Kind en Jongere Deel 3

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  1. Percentage of boys born with undescended testicles
  2. What does an APGAR score of less than 7 indicate?
    Perinatal asphyxia
  3. What is OME?
    Otitis Media met Effusie - a collection of fluid behind the ear drum. Resolves spontaneously within 3 months in 75% of cases. Carries a hearing loss of around 25 dB.
  4. Upto what age must a symptomatic diagnosis be made for asthma?
    6 years
  5. Prevelence of asthma
  6. Organic causes of asthma
    IgE-mediated allergic reaction
  7. Asthma is unlikely if there is no talk of _______.
    Wheezing (piepen)
  8. Differential diagnosis of asthma
    • Foreign body in airway
    • Bronchiolitis
    • Croup (swelling of airway causing 'steeple-sign')
  9. Treatment for asthma
    • Under 6: Use beta-2-adrenergic agonist until symptoms disappear - if asthma is suspected, continue with inhalation corticosteroids for 4-6 weeks
    • Over 6: Short-action beta-2-adrenergic agonist (10-15 mins before effort if effort-induced asthma), then inhalation corticosteroids for persistent symptoms. If no improvements after 3 months, should be treated as serious asthma.
  10. Medicine used to treat only severe asthma
    Oral prednison
  11. Most important characteristics with regards to pharmacokinetics
    • Remember DAME
    • Distribution
    • Absortion
    • Metabolism
    • Elimination
  12. Difference between off-label and unlicensed medication, with regards to medicating of children
    • Off-label = used for a purpose other than that specified
    • Unlicensed = should not be used for children
  13. Babies have a (higher/lower) percentage body water than adults. This affects dosage of water soluble antibiotics, such as ________ and ________.
    Higher, aminoglycosides, beta-lactams
  14. Babies have a (higher/lower) percentage of body fat than adults. This affects dosage of fat soluble medicines such as _______.
    Lower, Sedative H1 antagonists
  15. Babies have a (higherl/lower) concentration of albumine. This means that medicines that bind albumine must be given in (higher/lower) doses
    • Lower
    • Lower
  16. Very important barrier which is not fully developed in newborns
  17. Describe process by which growth hormone is released and acts
    GH (somatotropine) secretion incr by GRF (GH Releasing Factor) and decr by somatostatin (aka SRIF - Somatotropine Release Inhibiting Factor). GH circulates attached to GHBG (GH Binding Globulin) and incr release of IGF-1 from the liver.
  18. Factors causing an INCREASE in IGF-1
    • alpha-adrenergic stimulation, hypoglycemia, malnutrition, exersion, sleep and stress
    • (Remember, GH incr blood glucose)
  19. Factors causing a DECREASE in IGF-1
    beta-adrenergic stimulation, hyperglycemia
  20. When GH is high, IGF-1 is usually also high. What are the exceptions?
    • Underfeeding (GH high to incr blood glucose, but IGF-1 low)
    • Obesity (GH low to lower blood glucose, but IGF-1 normal)
    • GH deficiency (GH low b/c duh, IGF-1 low)
  21. Classic presentation (apart from being short) of a GH deficiency
    • Round face and trunk adipositis
    • (Thus round face and fat a**)
  22. DD for short length
    • Hypopituitarism
    • Hypothyroidism
    • Turner syndrome
  23. DD for long length
    Klinefelter, XXX, XYY, Fragile-X syndromes
  24. Landmarks for beginning of puberty for boys and girls
    • Girls (M2) - elevation of areola, beginning of hardening of nipple and formation of slight curve
    • Boys (G2) - enlargement of scrotum/testes (min volume of 4mL)
  25. Definition of pubertas praecox
    Puberty beginning too early - breast development at less than 8 yrs for girls, thinning of scrotum or development of pubic hair before 9 yrs for boys
  26. Differentiate actual central pubertas praecox from pseudo-pubertas praecox
    Central involves the hypothalamic-pituitary axis
  27. Who is more likely to experience pubertas praecox, boys or girls?
    Girls (23 times more likely)
  28. Tx for central pubertas praecox
    • GnRH agonist (Decapeptyl)
    • Side effect is decrease in final height
  29. McCune-Albright syndrome
    Precocious puberty and café-au-lait spots - treat with anti-androgens
  30. Often associated with Coeliakie (Celiac's disease)
    DM and thyroid disorders
  31. The pH of a baby's GI tract is (higher/lower) than that of an adults
  32. Baby's muscle is (more/less) vascularized
  33. Baby's ratio of surface area to weight is (higher/lower) than that of adults
  34. Baby's have a (higher/lower) body water percentage
  35. Babies have a (higher/lower) concentration of plasma bonding proteins than adults
  36. Enzyme responsible for most drug metabolism and equivalent in children
    CYP3A4, CYP3A7
  37. RBF and GFR for neonates and adults
    • 12mL/min, 3mL/min for neonates
    • 1000mL/min, 125mL/min for adults

    Flows approach adult levels by approx 5 months
  38. Effect of LH on girls, boys
    • Girls: Estrogen production
    • Boys: Testosterone production (via stimulation of cells of Leydig)
  39. Effect of FSH on girls, boys
    • Girls: Maturation of ovarian follicles
    • Boys: Stimulation of Sertolli cells for spermatogenesis
  40. When is it best to measure estrogen levels?
    During the night
Card Set:
Kind en Jongere Deel 3
2011-11-29 16:28:39
Kind en Jongere Deel

Kind en Jongere Deel 3
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