| What is the third leading cause of death in ages 10 to 19? | Suicide |
| What percentage of newborns have CHD? | 5% to 10% |
| List some environmental factors contributing to congenital heart defects | Intrauterine rubella exposure
Maternal alcoholism
Diabetes
Advanced maternal age
Maternal drug ingestion |
| List some genetic factors contributing to the development of congenital heart defects: | Sibling or parent with CHD
Chromosomal anomalies
Other noncardiac congenital anomalies |
| What is the source of oxygen and nutrients for the developing fetus? | The placenta |
| Oxygenated blood is brought to the fetus by the _________ vein | Umbilical |
| Oxygenated blood enters the fetal heart via the: | Inferior vena cava |
| The four CHD categories are related to: | Increased pulmonary blood flow
Decreased pulmonary blood flow
Obstruction to systemic blood flow
Mixed blood flow |
| Administration of ________ is effective in closing the ductus arteriosus in full-term and premature newborns | Indomethacin |
| Which palliative procedure can be performed in infants with symptomatic VSD's? | Pulmonary artery banding |
| What is the most common CHD resulting in decreased pulmonary blood flow? | Tetralogy of Fallot |
| Tetralogy of Fallot involves four defects: | 1. Pulmonary stenosis
2. VSD
3. Right ventricular hypertrophy
4. Overriding aorta |
| In coarctation of the aorta, blood pressure in the arm is _____ higher than that in the legs | 20 mm Hg |
| Iron-deficiency anemia peaks in children between which ages? | 6 and 24 months |
| Healthy infants have sufficient iron stores for the first __ to __ months of life | 4 to 6 |
| What is the recommended amount of iron per day for a child between 7 and 12 months? | 11mg |
| Toddlers require how much iron per day? | 7mg |
| List 3 iron-rich foods: | Red meat
Legumes
Iron-fortified cereals |
| How is anemia defined? | A decrease in red blood cells, hemoglobin, or both |
| Anemia reduces the ______ carrying capacity of the blood | Oxygen |
| What are the two classifications of anemia? | Hypoproliferative (defective production of erythrocytes)
Hemolytic (premature destruction of erythrocytes) |
| Infants who drink cow's milk have a ___% chance of fecal loss of blood | 50% |
| What are signs of mild to moderate anemia? | Irritability
Weakness
Decreased play activity
Fatigue |
| Hemoglobin values of 6 to 10 g/dL is considered: | Mild to moderate anemia |
| What are the clinical signs of a hemoglobin below 5 g/dL? | Anorexia
Skin pallor
Pale mucous membranes
Glossitis
Spoon fingernails
Inability to concentrate
Tachycardia
Systolic murmurs |
| Infants should be screened for iron deficiency anemia between which ages? | 9 to 12 months |
| Why are adolescents at risk for iron-deficiency anemia? | Rapid growth rate
Poor eating habits |
| Health care provider usually prescribe ________ until the hemoglobin value returns to normal | Oral iron supplementation (ferrous sulfate) |
| What should be taken with iron supplements? | Citrus fruits or juices |
| Ascorbic acid enhances ______ absorption | Iron |
| Packed RBC's are given only to which children? | Severely anemic |
| Oral preparations of iron should be given how many times daily between meals? | 3 times daily |
| What will the stool look like while receiving iron therapy? | Dark, tarry, green |
| Iron levels usually return to normal within how many months of treatment? | 2 months |
| Iron deficiency can cause the body to absorb too much ______ when exposed | Lead |
| How many African Americans have sickle cell trait? | 1 in 13 |
| What are some precipitating factors causing the sickling of erythrocytes? | Infection
Fever
Hypoxemia
Dehydration
High altitudes
Cold
Emotional stress |
| Name the three types of sickle cell crisis: | 1. Vasoocclusive
2. Sequestration
3. Aplastic |
| Children of what ages with sickle cell anemia are at highest risk of death? | Younger than 5 |
| Maintaining adequate ______ can prevent further sickling | Hydration |
| What happens to the red bone marrow in aplastic anemia? | Becomes yellow and fatty |
| What is used to determine whether a patient has sickle cell trait or sickle cell disease? | Hemoglobin electrophoresis |
| What is the only potential cure for sickle cell disease? | Bone marrow or stem cell transplantation |
| Hemophilia is inherited as an _________ recessive disorder | X-linked |
| Which gender is the carrier of hemophilia? | Transmitted by female carriers |
| How many male births are affected by hemophilia? | 1 in 5000 male births |
| Classic hemophilia (A) is caused by a deficiency in factor ______. | VIII |
| In hemophilia, where does bleeding most frequently occur? | Within the joints and muscles |
| In hemophilia, the partial thromboplastin time (PTT) is ____________. | Prolonged |
| What is the average age of diagnosis of hemophilia? | 9 months |
| What is the purpose of the infusion of the hormone desmopressin? | Prevent bleeding from occurring |
| What does RICE stand for? | Rest
Ice
Compression
Elevation |
| Idiopathic thrombocytopenia purpura (ITP) is the decrease in circulating _________ that results in bleeding beneath the skin. | Platelets |
| The onset of ITP is seen in children of which ages? | 2 to 10 years |
| The acute form of ITP usually follows what kind of infection? | Viral |
| What is the most serious complication of ITP? | Intracranial hemorrhage |
| What are usually the first signs of ITP? | Ecchymosis and petechial rash (usually over bony prominences) |
| Platelet counts lower than ______ are life-threatening | 10,000 /mm3 |
| Three-fourths of children with ITP recover within how many months? | 3 months |
| Children with chronic ITP that do not respond to therapy usually undergo a _________. | Splenectomy |
| A splenectomy eliminates the site of ________ ________ production | Platelet antibody |
| What is the leading cause of disease in children past infancy? | Neoplastic disease (cancer) |
| Leukemia is more common in which gender? | Boys |
| What is the most common form of leukemia in children? | Acute lymphoid leukemia (ALL) |
| In leukemia, there is an overproduction of _______ which accumulate in the marrow. | Blast cells (immature WBC's) |
| Which three problems develop as a result of the overproduction and accumulation of immature WBC's? | 1. Decrease in RBC production
2. Neutropenia leads to infection
3. Decrease in platelets, causing bleeding |
| What is often the first symptom of leukemia? | Anemia with pallor and fatigue |
| What is the route of choice for CNS prophylaxis? | Intrathecally (directly into cerebrospinal fluid) |
| What is the drug of choice for CNS prophylaxis? | Methotrexate |
| Which ages are considered to be high-risk when diagnosed with acute lymphoid leukemia (ALL)? | Younger than 1 and older than 10 |
| Infection with which virus is a risk factor for developing Hodgkin's lymphoma? | Epstein-Barr virus |
| What is the main diagnostic feature of Hodgkin's lymphoma? | Reed-Sternberg cells |
| What is the common indicator in all immunodeficiency disorders? | Unusual or recurrent, severe infections |
| Why does HIV target T helper lymphocytes? | They have more CD4+ receptors on their surface than any other cell |
| Severe immune problems occur when the CD4+ count drops below ____/uL | 200/uL |
| What is the greatest threat to an HIV infected infant younger than one year? | Pneumocystis jiroveci pneumonia |
| Juvenile idiopathic arthritis is more common in which gender? | Affects GIRLS twice as much as boys |
| How is JIA characterized? | Chronic inflammation of the synovium with joint effusion |
| Regular ______ exams are indicated for a child with JIA | Eye exams |
| What is the disadvantage of using DMARD's? | Increased chance of infection |
| What do TNF blockers do? | Reduce pain, morning stiffness, and joint swelling |
| What are the disadvantages of TNF blockers? | Increased risk of infection
Increased chance of lymphoma or other cancer |
| What are two examples of TNF blockers? | etanercept (Enbrel)
adalimumab (Humira) |
| What is respiratory distress caused by? | A deficiency of surfactant |
| Those who survive RDS gradually show improvement by the ___ day | Fourth |
| What kind of feedings are contraindicated in an infant with RDS? | Nipple and gavage |
| How is exogenous pulmonary surfactant administered? | Endotracheal tube directly into the lungs |
| What can the mother be given before delivery to increase the production of pulmonary surfactant in the preterm infant? | Betamethasone |
| How should the infant with RDS be positioned? | On the side with head in alignment |
| Frequent suctioning increases the risk for: | Bronchospasm
Infection
Pneumothorax
Hypoxia
Increased intracranial pressure |
| What is the most effective preventative measure for RDS? | Prevention of premature delivery |
| Infants who survive Bronchopulmonaary dysplasia are at risk for: | Chronic lung disease |
| What kind of pneumonia is most common? | Viral |
| Bacterial pneumonias are most common in _____ and ______. | Infants and children |
| What is the most common viral pneumonia in infants and children? | Respiratory syncytial virus (RSV) |
| What is prescribed as preventative therapy for RSV? | Palivizumab |
| What kind of pneumonias typically run a longer course? | Staphylococcal |
| How many infants die of SIDS? | 2 out of every 1000 |
| SIDS is often associated with which factors? | Premature birth
Low birth weight
Multiple births
CNS and respiratory dysfunctions |
| What does postmortem examination reveal in an infant with SIDS? | Pulmonary edema and intrathoracic hemorrhages |
| Strengths in visual processing, weakness in grammar and language, and delays in motor development are seen in which cognitive impairment disorder? | Down syndrome |
| All children should be screened for autism at what ages? | 18 and 24 months |
| What group of behaviors encompass ADHD? | Hyperactivity
Inattentiveness
Impulsivity |
| ADHD appears to have a ______ basis | Genetic |
| Which maternal factors are linked to ADHD? | Smoking and alcohol use |
