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60 Cards in this Set

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  • Back
Most common cause of cardiac arrest in a child
Lack of oxygen supply to heart 2nd to pulmonary problem
Most common cause of airway obstruction
victim's tongue
Pulse is assessed in the _ in infants and in the _ for children.
infants: brachial artery
children: carotid artery
Shock may be classifed based on _ or _.
Degree of compensation (look at BP) or by cause.
Most common cause of Shock in children
Hypovolemic shock (e.g. hemorrage or dehydration)
Describe the 2 stages of Septic Shock.
1) hyperdynamic stage: normal output with bounding pulses, warm extremities, and wide pulse pressures
2) decompensated, impaired mental status, cold, diminshed pulses
What is neurogenic shock?
often 2nd to spinal cord transection, characterized by loss of sympathetic vasoconstriction with pooling of venous blood/hypotension
T/F - shock can be difficult to notice since compensatory mechanisms that prevent hypotension 25% of intravascular volume is lost.
true- look for tachycardia before BP falls
What is the workup for suspected shock?
CBC, Electrolytes, BUN/Cr, Ca + Glucose, Coag Factors (DIC), Tox Screen
What is the proper bolus equation?
20ml/kg LR or NS
Leading cause of death in children older than 1 yoa?
Trauma (lead by MVA)
A specific fear in bone injuries of children?
the weak epiphyseal-metaphyseal jxn which puts growth plate at highest risk of injury.
Workup for Trauma.
1. ABCDE
2. ECG
3. Urinary Catheter and NG tube
4. Radiographs of spine, chest, and pelvis including CT head and abdomen if necessary
Infants are at risk of bleeding in the subgaleal and epidural areas during Trauma b/c of _.
open fontanelles and cranial sutures
Epidural hematoma is Associated with tearing of the _.
middle meningeal artery
_ is Associated with tearing of the middle meningeal artery.
Epidural hematoma
Epidural hematoma is associated with the radiographic finding of _.
lenticular density
_ is associated with the radiographic finding of lenticular density.
Epidural hematoma
Subdural hematoma is associated with tearing of the _.
meningeal veins
_ is associated with tearing of the meningeal veins.
Subdural hematoma
Radiographic evidence of _ is crescentic density.
subdural hematoma
Radiographic evidence of subdural hematoma is _.
crescentic density
Area most often affected within the brain parenchyma?
temporal or frontal lobe.
1st sign of increased ICP. 1st symptom?
sign: pupil changes and altered mental status,
symptom: headache
_ is an early sign of herniation in children younger than 4 yoa.
Bradycardia
Cushing's triad, a late sign of impending herniaiton is characterized by _
bradycardia, hypertension, irregular breathing
Management of increased ICP.
1. mild hyperventilation with 100% o2
2. elevation of head 30-45 degrees
3. diuretic
4. neurosurgery
T/F - Waiting for radiographic confimation of the diagnosis of tension pneumothorax can lead to a patient's death.
True - emergenct chest decompression
Second most common cause of accidental death in children
burns (most common scalding)
1st degree burn;
2nd degree burn;
3rd degree burn;
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
Rx of 1st degree burn? 2nd degree burn? 3rd degree?
1. moisturizer and analgesic
2. analgesics, debridement (leave bullae), ABX
3. skin grafting & hydrotherapy, ABX (1% silver sulfadiazine)
T/F - Treatment of near drowner is the same regardless of whether it occured in salt or fresh water.
True - rewarm body core with warm saline gastric lavage
Specific risk factor sfor child abuse (4)
Age younger than 4, Mental retardation, history of premature birth, chronic illness
T/F - Unlike physical abuse there are typically no overt physical signs of trauma in sexual abuse.
True- 80% are female and show signs of sexual behavior as a red flag, but is typically normal
Most common cause of death in children younger than 1 yoa.
SIDS
Postmortem examination of SIDS often finds _.
intrathoracic petechiae.
Odors
Bitter almond - _.
Garlic - _.
Moth balls - _.
Bitter almond - cyanide.
Garlic - arsenic, organophosphates.
Moth balls - camphor.
Skin Findings
Cherry Red - _.
Sweaty - _.
Gray cyanosis - _.
Cherry Red - CO or Cyanide.
Sweaty - Organophosphates.
Gray cyanosis - methemoglobinemia.
Radiogrphic substances
CHIPE: choloral hydrate and calcium, heavy meatals, iodine and iron, phenothiazines, enteric coated tablets
T/F - Syrup of ipecac is theoretically effective only within the first 30 minutes after ingestion.
True
Contraindications of gastric lavage.
caustic, hydrocarbon, nontoxic ingestions, and delayed presentation.
T/F - evidence suggests that activated charcoal improves clinical outcome, especially if given within 1 hour after an ingestion.
True
How is whole bowel irrigation accomplished?
polyethylene glycol and electrolyte solution.
How does tylenol cause hepatic damage?
depletion of glutathione
Rx for Tylenol ingestion.
1. gastric lavage
2. activated charcoal
3. obtain serum level
4. N-acetylcysteine if indicated by serum and best if within 8 hours.
Common physical exam finding of salicylate poisioning.
tinnitus
Rx for Salicylate poisioning.
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
IV _ binds iron in iron poisoning.
deferoxamine (look for pink urine)
Smear findings of lead intoxication. X ray?
microcytic anemia with basophilic stipling. metaphyseal bands
Caustic acid can lead to _ that produce superficial damage to the GI tract.
coagulation necrosis
Caustic alkali can lead to _ that produce deep and penetrating damage to GI tract.
liquefaction necrosis
Treatment of Caustic Agents.
1. no neutralization (exothermic)
2. endoscopy is performed to assess
3. C/I ipecac, gastric lav, charcoal
2 Physical exam findings of CO poisoning.
cherry red skin, and retinal hemorrages
Rx of CO poisoning.
1 100% oxygen
2. hyperbaric oxygen
3. hospitalization if CO-Hb > 25%
T/F -Bite wounds on the face, large wounds, and wounds less than 12 hours old should be sutured.
True
Black widow spider, with red hourglass marking can cause _ and _ as pathognomic signs.
sever hypertension, muscle cramps
Treatment of Brown Recluse Bite.
local wound care, tetanus prophylaxis, there is no antivenin
Metallic taste in the mouth can be associated with?
snake bites
T/F - Incision, Tourniquets and Suction are not recommended on pit viper snake bites.
True
Coral Snake Saying
Red next to yellow kill a fellow, red next to black friend of jack