2 Flashcards
When should a child be able to say first and last name?
4
When should a child be able to count to 10?
5
A child draws a picture of a girl with head, body, legs, arms, and hands. Child can also write first two letters of name. How old?
- Body with > 6 parts and some letters, numbers.
A kid can balance on one foot for a very short amount of time and can’t yet skip. How old?
likely 4.
What is in-toeing/pigeon-toed often caused by in a TODDLER? Does it need intervention?
tibial torsion in TODDLERS; usually resolves by 4 with weight-baring
What is in-toeing often cause by in 4-6 year olds? Does it need intervention?
femoral anteversion in 4-6; usually self-resolves by 12
When should a child be able to grip a crayon appropriately?
By 5
You are concerned about anemia in a picky eating child. What is a reasonable test?
Finger stick H/H
What is a normal Hg for 6 mo - 6 y
10.5-14
What 3 causes of anemia should be detected in newborn screen?
alpha thalassemia
G6PD deficiency
sickle cell disease
What to consider if more severe anemia in child (<9)
Decreased marrow production (e.g., aplastic anemia)
Hemolytic anemia
Vitamin deficiencies (e.g., folate and B6)
What BMI percentile is considered obese for a child?
95
What are some important causes of school failure?
Sleep disorder Mood disorder Conduct disorder Learning disability Sensory impairment
What are some “red flags” for learning disabilities?
History of maternal illness or substance abuse during pregnancy
Complications at the time of delivery
History of meningitis or other serious illness
History of serious head trauma
Parental history of learning disabilities or difficulty at school
What’s the generic name for Concerta?
methylphenidates
What are the ADHD stimulant meds SE?
Insomnia, decreased appetite, decrease in growth velocity
What are the RISK criteria used to screen kids for DM > 10 or after puberty?
Overweight (>85th percentile) + 2 of the following
- FHx of Type 2 DM in first- or second-degree relative
- Race/ethnicity (Native American, AA, Hispanic, Asian/South Pacific Islander)
- Signs of insulin resistance or assoc cond’n(acanthosis nigricans, PCOS, HTN dyslipidemia)
- Maternal history of DM or gest DM during kids preg
You had a 10 year old kid who is 95th percentile for weight, has parents with DM, and has acanthosis nigricans of axilla on exam. Should this kid be screened for DM and when?
YES b/c overweight + 2 of the RISK criteria. Screen now and then every 3 years if neg and continue to meet screening criteria.
What is prehypertension percentil?
90-95
What is stage II HTN percentile?
> 99
You see a newborn in office and the mom asks about when her baby can get the flu vaccine. What do you say?
First dose after 6 month. If less than 9 mo, we give two shots a month apart to provide a good boost of immunity.
What does HEEADSSS stand for?
H - Home E - Eating disorder E - Education and Employment A - Activities D- Drugs S - Sexuality S - Suicidality and depression S - Safety
What vital sign change is often seen in anorexia?
bradycardia
In addition to bradycardia, what other heart manifestations are common in anorexia?
Arrhythmias secondary to electrolyte abnormalities
Can thyroid disorders lead to menstrual abnormalities?
YES
A child just begins to have sparse pubic hair. What tanner stage?
2
When is growth spurt for girls? How about boys?
Girls GROW at 12, boys GROW at 14
General development pattern for boys and girls
Circles (breast buds girls, testes boys)
Hair (pubic hair both)
Growth 1 (growth spurt girls, testes and scrotum boys)
Fluids (menarche girls, ejaculation boys)
Growth 2 (growth spurt boys)
What labs to order when you suspect a bleeding disorder?
- CBC with platelets, RBC indices, and a smear
- Reticulocyte count
- PT and PTT
- Platelet function test
- Factor VIII activity
- von Willebrand factor antigen
- von Willebrand factor activity (Ristocetin cofactor)
What medication can be used to treat VWD?
Desmopressin
What to do to manage menstrual bleeding in someone with VWD?
Combo OCP or IUD
What is precordial catch syndrome?
sharp sporadic pain that is not associated with exercise or other symptoms; chest pain in adolescents
What does the CRAFFT screen stand for in substance abuse screening?
C - CAR R - RELAX A - ALONE F - FRIENDS F - FORGET T - TROUBLE
What type of murmur is always pathologic?
diastolic
A male has pubic hair extending to the thighs, what is the tanner staging?
5
What vaccines are due at 11 years old?
MCV4
TDaP
HPV
When is the first dose of TDaP given?
11-12 y/o visit
What vaccine do we give at 16?
Men B and booster of MCV4
How many of MCV4 are given?
2; one at 11-12, booster at 16
What is ddx of tachypnea in a newborn?
Respiratory distress syndrome Transient tachypnea Pneumothorax Meconium aspiration Hypoglycemia Hypothermia Cardiac abnormalities Neonatal sepsis Diaphragmatic hernia
When would you expect a newborn with cardiac abnormalities (VSD, PDA, AVC) to present with tachypnea?
around 6-8 weeks
What can cause persistent pulmonary hypertension of the newborn?
meconium aspiration syndrome, diaphragmatic hernia, hypoplastic lungs, and in utero asphyxia
What is weight percentile for LGA?
> 90
What do you call a newborn < 10th percentile for weight?
SGA
What is an SGA baby at risk of?
hypothermia, hypoglycemia, polycythemia and hyperviscosity
What to look for on exam of LGA baby after delivery?
brachial plexus injury, fractured clavicle, fascial nerve palsy
Would you expect normal bilateral breath sounds with a pneumothorax or diaphragmatic hernia?
NO
What may help differentiate between TTN and RDS for cause of tachypnea in a newborn?
XR
