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