CLIPP 2 Flashcards
What developmental screening tests may be used to assess development?
Parent’s evaluation of developmental status, ages and stages, Denver II developmental screening test
AAP mandates developmental screening at what months?
9, 18, 30
Specific autism screening is recommended at what ages?
18 mo and 2 yrs
What types of formula milk are available
cows milk protein, soy protein, hydrolyzed cows milk protein
How is powder prepared
2 scoops with 4 ounces of water
How is formula prepared
1 pt concentrate to 1 pt milk
When should babies be transitioned to cows milk?
Not before 12 mo
What happens if a baby is given cows milk
colitis because they can’t tolerate the protein–> microscopic bleeding and gradually worsening anemia
What are the caloric requirements of a 1-2 month old?
100-120 cal/kg/day. Daily weight gain avg is 20-30 grams. Preterm infants require 115-130 cal/kg/day
VLBW required up to 150 cal/kg/day
When does the primitive reflex palmar grasp disappear?
Persists until 2 to 3 months and consists of the infant grasping any object placed in the palm. This reflex must disappear before the infant can begin voluntary grasping of objects.
What is plantar grasp and how long does it persist?
The immediate flexion of the toes on palpation of the ball of the foot.
This reflex persists until around 8 months and must disappear before the child begins to take steps
What is fencing reflex and how long does it last?
Elicited by turning the infant’s head to one side passively.
The ipsilateral arm extends while the contralateral arm flexes at the elbow.
This allows the infant to see the hand along the arm and is one of the first steps in visual/reaching coordination.
This reflex disappears by 6 months.
How long does the Babinski response persist?
1-2 years
Developmental milestones at 2 mo
Lift head up (head up to 45), follow to midline (follow past midline), laugh (vocalize), smile,
Developmental milestones at 4 months
sit with head steady (roll over), grasp rattle (follow to 180), turn to rattling sound, regard own hand
Developmental milestone at 6 months
roll over (sit no support), reach (look for dropped yarn), work for toy (feed self), turn to rattling sound
Developmental milestones at 9 mo
stand holding on (pull to stand), pass cube (take 2 cubes, single syllables (mama-dada), feed self (wave bye-bye)
When will some infants start rice cereal with spoon?
4 mo
What is the AAP recommended daily allowance for vitamin D is what?
400 U/day
When do most babies sleep through the night?How should they sleep?
4-6 months, on back
Which vaccines are given for the 1st time at 2 mo?
DTaP, Hib, IPV, PCV 13, RotaV, HepB
Which vaccines arent given until 12 mo?
MMR and HepA
When should an infant double and triple their birth weight?
double by 5 mo, triple by 12 mo
Absence of red reflex may indicate what underlying abnormalities?
cataracts, glaucoma, retinoblastoma, chorioretinitis
At 6 mos, new foods may be added every __ days
5-7
At 6 mo, what is the expected sleep pattern?
2 naps per day, sleep at night
Should parents give tylenol at time of immunizations?
No, can lower antibody response
When an infant is drinking less than ___, you suggest an OTC multivitamin
32 ounces/day
Dietary guidelines for 9 mo old
100kcal/kg/day, can start meats,
How may hydronephrosis present?
mass 2/2 palpable kidney, UTI
What is the most common neoplasm in infancts?
Neuroblastoma, over half are diagnosed before 2
How may neuroblastoma present?
painless mass in neck chest or abdomen
Is teratoma common in infants
rare
How would teratoma present?
painless abdominal mass with symptoms 2/2 pressure effecst
How does Wilms tumor present
smooth masses that rarely cross midline, 1/2 have abdominal complaints, 3 yo on avg
What test is highly specific for neuroblastoma?
catecholamine metabolites (VMA, HVA) urine or serum
What bone marrow finding is suggestive of neuroblastoma?
small cell rosettes
What is the prognosis for neuroblastoma?
favorable in infants <1, may spontaneously regress
Describe the genetics of neuroblastoma
1% are familial (these are AD) most are non-familial
What should an infant be able to do at 18 mo?
walk backward, run, scribble, build a tower with 2 cubes, 3-6 word vocabulary, help in the house, remove garments
What should an infant be able to do at 15 mo?
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
What should a toddler be able to do at 36 mo?
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.
What should a toddler be able to do at 30 mo?
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.
What should a toddler be able to do at 1 yr?
pulling to stand, standing alone, and perhaps first steps. Fine motor skills including putting a block in a cup and banging 2 cubes held in hands. At this age a child should be able to imitate vocalizations/sounds and babble. The majority of children this age will know 1 or 2 words in addition to “mama” and “dada.” Social-emotional milestones at age one year are waving bye-bye and playing pat-a-cake
T or F Non-amplification of the n-myc gene is a favorable prognostic factor in neuroblastoma?
T
