Pediatrics From Blueprints

Front 1

ABCDE of the pediatric primary survey?

Back 1

Airway, Breathing, Circulation, Disability, Exposure

Front 2

How do you calculate the ET tube size for a child?

Back 2

4(age/4)

Front 3

What should be done in the following situations:
SVT (HDS):
SVT(hemodynamically unstable):
VT (HDS)
VT (unstable):
Pulseless VT/VF:

Back 3

SVT (HDS) - vagal maneuvers, adenosine, dig, esmolol, procainamide, amiodarone
SVT (unstable) - cardiovert
VT (HDS): amio, procainamide, treat hypok/mag.
VT (unstable) - cardiovert
VF/pulseless VT - non synch. cardioversion

Front 4

Describe the 3 stages of shock

Back 4

- Compensated - homeostatic mechanisms maintain organ perfusion. BP, Cardiac fxn, UOP all normal.
- Uncompensated - homeostatic mechanisms fail d/t ischemia, endothelial injury, toxins.
- irreversible - when uncompensated shock has progressed to cause irreparable end organ damage.

Front 5

Describe the 4 types of shock

Back 5

- Hypovolemic (most common)- decreased preload, stroke volume, CO, BP
- Cardiogenic - inadequate stroke volume results in decreased CO,hypotension
- Distributive - a state of relative hypovolemia due to peripheral pooling and vasomotor dysfxn leads to severe hypotension
- Septic shock

Front 6

What are the etiologies of the following types of shock:
Hypovolemic, Distributive, Cardiogenic

Back 6

Hypovolemic
water/lyte losses, hemorrhage, third spacing

Distributive
anaphylaxis, neuro injury, drug toxicity

Cardiogenic
congenital, ischemic, myopathy, arrhythmia, infxn

Front 7

Who should be in a car seat, who should face forward and who should face backward?

Back 7

All children in car seats weighing less than 40 lbs. Children > 20lbs and >1year can face forward

Front 8

When should a booster seat be used in a car?

Back 8

When the child outgrows the car seat and before the seat belt fits properly (usually between 8-12 years)

Front 9

what is the treatment of choice for foreign body removal in kids?

Back 9

rigid bronchoscopy

Front 10

What are the top 3 causes of injury in children?

Back 10

MVA
Drowning
Burns

Front 11

What are the three degrees of burns?

Back 11

1st - epidermis only is involved, no blisters
2nd -
superficial (less than half the dermis), painful, scald injuries
deep (most of the dermis but appendages intact) non painful, scarring, graft req'd
3rd - extend into subq and nontender.

Front 12

What are the five greatest risk factors for SIDS?

Back 12

Prone sleeping, Permature, low birth weight, IUGR, maternal smoking during pregnancy

Front 13

Does 24 hour apnea monitoring decrease the risk of SIDS?

Back 13

No

Front 14

What are some signs of a pathologic murmur in a child?

Back 14

Heaves/Thrills
Pulse delay, abnormal Splitting
S3, S4
click, snap, rubs
loud harsh or blowing murmur no change of murmur with patient positioning

Front 15

When are the following functional murmurs usually seen:
Venous Hum
Stills
Pulmonary Flow murmur
Carotid bruit
PPS

Back 15

--Venous Hum - 3-7 years old, continuous, soft humming murmur heard at the neck or RUSB
--Stills - 2-8 years old, II-III midsystolic musical murmur heard best at LLSB
--Pulmonary Flow murmur - 6yr-adolescence, systolic ejection murmur LUSB
--Carotid bruit - 3-8yr
--PPS - birth to 2 months, medium pitched SEM best heard at the LUSB radiating to the back

Front 16

At what level of deoxygenated Hb does cyanosis become clinically evident

Back 16

3g/dL

Front 17

Describe the 5 cyanotic heart defects and when is cyanosis seen?

Back 17

Truncus arteriosus - non specific murmur and cyanosis at birth and CHF develops in a matter of weeks as the pulmonary vascular resistance falls.

Hypoplastic left heart -

Transposition - 3:1 male predominance, parallel circuits, severe cyanosis present from birth. must give PGE immediately to keep DA patent. An ASD is also helpful.

Tricuspid Atresia - LA/LV handle the blood flow for lungs and systemic. Almost always a VSD/PFO. Cyanosis is progressive over the first two weeks of life

Tetralogy of Fallot - all patients have 22q11 microdeletion.

Front 18

What is suspected when preductal sats are lower than postductal or visa versa(4things)?

Back 18

Transposition, PPHN, LV outflow obstrustion (coarc, AS, LVOT obs.)

Front 19

Which cyanotic heart defects are ductal independant? dependant pulmonary flow? systemic flow?

Back 19

Independent - TA, TAPVR, Transposition

Dependant pulmonary flow - Tricuspid atresia, Tetralogy,
Ebstein anomaly

Dependant systemic flow - Hypoplastic left heart, Interrupted aortic arch

Front 20

What defects are associated with Tetralogy of Fallot?

Back 20

PS, VSD, overriding aorta, hypoplastic pulm. valve, RVH.

Front 21

what is the second most common cardiac lesion presenting in the first week of life and the most common cause of death from congenital heart disease in the first month of life?

Back 21

Hypoplastic Left Heart.

Front 22

Which types of ASD close spontaneously?

Back 22

Small secundum

Front 23

What is the most common congenital heart lesion?

Back 23

VSD 25%

Front 24

Describe 1st degree block, what its associated with.

Back 24

Results from slowing of AV conduction at the level of the AV node. It is associated with:
increased vagal tone, digoxin,
beta blocker administration, infectious etiologies
hypothermia
electrolyte(hypo/hyperkal, hypo/hypercal, hypomag)
congenital disease
rheumatic fever
cardiomyopathy

Front 25

Describe the types of 2nd degree block. Also, list associations.

Back 25

Mobitz I - progressive prolongation of PR until a dropped beat.
Mobitz II - abrupt failure of AV conduction below the AV node.