SUMMARY OF RESOLVED DISCUSSIONS
STUDY HALL, PLD FORUMS

1.  Babies of Moms with different dx conditions

Diabetic mom - hyperinsulinism/hypoglycemia (tremors, respiratory distress), large, increased birth weight
Narcotic mom - increased reflex irritability, restlessness, tremors, high pitch cry, poor feeding
Alcoholic mom - small head & body
Smoker mom - low birth weight
Barbiturate addict mom - pinpoint pupils
hyperthyroid mom - hyperthyroid baby
hyperthyroid mom on meds (eg. PTU) - hypothyroid baby
cocaine (withdrawal signs in baby): irritability, high-pitch cry (& others like narcotics)
alcohol (withdrawal signs in baby fetal alcohol syndrome): tremors, seizures, irritability, abdominal distention
    : later: mental retardation, speech problems, hyperirritability

2.  Which of the ff drinks should be avoided to prevent cardiac dysrhythmia is a cardiac patient?

a. hot tea
b. sanka
Ans: hot tea (caffeinated).   Sanda is decaf!

3. moon face - a sign of kwashiorkor (decreased osmotic pressure) , not marasmus

4. to know if fetus is in cephalic or breech presentation - maneuver #1 in leopold's

maneuver #1 - allows you to feel the fundus.  If you feel something hard, round and slightly movable, that's the head. If softer, larger and seems to move with the trunk, that's the buttocks.
maneuver #2 - feeling the left and right sides, comparing the back and the limbs.  
maneuver #3 - checking engagement
maneuver #4 - furthur assessment of fetal head and position to confirm findings in past steps.

5. Child with URTI - give Procaine Penicillin 300,000 'U'

6. Which cranial nerve is involved in speech problems?

a. trigeminal
b. facial
c. hypoglossal
Ans. hypoglossal.  Responsible for movement of tongue/articulation of letters D,L,N,T (consonants of DiLaNTiN)

7. ESSENTIAL AMINO ACIDS

Essential amino acids are not synthesized by our body, so intake from food is vital.  There are 8 for adults and 9 (some say 10) for infants.  Just a quick code to help you remember.

Pray Very Hard TILL Makapasar  Tanan
P-henylalanine
V-aline
H-istidine (in children)
T-ryptophan
I-soleucine
L-eucine
L-ysine
M-ethionine
T-hreonine
Some books say children also need Taurine.

8.  IRON - best taken with meals

Absorption is decreased by 40-50% when taken with meals, but iron causes GI distress, so it's still best to take it with a full stomach.

9.  HYPOTHALAMUS - satiety center

ventromedial hypothalamus - satiety center
lateral hypothalamus - hunger center
posterior hypothalamus - heat production/conservation
anterior hypothalamus - heat loss

10.  RADIATION THERAPY (Time, Distance, Sheilding)

Time- 10min (ave.); depends on the type of Radiation Therapy
Shielding- lead apron, lead-impregnated gloves, pick-up forceps for penetrating radiation like x-ray or gamma rays, wear film badges in front
Distance- do not remain within 1 meter(3 ft.)
Use the Inverse Square Law: Doubling the distance from a radiation source cuts the intensity received to 1/4
* During the period of radioactivity (24-72H), limit the amount of time spent with the client

11.  LIST OF INHERITED DISORDERS

AUTOSOMAL RECESSIVE
- most inborn errors of metabolism
- both parents should carry the recessive trait for the child to manifest the disease

1.  cystic fibrosis
2.  thalassemia
3.  sickle cell disease
4.  tay sach's disease
5.  phenylketonuria
AUTOSOMAL DOMINANT

1.  MODY (Maturity-onset diabetes of youth)
2.  osteogenesis imperfecta (fragile bones)
3.  achondroplasia


X-LINKED
- girls are carriers, boys are affected

1.  duchenne musculary dystrophy - most common
2.  hemophilia

12.  The 5-Bs in Beta Blockers (side effects)

Beta blocker blues (depression)
Bronchospasm
Bradycardia
BP-decreased
Libido-decreased

13.  The 6-S of Addison's Disease (a decrease in one or more of these)

* Sodium
* S
ugar (glucose)
* S
hock (hypovolemia)
* S
teroids production
* S
ensorium (mental function)
* S
tress (low resistance)

14.  QUESTION: Which of the following is not seen in rheumatic fever?
       A.  polyarthritis
       B.  subcutaneous nodules
       C.  abdominal pain
       D.  headache

       Ans:  headache.  Abdominal pain is frequently caused by liver engorgement

15.  QUESTION: What is the common side effect of vagotomy?
       A.  orthostatic hypotension
       B.  hypertension
       C.  diarrhea
       D.  abdominal distention

       Ans: diarrhea

16.  QUESTION: What is the route of transmission of HTLV?
       Ans: sexual contact

17.  QUESTION: What is the most common cause of acute pancreatitis?
       Ans: alcoholism

18.  QUESTION: A child with rheumatic fever takes antibiotics for a span of how many days?
       Ans: 10 days

19.  PKU TEST:
       Formula Fed Infants:
test is taken as early as  3 days old
       Breast Fed Infants: test taken at age 1 week
    ** Formula/Cow's milk is high in phenylalanine
    ** Test is repeated 7-14 days after to ensure accuracy

20.  CONCEPTS OF DEVELOPMENT (PIAGET's THEORY)

     INVARIANTS (developmental characteristics that are always present):

21.  PAIN DURING LABOR

PAIN during 1ST STAGE OF LABOR is due to DILATION OF THE CERVIX , hypoxia of uterine muscle cells during contraction, stretching of lower uterine segment, pressure on adjacent structures.

PAIN during 2ND STAGE OF LABOR is due to DISTENTION OF PERINEUM & VAGINA, hypoxia of uterine muscle cells, pressure on adjacent structures.

22.  EMERGENCY TREATMENT FOR BURNS:

23.  KNOTS: lactic acid accumulation and tense muscles that tighten the  fascia that enclose them. Other names: muscle pain syndrome, fibromyositis

24.  OPEN HEART SURGERY FACTS:

   >> uses heart-lung machine (pump-oxygenator or cardiopulmonary bypass)
   >> sternotomy - surgical division of the breastbone (sternum), performed to allow access to the heart and its major vessels

   >> heart feels ischemia in 10 seconds without blood supply
   >> necrosis starts after 20 minutes

>> What happens during the surgery...
An 11- to 12-inch incision is made in the chest and the breastbone is split in two (full median sternotomy). A retractor is then used to pull back the breastbone and attached ribs in order to open up the chest. The functions of the heart, including blood flow and oxygenation, are rerouted through a heart-lung machine, so that the heart can be safely stopped during the procedure by the injection of a cooled cardioplegia solution (ice-cold liquid solution).
After that, the major blood vessels are cut and the heart is separated from the body.  As long as it is kept in a cool temperature, the heart will be able to survive without oxygen for 3-4 hours or longer. After the desired procedure is done, ti the heart is reanastomosed to the major blood vessels and the heart is defibrillated to get it pumping again.


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