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