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Lernmaterialien für Pedics an der University of Cape Coast

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Signs of dehydration 

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Sunken fontanelles
Dry and sunken eyes
Dry mouth
Tearless cry

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Causes of neonatal jaundice 

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1st 24hrs: 

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Osteopenia of prematurity

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Risk factors
  • <30 weeks gestation
  • <1000g birthweight
  • male gender
  • Delayed establishment of full enteral feeds, fluid restriction
  • Prolonged intravenous nutrition
  • Chronic use of medications that increase mineral excretion (diuretics, dexamethasone, sodium bicarbonate)
  • Phosphorus deficiency (primary nutritional reason)
  • Vitamin D deficiency
  • Cholestatic jaundice
  • Short gut syndrome (malabsorption of vitamin D and calcium)

Investigations to confirm: Measurement of urinary calcium and phosphorus and serum 25-OH D should be considered.
Low serum phosphate concentrations
Low concentrations of inorganic phosphate (<1.8 mmol/L with elevated alkaline phosphatase (>900 IU/L).
However Elevated alkaline phosphatase values are seen with normal growth, healing rickets, fractures, or copper deficiency; low concentrations are seen with zinc deficiency, malnutrition, and congenital hypophosphatasia.

Symptoms
Poor weight gain
Faltering growth
Respiratory difficulties 
Failure to wean off ventilatory support due to excessive chest wall compliance.
Fractures may manifest as pain on handling

Treatment
Elemental calcium 2.5 - 4 mmol/kg/day and
Elemental phosphate 2 - 3 mmol/kg/day to be given in divided doses.
N.B. Calcium and phosphate must not be given at the same time (because they may precipitate), so in practice should be given at alternate feeds.
Ensure an adequate intake of calcium and phosphate from feeds
Weekly monitoring for infants being treated with additional calcium, phosphate, or vitamin D

Caution: Chronic diuretic therapy with loop diuretics (frusemide) increases urinary calcium excretion. High urinary calcium increases the risk of nephrocalcinosis.

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Causes of hypertension in Children 
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Renal
Acute; acute renal failure, acute glomerulonephritis and hemolytic uriremic syndrome
Chronic; Tumors or dysplasia, chronic pyelonephritis, hydronephrosis, renal artery stenosis, renal vein thrombosis

Endocrine
Cushing's syndrome
Hyperaldosteronism
Congenital adrenal hyperplasia
Hyperthyroidism

CNS; Neuroblastoma
Acute icp

Cardiac; coarctation of aorta

Drugs; sympathomimetics and steroids

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3 drugs that can be administered with a nebulizer 
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Salbutamol
Budesonide
Adrenaline
Tolbutamine
Ipatropium
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Devices that can be used in place of a nebulizer 
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An inhaler
Spacer
Metered dose inhaler

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Xray findings in pneumonia 
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Homogeneous opacification
Central trachea
Air bronchogram overlying the cardiac shadow



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Organisms that can cause pneumonia 
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All ages: TB
Neonatal:gbstrep
Infant to 4yrs: hemophilus influenza, staph aureus, respiratory syncytial virus, streptococcus pneumonia
>5yrs: mycoplasma pneumonia, strep pnemo 

Hospital acquired: proteus, klebsiella, enterobacter, pseudomonas
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Other causes of macrosomia
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Post dating
Excessive weight gain during pregnancy
Advanced maternal age >35
Maternal obesity
Previous Hx of fetal macrosomia


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Neonatal examination
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1. Introduction, permission, and explanation of the procedure
2. Baby's surroundings; meds, cannula, nasal prongs etc
3. Inspection: State of the baby (active, alert, movement of limbs, well flexed or floppy, colour pink or blue, ill looking, birthmarks, petechiae, vernix, lanugo, milla, mongolian spots,hemangiomas, bullous)
4. Anthropometric measurements; length, weight, head circumference and plot on the appropriate chart.

5. Head
Hair; colour, texture, distribution and pluckability.
Swellings; caput[Caput succedaneum between skin and epicranial aponeurosis ; crosses suture lines and containd edematous fluid] hematomas [Subgaleal haematoma: is between epicranial aponeurosis and periosteum; can cross suture lines. The child will be pale and touching the head causes intense pain. The infant must be transfused within 12 hours], [Cephal haematoma: is between periosteum and skull; does not cross suture lines. May contain blood that will undergo haemolysis to cause jaundice] and if they cross suture lines, abnormalities and dysmorphic features.
Palpate fontanelles, anterior fontanel is diamond-shaped and posterior triangularly shaped, are they sunken, flat or bulging. Palpate sutures to see if they are widened.

Face: Dysmorphic features (hyper/hypo telorism, lowset ears, flat nasal bridge, philtrum, cleft lip)

Eyes: Sclera for jaundice, Conjunctiva for palor, red reflex.

Mouth: teeth and cleft palate

Neck: Masses, SCM muscle mass, torticollis, webbed, clavicle-fracture

Chest: Inspect Respi Rate, palpate for breast, auscultate for heatbeat, and lung activity

Abdomen: Inspect umbilical cord,

Genitals: ambiguous, penis chordae, scrotal sac, testes unndescennded/retracted/ectopic urethra for epi/hypospadias, circumcised. Vagina for vulva and clitoris.
Wear gloves
Check suckling reflex
Anus for patency

Ortolani (adduct and pull out) and Barlow (Adduct and push in) maneuver for hip dislocation

Check for pitting pedal edema

Back: For dimpling, spine deformities, a tuft of hair

Reflexes:
Suckling: Infant will press lips against object pressed against roof of mouth and make sucking motions report as strong and sustained if normal
Moro: Occurs when the baby’s head suddenly shifts in position or there is a sudden loud sound. The infant will extend legs and head while the arms are initially extended, but afterward, arms are flexed and the hands clenched into fists.
Grasp: When object is placed in infant’s hand and strokes the palm, infant’s fingers will close and grasp with a palmar grasp.
Rooting: Infant turns head towards anything that strokes mouth or cheek until object is found

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GIT causes of clubbing
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Crohns Dx
Ulcerative colitis
Liver cirrhosis
Biliary atresia
Secondary hepatic amyloidosis
Severe acute malnutrition


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Hypertension in children 
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Systolic and diastolic pressures greater than the 95th percentile for age and gender on at least 3 occasions

The normal blood pressure at birth is 70/50 and increases by 10systolic and 5diastolic every 3 years

Degrees according to increase above normal range for age:
Mild hypertension: by 10sys or 5 dia
Moderate hypertension: by 20sys or 10dia
Severe hypertension: by 40sys or 20dia


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  • 326 Karteikarten
  • 138 Studierende
  • 0 Lernmaterialien

Beispielhafte Karteikarten für deinen Pedics Kurs an der University of Cape Coast - von Kommilitonen auf StudySmarter erstellt!

Q:

Signs of dehydration 

A:

Sunken fontanelles
Dry and sunken eyes
Dry mouth
Tearless cry

Q:

Causes of neonatal jaundice 

A:

1st 24hrs: 

Q:

Osteopenia of prematurity

A:
Risk factors
  • <30 weeks gestation
  • <1000g birthweight
  • male gender
  • Delayed establishment of full enteral feeds, fluid restriction
  • Prolonged intravenous nutrition
  • Chronic use of medications that increase mineral excretion (diuretics, dexamethasone, sodium bicarbonate)
  • Phosphorus deficiency (primary nutritional reason)
  • Vitamin D deficiency
  • Cholestatic jaundice
  • Short gut syndrome (malabsorption of vitamin D and calcium)

Investigations to confirm: Measurement of urinary calcium and phosphorus and serum 25-OH D should be considered.
Low serum phosphate concentrations
Low concentrations of inorganic phosphate (<1.8 mmol/L with elevated alkaline phosphatase (>900 IU/L).
However Elevated alkaline phosphatase values are seen with normal growth, healing rickets, fractures, or copper deficiency; low concentrations are seen with zinc deficiency, malnutrition, and congenital hypophosphatasia.

Symptoms
Poor weight gain
Faltering growth
Respiratory difficulties 
Failure to wean off ventilatory support due to excessive chest wall compliance.
Fractures may manifest as pain on handling

Treatment
Elemental calcium 2.5 - 4 mmol/kg/day and
Elemental phosphate 2 - 3 mmol/kg/day to be given in divided doses.
N.B. Calcium and phosphate must not be given at the same time (because they may precipitate), so in practice should be given at alternate feeds.
Ensure an adequate intake of calcium and phosphate from feeds
Weekly monitoring for infants being treated with additional calcium, phosphate, or vitamin D

Caution: Chronic diuretic therapy with loop diuretics (frusemide) increases urinary calcium excretion. High urinary calcium increases the risk of nephrocalcinosis.

Q:
Causes of hypertension in Children 
A:
Renal
Acute; acute renal failure, acute glomerulonephritis and hemolytic uriremic syndrome
Chronic; Tumors or dysplasia, chronic pyelonephritis, hydronephrosis, renal artery stenosis, renal vein thrombosis

Endocrine
Cushing's syndrome
Hyperaldosteronism
Congenital adrenal hyperplasia
Hyperthyroidism

CNS; Neuroblastoma
Acute icp

Cardiac; coarctation of aorta

Drugs; sympathomimetics and steroids

Q:
3 drugs that can be administered with a nebulizer 
A:
Salbutamol
Budesonide
Adrenaline
Tolbutamine
Ipatropium
Mehr Karteikarten anzeigen
Q:
Devices that can be used in place of a nebulizer 
A:
An inhaler
Spacer
Metered dose inhaler

Q:
Xray findings in pneumonia 
A:
Homogeneous opacification
Central trachea
Air bronchogram overlying the cardiac shadow



Q:
Organisms that can cause pneumonia 
A:
All ages: TB
Neonatal:gbstrep
Infant to 4yrs: hemophilus influenza, staph aureus, respiratory syncytial virus, streptococcus pneumonia
>5yrs: mycoplasma pneumonia, strep pnemo 

Hospital acquired: proteus, klebsiella, enterobacter, pseudomonas
Q:
Other causes of macrosomia
A:
Post dating
Excessive weight gain during pregnancy
Advanced maternal age >35
Maternal obesity
Previous Hx of fetal macrosomia


Q:
Neonatal examination
A:
1. Introduction, permission, and explanation of the procedure
2. Baby's surroundings; meds, cannula, nasal prongs etc
3. Inspection: State of the baby (active, alert, movement of limbs, well flexed or floppy, colour pink or blue, ill looking, birthmarks, petechiae, vernix, lanugo, milla, mongolian spots,hemangiomas, bullous)
4. Anthropometric measurements; length, weight, head circumference and plot on the appropriate chart.

5. Head
Hair; colour, texture, distribution and pluckability.
Swellings; caput[Caput succedaneum between skin and epicranial aponeurosis ; crosses suture lines and containd edematous fluid] hematomas [Subgaleal haematoma: is between epicranial aponeurosis and periosteum; can cross suture lines. The child will be pale and touching the head causes intense pain. The infant must be transfused within 12 hours], [Cephal haematoma: is between periosteum and skull; does not cross suture lines. May contain blood that will undergo haemolysis to cause jaundice] and if they cross suture lines, abnormalities and dysmorphic features.
Palpate fontanelles, anterior fontanel is diamond-shaped and posterior triangularly shaped, are they sunken, flat or bulging. Palpate sutures to see if they are widened.

Face: Dysmorphic features (hyper/hypo telorism, lowset ears, flat nasal bridge, philtrum, cleft lip)

Eyes: Sclera for jaundice, Conjunctiva for palor, red reflex.

Mouth: teeth and cleft palate

Neck: Masses, SCM muscle mass, torticollis, webbed, clavicle-fracture

Chest: Inspect Respi Rate, palpate for breast, auscultate for heatbeat, and lung activity

Abdomen: Inspect umbilical cord,

Genitals: ambiguous, penis chordae, scrotal sac, testes unndescennded/retracted/ectopic urethra for epi/hypospadias, circumcised. Vagina for vulva and clitoris.
Wear gloves
Check suckling reflex
Anus for patency

Ortolani (adduct and pull out) and Barlow (Adduct and push in) maneuver for hip dislocation

Check for pitting pedal edema

Back: For dimpling, spine deformities, a tuft of hair

Reflexes:
Suckling: Infant will press lips against object pressed against roof of mouth and make sucking motions report as strong and sustained if normal
Moro: Occurs when the baby’s head suddenly shifts in position or there is a sudden loud sound. The infant will extend legs and head while the arms are initially extended, but afterward, arms are flexed and the hands clenched into fists.
Grasp: When object is placed in infant’s hand and strokes the palm, infant’s fingers will close and grasp with a palmar grasp.
Rooting: Infant turns head towards anything that strokes mouth or cheek until object is found

Q:
GIT causes of clubbing
A:
Crohns Dx
Ulcerative colitis
Liver cirrhosis
Biliary atresia
Secondary hepatic amyloidosis
Severe acute malnutrition


Q:
Hypertension in children 
A:
Systolic and diastolic pressures greater than the 95th percentile for age and gender on at least 3 occasions

The normal blood pressure at birth is 70/50 and increases by 10systolic and 5diastolic every 3 years

Degrees according to increase above normal range for age:
Mild hypertension: by 10sys or 5 dia
Moderate hypertension: by 20sys or 10dia
Severe hypertension: by 40sys or 20dia


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