1. General Principles

Question 1

3 month old normal development

Answer 1

roll, grab, smile, laugh

Question 2

6 month old normal development

Answer 2

sit up, raking grasp, switch hands/move object, stranger anxiety, schmooze/ coo

Question 3

9 month old normal development (P hint)

Answer 3

pull self to standing, pincer grasp, able to play pat a cake, parent/separation anxiety, papa-single words, recognizes own name, object permanence

Question 4

12 month old normal development

Answer 4

stands tall, walk by one, track objects & points

Question 5

18 month old normal development

Answer 5

climbs stairs, uses cups & cutlery, complains- throws tantrums, calls objects by name- potty training begins

Question 6

2 yr old

Answer 6

uses 2 legs to run, may not engage with peers yet but engages with parents and family, 200 word vocab, 2 word sentences, follows 2 step commands

Question 7

3 yr old

Answer 7

able to ride tricycle, draw circle , 3 people- start playing w/ peers, toliet trained successful, 1000 word vocab. Constantly asks WHY

Question 8

4yr old

Answer 8

four limb dexterity- hop and balance on one leg, draw a square and cross, figments- may have imaginary friends, full sentences and storytelling. Two colors

Question 9

5 yr old

Answer 9

uses 5 fingers to play with a jump rope, uses 5 fingers to dress and groom self, button a button & tie shoes. Counts up to 10

Question 10

milestones for premature infants

Answer 10

adjust back by how many weeks/ months they are early. Ex: 12 weeks early (28wks) 6 month milestones at 9 months old. Until around 2 yr old milestones

Question 11

appropriate number of blocks stacked by age

Answer 11

3 X year old they are
-3 at 1yr
6 at 2 yr

Question 12

Overall trend in development is more important than specific timelines, what test to use if doubt?

Answer 12

M-CHAT, modified checklist for austism in toddlers

Question 13

What screening & preventive care measures at every pediatric visit?

Answer 13

height, weight, bp, development/behavior, age appropriate concerns

Question 14

when to introduce solid foods?

Answer 14

4 to 6 months, wait until 1 yr for honey and cows milk

Question 15

daily recomendation for activity in kids?

Answer 15

60 mins per day

Question 16

how often should head circumference be measured?

Answer 16

every visit until 2 yrs

Question 17

whats the first growth vital to become abnormal?

Answer 17

Weight, then height and last head circ

Question 18

Define Failure to thrive

Answer 18

-head circ, weight & height less than 5th percentile for age, weight less than 80% for age, or weight that drops two or more major lines on growth curve. Typically pyschosocial or functional problems not organic

Question 19

what causes 95% of obesity in children? 5%?

Answer 19

95% due to overeating and low exercise, 5% cushings, prader-willi or other organic causes

Question 20

Increased head circ in kids?
Decreased?

Answer 20

-hydrocephalus or tumor
- microcephaly( torch infection toxoplasmosis, syphilis, HIV, rubella, cytomegalovirus, herpes simplex, zika or aneuploidy)

Question 21

when are hearing & vision screened?

Answer 21

at lest omce by age 4yr old, measure every few years or more if history dictates

Question 22

What should you worry about for hearing loss in pediatrics?

Answer 22

-bacterial meningitis esp hemophilus influenzae sensorineural hearing loss of CN 8
-congenital Torch infections
-measles & mumps
-chronic middle ear effusions or chronic/ recurrent otitis media
-ototoxic drugs- aminoglycosides, furosemide

Question 23

Red reflex?

Answer 23

-see red when light shined at pupil due to underlying fundus. Check at birth and thereafter for congenital cataracts, strabismus or ocular tumors.

Question 24

When do you see white on eye instead of red reflex?

Answer 24

cataracts & tumors- known as leukocoria classically due to retinoblastoma

Question 25

How long is it normal to have strabismus in pediatrics?

Answer 25

until 4 months!

Question 26

How is strabismus managed beyond 3 months?

Answer 26

Patch the good eye, severe may require surgical involvement

Question 27

When should screening for iron deficiency anemia begin and in who?

Answer 27

• begins at 4 months, w/ h&h measured at 1 yr.
  -causes include, prematurity, low birthweight, cows milk before 1 yr, low diet intake

Question 28

Which infants should recieve iron supplementation?

Answer 28

-exclusively breastfed infants at 4 months of age. Formula fed infants do not need.

Question 29

what infants need vitamin D supplementation?

Answer 29

• exclusively or partially breast fed infants until they are weaned or begin to drink cow’s milk

Question 30

Guidelines for Renal screening in peds (screening after 2 yrs is controversial)

Answer 30

• screen after febrile UTI for congenital/anatomic abnormalities between 2 months & 2 years
  -ultrasound plus
  -voiding cystourethrogram VCUG or radionuclide cystogram RNC

Question 31

what vaccine is contraindicated in pediatric pts with intussusception?

Answer 31

Rotavirus