Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
EM Pediatric Emergen
EM Pediatric Emergency Med
| Question | Answer |
|---|---|
| Colic time frame | periodic 2-12 weeks |
| Infection | Otitis Media, thrush, UTI, Meningitis, Pneumonia, GE reflux |
| Bulging fontanel | ominous sign, ICP, meningitis, encephalitis |
| Other causes of irritable infant: teething, constipation, corneal abrasion, hernia, torsion, sickle crisis, medications and | volvulus, intussusception, encircling hair, fb, hydrocephalus, subdural, fracture, quiet infant may be ominous |
| red streak on external frenulum (between nose and mouth) indicates | fb |
| Femur fx | think of abuse |
| Toddler's fx | spiral tibial fx in child <5yo |
| Dissociative anesthetic | provides sedation and anesthesia (ketamine) |
| reversal agents | Naloxone for narcotics, flumazenil for benzodiazepines |
| Cardiac dz | arrhythmias, IHSS, Mitral prolapse, Pericarditis, myocarditis |
| Musculoskeletal | strains, trauma, costochondritis |
| respiratory | asthmna, pneumonia (may cause belly pain if lungs push down on belly area), pneumothorax, PE |
| GI | GE reflux, FB aspiration |
| Normal HR | <3mo (85-205), 3mo-2yr (100-190), 2-10yr (60-140), >10yr (60-100) |
| Stridor, hoaseness, distress are associated with | upper airway obstruction |
| Epiglottitis organisms | H. flu (used to be number one until vaccination), S.pyogenes, S. aureus , S. pneumonia |
| Sx of epiglottitis | ABRUPT ONSET of: high fever, sore throat, stridor, dysphagea and drooling. Caution on PE can cause laryngospasm. |
| Dx of Epiglottitis | lateral neck film in extension during inspiration |
| Steeple sign on AP of neck is evidence of | Croup - laryngotracheobronchitis, subglottic inflammation. Etiology: parainfluenza viruses I,II, III |
| Bronchiolitis | Etiology: RSV. Happy wheezers. Sx: URI sx wtih wheezing and +/- fever. Dx: CXR, Elisa RSV nasal wash, WBC, O2 sat |
| Admit for Bronchiolitis if | Age<3mo, prematurity, underlying dz, O2 sat<95%, toxic distress, dehydrated, unreliable parents |
| CXR of Bronchiolitis | Diffuse interstitial consolidation |
| unilateral wheezing suspect | fb in right mainstem bronchus. Bronchoscopy to remove it |
| hot potato voice | retropharyngeal abscess |
| Retropharyngeal abscess | most common in kids <5yo (GABS, S. aureus). Sx: fever, sore throat, odynophagia, dysphagia, stridor, hot potato voice. >3mm soft tissue swelling |
| PE of Retropharyngeal abscess | tender cervical adenopathy, pharyngeal erythema, and unilateral pharyngeal edema |
| Quincy | old term for peritonsillar abscess, etiology: GABS. Sx: sore throat, fever, dysphagia, drolling. |
| Asthma PE | Expiratory wheeze, retractions, nasal flaring. CXR shows: hyperinflation with flattened diaphragms. |
| Fever (rectal temp) | >38 (100.4) |
| Toxic infant | lethargy, poor perfusion, resp. distress |
| SBI: | serious bacterial infection. Meningitis, sepsis, UTI, pneumonia, Osteo, GI. 10% of well appearing young infants with temp. >38 have SBI |
| Rochester Criteria is used for | identifying febrile infants at low risk for serious bacterial infections |
| </= 1 month old with 100.4 fever | admit to hospital, full work up for sepsis |
| 2 ways to get U/A from infants | suprapubic tap (rare used), straight cath |
| Tx for FUO (fever of unknnown origin) | Infants<3mo Ampicillin and Gent., Infants>3mo Ceftriaxone, Cefotaxime |
| Febrile Seizures | 3mo-5yr. recurrence common, <5% develop epilepsy, adverse rxn to reset of temp. LP, MRI, EEG only if indicated (if suspect epilepsy) |
| Tx for Febrile seizure | evaluate for source of fever, temperature control, prophylactic phenobarbital not recommended, Lorazepam or Diazepam for status epilepticus |
| Dangerous Rashes | Meningococcemia, Rocky mountain spider fever, idiopathic thrombocytopenia. Think Purpura |
| Benign rashes | Viral exanthems (measles, scarlet fever, german measles, fifth disease, roseola), infestations, dermatitis |
| Vomiting and Diarrhea | Gastroenteritis |
| Double bubble sign | duodenal atresia |
| Bilious vomiting | a sign of intestinal obstruction |
| Malrotation w/ volvulus | ischemia |
| Meconium Ileus | retained meconium |
| Necrotizing ileus | blood in stool |
| Hirschsprung's | aganglionosis - no peristalsis, can't have appropriate bowel movement. |
| Bilious vomiting differential | Duodenal atresia, malrotation with volvulus, Meconium Ileus, necrotizing ileus, Hirschsprung's |
| non-bilious Vomiting | pyloric stenosis, Intussusception, TE fistula, Appendicitis, Ileus, Incarcerated inguinal hernia |
| Pyloric Stenosis | Hypertrophic pyloric sphincter causes gastric outlet obstruction. 3 – 6 weeks old. Can't keep anything down including water. More common in males, 4:1. Palapable pyloric "olive" |
| string of pearls, beak sign | duodenal obstruction |
| Most common cause of intestinal obstruction in infants<1yo | Intussusception |
| Bloody, "current jelly" stools with intermittent "colicky" abdominal pain | Intussusception. "sausage" feeling in RUQ. |
| ADCVANDISL (how to write admitting orders) | admitting, diagnosis, condition, vital signs, ambulation, Nutrition, Drugs, IV fluids, Special studies, Labs |
| Maintenance fluids | 4-2-1method. 4ml/kg/hr for the first 10kg. 40ml/hr +2ml/kg/hr for each kg between 10-20kg body weight. 60ml/hr +1mL/kg/hr for each kg>20kg |
| Fluid deficit | Calculate current TBW vol: 60% x Wt. Calculate desired volume: (plasma Na/140)x TBW. Fluid deficit= desired vol-current vol |
| Incarcerated hernia | Contents cannot be returned (reduced) to the abdominal cavity |
| Strangulated hernia | Blood supply to the bowel loop is compromised. Pain & nausea |
| Testicular Torsion | extreme pain, vascular compromise, more common in adolescents, true surgical emergency, diagnosis by doppler or ultrasound |
| Paraphimosis | inability of the retracted foreskin to reduce |
| Dactylitis, organ infarcts and acute chest syndrome are suggestive of | sickle cell crisis. Sickle cells obstruct vessels causing hypoxia and pain. Tx: hydration, pain management, abx, transfusion for Hgb<5g/dL |
| Sudden Cardiac Death | Belly sleepers are re-breathing their CO2 and become hypoxic. unsuspected cardiac disease most common |
| Most common cause of death in infants aged 1 mo to 1 year | SIDS |
| ALTE | acute life-threatening event: Sepsis, RSV, GER, 30% have identifiable cause |
| Prevention of SIDS | breast feed, avoid exposure to milk, avoid soft surfaces, back to sleep, parent BLS training |
| Red flags for child abuse includes: multiple lesions in diff. stages, lesions with shape of object, plus | trauma inconsistent with hx, hx that shifts with retelling, injury involves an unwitnessed event |
| retinal hemorrhages can be seen in | shaken baby syndrome |
| Fruity odor | isopropanol (anti freeze), acetone, nail polish remover |
| Garlic odor | Arsenic |
| Bitter almond odor | cyanide |
| Acetaminophen poisoning | most frequently seen. Rumack nomogram tells you if you'll have hepatic toxicity or not |
| # 1 cause of death <1yr | Accidents |
| Poison Tx: | 24-32 F orogastric tube (serial influsion/withdrawal 200ml), Activated charcoal: 1g/kg PO. Lavage and activated charcoal |
| Hypothesized cause of SIDs | Prolonged QT syndrome leading to arrhythmia. Hypoxia & apnea, either obstructive, central |
Created by:
ltm12