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anemia CORRECT ANSWERS✅ decreased number of RBCs and decreased O2- carrying capacity anemia causes CORRECT ANSWERS✅ -inadequate RBC production -^ed RBC destruction -excessive RBC loss -nutritional deficiency (inadequate Fe consumption, excess milk consumption) anemia s/s CORRECT ANSWERS✅ -fatigue -pallor (conjunctiva, palms, mucous membranes) -tachycardia -systolic heart murmur (turbulence) -cyanosis -delayed/slowed growth anemia diagnostic evaluation CORRECT ANSWERS✅ -routine screening @ 9 months -Hgb electrophoresis -CBC (decreased RBC, Hgb + Hct) [Hgb < 10 g/dL] anemia therapeutic management CORRECT ANSWERS✅ -treat underlying cause: transfusion, meds (Procrit), nutritional intervention, vitamins supplement -supportive care: O2, IV fluids, bed rest admin of oral Fe CORRECT ANSWERS✅ -give with vit C to ^ absorption
-avoid taking with milk (decreases absorption) -give 1 hr before or 2 hrs after milk -brush teeth after oral Fe -use straw to prevent staining -can turn stool black or green transfusion adverse reactions CORRECT ANSWERS✅ -monitor during and after transfusion -chills, fever, change in vitals, pruritis/urticaria, dyspnea, pain (back or head), change in patient status sickle cell disease manifestations CORRECT ANSWERS✅ -normal HR + RR -watching TV/phone (distraction) -asking for specific drugs that work for them sickle cell disease diagnosis/screening CORRECT ANSWERS✅ -Hgb electrophoresis -newborn screening in most states -genetic testing -sickle cell turbidity test (Sickledex) finger-prick test (does not distinguish between trait and disease) sickle cell crisis acute management CORRECT ANSWERS✅ -IV fluids -O2 for comfort or PRN -IV non-steroid anti-inflammatory (Toradol) -pain management (PCA pump)
ecchymosis CORRECT ANSWERS✅ bruising/discoloration of skin resulting from bleeding underneath hemarthrosis CORRECT ANSWERS✅ bleeding into joint cavities leading to stiffening + inability to mobilize joint hemophilia prevention CORRECT ANSWERS✅ -factor admin (self-infusion) -pressure after needle sticks -DDAVP (Desmopressin) -safety (no contact sports, concern for head injury) HIV modes of transmission CORRECT ANSWERS✅ -most common: anal or vaginal sex; needle or syringe sharing -less common: during pregnancy, birth, or breastfeeding; being stuck with an infected needle or sharp HIV CORRECT ANSWERS✅ -primarily infects CD4 T lymphocytes -CD4 count progressively declines, weakening the immune system AIDS CORRECT ANSWERS✅ advanced disease state of HIV infection caused by poor/failing immune system (CD4 count < 200) HIV Diagnostics CORRECT ANSWERS✅ -HIV PCR for newborns -18+ months ELISA (first) + western blot (confirm by isolating HIV antibodies)
HIV PCR CORRECT ANSWERS✅ -infants born to HIV infected mothers will test pos b/c of maternal antibodies -PCR detects intracellular HIV viral DNA -test again at 2 weeks, 2 months, and 4-6 months HIV manifestations CORRECT ANSWERS✅ -lymphadenopathy (swollen lymph nodes) -hepatosplenomegaly (enlarged liver and spleen) -oral thrush, chronic diarrhea, FTT HIV therapeutic management CORRECT ANSWERS✅ -antiretrovirals -PCP prophylaxis (Bactrim) beginning @ 6 weeks -PREP/PEP -immunizations (not live vaccines in AIDS) cardinal signs of childhood cancer CORRECT ANSWERS✅ -Unusual mass or swelling -Unexplained pallor + fatigue -Sudden tendency to bruise -Persistent localized pain or limping -Prolonged unexplained fever -Frequent headaches with vomiting -Sudden eye or vision changes -excessive, rapid weight loss leukemia CORRECT ANSWERS✅ -cancer of the bone marrow + lymph system
leukemia management CORRECT ANSWERS✅ chemotherapy, sometimes bone marrow transplant brain tumor symptoms CORRECT ANSWERS✅ -can arise from any cell in cranium -present with varying complaints -monitor for signs of ^ed ICP brain tumor treatment CORRECT ANSWERS✅ -diagnostic imaging -surgical resection (craniotomy) osteosarcoma CORRECT ANSWERS✅ bone cancer that begins in the cells that form bones; most often found in long bones Ewing sarcoma CORRECT ANSWERS✅ type of cancer that occurs in bones or in the soft tissue around the bones; most often begins in leg bones + the pelvis symptoms of bone cancer CORRECT ANSWERS✅ -bone pain -swelling -fever -unexplained fracture bone cancer treatment CORRECT ANSWERS✅ -chemotherapy + radiation -limb salvage surgery -amputation if necessary
Wilms tumor CORRECT ANSWERS✅ -kidney tumor in children -diagnosed under age 5 -90% survival Wilms tumor symptoms CORRECT ANSWERS✅ -painless abdominal mass -blood in urine -HTN at risk conditions for NHL CORRECT ANSWERS✅ people with HIV at ^ed risk hodgkin lymphoma (HL) age CORRECT ANSWERS✅ more common in adolescents 15- hodgkin lymphoma symptoms CORRECT ANSWERS✅ -presence of reed sternberg cells -painless enlargement of lymph nodes (firm to palpate, movable: mediastinum, axillary, groin) -coughing, trouble breathing, chest pain, fatigue, weight loss, fever, night sweats non-hodgkin lymphoma (NHL) age CORRECT ANSWERS✅ more common in children < 14 y/o non-hodgkin lymphoma symptoms CORRECT ANSWERS✅ -low WBC, RBC, + plts (crowds out health cells in bone marrow) -can arise in many locations (lymph nodes, thymus, spleen, abdominal organs) -trouble swallowing, coughing, wheezing, weight loss, night sweats
-non-acidic food/drinks -lip moisturizer alleviating altered nutrition in cancer CORRECT ANSWERS✅ -high calorie diet -TPN/lipids in extreme cases UTI etiology CORRECT ANSWERS✅ caused by E. coli (80% of cases) UTI risk factors CORRECT ANSWERS✅ -girls: short urethra; boys: uncircumcised penis -patients after catheterization -sexual activity -pregnancy: hormonal + mechanical changes can promote urinary stasis -diabetic patients: high urine glucose + decreased immunity UTI symptoms CORRECT ANSWERS✅ -dysuria (crying on urination or vocalized pain) -frequent urination (>q2/hr) -urgency -suprapubic discomfort/pressure (stomach ache) -fever in some cases -poor feeding -odiferous urine -blood in urine
UTI in 0-2 month old CORRECT ANSWERS✅ -fever -poor feeding -vomiting -irritability -FTT UTI diagnostic tests CORRECT ANSWERS✅ -straight/in-out cath: preferred sample -U bad for collection from child: not used for infections -clean catch: outpatient for older child UTI drug therapy CORRECT ANSWERS✅ -abx treatment based on culture and sensitivity -Bactrim (sulfa allergy, SJS) -amoxicillin, Keflex -pyridium (OTC + prescribed) about pyridium CORRECT ANSWERS✅ -provides soothing effect on urinary tract mucosa -stains urine reddish-orange (mistaken for blood) -effective in relieving discomfort Vesicoureteral reflux (VUR) pathophysiology CORRECT ANSWERS✅ -retrograde/backward flow of bladder urine into ureters + potentially to kidneys -a/w acute pyelonephritis, urosepsis, renal scarring, and deterioration of kidney function
Acute poststreptococcal glomerulonephritis manifestations CORRECT ANSWERS✅ HAD STREP HTN, ASO titer (positive), decreased GFR/UO, swelling (edema), tea-colored (blood) urine, recent strep infection, elevated BUN + creatinine, proteinuria BUN CORRECT ANSWERS✅ tells how well a patient is hydrated creatinine CORRECT ANSWERS✅ tells how well kidneys are working Acute poststreptococcal glomerulonephritis management CORRECT ANSWERS✅ - children w/ normal BP + UO are manage at home; otherwise, hospitalized -manage edema: diuretics, daily weights, strict I&O, sodium restriction if edema or HTN nephrotic syndrome CORRECT ANSWERS✅ -most common glomerular injury in children -mostly caused by minimal change disease (76%) nephrotic syndrome pathophysiology CORRECT ANSWERS✅ -^ed glomerular permeability to plasma protein (albumin) results in massive urinary protein loss -proteinuria, hypoalbuminemia, hyperlipidemia, edema, BP normal or slightly decreased nephrotic syndrome manifestations CORRECT ANSWERS✅ -periorbital, abdominal, gonadal, or lower extremity edema -extreme weight gain -decreased UO (fluid goes to interstitial space)
-pallor + fatigue nephrotic syndrome management CORRECT ANSWERS✅ -diet: protein restricted if renal failure or azotemia (excess nitrogen in blood); Na restriction if edema; H2O seldom restricted -steroids/prednisone: 2 mg/kg divided into BID doses; 4-6 weeks of therapy -immunosuppressant therapy/Cytoxan: more susceptible to infection -diuretics acute kidney injury CORRECT ANSWERS✅ -kidneys suddenly unable to regulate the volume + composition of urine -principal feature is oliguria -commonly caused by severe dehydration -usually reversible -dialysis may be needed temporarily chronic renal failure CORRECT ANSWERS✅ -begins when diseased kidneys cannot maintain normal chemical structure of body fluids -progressive deterioration over months to years -final stage is irreversible (end stage renal disease) -treat with dialysis + meds management of AKI + CRF CORRECT ANSWERS✅ -monitor BP, growth, and labs (BUN/creatinine) -administer diuretics
-rapid weight loss -fatigue general DM s/s CORRECT ANSWERS✅ polyuria, polyphagia, polydipsia DM1 treatment CORRECT ANSWERS✅ insulin (injection or pump) *urine testing for ketones (in DKA) DM2 CORRECT ANSWERS✅ -inadequate amount of insulin produced -insulin resistance -risk factor obesity DM2 s/s CORRECT ANSWERS✅ -onset is gradual -fatigue -obesity -acanthosis nigricans acanthosis nigricans CORRECT ANSWERS✅ -a/w insulin resistance -darkened/hyperpigmented, thick, velvety appearance to skin typically in nape of neck, axilla, groin, or over flexor surfaces DM2 treatment CORRECT ANSWERS✅ PO meds (metformin) + insulin PRN hypoglycemia management CORRECT ANSWERS✅ -hold insulin
-eat or drink something with sugar in it -glucagon IM or SQ diabetic ketoacidosis CORRECT ANSWERS✅ -characterized by metabolic acidosis, hyperglycemia, fluid + electrolyte shifts -occurs in newly diagnosed diabetics, insulin omission in known diabetics, and acute gastroenteritis w/ persistent vomiting diabetic ketoacidosis manifestations CORRECT ANSWERS✅ -vomiting -signs of dehydration (hypotension + tachycardia) -kussmal respirations (metabolic acidosis) -acetone odor on breath -decreased LOC -headache (cerebral edema risk)
