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What is mild persistent asthma?
- Symptoms: >2 days/week but not daily
- Nighttime awakenings: 3-4x/month
- SABA use: > 2 days/week but not daily
- Interference with normal activity: Minor
- Lung Function:
- FEV*: > 80% predicted
- FEV1/FVC: normal Persistent asthma means that you have symptoms regularly. People with mild persistent asthma have asthma symptoms more than twice a week, but not every day. What is moderate persistent asthma?
- Symptoms: Daily Created with OfficeSuite
- Nighttime awakenings: >1x/week but not nightly
- SABA use: Daily
- Interference with normal activity: Some limitations
- Lung Function:
- FEV*: < 60% but< 80% predicted
- FEV1/FVC: reduced 5% People with moderate persistent asthma have asthma symptoms every day. Your lung spirometry tests will show decreased lung function. What is severe persistent asthma?
- Symptoms: throughout the day
- Nighttime awakenings: often nightly
- SABA use: Several times a day
- Interference with normal activity: Extremely limited
- Lung Function:
- FEV*: < 60% predicted
- FEV1/FVC: reduced 5% Created with OfficeSuite
Which vaccines should I get if I am pregnant? the inactivated flu vaccine (the injection, not the live nasal flu vaccine) and the Tdap vaccine. What are possible complications for a person with Down's syndrome Heart Defects GI Defects immune disorders such as pneumonia Sleep apnea Obesity Spinal problems leukemia Dementia When to genetically test a child If the child is having trouble with sight, hearing, movement and balance, mood, immune system irregularities, slow or poor growth, problems with appetite, eating and digestion, or the disorder may cause seizures, heart arrhythmias or hormonal imbalances. first line treatment for back pain Acetaminophen and nonsteroidal anti-inflammatory drugs are first-line medications for chronic low back pain. Created with OfficeSuite
when should you do imaging for back pain imaging for low back pain in (1) patients who have had up to 6 weeks of medical management and physical therapy for low back pain without improvement in symptoms, and (2) patients with red flag symptoms for serious pathology. What is Osgood-Schlatter disease involves inflammation of the growth plate or area where the patellar tendon connects to the tibia (tibial tubercle) and is commonly diagnosed during the adolescent growth spurt. Signs and symptoms of Osgood-Schlatter disease Pain and swelling of tibial tubercle which worsens with athletic activity but relieved by rest Pronounced tibial tubercle Tight anterior and posterior upper leg muscles Diagnose with an x-ray Treatment of Osgood-Schlatter disease Rest Modified activity Ice Nonsteroidal anti-inflammatory drugs (NSAIDs) Strengthening and stretching Created with OfficeSuite
Referral to a neurosurgeon for ventriculoperitoneal (VP) shunt or surgical correction is warranted. Cerebral palsy is a neurologic condition characterized by motor impairment from a gestational brain injury Created with OfficeSuite
Cerebral palsy risks CP rates are higher in low-birth-weight infants, those born before 32 weeks, and those born after difficult labor. Over 75% of CP cases are spastic or characterized by muscular rigidity Ataxic CP is characterized by difficulties with balance and control, whereas athetoid (dyskinetic) CP involves a lack of muscular control. Concussion A concussion is a mild traumatic brain injury that affects normal brain function. It occurs as a result of a direct or indirect blow to the head. Signs and symptoms of concussion may be subtle and may appear immediately or even hours after impact. They include headache , drowsiness , dizziness , photophobia, and impaired cognition. Migraine headache Migraine signs and symptoms include at least 2 of the following: unilateral location, pulsating quality, moderate to severe pain with an increase during exertion, nausea/vomiting, photophobia, or phonophobia. HA lasts 4 to 72 hours. Meningitis Meningitis is a bacterial, viral, fungal, or parasitic infection within the subarachnoid space or meningeal or ependymal cells. The infection leads to inflammatory responses causing neurologic damage. Signs and symptoms of meningitis include headache, fever, stiff neck, and altered mental status Cluster HA Cluster headaches, or trigeminal autonomic cephalgia, are a group of idiopathic headaches that are associated with trigeminal neuralgia. The location is always unilateral around the eye. Presents as a deep explosive excruciating pain that begins quickly, ptosis of the eyelid, and miosis. Lacrimation, swollen eyelids, and nasal discharge may also occur. Duration is 30 minutes to 3 hours. Sinus HA Created with OfficeSuite
obtain abdominal X-ray contact a Pediatric Environmental Health Specialty Unit (PEHSU) or poison control center repeat test in 2 weeks to 1 month medication for lead poisoning Chelation therapy, a medication that binds to lead to excrete via urine, is recommended for levels greater than 45 μg/dL. primary, secondary, tertiary Quartenary care Quaternary care is considered an extension of tertiary care. However, it is even more specialized and highly unusual. Experimental medicine and procedures Uncommon and specialized surgeries vaccines in children sickle cell disease is an inherited disorder causing red blood cells to be hard, sticky, and malformed with a shorter lifespan. Over 80% of Blacks are carriers of the gene. treatment of sickle cell anemia Treatment focuses on preventing complications, such as infection, anemia, clotting, and pain. Treat with plenty of fluids, blood transfusions, pain control, and a medication called hydroxyurea How can you diagnose sickle cell anemia? Created with OfficeSuite
Diagnosis can be made using isoelectric focusing (IEF), hemoglobin electrophoresis, or sickle solubility testing normal physiological murmur Changes in blood pressure gradients or velocity cause chaotic flow and vibration that are often noticeable as a palpable thrill or heave seven characteristics of a murmur intensity - easily heard upon auscultation, soft, no thrill timing - systolic location - pulmonic area radiation - also heard in the left axilla quality - harsh crescendo-decrescendo duration - heard in mid systole pitch - medium sound 6 grades of murmur A grade 1 murmur is barely audible. A grade 2 murmur is soft but easily audible. A grade 3 murmur is louder but is not accompanied by a thrill. A grade 4 murmur is loud with a palpable thrill. A grade 5 murmur can be heard with the stethoscope partially off the chest and a thrill is palpable. Finally, the grade 6 murmur is audible without a stethoscope. All murmurs louder than grade 3 are pathological. How to diagnose HF Created with OfficeSuite
How do you treat rotavirus oral rehydration. resolves within three to seven days. enterovirus infection sx include fever, runny nose, sneezing, cough, skin rash, mouth blisters, and body and muscle aches. There is no specific treatment for enterovirus infections, but most people recover completely. Practice good hand hygeine. gold standard in foreign body imaging CT scanning motrin age No motrin before 6 months, use tylenol. Tylenol can be used before 6 months. Fever - See Immediately The child is less than 3 months of age with a fever > 100.4°F (38°C). The child is 3 to 36 months old with a fever > 100.4°F (38°C) for more than three days or looks sick. The child is 3 to 36 months old with a fever > 102°F (38.9°C). The child of any age has a fever > 104°F (40°C). The child with fever is crying inconsolably, lethargic, has a stiff neck, dyspnea, dysuria, or has had a seizure. The child with fever also has a chronic health condition, takes long-term steroids, or is undergoing chemotherapy. Created with OfficeSuite
Fever see within 24 hours The child is age 3 to 6 months and recently received the diphtheria, tetanus, and pertussis (DTaP) vaccine. The child is over 3 years old with fever more than three days Fever was gone for more than 24 hours and is noted again Recurrent fevers of more than 7 days allergic rhinitis an IgE moderated inflammatory disorder of the upper respiratory tract and nasal passages. Sx are nasal congestion, runny nose, watery eyes, sneezing, itching eyes. Treatment of Allergic rhinitis aimed at environmental control to reduce symptoms. Intranasal corticosteroids are considered first-line treatments scarlet fever a papular rash, similar in appearance to sandpaper, associated with bacterial pharyngitis, and common in school-aged and adolescent children. Seen a lot on the back. The rash begins a few days after flu-like symptoms and is caused by group A streptococcus (GAS). treatment of scarlet fever penicillin. A first-generation cephalosporin, clindamycin, or erythromycin may also be used if the client is allergic to penicillin. pediculosis infestation with lice. Created with OfficeSuite
All bedclothes and clothing of infected patients and household contacts should be washed. All close physical contacts should receive scabicide tx as well. Chiggers Chigger bites are itchy red bumps that can look like pimples, blisters, or small hives. They are usually found around the waist, ankles, or in warm skin folds. They get bigger and itchier over several days, and often appear in groups. chigger bite treatment antihistamines Using topical creams or lotion (calamine lotion). Taking diphenhydramine (Benadryl ®) or other antihistamines. Taking an anti-parasite medication (permethrin). Applying a cold compress. Cleaning the affected area of skin with soap and water regularly. contact dermatitis An inflammation of the skin caused by having contact with certain chemicals or substances; many of these substances are used in cosmetology. Avoid the allergen or irritant to treat. acute otitis media Created with OfficeSuite
usually associated with an upper respiratory infection and is most commonly seen in young children. Is an infection of the middle ear. often experience pain and diminished hearing, with redness or bulging of the tympanic membrane. Amoxicillin 45 to 90 mg/kg is recommended treatment. otitis externa Infection of the outer ear (ear canal). Also known as swimmers ear. patients often experience redness, inflammation, swelling, itching, pain, and pus discharge Tympanic membrane (TM) perforation can occur due to trauma (foreign body), infection, or barometric changes (airplane, scuba diving). Signs and symptoms include whistling sounds during sneezing or nose blowing, decreased hearing, ear infections with colds or water entries, and copious purulent discharge. Pain indicates a concurrent disease process but usually perforations are painless. Periorbital cellulitis skin infection around the eye. It is often caused by trauma or sinusitis and is unilateral in most cases. Trauma can include insect bites and facial injuries. Treatment is based on the type of trauma. Bacterial infections are often caused by Staphylococcus aureus. The treatment for methicillin-resistant Staphylococcus aureus (MRSA) cases is clindamycin. Conjunctivitis Conjunctivitis, or "pink eye", is divided into three categories: allergic, infectious, and chemical.Allergic conjunctivitis occurs with other allergy symptoms and is not infectious. It can be accompanied by itchy eyes and watery discharge that appears unilaterally or bilaterally. Treatment with antihistamines or artificial tears along with avoiding the irritant is recommended. Infectious conjunctivitis can be bacterial or viral. Bacterial conjunctivitis is localized with cloudy discharge while viral has systemic symptoms and a clear discharge. Only bacterial conjunctivitis is treated with antibiotic eye drops. Chemical conjunctivitis is caused by an irritant like chlorine in swimming pools. Eyes can be flushed with saline and irritant should be avoided. Created with OfficeSuite
A genetic disorder that is present at birth and affects both the respiratory and digestive systems. Patients with cystic fibrosis produce thick and sticky mucus and have high levels of salt in their sweat. The thick mucus can block respiratory passages, leading to wheezing and coughing, as well as chronic respiratory infections. Mucus can also block the pancreatic ducts, blocking the release of the pancreatic enzymes needed to digest nutrients How is Kawasaki disease diagnosed? No specific lab test. (no blood test) Liver tests may be abnormal Diagnosis is made by meeting these criteria: Fever for at least 5 days 4 of these 5 conditions must be met
- Mucous membrane changes such as red tongue and dry fissured lips
- Swelling of hands and feet.
- Enlarged lymph nodes in the neck
- Diffuse red rash covering most of the body.
- Redness of eyes. o Illness cannot be explained by any known disease process. Created with OfficeSuite
How to treat Kawasaki disease: IVIG and aspirin What is retinoblastoma? malignant tumor of the retina signs and symptoms of retinoblastoma whitish glow in pupil - cat's eye reflex (leukocoria). Eyes looking in different directions, poor vision, eye swelling, eye redness When should children be screened for retinoblastoma from birth up to the age of 7 years. After age 7 years, no further screening of asymptomatic children is recommended, unless they are known to carry an RB 1 mutation. Most children diagnosed are younger than 3 years old. Risk factors for retinoblastoma Diets low in fruits and vegetables among mothers during pregnancy Exposure to chemicals in gasoline or diesel exhaust during pregnancy Exposure of fathers to radiation Older age among fathers s/sx of hypothyroidism in pediatric clients Created with OfficeSuite
