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Pathophys, Exam 1: Altered Health in Children (8.23)
Terms in this set (428)
Age definitions: neonate
first 4 weeks of life
Age definitions: infant
1 month-12 months (18 months)
Age definitions: child
Age definitions: adolescent
Age definitions: toddler
1-3 years (18 mo-3 yr)
Age definitions: preschool
Age definitions: early childhood
Age definitions: middle to late childhood
Age definitions: first 4 weeks of life
Age definitions: 1 month-12 months (18 months)
Age definitions: 1-12 years
Age definitions: 13-18 years
Age definitions: 1-3 years (18 mo-3 yr)
Age definitions: 3-5 years
Age definitions: 2-5 years
Age definitions: 6-12 years
middle to late childhood
Gestational Age (GA) can be determined by what two methods?
by dates; by exam
If GA is determined by dates then it is by the number of __ from the onset of the __ __ __ __ until __.
weeks; mother's last menstrual period; birth
If GA is determined by exam then it is the assessment of __ by __ and __ exam.
maturity; physical; neuromuscular
This can be determined by the number of weeks from the onset of the mother's last menstrual period until birth OR by assessment of maturity by physical and neuromuscular exam.
gestational age (GA)
Neonates are born at __ to __ weeks GA.
__ are born at 38-42 weeks GA.
Near term is __ to __ weeks GA.
This is 34-38 weeks GA.
This is less than or equal to 34 weeks GA.
Preterm is less than or equal to __ weeks GA.
Post-term is born at greater than or equal to __ weeks.
This is born at greater than or equal to 43 weeks.
True or false: growth and development are equivalent terms
Growth and development are both affected by __ and __.
Defined as physical changes in the body as a whole or individual parts.
Defined as changes in body function and psychosocial behaviors.
Is growth or development more objective?
Does growth or development relate more to functionality?
Growth is more __ than development.
Development relates more to __ than growth.
True or false: rate of a child's physical growth is a constant factor
Rapid physical growth occurs during __ and __.
Rate of a child's __ growth is NOT a constant factor.
Having the right __ really impacts development, it is not just about genetics.
Development is changes in body function and __ behaviors.
Growth refers to __ changes in the body.
What three measurements are taken for growth charts?
weight; height; head circumference
Because of wide variability in growth, comparisons are made through statistics -- __ and __ __.
mean; standard deviation
Growth charts are __ and __ specific.
When we use growth charts, we are looking for growth to follow __.
trajectory (same curve over time)
A child who does not follow a normal trajectory (jumps or drops percentiles) on a growth chart could possess __.
What is average birth weight (BW)?
Smaller birth weights lead to __ risk of complications.
After birth, weight increases rapidly until __ months.
In the first week of life, all babies lose a fair amount of weight because of __ __.
In the first week of life, all babies lose a fair amount of weight because of fluid loss but this is regained __.
Do girls or boys begin their growth spurt earlier?
Do girls or boys complete their growth spurt earlier?
Girls reach their final adult height __ than boys.
Preterm babies are usually low BW, less than __ kg.
Further subdivisions, such as SGA, AGA, LGA, allow for __ assessment in terms of weight.
SGA, AGA, and LGA are specific to weight and allow for risk assessment. What do S, A, and L stand for respectively?
small for GA; average; large
There are more mortalities at __ birth weights.
Birth __ increases by 50% by the end of the first year of life.
Head circumference is measured around the __.
Intrauterine growth depends on efficient __ function, adequate provision of __, adequate provision of __ __, __ environment, and room in the __.
placental; energy; growth substrates; hormonal; uterus
__ growth depends on efficient placental function, adequate provision of energy, adequate provision of growth substrates, hormonal environment, and room in the uterus.
Low amniotic fluid can cause growth restrictions because there is little __ for __.
room for movement
Low __ __ can cause growth restrictions because there is little room for movement.
Intrauterine growth retardation (IUGR) can happen when in fetal development?
Intrauterine growth retardation (IUGR) is a process that causes reduction in an expected __ of growth, NOT specific to __.
True or false: intrauterine growth retardation (IUGR) is a a weight specific parameter, synonymous with SGA
Even though intrauterine growth retardation (IUGR) is NOT weight specific, many __ babies often have IUGR.
This is a process that causes a reduction in an expected pattern of growth, not specific to weight.
intrauterine growth retardation (IUGR)
Intrauterine growth retardation (IUGR) increases mortality 10-20x due to __ and __ anomalies.
Intrauterine growth retardation (IUGR) can be __ or __ insult.
Intrauterine growth retardation (IUGR) can be early or late insult. Which may be irreversible?
Intrauterine growth retardation (IUGR) can be early or late insult. Which is usually genetic?
Intrauterine growth retardation (IUGR) can be early or late insult. Which may be able to catch up?
Intrauterine growth retardation (IUGR) can be early or late insult. Which is during the 3rd trimester, depends on the abnormality if they can catch up?
Early insult intrauterine growth retardation (IUGR) is usually __ and may be __.
Risk factors for intrauterine growth retardation (IUGR) include __ mothers, low __ status, __ intervals between pregnancies, unusual or stringent __ restrictions, and heavy __ work.
adolescent; economic; short; diet; physical
Adolescent mothers, low economic status, short intervals between pregnancies, unusual or stringent diet restrictions, and heavy physical work are risk factors for what?
intrauterine growth retardation (IUGR)
Besides infections and chronic maternal illnesses, what two diseases are maternal risk factors for intrauterine growth retardation (IUGR)?
pre-pregnancy hypertension; diabetes mellitus
Infections (rubella, measles), chronic maternal illnesses, diabetes mellitus, and pre-pregnancy hypertension are risk factors for what?
intrauterine growth retardation (IUGR)
What are the three categories of environmental risk factors for intrauterine growth retardation (IUGR)?
recreational drugs; therapeutic drugs; environmental hazards
When we say environmental hazards can be risk factors for intrauterine growth retardation (IUGR), what could we be referring to?
LGA is fetal overgrowth and a birthweight above the __ percentile.
This is fetal overgrowth and a birthweight above the 90th percentile.
large for gestational age (LGA)
LGA is most frequently seen in moms who have what conditions?
What fetal factor can result in LGA?
LGA mostly leads to complications regarding __
Diabetes in a pregnant mother means the fetus is receiving high levels of glucose. This causes pancreatic islet __ and increased __ secretion. So the baby will store more __ and have a higher __ overall. Hence, LGA.
hyperplasia; insulin; sugar; (body) mass
Diabetes in a pregnant mother means the fetus is receiving high levels of glucose. This causes __ islet hyperplasia and __ insulin secretion. So the baby will store __ glucose and have a __ body mass overall. Hence, LGA.
pancreatic; increased; more; higher
What does primigravida refer to?
This term means first pregnancy.
Maternal age of less than __ or over __ increases the risk of birth injuries.
Someone who is having their __ pregnancy is at higher risk of birth injuries.
__ disproportion is a risk factor for birth injuries.
This is a head and hip disproportion -- increases the risk of birth injuries.
Cephalopelvic disproportion is a risk factor for birth injuries because feet first delivery can lead to trauma or __ injuries.
__ labor or __ delivery can increase the risk for birth injuries.
prolonged; precipitous (fast)
This is a defect in cerebral spinal fluid, it can't flow out of the CNS, causes head expansion.
Hydrocephalus increases the risk of __ injuries.
Hydrocephalus is a defect in __ __ __, it can't flow out of the CNS, causing head expansion.
cerebral spinal fluid
This term refers to a larger than average newborn.
Macrosomia is a __ than average newborn.
This is really just scalp edema.
Caput succedaneum is really just what?
Caput succedaneum (scalp edema) causes __ and usually resolves after how long?
bruising; first week of life
This cranial injury causes bruising and usually resolves over the first week of life. Jaundice can be a complication.
caput succedaneum (scalp edema)
What can be a complication of caput succedaneum (scalp edema)?
jaundice (because of bruise breakdown)
This cranial injury is collection of blood in the head.
Cephalhematoma is the collection of __ in the head.
Cephalhematoma occurs because of what?
ruptured blood vessels
True or false: caput succedaneum can cross suture lines
True or false: cephalhematoma can cross suture lines
True or false: cephalhematoma is not apparent in the first 24-48 hours
Cephalhematoma resolution takes how long?
2 weeks to 3 months
This cranial injury does NOT cross suture lines. It it not apparent in the first 24-48 hours. It resolves over 2 weeks to 3 months.
What is the worst type of cranial injury?
Subdural/subarachnoid hemorrhage is the worst type of cranial injury because it could cause what (which may lead to seizures or irritability)?
trauma or compression on the brain
Subdural/subarachnoid hemorrhage can cause trauma or compression on the brain which may lead to __ or __ from the added pressure.
Cranial injuries are often related to __ __ from the head coming through the birth canal.
The worst kind of cephalhematoma is on the __ of the bone.
True or false: cephalhematomas are worst when they are on the inside of the bone
True or false: skull fractures are common in delivery
false (bones not fused together)
Why are skull fractures uncommon in delivery?
bones not fused together, allows for molding
Skull fractures more often follow what kind of delivery?
If skull fractures do occur in delivery they are usually __ and require no treatment.
What kind of skull fracture in delivery would require surgery?
depressed, palpable indentation
What is the most frequently fractured bone during delivery?
If the clavicle is fractured during delivery then __ motion will elicit pain and a __ sound might be present.
This is the sound of bone rubbing on bone.
Crepitus is the sound of bone rubbing on what?
Pain from passive movement of the shoulder/arm and crepitus suggest what?
Clavicle fracture treatment is what?
arm and shoulder immobilization
What is the most common nerve injury?
The brachial plexus is above the __, anterolateral base of the __.
The brachial plexus is __ to __ nerves.
Brachial plexus injury is usually from a __ injury during the birth process. It may tear the lower roots of the __ __.
stretch; cervical cord
This injury is usually from a stretch injury during the birth process. It may tear the lower roots of the cervical cord.
A brachial plexus injury can cause temporary upper extremity __.
Brachial plexus injury treatment is __ to allow nerve endings to heal. Usually requires __ to __ __.
immobilization; 3-6 months
What are the two types of brachial plexus injuries?
Erb's palsy; Klumpke palsy
What type of brachial plexus injury is more common -- Erb's palsy or Klumpke palsy?
This brachial plexus injury is mostly upper arm paralysis, the fingers will still have good grasp.
This brachial plexus injury will leave the baby unable to move fingers or hands.
True or false: Klumpke palsy is more common than Erb's palsy
True or false: with Erb's palsy, the fingers still have good grasp
Erb's palsy and Klumpke palsy are two types of what injury?
brachial plexus injury
This is early suture closure.
Craniosynostosis is __ __ __.
early suture closure
Normal skull bones are __ connected at birth.
These are spaces of unossified membranous tissue at the junction of the sutures.
Fontanels are spaces of __ __ tissue at the junction of the sutures.
The __ fontanel is palpable until 2 years.
During the first __ year(s) of life, brain growth rapidly attains 90% of the adult size.
The primary cause of craniosynostosis is what?
Craniosynostosis does what to the head?
restricts growth = abnormally shaped head
Treatment of craniosynostosis usually involves surgery to do what?
break suture lines
The first doctor visit with a new baby and first parent should be how long after bringing the baby home?
It is recommended to take your child for visit at least how often?
Well-baby visits occur multiple times a year until how old?
At birth, the nervous system is not completely __ and not all nerves are __
True or false: at birth, the nervous system is completely integrated and myelinated
Reflex: moro = ?
Reflex: rooting = ?
Reflex: stepping = ?
Reflex: __ = startle
Reflex: __ = sucking
Reflex: __ = placing
At birth we see a lot of __ reflexes.
Before volitional movements can begin, __ reflexes must disappear.
True or false: volitional movements cannot begin until primitive reflexes disappear
Primitive reflexes must disappear for __ movements to begin.
This type of development serves as the basis of most standardized assessment and screening tools.
The __ of neurodevelopment is similar for all kids but the __ may vary.
Does trunkal coordination or mastery of extremities occur first?
__ coordination occurs before mastery of __.
Does controlled use of upper or lower extremities occur first?
Motor and psychological development assessments should evaluate what four things?
alertness; responsiveness; persistence; concentration
What type of development is the least reliable indicator of overall mental ability?
gross motor development
Gross motor development is the __ reliable indicator of overall mental ability.
What type of development is the most reliable indicator of overall mental ability?
speech and language development
Speech and language development are the __ reliable indicator of overall mental ability.
Speech and language development are the best predictors of subsequent __ __
The further a child is from "average" motor and psychological development, the __ likely he or she will be "normal".
Motor and psychological development is related to a variety of factors, including acute or chronic __, physical or sensory __, and quality of the __ __.
illness; handicaps; nurturing environment
Motor and psychological development parallels maturation of what?
What type of development parallels maturation of the CNS?
motor and psychological development
Cortical and motor function are associated with __ of the CNS.
__ and __ function are associated with myelination of the CNS.
The spinal cord is completely myelinated by what age?
Once the spinal cord is completely myelinated, the __ and __ __ can be controlled. __ is also achieved and mastered.
anal, urethral; locomotion
What allows for control of anal and urethral sphincters and achievement and mastery of locomotion?
complete myelination of the CNS
Myelination of the NS is completed by __ years.
In very preterm babies, most complications are __ in nature.
Infants tend to have __ respiratory rates compared to adults.
Infants are obligate __ breathers for 4-6 weeks of life.
Infants are obligate nose breathers for __ to __ weeks of life.
In infants, the __ is easily obstructed.
In infants, the trachea is __ to obstruct.
In terms of respiratory development, growth and number of __ increases with age.
In infants, the Eustachian tube is __ and __
The trachea is easily obstructed in infants because the cartilage is __ and __. Diameter is __.
small, soft; small
The nature of the __ __ in infants leads to more middle ear infections (otitis media).
In infants, the Eustachian tube is short and straight, allowing for a lot of __ exchange with the __.
Infants are prone to more __ __ infections because of the Eustachian tube.
Middle ear infections are common until about __ years of age.
In children, what type of infection is the leading cause of illness?
In neonates, what are the four respiratory pathology concerns?
TTN; RDS; apnea; SIDS
What is TTN?
transient tachypnea of the newborn
What is RDS?
respiratory distress syndrome
What is SIDS?
sudden infant death syndrome
In infants, what is the major respiratory pathology concern?
bronchiolitis/RSV (respiratory syncytial virus)
True or false: respiratory distress syndrome and respiratory distress have very similar pathophysiology
What are the four major signs of respiratory distress in newborns?
tachypnea; cyanosis; retractions or nasal flaring; low oxygen saturation
This is a respiratory rate of greater than 60 breaths/min in newborns.
This is bluing of the skin because of deoxy blood.
Cyanosis in newborns typically starts around what?
Cyanosis is bluing of the skin because of __ __
Retractions or nasal flaring occur because of respiratory distress. They are attempts to increase __ __.
oxygen flow (into lungs)
Congenital diaphragmatic hernia occurs when there is a hole in the __ in utero. This means the __ contents move and grow into the space where the __ are meant to be.
diaphragm; abdominal; lungs
TTN or RDS: term and near term neonate
TTN or RDS: primarily preterm
TTN or RDS: immediate onset
TTN or RDS: onset within 1st 6 hr of life
TTN or RDS: improvement in 12-24 hrs
TTN or RDS: improvement starts after 72 hours
TTN or RDS: clinical course is short, < 72 hours
TTN or RDS: clinical course progressively worsens over the next 72 hours
TTN or RDS: primary cause is delayed reabsorption of fetal lung fluid
TTN or RDS: primary cause is surfactant deficiency
Surfactant production begins __ in fetal development.
True or false: TTN is similar to RDS, hard to distinguish the two; requires full evaluation
TTN or RDS: give maternal steroids if mom is at risk for pre-term labor
TTN: primarily in what neonates?
term and near term
TTN: improvement in?
TTN: clinical course?
short, less than 72 hours
TTN: primary cause?
delayed reabsorption of fetal lung fluid
RDS: primarily in what neonates?
within 1st 6 hrs of life
RDS: improvement in?
RDS: clinical course?
progressively worsens over next 72 hours
RDS: primary cause?
RDS: "pre" treatment?
give maternal steroids if mom is at risk for pre-term labor
What is an example of a steroid that could be given to a mom at risk for pre-term labor, to prevent RDS?
Steroids are given to prevent RDS in moms at risk for pre-term labor because steroids stimulate __ __
True or false: we can actually administer surfactant in very preterm babies
We could see __ with respiratory distress.
What is this characteristic of? -- chest x-ray: reticulogranular pattern, ground glass appearance, homogenous, symmetrical
A neonate with surfactant deficiency will have a classic chest x-ray of a __ pattern, __ __ apperance, __genous, and __.
reticulogranular; ground glass; homogenous; symmetrical
This is defined as cessation of breathing for at least 20 seconds or less if associated with bradycardia or desaturation (cyanosis)
Apnea is cessation of breathing for at least __ seconds or less if associated with __ or __ (cyanosis).
20; bradycardia; desaturation
What are the three types of apnea?
central; obstructive; mixed
What is the most common type of apnea?
What is the least common type of apnea?
This type of apnea is due to immaturity of the respiratory center in the medulla oblongata.
This type of apnea is due to obstruction of the airway.
Central apnea is due to what?
immaturity of the respiratory center in the medulla oblongata
The respiratory center in the medulla oblongata recognizes increasing __ and will force __, if necessary.
Central apnea means the baby lacks the normal __ to breathe.
Obstructive apnea is often __ or __ muscular collapse.
Obstructive apnea is due to what?
airway obstruction (pharyngal or laryngeal muscular collapse)
In obstructive apnea, there might be __ but __ inspiratory effort.
vigorous but ineffective
Apnea is frequently associated with what cardiac condition?
Apnea is frequently associated with bradycardia because of __ stimulation of the __ __ chemoreceptors.
hypoxic; carotid body
__ is frequently associated with bradycardia because of hypoxic stimulation of the carotid body chemoreceptors.
This is intermittent failure to breathe for 10-15 seconds.
Periodic breathing is intermittent failure to breathe for how long?
Almost all neonate pathophys is inversely related to what?
Apnea resolves by __ weeks.
Almost all neonate pathophys is __ related to GA and BW.
Apnea is a diagnosis of __ because there are __ possible causes.
Treatment for apnea might involve gentle tactile stimulation to __ __ the __.
wake up the brain
What type of drug might be given for apnea?
Caffeine and theophylline are __ and might be given for __.
This is death of an infant < 1 that is unexplained.
SIDS peaks between __ and __ months of age.
The only way to diagnose SIDS is __, __ must be ruled out.
It is hypothesized that SIDS results from __ abnormalities.
SIDS involves prolonged __ __, increased frequency of a brief __ pause, periodic __, and impaired response to increased __ or __.
sleep apnea; inspiratory; breathing; CO2, O2
This involves prolonged sleep apnea, increased frequency of brief inspiratory pause, period breathing, and impaired response to increased CO2 or O2.
__ positioning is a risk factor for SIDS.
What two races are at higher risk for SIDS?
African American; Native American
__ mothers are at higher risk of SIDS.
Newborn hearts have __ ventricular compliance.
Newborn hearts have a lower ratio of __:__ myocardial proteins.
Newborn hearts -- more contractile or non-contractile myocardial proteins?
Newborns have __ resting heart rates.
Newborns have higher resting heart rates because of decreased __ __ and increased __ __
ventricular compliance; contractile proteins
Neonates have higher resting heart rates because they are less capable of increasing cardiac output by increasing heart rate without compromising __ __.
diastolic filling (CO = HR x SV)
Neonates have higher resting heart rates because they can't fix CO with __.
SV (CO = HR x SV)
Newborn hearts have a __ preload reserve.
In neonates, the __ ventricle is more muscular.
Newborn hearts have a lower __ reserve.
In infancy/childhood, ventricular strength __. Heart rate __ and systolic blood pressure __.
reverses; slows; rises
In infancy/childhood, __ blood pressure rises.
Blood pressure is __ in infants.
Blood pressure charts/curves are __ and __ specific.
Hypertension in children is usually a sign of what?
__ in children is usually a sign of kidney disease.
Hypertension is children is usually above the __ percentile.
What three structures are unique to fetal circulation?
ductus venosus; foramen ovale; ductus arteriosus
In the fetus, blood flow follows a different path because the __ don't have to __ blood.
This fetal structure shunts blood from the right atrium to the left atrium.
The foramen ovale shunts blood from the __ to the __
This fetal structure allows oxygenated blood to bypass the liver and go directly to the inferior vena cava.
The ductus venosus allows __ blood to bypass the __ and go directly to the __ __ __.
oxygenated; liver; inferior vena cava
This fetal structure directs the majority of the RV output to the descending aorta.
The ductus arteriosus directs the majority of the __ output to the __ __
RV; descending aorta
In the fetus, there is high __ pressure, so it is hard for blood to flow to the lungs.
Upon birth, the lungs are aerated, increasing __ __.
Fetal circulation structures close and constrict on their own over time because of __ changes.
Upon birth, the first breath expands the lungs and improves oxygenation to drop __ __ resistance. This allows blood to flow more easily to the __.
pulmonary vascular; lungs
Lung abnormalities or other issues in newborns might mean we keep the __ __ heart structure open until surgery.
Upon birth, increases in pulmonary venous return lead to increases in __ __ pressure. This closes the __ __.
left atrium; foramen ovale
What is the most common congenital disorder in newborns?
congenital heart disease (CHD)
Congenital heart disease (CHD) frequently requires __ or __ based intervention in the first year of life.
This is the leading cause of perinatal and infant death from congenital malformations.
congenital heart disease (CHD)
Most babies with congenital heart disease are identified __ after birth but not __
Many congenital heart lesions are __ dependent.
Neonates with congenital heart disease (CHD) may not be symptomatic immediately around birth because most lesions are __ dependent and the __ __ has not closed yet.
ductus; ductus arteriosus
Clinical manifestations of CHD should be looked for during the first discharge visit at __ to __ days of age.
Clinical manifestations of what disease should be looked for during the first discharge visit at 3-5 days of age?
congenital heart disease (CHD)
Although nonspecific, what are these symptoms of? -- difficulty in feeding, poor weight gain; cyanosis, respiratory findings; decreased activity, irritability; excessive sweating
congenital heart disease (CHD)
Congenital heart disease (CHD) symptoms are nonspecific but can include difficulty in __, poor __ __, __ and other respiratory findings, decreased __, __, and excessive __.
feeding; weight gain; cyanosis; activity; irritability; sweating
The digestive process is mature by __ months.
The __ process is mature by 3 months.
The newborn's first stool is usually very __, __.
This is the newborn's first stool which is composed of amniotic fluid, intestinal secretions, mucosal cells, sometimes blood.
Meconium is the newborn's __ __
Meconium, the newborn's first stool, is usually composed of __ fluid, __ secretions, __ cells, sometimes __.
amniotic; intestinal; mucosal; blood
Delayed meconium (first stool) could be due to an underlying illness causing delayed __, __ __, or __ disease.
feeding; cystic fibrosis; Hirschprung's
What is the most common reason for delayed meconium (first stool)?
This disease is due to a lack of nerves connecting with small and large intestines, nothing to stimulate contractions of the intestines
Hirschprung's disease is due to a lack of nerves connecting the __ and __ __
small and large intestines (nothing to stimulate contractions of the intestines)
The __ reflex is present at birth but may require several days to be effective.
The sucking reflex at birth is mostly __ thrust. It disappears in approximately __ months.
Neonates/infants require frequent feedings because of small __ __ and rapid __ __
stomach capacity; stomach emptying
Very preterm babies will lack the __ reflex
AAP recommends breast feeding until __ months of age.
Breast feeding provides some immune protection from __
Hypoglycemia is levels < __ to __ mg/dL
After __ hours of age, glucose levels stabilize between 50-80 mg/dL.
__ is common in newborns, especially if the mother is diabetic.
A mother with high glucose means the fetus' pancreas will increase insulin production. But upon birth the baby will have too much __ -- it takes time for feedback loops to kick in.
The following are signs of what? -- cyanosis; apnea; hypothermia; hypotonia; poor feeding; lethargy; seizures
What are the three risk factors for hypoglycemia?
infants of diabetic mothers; SGA; premature
Hypoglycemia is common in infants of diabetic mothers because of hyperinsulinemia and diminished __ secretion.
True or false: glucose readily crosses the placenta
Hypoglycemia in premies is related to inadequate stores of liver __, muscle __, and body __
glycogen; protein; fat
What are the two forms of bilirubin
conjugated (direct); unconjugated (indirect)
Bilirubin conjugation occurs where?
What type of bilirubin can cross the BBB?
If unconjugated (indirect) bilirubin crosses the BBB it can deposit and cause __.
Is conjugated bilirubin direct or indirect?
Is unconjugated bilirubin direct or indirect?
Bilirubin is a __ process. It comes from the breakdown of __.
RBCs have a __ lifespan in newborns compared to children.
Bilirubin conjugation makes it __ water soluble.
Newborns have __ liver conjugation.
Babies are very hypoxic in utero so they have increased __ production to increase oxygen carrying capacity.
Babies in utero have __ hemoglobin
All babies have to become anemic at some point to kick back for normal production of __
When a baby is born it doesn't need as much hemoglobin so the cells start to __ and this increases __ levels.
Jaundice can occur because of __ breakdown, producing __ that cannot be __ quickly.
hemoglobin; bilirubin; conjugated
Physiologic jaundice is NOT pathologic but a normal process to __ the feedback loop.
Physiologic jaundice is noted in the full-term infant __ to __ days after birth.
This type of jaundice is NOT pathologic but a normal process to kickback the feedback loop.
This is a form of brain damage caused by excessive jaundice.
kernicterus (bilirubin encephalopathy)
Kernicterus is brain damage from excessive __
Kernicterus is a neurologic syndrome from deposition of __ __ in the basal ganglia and brain stem.
Kernicterus is a neurologic syndrome from deposition of indirect bilirubin in the __ __ and __ __
basal ganglia; brainstem
Breast milk jaundice occurs after DOL 7, persists __ than physiologic jaundice.
The cause of breastmilk jaundice is __
multifactorial (no single cause)
Jaundice treatment involves frequent __ and __, __ feed, __therapy, and __ __ for very high levels.
feeding, hydration; formula; phototherapy; exchange transfusion
Fetal iron stores are depleted around __ months. Introduce iron fortified __ at this time.
Babies have __ anemia, not iron deficiency anemia.
All babies become __, similarly to jaundice and hyperbilirubin.
True or false: we don't really know why colic happens
Irritable infant syndrome is another name for __
Irritable infant syndrome/colic is most common under __ months but can persist up to __ months.
This involves paroxysmal abdominal pain or cramping, crying, drawing legs up to abdomen, extreme irritability.
irritable infant syndrome/ colic
Irritable infant syndrome/colic involves paroxysmal __ __ or __. A lot of crying and extreme __.
abdominal pain; cramping; irritability
What is the Rule of 3 for irritable infant syndrome/colic?
crying for more than 3 hours a day, more than 3 days a week, longer than 3 weeks
What illness is the Rule of 3 for?
irritable infant syndrome/colic
Infants with irritable infant syndrome/colic are otherwise __ __-fed infants. They will __ it eventually.
health well-fed; outgrow
The key to colic treatment is __ __.
What could this treatment be for? -- antispasmodics, sedatives, antiflatulents, PARENTAL SUPPORT
irritable infant syndrome/colic
This is inadequate growth due to inability to obtain or use essential nutrients.
failure to thrive
Failure to thrive is inadequate growth due to inability to obtain or use __ __
This is growth below 3rd-5th% or a change in growth seen as a drop in 2 %ile over a short time.
failure to thrive
Failure to thrive is growth below the __ to __ %ile or a change in growth seen as a drop in __ %ile over a short time.
Failure to Thrive therapy depends on whether the cause is __ or __.
organic (metabolism/genetics); non-organic (neglect; psychosocial)
Overweight/obesity is BMI at or above the __ percentile for children of the same age and gender.
This is BMI at or above the 95th percentile for children of the same age and gender.
What is the formula for BMI?
weight in kg/height squared in m
Overweight/obesity is more common in what two races?
African Americans; Mexicans
Most obesity is __ related as far as pathophys goes.
Overweight/obesity can cause what four illnesses/problems?
hypertension; hyperlipidemia; hyperinsulinemia; type 2 diabetes
Premature infants are at a high risk of what infection?
Maternal transfer of __ in last trimester increases risk of infections.
Maternal transfer of IgG in last trimester increases risk of __
This involves prolonged rupture of membranes, foul-smelling amniotic fluid, maternal fever and maternal UTI.
Sepsis can involve prolonged __ of membranes, foul-smelling __ __, maternal __, and maternal __.
rupture; amniotic fluid; fever; UTI
With sepsis, maternal colonization can involve __ and __.
What is GBS?
Group B streptococcal infection
Sepsis treatments are __ in nature -- IV access and intubation.
Sepsis treatments are invasive in nature -- __ access and __.
With sepsis treatments, prior antibiotics can alter normal __
What organ systems does sepsis affect?
all organ systems
Sepsis affects all organ systems because the immune system is __ and __
Signs of sepsis in newborns are generally __
What could these be symptoms of? -- poor feeding; not acting right; lethargic; temperature instability
In middle to late childhood, __ infections are most common, followed by __.
In middle-late childhood, __ care is important and __ infections can be common because of exposure to skin lesions.
What has the biggest impact on infant health?
Immunizations have lowered the prevalence but NOT eliminated what 5 things?
DTaP (diptheria, tetanus, pertussis); Haemophilus influenzae type B (Hib); Polio; Measles, Mumps, Rubella, Hep B
In middle to late childhood, what are four possible new diagnosis'?
asthma; epilepsy; childhood cancers; developmental/learning disabilities
Adolescence is a relatively healthy time with some __ system changes.
In adolescents, what is the biggest influence on diseases?
lifestyle choices (psychosocial changes, drugs and drinking, risky sexual behavior)
What is the leading cause of non-violent deaths in teens?
What type of injury/accident is more prevalent in adolescents?
motor vehicle accidents/suicide
In adolescence, the skin becomes __, __ growth increases, and __ is present.
thicker; hair; acne
Acne is a problem in adolescence because the __ and __ glands activity increases.
__ __ stimulate the sebaceous gland in adolescents = acne.
Adolescents can experience increased body odor because of increased __ __ activity.
Newborns and infants are at higher risk for illness because of __ __ immaturity.
In early childhood __ __ and __ illnesses are common. The __ system grows and develops.
otitis media; respiratory; neuromuscular
THIS SET IS OFTEN IN FOLDERS WITH...
Pathophys, Exam 1: Liver Disease (8.25)
Pathophys, Exam 1: Renal (8.30)
Pathophys, Exam 1: Hematology (9.1)
Pathophys, Exam 1: Oncology (9.1)
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