Upgrade to remove ads
Pediatric 06 CLIPP Case
Terms in this set (40)
Outline vaso-vagal response
Vasovagal syncope, often referred to as fainting, is caused by self-limited systemic hypotension due to altered neurocardiogenic reflexes leading to bradycardia and/or peripheral vasodilation.
Presentation of vaso-vagal syncope
Children frequently describe prodromal symptoms that include dizziness, lightheadedness, sweating, nausea, weakness, and visual changes. Many times children experience the prodromal symptoms without syncope.
caused by irritation of the growth plate at the tibial tuberosity [front of the tibia bone]. It is usually a self-limited growing pain that resolves with rest and with finishing the growth spurt.
treat with ice and NSAIDs
Differential for chest pain in kids
Precordial catch syndrome, costochondritis, GI issues, Asthma or exercise induce bronchospasm,
Outline precordial catch syndrome
most common cause of chest pain in adolescents
Presentation of precordial catch syndrome
sudden, sporadic onset of sharp pain, usually along the left sternal border, which is often exacerbated with deep inspiration.
pain is brief, lasting seconds to a few minutes, and resolve spontaneously.
The pain can often be "broken" with a forced deep inspiration.
It is often not associated with exercise.
Presentation of costochondritis
benign cause of chest pain but less common.
due to inflammation and typically will last for hours or days.
Presentation of GI causes of chest pain
Gastrointestinal causes of chest pain include gastroesophageal reflux, gastritis, and esophagitis.
These often cause pain that is described as:
Non-radiating Associated with meals
5 things that may cause GI related chest pain
Cocaine or other drugs
Presentation of Asthma or exercise-induced bronchospasm
Asthma or exercise-induced bronchospasm (EIB) may cause chest pain - usually in association with cough, wheezing, or respiratory distress
Fever and chest pain suggests
Fever suggests a possible infectious etiology such as pericarditis or pneumonia.
Why look at body habitus in evaluating chest pain
Take a general look at the body habitus for any suggestion of genetic disorder that might be associated with cardiac disease (Marfan's).
How to assess for musculoskeletal causes of chest pain
Inspect the chest wall for signs of injury: reproducibility of pain implies a musculoskeletal origin.
Symptoms and Signs of Cardiac Chest Pain
Onset = Pain triggered by exertion or stress
Quality = Pressure or crushing sensation
Duration = 10-15 minutes
Associated symptoms = Syncope, palpitations
Exam findings = Murmur, thrill, hyperdynamic precordium
Strategies for Talking With Adolescents About Performance-Enhancing Drugs
Use may cause undesired physical changes and side effects - adolescents care about their physical appearance
Drug-testing - fear of being discovered
Examples of consequences - professional athletes
Less effective strategies of performance-enhancing drugs
Discussing long term consequences of use: Although the long term effects of substance abuse is a key concern of healthcare professionals, discussing this with teenagers who feel impervious usually does not change behavior.
Effectiveness of "just say no" strategy
The "just say no" strategy has been recommended for pre-adolescents. As they are not yet abstract thinkers, just describing the potential side effects and having families tell them to stay away from the substances has been effective. This strategy is less effective for teenagers
Tanner staging of 1/prepubertal in males
Childlike phallus, testicular volume < 1.5 ml, No pubic hair
Tanner stage of 2 in males
Childlike phallus, testicular volume 1.6-6 ml, reddened thinner and larger scrotum
Small amount of fine hair along the base of scrotum and phallus
Tanner stage 3 in males
Increased phallus length, testicular volume 6-12 ml, greater scrotal enlargement
Moderate amount of more curly, pigmented, coarser hair extending laterally
Tanner stage 4 in males
Increased phallus length and circumference, testicular volume 12-20 ml, further scrotal enlargement and darkening
Coarse curly adult like hair that doesn't yet extend to the medial surface of thighs
Tanner stage 5 in males
Adult scrotum and phallus, testicular volume > 20 ml
Adult-type hair extending to medial surface of thighs
What is in the dtap vaccine? What is the dosing schedule
tetanus, diphtheria, and acellular pertussis
First dose = pre-adolescents
Second dose = 11-12 ages
Difference between DTap versus Tdap
The difference between the DTaP and Tdap vaccines is the amount of diphtheria toxoid contained in each
Which is for pediatric patients big D or little d? in DTAP
Big D = pediatric
Big D dtap vaccine overview
contains 3-5 times more diphtheria toxoid than the adult Tdap [little d] and is only given to children 6 years old and younger
Little d dtap vaccine is used for what ages
little d = used for adults and children 7 years of age and older who need booster doses of diphtheria, tetanus toxoid, and acellular pertussis
What are the two meningococcal vaccines and what are the differences
MCV4 includes serotypes A,C,W and Y
MenB includes serotype B
Complete meningococcal immunizations consist of both of these
Immunization schedule for the two meningococcal vaccines
MCV4: First dose routinely given at age 11 years, with a booster dose at age 16 years
MenB: One dose given at 16 years
Immunization considerations for patients who are high risk for meningococcal infections
For high risk populations, MCV4 is indicated as early as 2 months
HPV vaccine schedule
The first dose is routinely administered at 11 years of age
The series consists of 3 immunizations over 6 months.
HPV vaccine given to which gender? Youngest age this vaccine can be given
Recommended for both males and females. Can be administered as early as 9 years of age
What is CRAFFT? What ages is this good for?
6 questions developed to screen adolescents for high risk alcohol and other drug use disorders simultaneously.
under age 21
What are the questions of CRAFFT?
During the Past 12 months, did you:
1. Drink any alcohol (more than a few sips)?
2. Smoke any marijuana or hashish?
3. Use anything else to get high?
What happens if patient answers no to all three of the first set of CRAFFT questions?
if patient answer no to all three you ask C
if yes to any one of the three ask all six CRAFFT questions
What are the six CRAFFT questions?
Have you ever ridden in a CAR driven by someone (including yourself) who was "high" or had been using alcohol or drugs?
Do you ever use alcohol or drugs to RELAX, feel better about yourself, or fit in?
Do you ever use alcohol/drugs while you are by yourself, ALONE?
Do you ever FORGET things you did while using alcohol or drugs?
Do your family or FRIENDS ever tell you that you should cut down on your drinking or drug use?
Have you gotten into TROUBLE while you were using alcohol or drugs?
When does a murmur in an adolescent warrant further evaluation?
Note: *Murmurs are common in healthy adolescents, but if any of the following characteristics are noted, the murmur deserves further evaluation:
Louder than grade III/VI
Any diastolic murmur
Any murmur that increases with standing or Valsalva
Components of the genitourinary exam in males
Inguinal hernia, Undescended testicle, demonstrate proper testicle exam
having a single testicle is not a contraindication; however, a better protective cup to protect the single testicle is necessary and must be required.
What must be done in a patient with syncope
In any patient with syncope, an ECG should be obtained. Without an ECG, it is impossible to rule out some of the important arrhythmic causes of syncope, such as Wolf-Parkinson-White syndrome and long QT syndrome.
In addition, hypertrophic cardiomyopathy, the most common cause of sudden death in young athletes, can first present with syncope; the ECG is abnormal in more that 90% of patients with hypertrophic cardiomyopathy and is thus an essential screening test.
One etiology other than congenital heart defect for congenital heart block
Congenital heart block can be caused by congenital heart defects and autoimmune disease in pregnant women (lupus). This condition is a rare cause of arrhythmia and is often diagnosed early in life. Many patients require a pacemaker
THIS SET IS OFTEN IN FOLDERS WITH...
Pediatric 04 CLIPP Case
Pediatric 10 CLIPP Case
Pediatric 02 CLIPP case
Pediatric 05 CLIPP Case
YOU MIGHT ALSO LIKE...
FM Cases part 3
Pharmacology Analgesics Pain Relief
NRSG 2100 Unit 5
OTHER SETS BY THIS CREATOR
OBGYN Uworld Notes 3
OBGYN Uworld Notes 2
OBGYN Uworld Notes
Uwise objectives 55, 56, 57, 58
OTHER QUIZLET SETS
Time Period 3 Review
Social cognition and attitudes quiz
Roman Study Guide
Chapter Fifteen: the West Between Wars, the Rise o…