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Sam: Peds > Clin Assess -- Everything else > Flashcards

Clin Assess -- Everything else Flashcards

1
Q

When do we screen for congenital heart disease with pulse ox?

A

24 hours after birth and before discharge

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2
Q

When should the baby regain or exceed birth weight by?

A

2 weeks

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3
Q

What is a normal APGAR score?

A

8-10

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4
Q

What is a normal heart rate and respiratory rate in a newborn?

A

HR 120-160

RR 40-60

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5
Q

How long do we exclusively breast feed?

A

6 months

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6
Q

What is the leading cause of death in children and adolescents?

A

Injuries – MVA, bicycle, skiing, firearms, drowning, choking

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7
Q

When do we start depression screening?

A

Screen at ages 11 through 21

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8
Q

What are some mental health “red flags?”

A

Excessive sleeping/insomnia, loss of self-esteem, abandonment or loss of interest in favorite activities, unexpected and dramatic declines in academic performance, weight loss and loss of appetite, personality shifts and changes

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9
Q

When do we apply fluoride varnish?

A

6 months to 5 years

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10
Q

What is an appropriate amount of “screen time”?

A

Avoid before age 2; limited to 2 hours for children and teens

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11
Q

When do we start measuring blood pressure?

A

Age 3

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12
Q

When do we monitor hearing?

A

After birth, then at age 4

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13
Q

How often should we measure cholesterol?

A

Once between 9-11 years, again between 17-21 years

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14
Q

When it comes to “crying and colic” what is the “rule of 3’s?”

A

healthy infant cries for >3 hours per day, for >3 days per week, for >3 weeks.

usually peaks by age 2-3 months

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15
Q

How often do temper tantrums occur in children ages 1-4 years of age?

A

50-80% have 1/week

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16
Q

An enlarged posterior fontanelle should make you think of what?

A

Congenital hypothyroidism

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17
Q

When does the anterior fontanelle close?

A

Between 4 and 26 months

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18
Q

A depressed anterior fontanelle should make you think of?

A

Dehydration

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19
Q

What might early closure of fontanelles cue you into?

A

Developing microencephaly or to craniosynostosis or some metabolic abnormalities

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20
Q

What is caput succedaneum?

A

When scalp is swollen over occipitoparietal region from capillary distension and extravasation of blood and fluid resulting from the vacuum effect of rupture of the amniotic sac

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21
Q

What is a cephalohematoma?

A

Caused by subperiosteal hemorrhage from birth trauma; swelling does not cross suture lines and resolves in 3 weeks

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22
Q

What is a subgaleal hemorrhage?

A

rare, life-threatening; bleeding in the potential space between the skull periosteum and the scalp galea aponeurosis.

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23
Q

If on eye exam we see cloudiness in the cornea, what should we concerned about?

A

Congenital glaucoma

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24
Q

If you see asymmetry in the red reflex, what should you do?

A

Immediate referral to ophthalmology – worry about cataracts and neuroblastoma

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25
Q

What is dacryostenosis?

A

Persistent ocular discharge and tearing from birth

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26
Q

If a preauricular tag or pit is found on exam, what other organ do we need to check?

A

Kidneys!

Do an ultrasound

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27
Q

What do we call a thick or short frenulum? It can cause limited protrusion of the tongue (tongue tied) – almost make breastfeeding difficult.

A

Ankyloglossia

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28
Q

What are tiny, white or yellow, rounded mucous retention cysts located along posterior midline of hard palate; gone in months.

A

Epstein pearls

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29
Q

This lung issue occurs within the first 6 hours of life – sometimes mild hypoxia associated. Will have a high respiratory rate and chest x-ray will show a diffuse, course infiltrate pattern.

A

Transient tachypnea of the newborn

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30
Q

How will infiltrate on x-ray appear different between transient tachypnea of the newborn and neonatal pneumonia?

A

Neonatal will have more of a focal infiltrate

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31
Q

What will a pneumothorax look like on x-ray?

A

Look for black rim along x-ray – requires a chest tube immediately

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32
Q

I say ground-glass appearance you say?

A

Hyaline membrane disease

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33
Q

What is going on with hyaline membrane disease?

A

Decreased surfactant

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34
Q

What substance not only causes stress in utero but also causes a skinny, scrawny cord?

A

Tobacco

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35
Q

What is it called when the entire peritoneal contents and peritoneum are outside the abdomen?

A

Omphalocele

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36
Q

What is it called when the entire peritoneal contents are NOT within peritoneum; totally exposed and have a very high risk of infection?

A

Gastroschisis

37
Q

How does stool color compare between meconium and transitional stool?

A

Meconium – dark, black stool with blood, amniotic fluid (make sure baby has passed at least 1 in first 24 hours of life)

Transitional – green, brown, yellow, seedy, smushy stool

38
Q

What is an imperforate anus?

A

No anal opening

39
Q

If urethral meatus is below the glans (ventral)

A

Hypospadias

40
Q

If urethral meatus is on top of glans penis?

A

Epispadius

41
Q

Curvature of the penis – shortened and tied down

A

Chordee

42
Q

What type of hernia will you be able to hear bowel sounds in the scrotum and what population does this commonly affect?

A

Inguinal hernia – premature boys

43
Q

At what age do babies go through a physiologic peeling of their hands and feet?

A

1-2 weeks

44
Q

Yellow or white pustules surrounded by a red base – look like flea bites and pin-pricks all over the body

A

Erythema Toxicum

45
Q

What is a nevus simplex?

A

Sometimes called a salmon patch or stork bite depending if its on the forehead of back of neck

46
Q

What may be misinterpreted as a bruise on a babies butt?

A

Mongolian spots

47
Q

What may be the underlying causes of pathologic jaundice in a newborn?

A

Hemolytic disease

48
Q

What may be the underlying cause of late appearing jaundice persisting 2-3 weeks?

A

Biliary obstruction or liver disease

49
Q

What does

SGA

AGA

and LGA mean?

A

They all reflect gestational age – small, appropriate, and large

50
Q

Tachycardia, tachypnea, respiratory distress, low tone, poor feeding, hypoglycemia are all symptoms of what in a newborn?

A

Sepsis

51
Q

Marked and immediate dilation of the anus in knee-chest position, with no constipation, stool in the vault, or neurologic disorders should make you think of?

A

Sexual abuse

52
Q

Periorbital cellulitis should make you think of what VPD?

A

Haemophilius influenzae type B

53
Q

What is the most common congenital penile abnormality?

A

Hypospadius – urethral mass opens abnormally on the ventral surface of the penis

54
Q

This murmur often presents with a prominent ejection click in early systole.

Inspiration may increase murmur, expiration may increase click.

A

Pulmonary valve stenosis

55
Q

Where should you listen for pulmonary valve stenosis

A

Upper left sternal border

56
Q

What murmur presents with a harsh, systolic murmur that may be associated with an ejection click?

A

Aortic valve stenosis

57
Q

Where should listen for aortic valve stenosis?

A

Mid-sternum, upper right sternal border

58
Q

What should you think of when a baby is failing to gain weight with persistent and increasingly cyanosis?

A

Tetralogy of Fallot

59
Q

What is a severe defect with failure of rotation of the great vessels, leaving the aorta to arise from the right ventricle and the pulmonary artery from the left ventricle?

A

Transposition of the Great Arteries

60
Q

Pancystolic, usually harsh, may obscure S1 and S2 if loud enough

Thrill if grade III/VI or higher

What murmur is this?

A

Ventricular Septal Defect

61
Q

Where do we hear a ventricular septal defect murmur?

A

Lower left sternal border, does not radiate

62
Q

Continuous flow from aorta to pulmonary artery throughout the cardiac cycle when ductus arteriosus – does not close after birth.

A

Patent Ductus Arteriosus (PDA)

63
Q

“Machinery-like” murmur?

A

PDA

64
Q

Left to right shunt through an opening in the atrial septum

A

Atrial septal defect

65
Q

What does the murmur of atrial septal defect sound like?

A

Widely split second sounds throughout all phases of respiration, normal intensity

Usually not heard until after age of 1 year

66
Q

The absence or diminution of femoral pulses is indicative of what?

A

Coractation of the aorta

67
Q

With coarctation of the aorta, will blood pressure be higher, equal, or lower in the legs?

A

Equal or lower

68
Q

What are some of the causes of sustained hypertension in newborns?

A

Renal artery stenosis, congenital renal malformations, and coarctation of the aorta

69
Q

Where is the best location to look for cyanosis?

A

Mucosal membranes

70
Q

How does the color of mucosal membranes differ between a healthy baby and a cyanotic baby?

A

Healthy baby — “strawberry” colored gums

Cyanotic baby – “raspberry” colored gums

71
Q

What are Brushfield’s spots?

A

Abnormal speckling spots of the iris; suggest down syndrome

72
Q

A baby with short palpebral fissures, a wide and flattened philtrum, and thin lips should make you think of?

A

Fetal Alcohol Syndrome

73
Q

Hoarse cry, umbilical hernia, dry and cold extremities, myxedema, mottled skin, and mental retardation – sxs of?

A

Congenital hypothyroidism

74
Q

Hutchinson’s teeth, bulging of frontal bones, and nasal bride depression (saddle nose) – sxs of?

A

congenital syphilis

75
Q

This abnormality presents with swelling that does not extend across a suture – swelling is initially soft, then develops a raised bony margin within a few days from the calcium deposits at the end of the periosteum; tends to resolve within several weeks.

A

Cephalohematoma

76
Q

This abnormality presents with a bulging anterior fontanelle – eyes may be deviated downward, revealing the upper scleras and creating a setting sun sign.

A

Hydrocephalus

77
Q

Bright red rash involving intertriginous folds with small “satellite lesions”

A

Candida

78
Q

What is the difference between verruca vulgaris, verruca plana, and plantar warts?

A

Verruca vulgaris – dry, rough warts on hands

Verruca plana – small, flat warts

Plantar warts – tender warts on feet

79
Q

Annular lesions with central clearing and papules along border

A

Tinea corporis

80
Q

What are the top 3 causes of morbidity and mortality in adolescents?

A
  1. Unintentional injury
  2. Suicide
  3. Homicide
81
Q

What are some things that parental consent in NOT needed for?

A

Substance abuse treatment, STI screening and treatment, pregnancy prevention and care; sometimes abortion, mental health care, emergency care

82
Q

What is the average age of onset of puberty for boys and girls?

A

10 for girls

11.5 for boys

83
Q

At what ages do growth spurts end for boys and girls?

A

14 for girls

17 for boys

84
Q

How is delayed puberty defined?

A

Absence of incomplete development of secondary sexual characteristics by an age at which 95% of children of that sex and culture have initiated sexual maturation

85
Q

What is the first sign of puberty in girls? boys?

A

girls – breast development

boys – increase testicular volume

86
Q

What is the female athlete triad?

A

Eating disorder with low caloric intake, menstrual dysfunction, low bone density

87
Q

What will Acute Lymphocytic Leukemia show on blood smear?

A

Blast cells

88
Q

What is the gold standard for evaluation of CSF in suspected meningitis or encephalitis or

A

Lumbar puncture

89
Q

How will the pressure differ between acute bacterial meningitis and acute viral meningitis?

A

Bacterial will have very high pressures and viral will either be normal or slightly elevated

Sam: Peds (5 decks)

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