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CV Pediatrics
Pediatic Acquired Heart Disease and Pediatric Hypertension
| Question | Answer |
|---|---|
| Most common cuase of acquired heart disease in children | Kawasaki |
| At what age is kawasaki more prevelant and does it occur in more boys or girls, | less than 5, more in boys |
| How long do you have to have a fever for it to be kawasaki | 5 days |
| Erythema of oral membranes | kawasaki |
| Red where you should be pink | kawasaki |
| Do kawasaki patients prevent as sick or healthy appearing | very sick |
| What condition can develop from untreated kawaaki and at what prevelance | coronary artery anuerysm (15-25%) |
| ELEVATED: platelets, ESR, WBC, and liver transaminases | kawasaki |
| What day does all of the scary stuff with kawasaki start to occur | day 3 |
| Tx for kawasaki | IV gamma globulin and aspirin |
| how is aspirin administered in kawasaki | start high and go low |
| how long do you keep someone on aspirin when they've had kawasaki | until labs normalize |
| Febrile child, no responding to antibiotics | kawasaki |
| Cervical adenopathy | kawasaki |
| dry/fissured lips | kawasaki |
| non-exudative conjunctivits | kawasaki |
| polymophus exanthem | kawasaki |
| Is cardiomegaly a sign of kawasaki | NO! |
| second most common acquired heart disease | rhuematic fever |
| can you get rhuematic fever from type A strep in your GI tract or skin | NO |
| Name three high risk factors for strep | age 6-15, high family occurance, and low socioeconomic status |
| #1 symtpom in the Jones criteria | arthirits (MIGRATES) |
| name the five jones critria | arthritis, chorea, carditis, erythema marginosum, and subcut. nodules |
| which vlave is most damaged with rhumeatic fever? Which is second | mitral, aortic |
| purposeless movements that may be aggrivated by stress | sydenhams chorea |
| Where does erythema marginitum NOT occur | face |
| Where can subcutaneous nodules from rhueamatic fever be found | extensor surfaces of joints |
| What would you use to treat normal rhuematic fever? Severe? | supprative care; prednisone |
| How will you treat a patient who has had rhuematic fever that cleared but still has a murmur | continue antibiotics |
| Which three professions required life long antibiotics after rhuematic fever | medical professionals, military, and teachers |
| Where is a murmur heard best in rhuematic heart disease | APEX |
| What is the most common cause of death from cardiovascular disease | athlerosclerosis |
| By what percent does the risk of athlerosclerosis increase if one parent is overweight or obese | 40% |
| If your fat when your young, what are the chances you fat when your older | 70% |
| Most important prevention for athlerosclerosis | healthy diet and excercise (nonfat dairy in children over 2) |
| What is the classification for children's BP based on | normative distribution in a healthy population |
| What is normative BP defined as in children | less than the 90TH percentile |
| What is hypertension defined by in pediatrics | SBP or DBP above the 95th percentile for geneder age and height over 3 seperate occasions |
| At what BP does JNC 7 define prehypertension and recommend lifestyle changes | 120/80 |
| at what age should children be having their BP taken during medical visits | 3 |
| Which method shoudl you use to take a pediatric BP | auscultation |
| Ideally, when do you want to take a childs BP | avoidance of stimulants or food, sitting quietly for 5 minutes, back supported and feet on floor, right arm supported at heart level |
| BP between the 90th and 95th percentile OR greater than 120/80 | prehypertensive |
| When does SBP typically go above normal | age 12 |
| when does DBP typically go above normal | 16 |
| When would you treat a pediatric patient who is prehypertensive with a pharmacolgical intervention | kidneys disease, DM, HF, or LVH |
| At which stage do you automatically place a patient on drugs | stage 2, stage 1 needs an indication |
| 95-99 percentile plus 5mmHG | stage 1 |
| greater than 99th pecentile plus 5mmHG | stage 2 |
| What shoudl also be taken in the case of a hypertensive youth | sleep history |
| Children and adolescents who are hypertensive are also likely to be... | overweight |
| overweight and high BP are components of... | metabolic disorder |
| B.E.A.R.S. is a acronym for what | sleep disordersB - bedtime problemsE - excessive daytime drowsinessA - Awakening during the nightR - regularity and duration of sleepS - sleep disorder breathing |
| Is secondary hypertension more common in children or adults | Children |
| Checking BP in both arms and one leg looks for.. | coarctation of the aorta |
| Name two major organs to look at in secondary hypertension | heart and kidneys |
| How do you inquire about drug use | directly |
| What are you looking at in a CBC for hypertension | anemia reflecting chronic disease such as vasculitis and chronic renal diseas |
| When shoudl you preforma plasma glucose on a prehypertensive child | obese, family history, or renal disease |
| what is the most prominant clinical sign/evidence of end organ damage in hypetension | LVH |
| primary therapy for weight related hypertension | thearputic lifestyle changes |
Created by:
lowryc