Shared Flashcard Set

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Pediatrics
Pediatrics
336
Medical
Not Applicable
06/01/2007

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Cards

Term
What is the most developed sense of a newborn?
Definition
Touch
Term
Ritualism is associated with which age group?
Definition
3 years old
Term
The newborn is unable to hear until this happens.
Definition
First sneeze to clear amniotic fluid from ears.
Term
What is the average weight of a newborn?
Definition
7 lbs.
Term
What is the normal head circumference of a newborn?
Definition
33 - 33.5 cm

(13 - 14 inches)
Term
What shape is the anterior fontanel?
Definition
Diamond
Term
What shape is the posterior fontanel?
Definition
Triangle
Term
When does the posterior fontanel close?
Definition
3 months of age
Term
When does the posterior fontanel close?
Definition
18 months of age
Term
What is the principal disorder of posterior pituitary hypofunction?
Definition
Diabetes Insipidus
Term
Acromegaly is associated with which disorder?
Definition
Overproduction of the anterior pituitary after puberty

(pituitary hyperfunction)
Term
Why is Ipecac and charcoal never given at the same time?
Definition
They neutralize each other.
Term
What is the normal respiration rate for an infant?
Definition
30 - 60 breaths / minute
Term
What are the three (3) stages of separation anxiety?
Definition
1. Protest
2. Despair
3. Detachment
Term
Object permanence is associated with this age group.
Definition
11 months
Term
Imitative play is associated with this age group.
Definition
11 months
Term
A Clique is associated with this age group.
Definition
10 - 12 years old
Term
Beginning of competitive play is associated with which age group?
Definition
7 - 8 yrs old
Term
Children are most highly imaginative at this age.
Definition
3 yrs old
Term
Bladder control occurs at this age.
Definition
3 years old
Term
Bowel control occurs at this age.
Definition
2.5 years old
Term
Infant has to place head in this position before infant can start to cry.
Definition
Midline
Term
What developmental function(s) are affected by a Cleft Palate?
Definition
1. Impacts speech

2. Feeding problems until repair
Term
Negativism is associated with this age group.
Definition
2 year old
Term
What is the normal weight range of a newborn?
Definition
5 lbs, 8 oz - 8 lbs, 13 oz

(2.5kg - 4kg)
Term
This is the master gland of the endocrine system.
Definition
Pituitary gland
Term
What is the Life Stage and Psychosocial Crisis for (4-6 yrs)?
Definition
1. Early School Age

2. Initiative vs. Guilt
Term
What is the Life Stage and Psychosocial Crisis for (2-4 yrs)?
Definition
1. Toddlerhood

2. Autonomy vs. Shame & Doubt
Term
What are the three (3) parenting styles?
Definition
1. Autocratic

2. Democratic

3. Indulging
Term
What is the Life Stage and Psychosocial Crisis (12-18 yrs)
Definition
1. Early Adolescence

2. Group Identity vs. Alienation
Term
What is the Life Stage and Psychosocial Crisis (6-12 yrs)
Definition
1. Middle School Age

2. Industry vs. Inferiority
Term
A newborn will need furhter assessment if the infant does not pass a stool within _________ of birth?
Definition
24 hours
Term
A high-pitched cry can indicate what type of disorder?
Definition
(CNS) central nervous system disorder
Term
Boys and Girls playing together is associated with this age group?
Definition
6 - 7 years old
Term
Cooperative play is associated with this age group.
Definition
3-5 years old
Term
Parallel play is associated with this age group.
Definition
2 - 3 yrs old
Term
What does the acronyn CRIES represent?
Definition
C - Cries
R - Requires oxygen
I - Increased vital signs
E - Expression
S - Sleepless
Term
What product should not be given to an infant with Gastroenteritis?

Why?
Definition
1. Pepto

2. Can poison baby
Term
Eosinophils present in stool culture of a child suspected of having Gastroenteritis indicates?
Definition
Allergy
Term
Acid & sugar present in stool culture of a child suspected of having Gastroenteritis indicates?
Definition
Formula intolerance

(Doc usually changes formula)
Term
Inflammation of the stomach and intestinal tract that causes vomiting, diarrhea, or both
Definition
Gastroenteritis
Term
When does an infant lose 10% of it's birthweight?
Definition
Within first 3 to 4 days after birth.
Term
Birth weight quadruples at this age.
Definition
2.5 years (30 months)
Term
Birth weight doubles at this age.
Definition
6 months
Term
Birth weight triples at this age.
Definition
12 months
Term
Normal chest circumference of a newborn.
Definition
30.5 - 33cm

(12 - 13 inches)
Term
Normal body temperature range of an infant.
Definition
36.5 - 37.5 C (Axillary)

(97.7-99.5 F)

36.5 - 37.6 C (Rectal)

(97.7 - 99.7 F)
Term
Life Stage and Psychosocial Crisis
(Birth - 2 yrs)
Definition
1. Infancy

2. Trust vs. Mistrust
Term
What is Infant Mortality?
Definition
# of deaths of childen between 30 days to 1 year of age per 100 live births per year
Term
Group play is associated with this age group.
Definition
8 - 10 yrs old

If group play is not provided, children may find a gang to become involved in a group.
Term
Solitary play is associated with this age group.
Definition
2 - 3 yrs old
Term
Acromegaly is associated with this disorder.
Definition
Overproduction of the ANTERIOR pituitary gland AFTER puberty

"Pituitary Hyperfunction"
Term
Fencing Reflex disappears by this age.
Definition
3 - 4 months
Term
Gigantism is associated with this disorder.
Definition
Overproduction of the ANTERIOR pituitary BEFORE puberty.

"Pituitary Hyperfunction"
Term
What is Perinatal Mortality?
Definition
# of FETAL (<20 weeks gestation) plus
# of death of INFANTS less than 30 days per 1000 live births per year.
Term
What is Morbidity?
Definition
Prevalence of specific ILLNESS during specific time per 1000 population.
Term
First temperature of a newborn should be taken where?

Why?
Definition
1. Rectally

2. Verifies patency of anus
Term
What should the first feeding of a BOTTLE FED newborn consist of?

Why?
Definition
1. Glucose and water (not formula)

2. Easily breaks down
Term
Solid food should be introduced to the infant at this age.
Definition
6 months
Term
When can a child receive an IM injection in the gluteal region?
Definition
Child has to have a history of walking for at least 12 months (1 year)
Term
Normal for a newborn to lose 10% of it's birth weight after birth. When does newborn's weight return to birth weight?
Definition
Usually by 10th day after birth.
Term
Normal length range of a newborn.
Definition
48 - 53 cm

(19 - 21 inches)
Term
Normal length range of a newborn.
Definition
48 - 53 cm

(19 - 21 inches)
Term
What is the AVERAGE length of a newborn?
Definition
20 - 21 inches
Term
UNILATERAL wheezing in a child may indicate this.
Definition
Foreign body aspiration / occlusion
Term
What is NEONATAL mortality?
Definition
# of deaths of infants (< 30 days old) per 1000 live births per year.
Term
Clark's Formula for pediatric dosage calculation.
Definition
Multiply weight of child in pounds with amount of adult dosage and divide by 150
Term
Fried's Formula for pediatric dosage calculation.
Definition
Multiply child's age in months with adult dosage amount and divide by 150.
Term
Formula to calculate # of erupted teeth.
Definition
Age of child in months - 6.
Term
Normal heart rate range for a newborn.
Definition
110 - 160 beats / minute

100 (sleeping)

180 (crying)
Term
Drooling begins at this age.
Definition
4 months
Term
No head lag when pulled to sitting position by this age.
Definition
5 months
Term
Begins to use pincer grasp using index, fourth, and fifth fingers against lower part of thumb at this age.
Definition
8 - 9 months

8 months - starts using pincer grasp
9 months - uses thumb and index finger in crude pincer grasp
Term
Recognizes parents; begins to fear strangers at this age.
Definition
6 months
Term
Pulls self to standing position and stands holding onto furniture.
Definition
9 months
Term
Rolls from back to side at this age.
Definition
4 months
Term
Can turn over from abdomen to back at this age.
Definition
5 months
Term
Rolls from BACK to ABDOMEN at this age.
Definition
6 months
Term
Starts to creep on hands and feet by this age.
Definition
9 months
Term
What is Tongue Retusion Reflux and when does it usually disappear?
Definition
1. Whatever goes in the infant's mouth, the tongue pushes the food / object foward.

2. Usually disappears by 6 months of age.
Term
First solid food given to an infant.
Definition
Rice cereal
Term
First solid food given to an infant.
Definition
Rice cereal
Term
Discipline Rule
Definition
1. Tell what rule was broken (no
more than 10 words)
2. Put child in a place where there is
no view and is uncomfortable
(corner)
3. Time-out (1 min per year of age)
4. Hug and tell why they had timeout
(no more than 10 words)
Term
What is (PKU) Phenylketonuria?
Definition
A congenital, autosomal recessive disease marked by failure to metabolize the amino acid phenylalaline (protein) to tyrosine

Prohibits digestion of protein
Term
(PKU) Pheylketonuria can cause this type of disorder.
Definition
Severe neurological deficits such as mental retardation in infants.
Term
Transfer of gastric contents into the esophagus is associated with this dysfunction.
Definition
(GER)Gastroesophageal Reflux
Term
What is the treatment for Gastroesophageal Reflux (GER)?
Definition
1. Depends on the severity

2. Some children require small, frequent feedings of thickened formula & positioning therapy

3. Constant N/G feeding maybe necessary for infant if FTT occurs

4. Pharmacologic therapy maybe used as adjunct therapy
(Ex: Pepcid, Tagament, Zantac)

5. Surgical management for children with severe complications such as:
Apnea, FTT, Recurrent Aspiration Pneumonia
Term
type of diet for a child with PKU (Phenylketonuria).
Definition
Very low protein diet

Enough protein for growth & development, but not enough to raise levels to cause problems.
Term
GER-chalasia is another name for which disorder?
Definition
Gastroenteritis
Term
What is Celiac Disease?
Definition
Intolerance to gluten
(wheat, barley, rye, oats)

Gluten will kill the villi in the small intestines resulting in mal absorption of nutrients.
Term
Leukocytes present in a stool culture of a child suspected of Gastroenteritis indicates?
Definition
Usually a specific pathogen causing the inflammation.
Term
Celiac disease usually shows up between this age group.
Definition
6 months to 1 year of age.
Term
Bulky, frothy, foul smelling stools are associated with this type of disorder.
Definition
Mal Absoprtion disease

Ex: Celiac Disease, Cystic Fibrosis
Term
A normal protruding stomach, but no butt is associated with what type of disorder.
Definition
Mal Aborption disease

Ex: Celic Disease, Cystic Fibrosis
Term
Children with Celiac Disease often have this intolerance.
Definition
Lactose intolerance.
Term
Celiac Disease is also known as:
Definition
Sprue
Term
Sign/Symptom of Celiac Disease
Definition
(FTT) Failure to thrive due to mal absorption of nutrients.
Term
Cystic Fibrosis is a disorder of:
Definition
Mucuous and sweat glands
Term
Children with Celiac Disease can eat these products
Definition
Rice and corn
Term
Type of diet for children with Celiac Disease.
Definition
"Glutten free"; low gluten diet as it is impossible to remove every source of gluten protein
Term
Signs / symptoms of Cystic Fibrosis.
Definition
1. FTT (Failure to Thrive) due to
malabsorption of nutrients

2. Respiratory problems due to thick
mucuous
Term
Pathophysiology of Cystic Fibrosis.
Definition
1. Increase vicosity of mucous gland
secretions

2. Elevation of sweat electrolytes

3. Missing enzymes for digesting food

4. Increase in several organic &
enzymatic constituents of saliva

5. Abnormalities in autonomic nervous
system function
Term
What is the primary factor & main one responsible for many of the clinical manifestations of Cystic Fibrosis?
Definition
Mechanical obstruction caused by increased viscosity of mucous gland secretions.
Term
What is the mode of transmission for Cystic Fibrosis?
Definition
Defective gene inherited from both parents.
Term
What is the earliest manifestation of Cystic Fibrosis?
Definition
Meconium ileus in the newborn.
Term
What type of test is used as a diagnotic tool for Cystic Fibrosis?
Definition
Sweat gland test - determines how much chloride is in the sweat

(Hand is placed under a machine that detects chloride level)
Term
Child with Cystic Fibrosis usually have high concentrations of these components in their sweat.
Definition
Sodium and chloride
Term
Children with Cystic Fibrosis usually require chest physiotherapy to help clear up alveoli. What is chest physiotherapy?
Definition
Postural drainage by percussion
Term
What drug therapy is used for Cystic Fibrosis?
Definition
PULMOZYME - loosens up secretions in the lungs

VIOKASE - synthetic pancreatic enzyme
Given before meals to aid in digestion
Term
Physical manifestations of children with Cystic Fibrosis
Definition
Normal protruding stomach, but no butt.
Term
An infant with Cystic Fibrosis will taste?
Definition
Salty
Term
Why is it important for children with Cystic Fibrosis to remain updated on all immunizations?
Definition
They are very weak and susceptible.
Term
Why should children with Cystic Fibrosis not run around as much as other children?
Definition
They could loose too much sodium and chloride from sweating.
Term
What is Kwashiokor?
Definition
A severe protein-deficiency type of malnutrition of children

Means: "Deposed Child"
Term
White streak in hair of a child is associated with this disorder.
Definition
Kwashiorkor
Term
What are the clinical manifestations in a child with Kwashiorkor?
Definition
1. Prominent abdomen from edema (ascites)
2. Scaly & dry skin with areas of depigmenation
3. Permanent blindness often from lack of Vitamin A
4. Diarrhea common
5. Melanin deficiency
6. Protein deficiency
Term
What is the treatment for Kwashiokor?
Definition
Add protein to diet
Term
What is Morasmus?
Definition
Malnutrition - Deficiency in all nutrients (starvation)
Term
Morasmus is usually seen in what areas of the world?
Definition
3rd world countries
Term
What are the clinical manifestations of a child with Morasmus?
Definition
Gradual wasting and atrophy of body tissues, especially subcutaneous

Child appears old, with flabby, wrinkled skin
Term
Why is Cystic Fibrosis considered a Respiratory and a GI disorder?
Definition
1. RESPIRATORY - pulmonary complications resulting from thick mucous poses the most serious threat to life.

2. GI - Thickness of mucous causes obstruction in GI tract and there are many enzymes missing which help to digest food
Term
What is Bezoar?
Definition
It is an undigestible substance ingested in the stomach

Ex: hair chewing (causes hair ball);
Term
Children tend to swallow things. What would be the treatment be for a swallowed penny?
Definition
Observe for the passage through stool with a tongue blade depressor and give a high fiber diet.
Term
What is contraindicated to treat a child who has swallowed a foreign body such as a penny?
Definition
Laxatives
Term
What is the pulmonary & gastrointestinal treatment for Cystic Fibrosis?
Definition
1. Antibiotic therapy
2. Chest physiotherapy
3. Bronchodilator therapy PRN
4. Physical exercise (moderate)
5. Replacement of pancreatic enzymes
6. Well-balanced, high-protein,
high-caloric diet
Term
What is the antidote for Tylenol poisoning?

How much does a child need to take?
Definition
1. Mucomyst

2. 17 to 18 doses
Term
What are the s/sx of Aspirin poisoning?
Definition
Bleeding and tinnitus (rining in ears)
Term
Overdose of either Aspirin or Tylenol can lead to the failure of this organ.
Definition
The liver
Term
What is Syrup of Ipecac?
Definition
Emetic (induces vomiting) - exerts action through irritation of the gastric mucosa & by stimulating vomiting center of the brain

Also a poison itself.
Term
What is Activated Charcoal?
Definition
Nontoxic, odorless, tasteless, fine black powder that absorbs many compounds reducing their toxicity through entire length of GI tract.
Term
What two gastric decomtaminates are given for poisonings?
Definition
1. Syrup of Ipecac

2. Activated charcoal
Term
What is the formula used to determine how much was ingested with each swallow?
Definition
.21 ml/kg = 1 swallow

Ex: Child weighs: 18 kg

.21 x 18 = 3.78ml per swallow
Term
Why is it no longer suggested to have Ipecac at home.
Definition
Ipecac is a poison itself and it is meant to be vomited. If a child does not vomit, the Ipecac itself can be a problem for the child.
Term
When is Ipecac contradindicated?

Why?
Definition
1. When a child has swallowed a corrosive or a hydrocarbon substance.

2. Corrosive materials eat away at tissue and will cause more damage if the corrosive material is vomited.

A hydrocarbon has a high risk of aspiration
Term
Lead poisoning is known as:
Definition
Plumbism
Term
Why is Syrup of Ipecac and Activate charcoal never given at the same time?
Definition
They neutralize each other.
Term
What are the independent risk factors to Lead Poisoning?
Definition
1. Poverty

2. < 6 yrs old

3. African-American

4. Dwelling in city
Term
What are the causes of Lead Poisoning?
Definition
1. DIGESTION: Eating lead-based paint;high level of lead in newpaper colored comics and ads (children place in mouth to make spitballs)

2. INHALATION: From environment such as contaminated soil; leaving close to freeways; gasoline emitted lead in air which falls on fruits and vegetables which are then ingested
Term
Serum level of lead greater than _____ is toxic.
Definition
10
Term
Lead poisoining can lead to:
Definition
Cerebral edema & encephalopathy
Term
Signs/Symptoms of lead encephalopathy?
Definition
1. Headache

2. Personality changes

3. ALOC - child will not be alert
Term
Why is an increased level of lead toxic?
Definition
1. Lead competes with molecules of calcium at cellular level (interferes with reglating action of calcium)

2. Prevents hemoglobin from combining with iron which results in iron deficiency anemia
Term
Xrays will show this in a child with lead poisoning.
Definition
Lead line across the bone
Term
Why type of therapy is used for Lead Poisoning?
Definition
Chelation therapy - medication given that removes lead from the blood and to some extent, in other places in the body
Term
What are the drugs used for chelation therapy in a child with Lead Poisoning?
Definition
1. EDTA - IV over few hours or IM

2. BAL - Deep IM
Term
What is PICA?
Definition
Eating disorder manifested by a craving to ingest any material not normally considered as food.

Particular problem with lead poisoning

Can cause toxicity dependent on component ingested
Term
What gastric decontaminate should be used for a child who has ingested a corrosive material or a hydrocarbon substance?
Definition
Activated charcoal.
Term
What is the treatment for a Tooth Avulsion?
Definition
Place tooth in milk (isotonic solution) to preserve
Term
Why is it contraindicated to place a Tooth Avulsion in water?
Definition
Water is a hypotonic solution; it would draw the fluid from the root of the tooth
Term
Most common helminthic infection in U.S.
Definition
Pinworms (Oxyuriasis)
Term
What type of test is used as a diagnostic tool for pinworms?

When is it performed?
Definition
1. Scotch tape test - piece of tape applied to anus of child

2. First thing in the morning as soon as child wakes up
Term
Drug used for treatment of pinworms.
Definition
Povan
Term
What is the mode of transmission for pinworms?
Definition
Eggs ingested or inhaled

Eggs hatch in the upper intestine, mature & migrate through the intestine

After mating, females migrate out the anus (when child sleeping)and lay eggs
Term
Mode of transmission for Roundworms.
Definition
Transfer to mouth by way of contaminated food, fingers, or toys

Eggs penetrate wall of intestine & travels to lungs

Child coughs & swallows sputum (continues cycle)
Term
Ascariasis is also known as:
Definition
Roundworm
Term
Oxyriasis is also known as:
Definition
Pinworm
Term
Largest of intestinal helminths.
Definition
Roundworm
Term
Signs and Symptoms of Pinworm.
Definition
Itchy anus
Term
Signs/Symptoms of Roundworm.
Definition
Chronic cough with no other signs of illness
Term
Necator is also known as:
Definition
Hookworm
Term
Mode of transmission for Hookworm.
Definition
Direct skin contact with discharged eggs in soil.

Picked up by walking barefoot - gets into the blood from the hair follicles.

Migrates to lungs where the eggs mature. Child coughs up mature egg, and swallow again (continuous cycle)
Term
Signs/Symptoms of Hookworm.
Definition
Itching and burning followed by erythema at entrance site.

Wear shoes to prevent
Term
Trichuriasis is also known as:
Definition
Whipworm
Term
Mode of transmission for Whipworm.
Definition
Ingestion of eggs - usually by eating rare or undercook meat (especially pork)

Larvae get in the duodenum and pierce through it and get in the bloodstream. They settle in tissue (muscle) causing an abscess.

Has to be surgically incised
Term
Schistosomiasis is also known as:
Definition
Blood Fluke
Term
Mode of transmission for Blood Fluke.
Definition
Contact with infected snails / infested (still) water

Larvae can attach to hair follicles.

May cause GI bleeding
Term
Signs/Symtpoms of Blood Fluke?
Definition
Swimmer's itch.
Term
Atresia of Esophagus is also known as:
Definition
(TEF) Tracheo Esophageal Fistula
Term
Condition in a pregnant woman that may indicate the fetus has Artresia of Esophagus.
Definition
Polyhydramnios - too much amniotic fluid indicates may indicate the fetus is unable to ingest amniotic fluid.
Term
What are the different pathologies that can develop in Atresia of Esophagus?
Definition
1. Esophagus is blocked off (does not connect to stomach or trachea)

2. Esophagus goes into the trachea instead of stomach

3. Trachea connects to stomach

4. Esophagus connects to trachea and trachea connect to stomach
Term
What are the signs/symptoms of Atresia of Esophagus?
Definition
1. Distended abdomen

2. Drooling (infant < 4 months old)

3. Vomiting

4. Choking
Term
Who should always be present for a newborn's first feeding?

Why?
Definition
1. Nurse

2. Assess for any problems.
Term
Ribbon like stool is associated with this disorder.
Definition
Imperforated Anus - anus dimpling smaller than GI.
Term
What are the different types of an Imperforated Anus?
Definition
1. GI tract and anus do not connect.

2. Connection blocked (membrance between GI and anus did not rupture)

3. No anus dimpling present

4. Connection, but anus dimpling smaller than GI.
Term
What are the two methods used when taking an X-ray in a child suspected of having an Imperforated Anus?
Definition
1. Piece of metal inserted into anus to see how far up the anus is

2. Feed baby ginger ale and turn baby upside down before taking X-ray. The bubbles go bottom of GI tract and can be seen on X-ray
Term
What is a Cleft Lip?
Definition
Facial malformation - results from failure of the maxillary & medial nasal processes to fuse by 11th week gestation.

May vary from a small notch to a complete fissure extending into the base of the nose
Term
What is a Cleft Palate?
Definition
Incomplete connection of nasal & maxillary processes resulting in a midline fissure (hole)inside upper roof of mouth.
Term
When is a Cleft Lip usually repaired?
Definition
About 11 weeks after birth.
Term
When is a Cleft Palate repaired.
Definition
Usually about 18 months of age.
Term
Why can't a Cleft Palate be repaired before 18 months of age?
Definition
Time is needed for area to grow to make room for teeth.
Term
Which is repaired first in a child who has both Cleft Lip and Cleft Palate?

Why?
Definition
1. They are not repaired at the same time. Palate is repaired first and allowed to heal.

2. Palate is repaired first to avoid disrupting the lip after it has been repaired.
Term
How does a cleft palate affect development?
Definition
1. Impacts feeding - infant unable to suck (specialized nipples used until repaired)

2. Impacts speech
Term
Name of surgical procedure to repair a Cleft Lip.
Definition
Cheiloplasty
Term
Name of surgical procedure to repair a Cleft Palate?
Definition
Staphlylorraphy or Palatoplasty
Term
What is Pyloric Stenosis?
Definition
Hypertrophy (overgrowth) of the pyloric muscle causing narrowing of the opening.
Term
When does Pyloric Stenosis develop?
Definition
Usually within the first few weeks after birth.
Term
Projectile vomiting is associated with this disorder.
Definition
Pyloric Stenosis
Term
Signs/Symtpoms of Pyloric Stenosis.
Definition
1. Visible peristalsis

2. Able to palpate lump

3. Projective vomiting

4. FTT (Failure to Thrive)

5. Metabolic alkalosis

6. Dehydration
Term
Conservative treatment for Pyloric Stenosis.
Definition
1. Thicken feeding

2. Anti-reflux - keep baby in fowler's position during and after feeding.

3. Drug therapy (Reglan) - empties stomach faster (given before meals)
Term
Surgical treatment of Pyloric Stenosis is called?

How is procedure done?
Definition
1. Ramstedt

2. Incision is made only in the pyloric muscle
Term
What position should an infant be placed after surgical procedure for Pyloric Stenosis?
Definition
Knees are keep slightly flexed to help keep strain off surgical site

Baby can be placed in a car seat which keeps baby's knees slightly flexed
Term
What is Hirschsprung's Disease?
Definition
Most common cause of lower GI obstruction in neonates

Caused by a congenital absence of some or all the normal bowel ganglion (nerve) cells.
Term
Signs/Symptoms of Hirschsprung's Disease.
Definition
1. Constipation

2. Hx of laxative use

3. Distended bowel (cannot be seen)
Term
What type of enema should never be used in a child with Hirschsprung's Disease?

Why?
Definition
1. Water enema

2. Can cause hypotonic dehydration & death
Term
Congenital Megacolon is also known as:
Definition
Hirschsprung's Disease
Term
How is Hirschsprung's Disease treated?
Definition
Surgically - sectionlacking the nerve endings is excised and then colon is sutured to connect.
Term
What is Intussusception?
Definition
Intestinal obstruction - occurs when a proximal segment of the bowel telescopes into a more distal segment, pulling the mesentery with it.
Term
Currant jelly stool is associated with this disorder.
Definition
Intussusception
Term
Currant jelly stool is associated with this disorder.
Definition
Intussusception
Term
What is the treatment for Intussusception?
Definition
Barium enema - the weight of the barium pushes tract to the direction it needs to go.

Air pressure works just as well and some use carbon dioxide
Term
What is (PKU) Phenylketonuria?
Definition
Congenital disorder marked by failure to metabolize protein
Term
What liquid should not be given to a child with Phenylketonuria?

Why?
Definition
1. Milk

2. Unable to break down protein in milk

Child should be given milk substitute such as Lefenolac.
Term
Type of diet for child with Phenylketonuria.
Definition
Very low protein diet - give enough protein for growth and development, but not enough to raise levels to cause problems.
Term
Phenylketonuria can cause this disorder.
Definition
Mental retardation
Term
Therapeutic management for Atresia of Esophagus.
Definition
1. Surgical repair of anomaly
2. Maintenance of airway
3. Prevention of pneumonia
4. Infant placed on NPO and IV therapy
until diagnosed
5. Early, broad spectrum antibiotic
started due to aspiration pneumonia
is almost inevitable
Term
What are the five (5) phases of childhood communicable diseases?
Definition
1. Incubation
2. Prodromal
3. Fastigium
4. Defervesence
5. Convalesence
Term
Exposure to 1st symptom of being ill is the __________________ period of a communicable disease.
Definition
Incubation
Term
1st sign & symptom to characteristic rash is the _______________ period of a communicable disease.
Definition
Prodromal
Term
Characteristic rash to signs & symptoms start to disappear is the
________________ period of a communicable disease.
Definition
Fastigium
Term
All signs & symptoms disappear is the ________________ period of a communicable disease.
Definition
Defervesence
Term
What is the incubation period for a viral infection?
Definition
7-21 days
Term
What is the incubation period for a bacterial infection?
Definition
Usually < 7 days
Term
Most contagious stage of a communicable disease.
Definition
Incubation period
Term
Varicella is also known as:
Definition
Chicken Pox
Term
Variola is also known as:
Definition
Scarlet Fever
Term
All five (5) stages of this communicable disease is present at the same time?
Definition
Chicken Pox (Varicella)
Term
The five (5) phases of this communicable disease are present one stage at a time.
Definition
Small Pox (Variola)
Term
Temperature rises (up to 105 F), drops dramatically, then rash erupts.
Definition
Roseola
Term
Mode of transmission for Mumps.
Definition
Spread by saliva
Term
What is a major complication of Mumps (especially in males)?
Definition
Orchitis - sterility possible if infected after puberty.
Term
Swelling of the glands (Bull neck) is associated with this communicable disease.
Definition
Mumps
Term
Erythema Infectiosum is also known as:
Definition
Fifth's Disease
Term
Human parvo virus 19 is associated with this communicable disease.
Definition
Fifth's Disease (Erythema Infectiosum)
Term
Gray, white membrane across inside of throat that will bleed if removed is associated with this communicable disease.
Definition
Diphtheria
Term
Human parvovirus B19 (HPV) is associated with this communicable disease.
Definition
Fifth's Disease
Term
Rubella is also known as:
Definition
German Measles
Term
Koplik spots are associated with this communicable disease.
Definition
Rubeola
Term
Whooping Cough is also known as:
Definition
Pertussis
Term
What vitamin is given to children with Rubeola?
Definition
Vitamin A
Term
What is the ENATHEM characteristic sign of Scarlet Fever?
Definition
Strawberry tongue
Term
What are the EXANTHEM signs of Scarlet Fever?
Definition
1. Red rash (erythema) all over the
body (blanches on pressure)
2. Bright red rash, but have
circumoral pallor
3. Skin can peel as rash starts to
disappear
Term
What are the two (2) kinds of immunity for Scarlet Fever?
Definition
1. Antibacterial

2. Antitoxic Immunity
Term
If a child is innoculated against Scarlet Fever, child will develop this condition instead if exposed to Scarlet Fever.
Definition
Strep throat
Term
This communicable disease can cause congenital anomalies during pregnancy.
Definition
German Measles (Rubella)
Term
What are "Koplik Spots"?
Definition
Small, irregular red spots with a minute, bluish white center

First seen in mouth about 2 days before eruption of rash
Term
Conjunctivitis is associated with this communicable disease.
Definition
Rubeola (Regular Measles)
Term
What is the pathnomonic sign of Whooping Cough?
Definition
Fit of coughing & have inspiratory whooping sound
Term
Corney Bacteria is also known as:
Definition
Diptheria
Term
What should be at the bedside of a child who has Diptheria?

Why?
Definition
1. Trach set

2. Diptheria affects swallowing (possibility of aspiration)
Term
Why is it important to the abdomen of a child with Whooping Cough during a fit of coughing?
Definition
Possibility of a hernia from coughing fit.
Term
Contraindications to immunization.
Definition
1. High fever
2. Immunosuppression
3. Pregnancy
4. Hx of allergy response to
immunization

Such as: high fever, seizure,
inconsolable crying > 3 hrs.
Term
What is an Enanthem?
Definition
Rash on mucous membrane

Ex: conjuctivitis, thrush
Term
What is an Exanthem?
Definition
Rash on skin
Term
What is a macule?
Definition
Exanthem - circumscribed red area on the skin
Term
What is a papule?
Definition
Exanthem - circumscribed red area on the skin that is elevated
Term
What is a pustule?
Definition
Exanthem - circumscribed red area on skin that is elevated & contains pus
Term
What is a vescile?
Definition
Exanthem - circumscribed red area on the skin that is elevated, & contains clear liquid
Term
What type of immunity is given by a vaccination?
Definition
Active immunity
Term
What type of immunity is given by an innoculation?
Definition
Passive immunity
Term
What is an Endotoxin?
Definition
Toxin is inside bacteria and does not get released into the body until bacteria dies.
Term
What is an Exotoxin.
Definition
Toxin that is released while bacteria is alive.
Term
What is active immunity.
Definition
Make own antibodies.
Term
What is Passive immunity?
Definition
Given antibodies
Term
What is acquired immunity?
Definition
Immunity after birth.

Can be either active or passive
Term
What is natural immunity?
Definition
Born with the immunity
Term
What is a toxoid?
Definition
Gives active immunity - body will make own antibodies
Term
What is an antitoxin?
Definition
Gives passive immunity - antibodies are given
Term
Redness on the face (slapped face) is associated with this disease.
Definition
Erythema Infectiosum (Fifth's Disease)
Term
It is not a disease entity; it is a syndrome.
Definition
Scarlet Fever
Term
Sometimes pulse is out of porportion to the fever is associated with this condition.
Definition
Scarlet Fever
Term
Which vaccines are given IM?
Definition
1. DPT (Diphtheria, Pertussis, Tetanus)
2. Polio
3. Numococcal
4. Hep A
Term
Which vaccines are given SubQ?
Definition
1. MMR (Measles, Mumps, Rubella)
2. Varicella
Term
What is Otitis Media?
Definition
Inflammation of the middle ear with a rapid onset of the signs & symptoms of an acute infection.
Term
Signs/Symtpoms of Otitis Media.
Definition
1. Otalgia (earache)
2. Fever
3. Purulent dishcarge (otorrhea) may or
may not be present
Term
What is Otitis Media with Effusion?
Definition
Fluid in the middle ear without symptoms of acute infection
Term
When is antibiotic treatment started for a child with otitis media.
Definition
After 72 hours if fever has been present.
Term
Antibiotic treatment for otitis media is started immediately for what age group?

Why?
Definition
Infants < 6 months of age - (immature immune system)

Children < 2 yrs old with acute symptoms of fever & severe pain
Term
Ear drops are not a curative. Why are they given to children with otitis media?
Definition
Helps to relieve pain.
Term
What is Myringotomy?
Definition
Surgical incision of the eardrum
Term
When is a Myringotomy necessary?
Definition
1. Alleviate pain of otitis media

2. Provide drainage of infected middle
ear fluid in the presence of
complications
Term
What is Tympanosotmy Tube Placement?
Definition
Procedure done under general anesthesia to insert pressure-equalizer (PE) tubes or grommets inside child's ears.
Term
What is the purpose of a Pressure-Equalizing (PE) tube or grommet?
Definition
Facilitates continued drainage of fluid in middle ear & allow ventilation of the middle ear.
Term
When are pressure-equalizing tubes or grommets removed from the child's ear?
Definition
The tubes usually fall out on their own.
Term
When should hearing tests be conducted on a child with otitis media?
Definition
Test should be performed 3 months after acute otitis media for hearing loss.
Term
What is Croup?
Definition
General term applied to a symptom complex characterized by:

1. Hoarseness
2. A resonant cough (barking)
3. Varying degree of inspiratory
stridor
4. Varying degrees of respiratory
distress
Term
"Midnight Croup" or "Twilight Croup" is also known as:
Definition
Acute Spasmodic Laryngitis
Term
Why is Acute Spasmodic Laryngitis also called the "Midnight or Twilight Croup"?
Definition
Signs and symptoms occur at night.

Child wakes suddenly with characteristic "barking" cough
Term
What is the therapeutic management for Acute Spasmotic Laryngitis?
Definition
Moisture (cold/warm) in room helps relieve cough

Ipecac sometimes prescribed to induce vomiting. Child feels better after vomiting - (rid of mucous, etc.)
Term
Croup can affect what parts of the body?
Definition
Larynx, trachea, & bronchi
Term
What is Laryngismus Stridulous?
Definition
Larynx spasm that causes stridor

Child usually outgrows
Term
What are the benign (not serious) croup syndromes?
Definition
1. Acute Spasmodic Laryngitis

2. Laryngismus Stridulous
Term
What are the serious croup syndromes?
Definition
1. Acute Epiglottitis

2. Acute Laryngotracheobronchitis

3. RSV (Respiratory Synctical Virus)
Term
What is Acute Epiglottitis?
Definition
Serious obstructive inflammation of the glottis
Term
Looks like a beefy red thumb is associated with this syndrome.
Definition
Acute Epiglottitis
Term
Signs/Symptoms of Acute Epiglottitis.
Definition
1. Child insists on sitting upright & leaning forward with chin thrust out, mouth open, and tongue protruding
2. Drooling & saliva
3. Anxious & agitated
4. Froglike croaking on inspiration
5. Absence of spontaneous cough
Term
What should be readily available when examining a child with suspected acute epiglottitis?
Definition
Trach set and oxygen
Term
What is the therapeutic management of acute epiglottitis?
Definition
May require endotracheal intubation or tracheostomy

Antibiotic therapy 7-10 days
Term
What is Bronchiolitis?
Definition
Inflammation of the smaller airways of bronchioles of the lung.

Infection of lower respiratory tract that usually affects infants.
Term
What is Acute Laryngotracheobronchitis?
Definition
Inflammation of the mucosa lining of the larynx, tracheo, & bronchioles
Term
Also known as "True Croup"
Definition
Acute Laryntracheobronchitis
Term
Signs/Symptoms of Acute Laryngotracheobronchitis?
Definition
1. Inspiratory stridor
2. "Barking Cough"
3. Difficulty breathing
4. Thick secretions
5. Pallor
6. Yawning (if baby does - means lack of oxygen)
Term
What is (RSV) Respiratory Syncticial Virus?
Definition
Most frequent lower respiratory tract infection

Broncchiole mucosa swell, & lumina are filled with mucous & exudate
Term
What medication is given to treat children with RSV (Respiratory Syncticial Virus)?

How is it administered?
Definition
1. Ribovirin

2. Given in a nebulizer
Term
What are the precautions that should be taken when using Ribovirin to treat a child with RSV (Respiratory Syncticial Virus)?
Definition
Possibly toxic or teratogenic - pregnant healthcare workers should not care for a child receiving Ribovirin.

Distorts plastics (may distort contact lenses)

Shut off nebulizer & wait a few minutes before opening tent
Term
What is Respigam?
Definition
Immune globulin given for RSV (Respiratory Syncticial Virus)
Term
Why should vaccine immunizations be deferred for 9 months after the last does of Respigam is given?
Definition
Antibodies in the immune globuin (Respigam) may interfere with the immune response of live virus vaccines.
Term
Signs/Symptoms of Respiratory Distress.
Definition
1. Nasal flaring
2. Grunting (expiratory)
3. Stridor (inspiratory)
4. Head bobbing
5. Grimacing / retractions
6. nonproductive small coughs
7. Clubbed fingers
8. Cianosis - 5gm of total Hgb has to
be unoxygenated blood
9. Tachypnea
Term
What is Asthma?
Definition
Chronic inflammatory disorder of the airways in which many cells (mast cells, eosinophils, & T lymphocytes) play a role
Term
Signs/Symptoms of Ashtma
Definition
1. Prolong expiration
2. Bilateral wheeze
3. Signs of respiratory distress
4. Air trapped in alveoli
Term
What are some of the warning signs that a child is developing Ashtma?
Definition
1. Atopy - genetic predisposition
2. RAD - Reactive airways disease
3. Allergic rhinitis - (some do not have)
4. allergic shiners (dark circle around eyes)
5. long silky eyelashes (most have)
6. Geographic tongue - (light & dark area on tongue changes)
Term
What are the four (4) components of Asthma?

Do all four (4) have to be present
Definition
1. Edema & mucous
2. Bronchospasm
3. Inflammation
4. Airway reactivity or hyper-reactivity

No, all four components do not have to be present
Term
What NSAID medication is usually taken before exercise to prevent an ashtma attack?
Definition
Cromolyn sodium
Term
What beta-adrenergic agonist medications are used for immediate care (acute exacerbation) of ashtma?
Definition
Albuterol, Metaproterenol, & Terbutaline
Term
What bronchodilator medication is used for long-term prvention of ashtma symptoms?
Definition
Salmeterol, Singulair, Advair
Term
What is "status asthmaticus"
Definition
Continous display of respiratory distress despite vigorous therapeutic measures
Term
Signs/Symptoms of "status asthmaticus".
Definition
1. Constant ashtma attacks
2. Talk test - can't finish a sentence
without taking a breath
3. ALOC - unresponsive, but awake -
(need medical attention)
Term
What is the therapeutic management of "status asthmaticus"?
Definition
Aimed at improvement of ventilation - patient may have to be chemically induced into a coma & intubated
Term
What is Hyperbilirubinemia?
Definition
Excessive level of accumulated bilirubin in the blood
Term
Hyperbilirubinemia is characterized by:
Definition
Jaundice - yellowish discoloration of the skin, sclerae, & nails
Term
What is the normal lab values of unconjugated bilirubin?
Definition
0.2 to 1.4 mg/dL
Term
Levels of bilirubin must exceed ___________ in a newborn before jaundice is observable.
Definition
Exceed 5mg/dL
Term
Jaundice present within 24 hours of birth is known as:
Definition
Pathologic jaundice
Term
Unconjugated bilirubin is highly toxic to neurons. Infant with severe jaundice is at risk of developing:
Definition
Kernicterus
Term
What is Kernicterus?
Definition
A syndrome of severe brain damage resulting from the depostiion of unconjugated bilirubin in the brain cells
Term
Bilirubin Encephalopathy is also known as:
Definition
Kernicterus
Term
Signs/Symptoms of Kernicterus?
Definition
1. Decreased reflexes
2. High-pitch cry
3. Lethargy
Term
Jaundice that does not appear until after 24 hours of birth is known as:
Definition
Physiologic jaundice
Term
Therapeutic management of hyperbilirubinemia.
Definition
1. Phototherapy
2. Exchange transfusion - generally
used for reducing dangerously high
bilirubin levels that occur within
hemolytic disease
Term
What is the purpose of phototherapy to treat jaundice?
Definition
Light promotes bilirubin excretion by photoisomerization, which alters the structure of bilirubin to soluble from to easier excretion
Term
What are the minor side effects of phototherapy?
Definition
1. losse, greenish stools
2. transient skin rashes
3. hyperthermia
4. increased metabolic rate
5. dehydration
6. electrolyte disturbance such as
hypocalcemia
Term
What is Erythroblastosis Fetalis?
Definition
Abnormally rapid rate of RBC destruction in the newborn.
Term
Most severe form of erythroblastosis fetalis.
Definition
Hydrops fetalis
Term
What is Hydrops fetalis?
Definition
Most severe form of erythroblastosis fetalis

Progressive hemolysis causes fetal hypoxia, cardiac failure, generalized edema (anasarca), & effusions into the pericardial, pleural, & periotoneal spaces
Term
What is Hydrops fetalis?
Definition
Most severe form of erythroblastosis fetalis

Progressive hemolysis causes fetal hypoxia, cardiac failure, generalized edema (anasarca), & effusions into the pericardial, pleural, & periotoneal spaces
Term
What is Rh incompatibility (isoimmunization)?
Definition
Mother has Rh negative blood and fetus has Rh positive blood. If fetus blood gets mixed with maternal blood, the mother's body builds up antibodies to the Rh positive. These antibodies return to fetus and causes hemolysis of fetus's RBCs
Term
What is Rh incompatibility (isoimmunization)?
Definition
Mother has Rh negative blood and fetus has Rh positive blood. If fetus blood gets mixed with maternal blood, the mother's body builds up antibodies to the Rh positive. These antibodies return to fetus and causes hemolysis of fetus's RBCs
Term
What is the most common blood group incompatibiity in neonate?
Definition
Mother with O blood and infant has A or B blood
Term
Clinical manifestations of Erythroblastosis fetalis.
Definition
1. Jaundice may appear within the first 24 hours of birth
2. Serum levels of bilirubin rise rapidly
3. Anemia results from hemolysis of large number of RBCs
4. Hypoglycemia may occur
Term
What is the treatment of choice for hyperbilirubinemia & hydrops caused by Rh incompatibility?
Definition
Exchange Transfusion - infant's blood is removed in small amounts (usually 5 to 10 ml at a time) within 15 to 20 secs, then the same volume of donor blood is infused over 60 to 90 secs
Term
What is Kawasaki Disease?
Definition
Acute febrile vasculitis of unknown cause

Inflammation of all blood vessels
Term
Child must have fever and at least four other criterias to be diagnosed with Kawasaki Disease. What are the diagnostic criteria for this disease?
Definition
1. Fever for 5 or more days which is unresponsive to any treatment

2. Bilateral conjuctivial injection (inflammation) without exudation

3. Changes in oral mucous membranes such as: fissuring lips, erythema, sore throat, strawberry tongue

4. Changes in extremities such as:
peripheral edema; erythema of the palms & soles; peeling of hands & feet

5. Polymorphous rash

6. Cervical lymphadenophathy (at least one lymph node > 1.5cm)
Term
What is the confirming factor of diagnosis for Kawasaki Disease?
Definition
Periungual desquamation (peeling) of the fingers
Term
Principal area of involvement in Kawasaki Disease.
Definition
Cardiovascular system
Term
The most serious complications of Kawasaki Disease:
Definition
Potential for myocardial infarction which generally results from throbotic occlusion of a coronary aneurysm
Term
Therapeutic management of Kawasaki Disease includes:
Definition
High-dose IV gamma globulin & salicylate (aspirin) therapy
Term
If a child with Kawasaki Disease develops coronary artery abnormalities, this medication therapy will be continued indefinitely.
Definition
Aspirin therapy
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