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147 Cards in this Set
- Front
- Back
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Neonate VS (1-28 days)
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HR 110-160
R 32-60 BP 82/46 -respirations irregular -short periods of apnea -diaphragm and abdominal |
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Toddler VS (1-3)
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HR 100
RR 26 BP 99/64 |
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Preshool VS (3-5)
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HR 90-100
RR 25 BP 85/60-90/70 |
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School-Age VS (5-12)
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HR 75-115
RR 20-25 BP 106/69/117/76 |
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Adolescent VS (12-18)
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Near adult levels
HR 60-100 RR 12-20 BP 120/80 |
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Primative Reflexes
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AKA newborn reflexes
-Moro -Stepping -Rotting -Tonic Neck -Babinski -Palmer -Planter -Suck -Truncal Incurvation -Anocutanous |
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Protective Reflexes
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-Last thru life
-Blinking -Parachute -Gag reflex -etc |
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Moro Reflex
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-birth to 4 months
-baby reaches out protectively if "dropped" -this is what monkeys do to stay with mother and in trees |
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Tonic Neck
AKA Fencing Reflex |
-birth to 3-4 months
-turn infants head and it will do a "fencer" pose with arm extended in same direction as head turned |
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Palmer Grasp Reflex
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-birth to 3-6 months
-will grasp what is placed in palm -again this is to "hold on" to mom |
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Plantar Grasp Reflex
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-birth to 8-10 months
-wraps toes around object in foot -"holds on" |
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Sucking Reflex
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-32 weeks gestation to 36 then to 3-4 months
-premature infants have issues |
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Rooting Reflex
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-birth to 3-4 months
-turns head when cheek is touched |
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Babinski Reflex
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-birth to 18 months
-toes out turns foot in |
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Stepping Reflex
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-birth to 6-8 weeks
-"walks" with help |
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Truncal Incurvation Reflex
AKA Galant Reflex |
-birth to 2-4 months
-run finger down spine when prone baby curves to that side |
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Extrusion Reflex
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-birth to 4 months
-sticks out tongue when object in mouth -must be gone b4 "feeding solids" |
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Anocutaneous Reflex
AKA anal wink |
-birth to first few weeks??
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Parachute Reflex
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-9 months to forever
-arms out if "falling" forward |
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closure of posterior fontanel
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2 months
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No head lag
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4 to 5 months
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doubled birth weight
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6 months
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tripled birth weight
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12 months
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anterior fontanel closed
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12-18 months
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birth length increased by 50%
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12 months
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smiles socially
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2 months
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turns head to locate sound
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3 months
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can turn/roll over
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5 to 6 months
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plays peek-a-boo
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6 months
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transfers object to hand
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7 months
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Stranger anxiety
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7 to 9 months
reappears at??? |
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sits unsupported
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8 months
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crawls
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10 months
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waves bye-bye
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10 months
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laughs in response to stimuli
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4 months
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walks with help
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10-12 months
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says a few words
AND "mama"/"dada" |
12 months
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birth weight X4
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30 months
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can throw a ball overhand
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18 months
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kicks a ball
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24 months
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feeds self with spoon and cup
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2 years
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daytime toilet training started at
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2 years
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can speak 2-3 word sentences
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2 years
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3-4 word sentences
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3 years
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able to state first and last name
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2.5-3 years
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average height and weight gain in preschooler (3-5)
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5lbs and 2.5-3 inches/year
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can use scissors
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4 years
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able to tie shoes
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5 years
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20/20 vision
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preschool age
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5-8 word sentences
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preschool age
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50% adult height by
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2 years
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girls growth spurt
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10 years
finish growing at 15 |
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boys growth spurt
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14
finish growing at 17 |
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Autosomal Recessive Diseases
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-Huntington's
-sickle cell amemia -cystic fibrosis -PKU -Marfans -Polydactyl -Anchondroplasia -Polycystic Kidney dz 50% chance if 1 parent has trait |
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X-linked recessive Diseases
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-Muscular Dystrophy
-Hemophilia A -Females are carries=never have dz -Males have dz but cant pass it on -25% chance =child with dz -25% chance=carrier |
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Scoliosis
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-Milwauke Brace 23 hrs a day
-Log rolling |
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Trisonomy 21
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-Down Syndrome
-simian creases on palm -hypotonia -protruding tongue -upward slant to eyes |
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Cerebral Palsy
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-scissoring
-feed upright and support jaw |
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PKU
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-leads to MR
-Guthrie Test -Aspartame (Nutrasweet) |
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Hypothyroidism
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-leads to MR
-"good, quiet baby" -large posterior fontanel -umbilical hernia -prolonged jaundice -thinning hair -cold intolerance TX=prevents cretinism -Levothyroxine |
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Myelomeningocele
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-cover with sterile water
-no pressure |
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Hydrocephalus
signs of ICP |
opposite of shock
SHOCK -increased pulse/decreased BP ICP -decreased pulse/increased ICP + altered LOC |
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Muscular Dystrophy
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-x-linked recessive
-waddling gait -hyper lordosis -Gowers sign -fat(pseudohypertrophy) of calves -walks up legs when standing (Minors sign) |
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Meningitis -bacterial
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LP=increased WBCs,protein,IICP
and decreased glucose -may lead to SIADH(too much ADH)=water retention, fluid overload, dilutional hyponatremia |
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Cystic Fibrosis
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-sweat test
-salty skin -fatty stools -enzymes on food -low carb,high protein, mod-high fat -autosomal recessive -meconium ileus at birth -fat soluble vitamins -1.5X normal calories |
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Children with Rubella
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-threat to MOM if PREGNANT
-can get 7 days before and 5 days after rash |
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MMR vaccine
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-eggs
-neomycin -not if pregnant 12-15 4-6 years 11-12 years SQ |
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Immunization side effects
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T 102
-redness, soreness for 3 days -bicycle legs -Tylenol -call PCP if... seizures,high fever, high-pitched cry |
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All cases of poisoning
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-CALL poison control center
-DO NOT USE IPECAC |
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Epiglottitis
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-H. influenza B
-upright, chin and tongue out -may see tripod position -prepare for INTUBATION -DO NOT put anything in mouth -mass on x-ray |
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RSV
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Respiratory Syncytial Virus
-contact precations -private room -mist tent for O2 -Ribavirin -not so bad for adults but is in kids -watch out for older siblings |
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Acute Glomerulonephritis
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-after Strep B antigen
-antibody complexes CLOG glomeruli -reduces GFR -DARK URINE -proteinuria |
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Wilm's Tumor
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-large kidney tumor
-DO NOT PALPATE |
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Tracheoesophageal Atresia
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-3 C's of TEF
-coughing -chocking -cyanosis |
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Cleft Lip Palate post-op
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-on side
-Logan Bow -elbow restraints |
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Congenital Megacolon
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AKA Hirschsprung's dz
-no ganglion cells in colon -no peristalsis -suspect if no meconium in 24 hrs -and RIBBON-like FOUL smelling stools |
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Iron Deficiency Anemia
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-Iron on empty stomach w/juice
-Vit C -NOT WITH MILK -dropper or straw to prevent teeth stain -Tarry stools -limit milk to 32oz/day |
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Sickle Cell Disease
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-hydration most important
-stress/heat/illness=trigger -more common in AA CRISIS= -fever -abdominal pain -painful swollen hands/feet (hand-foot syndrome) -arthralgia |
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Tonsillitis
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-often Strep B
-get PTT and PT Pre-Op -suspect bleeding if coughing,swallowing,clearing throat -no red liquids or straws -no citrus etc -ice collar and soft foods Risk for hemorrhage -first 24 hours -5-10 days after when scabs fall off |
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Primary Meds for ER respiratory distress
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-Sus-phrine(Epinephrine HCI)
-Theophyline(Theo-dur) -Bronchodilators |
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RR newborn
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30-60
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RR 1-11 months
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25-35
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RR 1-3 years
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20-30
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RR 3-5 years
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20-25
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RR 6-10 years
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18-22
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RR 11-16 years
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16-20
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Acyanotic Heart Defects
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-Ventricular Septal Defect VSD
-Atrial Septal Defect ASD -Patent Ductus Arteriousus PDA -Coarctation of the aorta -Aortic Stenosis -PDA -machine-like murmur -antiprostogladins to close in neonatal period ONLY |
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3 T's of cyanotic heart dz
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-Tetralogy of Fallot
-Truncus ateriosis -Transposition of the great vessels -MIXING OF BLOOD -polycythemia common |
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Tetralogy of Fallot
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-unoxygentaed blood into aorta
-pulmonary stenosis -ventricular septal defect -overriding aorta -right ventricular hypertrophy spells relieved by squatting or knee chest |
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Rheumatic Fever
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Aquired heart dz
-affects aortic and mitral valves -beta hemolytic strep infection -erythema marginatum rash -high ASO titer and ESR -chest pain, SOB -migratory large joint pain -tachycardia even when sleeping -TX w/penicillin G |
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Trousseau's sign
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-carpal spasm via BP cuff
-hypocalcemia -hypoparathyroidism |
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Chvostek's sign
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-facial spasm after facial nerve tap
-hypocalcemia -hypoparathyroidism |
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Ulcerative Colitis
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bloody diarrhea
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Pyloric Stenosis
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-olive-shaped mass in epigastric
-projectile vomitting |
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Intussiception
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-current jelly stool
-sausage-shaped mass in RUQ |
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Mantoux Test
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-for TB
-+ if 10mm induration 48hrs post -previous vaccine for BCG= + |
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Systemic lupus erythematosus
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butterfly rash
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Acute Pancreatitis
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-Cullens sign=periumbilical discoloration
-Turner's sign=blue flank -fetal position -board-like abdomen -self digestion of pancreas by trypsin |
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Murphy's sign
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-pain on palpation during inspiration
-GB or Liver dz |
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Brain Tumor
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-headache more severe when waking
-vomiting but NO nausea |
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Multiple Sclerosis
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-IG bands on electrophoresis
-bowel/bladder function -demyelination -weakness starts at top TX -ACTH -coticosteriods -Cytoxan -immunosupressives |
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Hodgkins
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Reed-Sternberg cells
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Rubeola
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AKA Measles
-Koplik spots -vitamin A |
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Droplet Precautions
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-wear MASK
-Sepsis -Scarlet Fever -Strep -5ths dz(parvo B19) -Pertussis -Pneumonia -Influenza -Diptheria -Epiglottitis -Rubella -Rubeola -Meningitis -Mycoplasma -Adenovirus -Rhinovirus -RSV |
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Respiratory Isolation
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TB
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infant-bodily injury
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remembers pain after 6 months
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toddler-bodily injury
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intrusive procedures
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preschooler-bodily injury
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mutilation
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school-age-bodily injury
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loss of control of body
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adolescent-bodily injury
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body image
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DTaP vaccine
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2 months
4 months 6 months 12-18 months 4-6 years NOT past 7th birthday -given Td 10 years after last DTaP NOT -enchephalopathy w/7 days after last -hx of seizures -neuro symptoms after last |
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IPV vaccine
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-recommended for all under 18yrs
-SQ or IM 6 months 9 months 18 months 4-6 years NOT if -neomycin -streptomycin |
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DaTP/Hib combo
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-should be used as primary
2,4, or 6 months |
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Hib
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-IM
-if at risk AFTER age 5 2 months 4 months 6 months 12-15 months protects against bacteria... -epiglottitis -bacterial meningitis -septic arthritis -etc |
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Hep B vaccine
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IM
-given to newborns -all 0-18 years -2 months -4 months -6-18 months -11-16 years NOT if.... -common baker's yeast |
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Varicella vaccine
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-must be OVER 12 months
-12 to 18 months give with MMR on SAME day OR 30 days apart safe for HIV if NO symptoms |
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Pertussis
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AKA Whooping Cough
-lasts 4-6 weeks TX=erythromycin |
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lund browder chart
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to assess burns in children
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Bronchiolitis
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-RSV
-isolation -mist tent Synagis (palivizumab) for immunocompressed to prevent |
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Digoxin in kids
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0.8-2ng/ml
-hold if bradycardia -vomiting -anorexia -diarrhea -abdominal pain hypokalemia makes it worse |
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at bedside when using
l-asparginase |
-Epi
-O2 |
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DKA insulin
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given in normal saline
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fractures r/t child abuse
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spiral
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HgB -newborn
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14-24 g/dl
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HgB-Infant
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10-15g/dl
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HgB-child
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11-16g/dl
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Kawasaki Disease
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-vasculitis
-pancarditis (all heart structures) ECHO=ectasia-dialation of vessel -strawberry tongue -1st sign=HIGH fever 5+ days -more common in Japan -use soft toothbrush |
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Monro-Kellie Hypothesis
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-once sutures in skull close
-noncompressable contents -brain 80% -blood 10% -CSF 10% if 1 component increases then another area MUST decrease or ICP WILL INCREASE |
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Normal ICP
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-adult 3-15mmHg
-child 0-10mmHg want it less than 20mmHg |
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s/s of ICP
late s/s in infant |
-LOC
-pupilary reaction -weakness/headache ----------------------------------- -severe LOC -VOMITING -change in VS -impaired reflexes ------------------------------------- -HIGH-PITCHED CRY -Bulging fontanels -distended scalp veins |
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Spina Bifida
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LATEX
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Hypopituiarism
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-short stature
-higher height to weight ratio -delayed bone age |
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Beta-thalassemia
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-chronic transfusions
-may need splenectomy -bone marrow transplant -chelation therapy -RISK for infection post-op |
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Aplastic Anemia
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PANCYTOPENIA
-neotrophils below 500 -platelets below 20,000 -reticulocytes below 1% -primary=congenital Fanconi's anemia -secondary=aquired -injury/viral/toxic/etc |
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Hemophilia A
Hemophilia B |
factor VIII
-aka classic --------------------------------- factor IX -aka Christmas dz ---------------------------------- BOTH -prolonged PTT -normal everything else -1st aide for bleeding=RICE -plasma derived or recombinant transfusions -DDAVP for mild type A |
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Hemophilia C
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factor XI
aka Von Willebrand's dz -vWf transports factor VIII TX=DDAVP and vWf replacement |
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Hyperthyroidism
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-increased growth
-wt loss with good eating -tachycardia -warm/moist skin -eye changes -heat intolerance -insomina -tremors TX -antithyriod meds -radioactive iodine -cut it out |
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Adrenal Hyperplasia
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-no signs in male
FEMALE -pseudohermaphroditism -hirstutism -early period -faster growth |
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RBC life span
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120 days
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lyme disease
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-deer tick
-spirochete -bull's eye rash -athralgia later tx -doxy/tetracycline if over 8 years old -amoxicillin or penicillin if less |
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scabies
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-thread-like lines
-itching |
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Rotavirus
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most common cause of diarrhea in kids
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MMR vaccine
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12-18 months
4-6 years |
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5th disease
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-erythema infectiosum
-can get it 1 week after rash and before s/s -SLAPPED CHEEK -arthralgia -can cross placenta -anemia and immune hydrops in fetus |
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car seat
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rear facing -back seat
forward facing when 1 year AND 20+lbs |
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iron deficiency anemia
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Hg below 12
Hct below 30% |
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have an adult concept of death
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9-10 years old
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