3- 3 year old acc Flashcards
eczema treatments
Protecting skin by lubricating extensively
Using anti-inflammatories in short bursts, and
Treating associated skin infections aggressively.
steroids
antihistamines
topical antiinflammatories- calcienurin inhibitors
when should you discotnue the bottle and why
12-15 months
causes dental cavities`
intoeing in toddlers vs preschool/school aged
toddlers: caused by tibial torsion. In tibial torsion, when the patella faces straight ahead, the foot turns inward. Tibial torsion resolves naturally with weight bearing - usually by 4 years of age.
school: caused by femoral anteversion. In femoral anteversion both the feet and knees turn inward. Femoral anteversion usually resolves spontaneously by 8-12 years of age.
caloric requirements of term infant, preterm infant, and very low birth weight infant
term: 100-120 cal/kg/day
preterm: 115-130
VLBW: 150
neonatal acne
Results from hormonal stimulation of the sebaceous glands. Papules and pustules
benign, resolves over time
how long do palmar and plantar grasp reflexes last
palm: 2-3 mo
plantar- 8 mo
what age is forward facing car seat
2-4 years
what age is booster seat
4- 8
when should you double and triple your weight
double- 4-5 mo
triple- 12 mo
absence of red reflex suggest
Cataracts
Glaucoma
Retinoblastoma
Chorioretinitis
when can solid foods be added?
6 mo- every 5 to 7 days.
some infants may be started on rice cereal with a spoon at age 4 months.
differential for abdominal mass in asymptomatic 9 year old?
F. Hepatic neoplasm- Asx or jaundice, rare
G. Hydronephrosis- UTI, flank mass
H. Neuroblastoma-age 2- painless or ill from mets
I. Teratoma- painless or pressure, rare
*J. Wilms’ tumor- asx, doesn’t cross midline
neuroblastoma on imaging
CT scan may reveal calcifications and a heterogenous mass with cystic areas representing either hemorrhage or necrotic tumor.
Metastases are primarily to regional lymph nodes and to the liver, bone marrow, and skeleton.
Chest radiograph will reveal any lymph node involvement in the chest or additional tumors that may present in the posterior mediastinum.
neuroblastoma labs
Histopathology reveals “small round blue cells” or small, uniform cells containing dense, hyperchromatic nuclei and scant cytoplasm, forming small cell rosettes.
Urinary HVA/VMA will be elevated in 90-95% of cases.
CBC: anemia or other cytopenias that are secondary to bone marrow infiltration.
wilms tumor imaging
Ultrasound - intrarenal.
CT scan –heterogenous with areas of low density representing necrosis. A pseudocapsule may be observed because of the sharp demarcation between tumor and normal renal parenchyma.
Pulmonary metastases may be identified on chest radiograph.
wilms tumor labs
hematuria
hepatic tumor imaging
Radiograph of abdomen will demonstrate hepatic enlargement with hepatic tumors.
CT scan will show tumor and origin of tumor.
Chest CT is indicated to look for pulmonary metastases.
hepatic tumor labs
Diagnosis is dependent on histologic examination.
Laboratory studies of liver function are usually normal but liver enzymes and bilirubin may be elevated in 20% of cases.
Alpha-fetoprotein levels will be increased in most patients.
teratoma imaging
CT best- solid and cystic
x ray only if calcified teeth
constipation imaging
plain radiograph
is neuroblastoma hereditary?
1% familial- aut dom
how old is this child? a child should be able to walk backward, and 50-90% of children can run at this stage. be able to scribble, build a tower of 2 cubes, have 3-6 words in her or his vocabulary, and be able to help in the house and remove garments.
18 mo
how old is this child? child should be able to stoop and recover and walk well, put a block in a cup, have a vocabulary of a few words, wave bye-bye, and drink from a cup.
15 mo
how old is this child? kids can jump up and throw a ball overhand. They can build a tower of 6-8 cubes, point to 6 body parts, name 1 picture, put on clothing, and wash and dry their hands.
2.5 years
how old is this child?children can balance on each foot for 1 second, wiggle their thumbs, name 4 pictures, name 1 color, name a friend, and brush their teeth with help.
age 3
when do most babies sleep through the night
4-6 mo
initial work up for abdominal mass
CBC- test for anemia
catecholamine excess?
CXR and skeletal survey- mets?
abdominal US > x ray and CT
