
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what are the severe fetal effects in maternal DM
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growth retardation "tiny, sickly babies"
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*what are the 5 major jones criteria for rheumatic fever*
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polyarthritis
carditis chorea erythema marginatum subQ nodules |
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*How can you make the diagnosis of rheumatic fever*
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evidence of recent GABHS infection
AND 2 major criteria or 1 major and 2 minor |
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characteristics of Henoch-Schonlein purpura
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Purple rash on legs and butt
vasculitis abdominal pain swolen joints Kidney damage |
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What time of year do you typically see henoch-schonlein purpura
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autumn and spring
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how do you treat henoch-schonlein
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self limiting
symptomatic treatment hospitalize if dehydrated or serious kidney problems |
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what are the 2 leading causes of aquired heart disease in children
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Kawasaki
rheumatic fever |
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*what is Kawasaki's also known as*
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mucocoutanious lymph node synd
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*what are the clincal manifestations for the acute phase of kawasaki's*
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fever
conjunctival erythema cracked lips and strawberry tongue cervical lymphadenopathy swelling in the hands and feet rash giant coronary artery aneurysms |
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*what are the clinical manifestations of subacute kawasaki's*
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gradual resolution of acute sympt over 4 weeks
Desquamation of skin on fingers and toes thrombocytosis coronary artery aneurysms |
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*what happens in the convalescent phase of kawasaki's*
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6 to 8 weeks later
symptoms are gone ESR returns to normal |
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how do you treat kawasai's
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IV Ig & aspirin
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