NFDN 2005 EXAMS TEST 2 QUESTIONS AND
ANSWERS SET A+
✔✔Why is immunization especially important in children with sickle cell anemia? -
✔✔Infections can cause a crisis
By age 7, most children have functional asplenia (no working spleen)
✔✔What is hemophilia? - ✔✔Absence of a particular clotting factor
More common in males vs. females
Treatment - depends on which clotting factor missing
✔✔What is the most common site for bleeding in hemophilia? - ✔✔Joints
(hemarthrosis)
May cause progressive deformity
Subcutaneous, intramuscular
✔✔How is hemophilia treated? - ✔✔Infusions of required clotting factor
Corticosteroid use (hematuria, acute hemarthrosis, chronic synovitis)
✔✔teaching about menstruation and pregnancy in von Willebrand disease (type of
hemophilia). - ✔✔Puberty later
High-risk pregnancy
Menstruation may be heavier than normal
If having to change pad every hour & saturated - dangerous
Keep on top of her transfusions - should be able to get pregnant
✔✔What is ITP? - ✔✔Idiopathic Thrombocytopenia Purpura
Decrease in platelets, usually about 2 weeks post viral infection
Presents with bleeding, bruising, marked low platelets on CBC
✔✔How is Idiopathic Thrombocytopenia Purpura treated? - ✔✔Steroids
IVIG
,✔✔Thrombocytopenia Purpura teaching - ✔✔Super easy bruising
Lasts about 3 months
No advil - increase bleeding chance
✔✔What are your protective mechanisms? - ✔✔Skin
Immune response
Endocrine and metabolic systems
✔✔What are some important considerations when treating children for skin disorders? -
✔✔**Skin is thinner in children**
Secondary infections may occur
scratching
Immune system still developing
✔✔What is eczema? - ✔✔Atopic Dermatitis
Red
Itchy
possibly weeping patches
✔✔What are the possible complications with eczema? - ✔✔Secondary infections
✔✔What other conditions commonly occur with eczema? - ✔✔Asthma
allergies
✔✔How is eczema diagnosed? - ✔✔visual
Physical exam
Family history increased risk if mother is allergic/has eczema compared to father
Can be genetic
✔✔How do we treat eczema? - ✔✔Lotion (emollient)
Hypoallergenic laundry detergent
Tepid bath followed by emollient lotion (Cetaphil, Eucerin, Aquaphor)
✔✔What medications are used for eczema? - ✔✔Pimecrolimus/tacrolimus (low-dose)
Steroids (low-dose; sparingly for short periods)
✔✔Contact Dermatitis - ✔✔Inflammatory reaction of skin
Initial reaction to exposed region (face, neck, backs of hands [most common], forearms,
male genitalia, lower legs
Major goal to prevent further exposure to irritant
✔✔Acne - ✔✔Caused by testosterone
Contributors: bacterial growth, inflammation, abnormal desquamation of follicles
Management: rest, moderate exercise, well-balanced diet
, ✔✔Acne treatment - ✔✔Tretinoin (Retin-A) only medication effectively manages
comedonal acne ("blackheads", "whiteheads")
Apply 20-30 minutes after washing
Avoid direct sun exposure, daily application of sunscreen
Decrease stress, rest, nutrition, wash face up to twice daily, wash hands, don't touch
face
Be careful in sunshine
Accutane - last resort
✔✔What types of bites might we see on children? - ✔✔Pets
Biting insects
Other children
✔✔What questions should you ask with animal bites? - ✔✔What kind of animal?
Child up to date on vaccines?
Was it a family pet/known animal?
Was it provoked?
Was it exhibiting odd behaviour?
✔✔How would we treat animal bites? - ✔✔Amoxicillin/clavulanate PRN
Immunizations (tetanus; rabies PRN)
✔✔animal bite prevention - ✔✔Select pets that are good for children
Spay and neuter pets
✔✔How should children behave around pets and animals? - ✔✔Supervision, watch for
cues
Never approach a mother with babies
Feed farm animals with your hand flat
✔✔What are the risks of human bites? - ✔✔Infection human mouth is full of bacteria
✔✔What reactions can occur to insect bites? - ✔✔Self-limiting; may see welts with
horse flies and sand flies
Bee and wasp stings may cause allergic reaction
Get stinger out asap if possible
✔✔insect bite treatment - ✔✔Afterbite
Benadryl
Allergic reaction - epi pen, then hospital
Always ask if they've travelled anywhere in last 6 months
✔✔Arthropod bites Brown Recluse - - ✔✔pain, erythemia, can become necrotic, fever,
n/v, joint pain
ANSWERS SET A+
✔✔Why is immunization especially important in children with sickle cell anemia? -
✔✔Infections can cause a crisis
By age 7, most children have functional asplenia (no working spleen)
✔✔What is hemophilia? - ✔✔Absence of a particular clotting factor
More common in males vs. females
Treatment - depends on which clotting factor missing
✔✔What is the most common site for bleeding in hemophilia? - ✔✔Joints
(hemarthrosis)
May cause progressive deformity
Subcutaneous, intramuscular
✔✔How is hemophilia treated? - ✔✔Infusions of required clotting factor
Corticosteroid use (hematuria, acute hemarthrosis, chronic synovitis)
✔✔teaching about menstruation and pregnancy in von Willebrand disease (type of
hemophilia). - ✔✔Puberty later
High-risk pregnancy
Menstruation may be heavier than normal
If having to change pad every hour & saturated - dangerous
Keep on top of her transfusions - should be able to get pregnant
✔✔What is ITP? - ✔✔Idiopathic Thrombocytopenia Purpura
Decrease in platelets, usually about 2 weeks post viral infection
Presents with bleeding, bruising, marked low platelets on CBC
✔✔How is Idiopathic Thrombocytopenia Purpura treated? - ✔✔Steroids
IVIG
,✔✔Thrombocytopenia Purpura teaching - ✔✔Super easy bruising
Lasts about 3 months
No advil - increase bleeding chance
✔✔What are your protective mechanisms? - ✔✔Skin
Immune response
Endocrine and metabolic systems
✔✔What are some important considerations when treating children for skin disorders? -
✔✔**Skin is thinner in children**
Secondary infections may occur
scratching
Immune system still developing
✔✔What is eczema? - ✔✔Atopic Dermatitis
Red
Itchy
possibly weeping patches
✔✔What are the possible complications with eczema? - ✔✔Secondary infections
✔✔What other conditions commonly occur with eczema? - ✔✔Asthma
allergies
✔✔How is eczema diagnosed? - ✔✔visual
Physical exam
Family history increased risk if mother is allergic/has eczema compared to father
Can be genetic
✔✔How do we treat eczema? - ✔✔Lotion (emollient)
Hypoallergenic laundry detergent
Tepid bath followed by emollient lotion (Cetaphil, Eucerin, Aquaphor)
✔✔What medications are used for eczema? - ✔✔Pimecrolimus/tacrolimus (low-dose)
Steroids (low-dose; sparingly for short periods)
✔✔Contact Dermatitis - ✔✔Inflammatory reaction of skin
Initial reaction to exposed region (face, neck, backs of hands [most common], forearms,
male genitalia, lower legs
Major goal to prevent further exposure to irritant
✔✔Acne - ✔✔Caused by testosterone
Contributors: bacterial growth, inflammation, abnormal desquamation of follicles
Management: rest, moderate exercise, well-balanced diet
, ✔✔Acne treatment - ✔✔Tretinoin (Retin-A) only medication effectively manages
comedonal acne ("blackheads", "whiteheads")
Apply 20-30 minutes after washing
Avoid direct sun exposure, daily application of sunscreen
Decrease stress, rest, nutrition, wash face up to twice daily, wash hands, don't touch
face
Be careful in sunshine
Accutane - last resort
✔✔What types of bites might we see on children? - ✔✔Pets
Biting insects
Other children
✔✔What questions should you ask with animal bites? - ✔✔What kind of animal?
Child up to date on vaccines?
Was it a family pet/known animal?
Was it provoked?
Was it exhibiting odd behaviour?
✔✔How would we treat animal bites? - ✔✔Amoxicillin/clavulanate PRN
Immunizations (tetanus; rabies PRN)
✔✔animal bite prevention - ✔✔Select pets that are good for children
Spay and neuter pets
✔✔How should children behave around pets and animals? - ✔✔Supervision, watch for
cues
Never approach a mother with babies
Feed farm animals with your hand flat
✔✔What are the risks of human bites? - ✔✔Infection human mouth is full of bacteria
✔✔What reactions can occur to insect bites? - ✔✔Self-limiting; may see welts with
horse flies and sand flies
Bee and wasp stings may cause allergic reaction
Get stinger out asap if possible
✔✔insect bite treatment - ✔✔Afterbite
Benadryl
Allergic reaction - epi pen, then hospital
Always ask if they've travelled anywhere in last 6 months
✔✔Arthropod bites Brown Recluse - - ✔✔pain, erythemia, can become necrotic, fever,
n/v, joint pain
