Test 3

Risk factors related to elevated cholesterol

• Obesity

• Diabetes

• Hypertension

• Family history:

o Coronary heart disease prior to age 55

o Hyperlipidemia

o Diabetes

Tetralogy of Fallot what is it, what are clinical findings

• Cyanosis: caused by blood low in oxygen

• Shortness of breath and rapid breathing, especially during feeding or exercise.

• Loss of consciousness

• Clubbing of fingers and toes

• Poor weight gain, delayed growth

• Polycythemia, metabolic acidosis

• Systolic murmur at 2nd left ICS & holosystolic murmur at LLSB

What criteria would you have to consider inpatient admission in a patient with pneumonia

• Infants less than 4 months old

• Infant with poor feeding, grunting, O2 saturation <92>70

• Older child with grunting, inability to tolerate oral intake, oxygen saturation ≤ 92 percent, respiratory

rate > 50 breaths per minute

• Any age: Comorbidities (e.g., chronic lung disease, asthma, unrepaired or incompletely repaired

congenital heart disease, diabetes mellitus, neuromuscular disease)

Visual acuity of a 2-month-old

• Vision is 20/400

• Fix and follow objects

Viral conjunctivitis: what is it, how treated, clinical findings on exam

• Etiology: Adenovirus is the most common cause. Other causes: HSV, herpes zoster, and varicella

• Symptoms: 

o Watery discharge (profuse and clear), foreign body sensation, redness

o URI symptoms are common including sore throat and fever

o Itchy conjunctiva and swollen eye lids

o Often bilateral

• Clinical findings: 

o Normal visual acuity, PERRLA, EOMI, Fund normal

o Mucoid-profuse watery discharge

o Mild, diffuse injection and itching

o *Preauricular lymphadenopathy

• Treatment: 

o Symptomatic only

o Warm or Cool compresses

o Strict eye hygiene

Patient with elevated BP (stage 1) during initial visit

• Repeat in 1-2 weeks and average the BP over 3 visits

Asthma is disruptive several times during the night/interrupting sleep at least 3 times a week

• Use/prescribe an inhaled steroid (Flovent, Asmanex, etc.)

Causative organism of bronchiolitis

• Respiratory syncytial virus most likely cause

Treatment for prehypertension seen in a patient on initial visit

• Monitor blood pressure over the next three visits

• Encourage healthy lifestyle choices.

Murmur with change (decrease) in intensity when patient moves from supine to standing position

• Innocent (benign) murmur

o Heard in up to 50% of children

o No radiation

o Systolic

o Grade

o Does not interfere with S1 & S2

o Decreases with sitting and standing

o Equal femoral and radial pulses

o Normal PMI

Symptoms of croup

• Barking cough

• Fever

• URI symptoms

Bronchiolitis:

• inspiratory and expiratory wheezing accompanied by:

o fever

o URI symptoms including profuse clear nasal discharge

When to use inhaler to treat exercise induced asthma

• asthma triggered by exercise, short-acting inhalers can make activities that need extra lung power more

doable

• Use rescue inhaler 15-30 minute prior to activity

Kawasaki disease:

• Idiopathic multisystem disease characterized by asculitis of small and medium blood vessels including

coronary arteries

• 75% diagnoses are <5>

• More common in boys

• More common in winter and early spring

• Viral etiology

• Non-contagious