Pediatrics Brs Chapter 20

Front 1

Most common cause of cardiac arrest in a child

Back 1

Lack of oxygen supply to heart 2nd to pulmonary problem

Front 2

Most common cause of airway obstruction

Back 2

victim's tongue

Front 3

Pulse is assessed in the _ in infants and in the _ for children.

Back 3

infants: brachial artery
children: carotid artery

Front 4

Shock may be classifed based on _ or _.

Back 4

Degree of compensation (look at BP) or by cause.

Front 5

Most common cause of Shock in children

Back 5

Hypovolemic shock (e.g. hemorrage or dehydration)

Front 6

Describe the 2 stages of Septic Shock.

Back 6

1) hyperdynamic stage: normal output with bounding pulses, warm extremities, and wide pulse pressures
2) decompensated, impaired mental status, cold, diminshed pulses

Front 7

What is neurogenic shock?

Back 7

often 2nd to spinal cord transection, characterized by loss of sympathetic vasoconstriction with pooling of venous blood/hypotension

Front 8

T/F - shock can be difficult to notice since compensatory mechanisms that prevent hypotension 25% of intravascular volume is lost.

Back 8

true- look for tachycardia before BP falls

Front 9

What is the workup for suspected shock?

Back 9

CBC, Electrolytes, BUN/Cr, Ca + Glucose, Coag Factors (DIC), Tox Screen

Front 10

What is the proper bolus equation?

Back 10

20ml/kg LR or NS

Front 11

Leading cause of death in children older than 1 yoa?

Back 11

Trauma (lead by MVA)

Front 12

A specific fear in bone injuries of children?

Back 12

the weak epiphyseal-metaphyseal jxn which puts growth plate at highest risk of injury.

Front 13

Workup for Trauma.

Back 13

1. ABCDE
2. ECG
3. Urinary Catheter and NG tube
4. Radiographs of spine, chest, and pelvis including CT head and abdomen if necessary

Front 14

Infants are at risk of bleeding in the subgaleal and epidural areas during Trauma b/c of _.

Back 14

open fontanelles and cranial sutures

Front 15

Epidural hematoma is Associated with tearing of the _.

Back 15

middle meningeal artery

Front 16

_ is Associated with tearing of the middle meningeal artery.

Back 16

Epidural hematoma

Front 17

Epidural hematoma is associated with the radiographic finding of _.

Back 17

lenticular density

Front 18

_ is associated with the radiographic finding of lenticular density.

Back 18

Epidural hematoma

Front 19

Subdural hematoma is associated with tearing of the _.

Back 19

meningeal veins

Front 20

_ is associated with tearing of the meningeal veins.

Back 20

Subdural hematoma

Front 21

Radiographic evidence of _ is crescentic density.

Back 21

subdural hematoma

Front 22

Radiographic evidence of subdural hematoma is _.

Back 22

crescentic density

Front 23

Area most often affected within the brain parenchyma?

Back 23

temporal or frontal lobe.

Front 24

1st sign of increased ICP. 1st symptom?

Back 24

sign: pupil changes and altered mental status,
symptom: headache

Front 25

_ is an early sign of herniation in children younger than 4 yoa.

Back 25

Bradycardia

Front 26

Cushing's triad, a late sign of impending herniaiton is characterized by _

Back 26

bradycardia, hypertension, irregular breathing

Front 27

Management of increased ICP.

Back 27

1. mild hyperventilation with 100% o2
2. elevation of head 30-45 degrees
3. diuretic
4. neurosurgery

Front 28

T/F - Waiting for radiographic confimation of the diagnosis of tension pneumothorax can lead to a patient's death.

Back 28

True - emergenct chest decompression

Front 29

Second most common cause of accidental death in children

Back 29

burns (most common scalding)

Front 30

1st degree burn;
2nd degree burn;
3rd degree burn;

Back 30

1st: epidermis, red blanching skin, painful, no scar;
2nd: entire epi + part dermis, superficial - blister, deep pale white and scar;
3rd: epi + derm + part sc, dry, white and leathery, insensitive to pain

Front 31

Rx of 1st degree burn? 2nd degree burn? 3rd degree?

Back 31

1. moisturizer and analgesic
2. analgesics, debridement (leave bullae), ABX
3. skin grafting & hydrotherapy, ABX (1% silver sulfadiazine)

Front 32

T/F - Treatment of near drowner is the same regardless of whether it occured in salt or fresh water.

Back 32

True - rewarm body core with warm saline gastric lavage

Front 33

Specific risk factor sfor child abuse (4)

Back 33

Age younger than 4, Mental retardation, history of premature birth, chronic illness

Front 34

T/F - Unlike physical abuse there are typically no overt physical signs of trauma in sexual abuse.

Back 34

True- 80% are female and show signs of sexual behavior as a red flag, but is typically normal

Front 35

Most common cause of death in children younger than 1 yoa.

Back 35

SIDS

Front 36

Postmortem examination of SIDS often finds _.

Back 36

intrathoracic petechiae.

Front 37

Odors
Bitter almond - _.
Garlic - _.
Moth balls - _.

Back 37

Bitter almond - cyanide.
Garlic - arsenic, organophosphates.
Moth balls - camphor.

Front 38

Skin Findings
Cherry Red - _.
Sweaty - _.
Gray cyanosis - _.

Back 38

Cherry Red - CO or Cyanide.
Sweaty - Organophosphates.
Gray cyanosis - methemoglobinemia.

Front 39

Radiogrphic substances

Back 39

CHIPE: choloral hydrate and calcium, heavy meatals, iodine and iron, phenothiazines, enteric coated tablets

Front 40

T/F - Syrup of ipecac is theoretically effective only within the first 30 minutes after ingestion.

Back 40

True

Front 41

Contraindications of gastric lavage.

Back 41

caustic, hydrocarbon, nontoxic ingestions, and delayed presentation.

Front 42

T/F - evidence suggests that activated charcoal improves clinical outcome, especially if given within 1 hour after an ingestion.

Back 42

True

Front 43

How is whole bowel irrigation accomplished?

Back 43

polyethylene glycol and electrolyte solution.

Front 44

How does tylenol cause hepatic damage?

Back 44

depletion of glutathione

Front 45

Rx for Tylenol ingestion.

Back 45

1. gastric lavage
2. activated charcoal
3. obtain serum level
4. N-acetylcysteine if indicated by serum and best if within 8 hours.

Front 46

Common physical exam finding of salicylate poisioning.

Back 46

tinnitus

Front 47

Rx for Salicylate poisioning.

Back 47

1. gastric lavage
2. Activated charcoal
3. obtain serum level at least 6 hours after ingestion
4. alkanization of urine with HCO3 to urine pH>7
5. dialyis in worse case

Front 48

IV _ binds iron in iron poisoning.

Back 48

deferoxamine (look for pink urine)

Front 49

Smear findings of lead intoxication. X ray?

Back 49

microcytic anemia with basophilic stipling. metaphyseal bands

Front 50

Caustic acid can lead to _ that produce superficial damage to the GI tract.

Back 50

coagulation necrosis

Front 51

Caustic alkali can lead to _ that produce deep and penetrating damage to GI tract.

Back 51

liquefaction necrosis

Front 52

Treatment of Caustic Agents.

Back 52

1. no neutralization (exothermic)
2. endoscopy is performed to assess
3. C/I ipecac, gastric lav, charcoal

Front 53

2 Physical exam findings of CO poisoning.

Back 53

cherry red skin, and retinal hemorrages

Front 54

Rx of CO poisoning.

Back 54

1 100% oxygen
2. hyperbaric oxygen
3. hospitalization if CO-Hb > 25%

Front 55

T/F -Bite wounds on the face, large wounds, and wounds less than 12 hours old should be sutured.

Back 55

True

Front 56

Black widow spider, with red hourglass marking can cause _ and _ as pathognomic signs.

Back 56

sever hypertension, muscle cramps

Front 57

Treatment of Brown Recluse Bite.

Back 57

local wound care, tetanus prophylaxis, there is no antivenin

Front 58

Metallic taste in the mouth can be associated with?

Back 58

snake bites

Front 59

T/F - Incision, Tourniquets and Suction are not recommended on pit viper snake bites.

Back 59

True

Front 60

Coral Snake Saying

Back 60

Red next to yellow kill a fellow, red next to black friend of jack