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31 Cards in this Set
- Front
- Back
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What is the most important vital sign associated with increased ICP and coma?
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Hyperventilation
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A patient has unilateral dilated pupil. What is your biggest concern?
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Cerebral edema
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What is the best way to distinguish tachypnea from central hyperventilation?
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Central hyperventilation has non-reactive pupils
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A patient in the PACU has tachypnea, muscle rigidity and fever. Blood gas reveals increased CO2 and acidosis. What is the diagnosis? What is the treatment?
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This is Malignant hyperthermia. Treat with hyperventilation, oxygen and DANTROLENE.
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What are the components of cushing's triad?
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Bradycardia
HTN Irregular respiration |
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True or False
Agitation is a common sign of hypoxia. |
True
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A child has increased heart rate when crying, a soft vibratory ejection murmur, and an intermittent brisk JVP of the neck wave. What would you be watchful of on the heart monitor?
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Complete heart block
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True or False.
Heart rate should not rise when an otherwise healthy child cries. |
True
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A child comes in to ED with fatigue, vomiting, headaches and salt wasting. She has hypoglycemia, hyperkalemia and hyponatremia. What is her diagnosis?
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Adrenal insufficiency
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IA child comes in to ED with fatigue, vomiting, and headaches. She has hypoglycemia, hyperkalemia and hyponatremia. Her cultures reveal candidiasis. What is her diagnosis?
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Autoimmune polyendocrinopathy
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A child with adrenal insufficiency is found to have elevated ADH. Is this SIADH?
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No, the ADH levels are appropriate in this case.
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An otherwise healthy 1yo comes in with afebrile seizure after a day at the swimming pool. What is the cause?
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Water toxicity causing hyponatremic seizure.
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A mother comes in devastated because her daughter was accidentally submerged in the bathtub water for less than 1 minute. The baby is presently happy and playing with the med-tech. What tis your next step?
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Observe at home.
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A 6yo boy was rescued from a lake after he nearly drowned. He appears stable upon arrival to the ED, although somewhat disoriented. He was apneic and required CPR in the field. What factor will determine the boys prognosis?
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Duration of time from submersion to adequate respiration, determines the extent of damage.
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What is the initial problem in ARDS?
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Pulmonary edema, which looks like fine reticular infiltrate on x-ray.
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What are the GCS requirements of intubation?
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GCS < 8 or head trauma
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What is the treatment for SVT given that your first two doses of adenosine worked only temporarily?
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Diltiazem
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What are three criteria for poor prognosis in terms of acute respiratory distress?
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Submersion > 25 minutes
Apnea or Coma at admission pH < 7.0 |
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True or False.
A patient who requires < 10 min CPR has a good prognosis. |
True
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What is the acute management of flail chest with respiratory distress?
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Chest tube
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What is the most important aspect of vent support in ARDS in kids?
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PEEP
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A 3week old is brought in with poor weight gain, tachycardia, and has a murmur. CXR has cardiomegaly and ECHO reveals EF < 25% and mitral regurgitation. What is the diagnosis?
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CHF
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What is the best initial IV therapy of an infant in heart failure?
A) Furosemide B) Steroids C) Epinephrine D) Digoxin E) Captopril |
A
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A 3 day old is found to have aortic stenosis. What do you need to give this patient?
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PGE to maintain PDA
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What are three signs of cardiogenic shock in infants?
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Gray color, poor cap refill and thready pulse
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A child has been brought to ED after passing out in a pool. A close family member has recently died and had epilepsy. What is the most likely abnormality to be confirmed in your patient?
A) Abnormal EEG B) Abnormal ECHO C) Abnormal Angiography D) Abnormal EKG |
D. This child likely has long QT syndrome which is caused by v-tach and can result in brief seizures.
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A patient has pulsus paradoxus and muffled heart sounds. What is the likely diagnosis and treatment?
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Cardiac Tamponade from pericardial effusion. Do pericardiocentesis and call Surgery STAT
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What is pulsus paradoxus?
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The difference in systolic BP between inhalation and exhalation is > 10mmHg. There is decreased systolic BP during inspiration.
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What is the definition of brain death and how do you confirm it?
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Irreversible absence of cardiorespiratory function.
Abscence of vertebral blood flow is pathognomonic for brain death. Do a radionucleotid scan or carotid angiography. |
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What are the two most important findings in a child with impending liver failure?
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Elevated ammonia and Altered mentation
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A patient has chronic tremors and appears anxious. Her labs reveal elevated LFTs. What is your suspicion?
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Wilson's Disease
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