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CPNP EXAM PREP > Development > Flashcards

Development Flashcards

1
Q

Initial weight loss

A

8-10% regained by days 7-14

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2
Q

Weight doubles in newborn by

A

5-6 months

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3
Q

Weight triples in newborn by

A

1 year

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4
Q

Weight quadruples by

A

2 years

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5
Q

Weight gain per month during months 6-12

A

12-20 oz

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6
Q

Weight gain per month during first 6 months

A

5-7 oz (150-210g)

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7
Q

Length increase in 1 year

A

50%

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8
Q

Length doubles by

A

4 years

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9
Q

Posterior Fontanel closes by

A

6-8 weeks/2-3 month

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10
Q

Anterior fontanel

A

Closes 12-18 months

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11
Q

Primary teeth

A

Central incisor
Lateral
Canine (bicuspid)
First and second molar

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12
Q

Social smile

A

Begins 6 weeks

Developed at 2 month

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13
Q

Stranger anxiety

A

6-7 start. ——12 months

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14
Q

Separation anxiety

A

8-18 months

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15
Q

Survival reflexes

A

Breathing
Hiccups
Sneeze
Suck and swallowing

(B) temperature
Cry
Shiver
Tuck in legs

(C) feeding
Sucking
Rooting
Crying

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16
Q

Non survival reflexes

A 
Babinski
Stepping 
Swimming 
Moro
Startle
Grasping
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17
Q

Newborn vision

A

Blink and pupil constriction

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18
Q

Night terror

A

Partial arousal deep non rem sleep
Minimum recollection

~2-4 years

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19
Q

Nightmare

A

Remembers

Starts ~3 years

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20
Q

Gender identification

A

2 years

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21
Q

Gender preferences

A

3-4 years

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22
Q

Gender notions

A

5-6 years show notions about how genders should act, dress behave

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23
Q

School age weight gain

A

5-7 lbs

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24
Q

School age height

A

2 inches per year

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25
Q

Thimerosal

A

Thimerosal is added to vials of vaccine that contain more than one dose (multi-dose vials) to prevent growth of germs, like bacteria and fungi.

No connection to autism

Thimerosal is a mercury-based preservative that has been used for decades in the United States in multi-dose vials (vials containing more than one dose) of medicines and vaccines. There is no evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site. However, in July 1999, the Public Health Service agencies, the American Academy of Pediatrics, and vaccine manufacturers agreed that thimerosal should be reduced or eliminated in vaccines as a precautionary measure.

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26
Q

Atlantooccipital instability

AAI

A

Common in down syndrome and other genetic disorders

Sports that should not be done our diving, contact sports, weightlifting, equestrian

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27
Q

Should an adolescent take salt tablets during physical activity

A

Do not take salt tablets = hypernatremia/delayed gastric emptying

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28
Q

Should adolescence take protein supplements

A

Protein supplements should not be taken for the risk of hypercalcemia , Dehydration if too much protein

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29
Q

Post physical activity and adolescent shit and just how much protein with carbs

A

Ingest 10-20 g Protein with carbs (1.0 to 1.5 g /kg)

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30
Q

What type of liquid intake should an adolescent take during physical activity

A

Plain water before, during, and after activity less than one hour

> 1 hour = sodium/CHOS (sports drink) but no direct evidence

Avoid caffeine/carbonated/energy drinks!!!!!

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31
Q

Should children participants boxing ?

A

The AAP opposes boxing

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32
Q

What heart problem is strictly contra indicated for a child to participate in physical activity on a sports form

A

Carditis = sudden death needs further evaluation

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33
Q

Other heart problems that need further evaluation for physical activity clearance

A

congenital heart , heart murmur, Dysrhythmia, HTN, mitral valve prolapse wolf Parkinson’s white syndrome , Kawasaki’s , Marfan

Anything congenital with surgery need further clearance

Consult cardiologist

Stricter heart disease, rheumatic fever, cardiomyopathy, coronary artery disease

Fever / diarrhea wait till illness subsides

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34
Q

Precocious puberty

A

Before 8 years female

Before 9 in males

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35
Q

Puberty onset females

A

9-10 years

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36
Q

Puberty on set in males

A

11-12 years

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37
Q

Delayed puberty

A

Female- after 13 years

Male- after 14 years

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38
Q

First physical sign of female puberty

A

Breast buds

Then pubic hair

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39
Q

First physical sign of male puberty

A

Testicular growth

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40
Q

Menarche start

A

12 years

Before 9.5 = precocious

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41
Q

11-year old boy is developing sexual characteristics, can you cancel the family based on the knowledge that puberty is considered precocious and boys if secondary sexual characteristics appear prior to age____.

A

9 years In boys

age 8 in girls (breast) / pubic hair before (9) and mended before (9.5)

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42
Q

Spermarche

A

13-14 years

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43
Q

How long does it take to go from Tanner stage 2 to 5 MAles

A

4 years

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44
Q

Tanner stage 2 male

A

Enlargement of scrotum and testes; scrotum Redddens & roughens

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45
Q

Tanner stage 3 Males

A

Penis enlarges primarily in length

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46
Q

Tanner stage 5 male

A

Adult size and shape

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47
Q

Stage 1 breast development

A

Pre-adolescent breast with nipple elevation

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48
Q

Stage 2 breast development

A

Breast budding with areolar enlargement

Breast enlargement before pubic hair

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49
Q

Stage 3 breast development

A

Breast enlargement without separate contour with nipple

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50
Q

Stage 4 breast development

A

Projection of areola and nipple as a secondary mound to breast

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51
Q

Stage 5 breast development

A

Adult breast with areola receding and nipple projecting from the breast

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52
Q

Pubic hair development and males and females

A

stage 1: pre-adolescent without pubic hair
Stage 2: sparse, pale, fine pubic hair
Stage 3: darker, curled, increased amount
Stage 4 : hair is adult but does not cover entire area
Stage 5: adult

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53
Q

Stuttering

A

Speech dysfluency with initial onset during preschool years

Males >females

Spontaneously revolves without intervention

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54
Q

Stuttering management

A

Encourage parents to avoid excessive attention to stuttering

Refer to speech and language it’s causing problems with communication

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55
Q

Obesity

A

Body mass index greater than 95th percentile

Percentage of ideal body weight greater than or equal to 120%

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56
Q

Acts of commission

A

Abuse

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57
Q

Acts of omission

A

Neglect

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58
Q

At what age does the does a child understand the concept of cheating

A

Seven years old

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59
Q

Head circumference that is 2 to 3 standard deviation‘s below the mean for Age, sex and gestation

A

Microcephaly

Genetics
Secondary cause : affected fetus in utero
TORCH ,HIV , STD, Malaria, varicella zoster, cytomegalovirus, fetal exposure to toxic substances including alcohol or medication, prenatal hypoxia trauma, poor nutrition during the first six months

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60
Q

Head circumference greater than 2 to 3 standard deviations from the mean for age, sex and gestation

A

Macrocephaly

Causes can be hydrocephalus (increased cerebrospinal fluid) , intracranial neoplasms, enlargement of the school, increase spring size, benign family trait

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61
Q

Management of macrocephaly

A

CT, MRI, or ultrasound of head, surgical shunt placement with hydrocephalus or tumor resection, genetic counseling

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62
Q

Increase production impaired absorption or obstruction in flow through spinal fluid leading to increased CSF and cerebral ventricles

A

Hydrocephalus

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63
Q

Child it has apparent large head, sluggish, feeding, vomiting, piercing cry, irritability

Older children have personality changes, confusion, decline academic performance

A

Hydrocephalus

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64
Q

Hydrocephalus diagnosis/ mangement

A

May have physical findings of bulging anterior fontanelle, setting sun sign, separated school sutures, slow PERRL, hypertonia, Spastic
Children present with strabismus, ataxia, optic atrophy

CT scan/ultrasound

Managed with shunts , to of neoplasm

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65
Q

Diffuse swelling of soft tissue that cross the suture line

A

Caput
“Everything is caput “

Due to compression of trauma the scalp during dissent of the baby through the birth canal may have bruising

Disappears within the first few days of life

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66
Q

Collection of blood found by the suture lines usually surrounding the parietal bones

A

Cephalohematoma

Occur secondary from difficult delivery and trauma OK forceps used, I’m normal presentation, possible cranial hemorrhage

Presents hours to days after delivery
More commonly unilateral

Management requires observance for hyperbili
Due to the prolonged absorption of the large hematoma typically will resolve on its own over a few weeks to months

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67
Q

Premature closure of one or more of the cranial sutures causing a skull deformity

A

Craniosynostosis

Normally suture line will remain open to three years of age

Cause unknown

Plain skull X-ray
Surgery to open fused line

68
Q

When should you refer a child that stuttering

A

> than 6 months, stops talking, for greater than 6 years

69
Q

BMI in 85th to 95th %

A

Overweight

70
Q

BMI > 95%

A

Obesity

71
Q

A young girl just has her menses her parents want to know if she will grow any more how much for a girls height increase?

A

1 to 3 inches post menarche

72
Q

How many kg/kcal/day should a child have from birth to 6 months

A

120 kg/kcal/day

73
Q

How many kg/kcal/day for a child 7 months - 1year

A

100 kg/kcal/day

74
Q

How many kg/kcal/day for child 2-10years?

A

70-100 kg/kcal/day

75
Q

How many kg/kcal/day for child adolescent ?

A

45 kg/kcal/day

76
Q

When can a child start eating solid foods

A

6 months

77
Q

Why is vitamin D recommended in all infants especially breast-fed infants?

A

Because they’re not recommended to get much sunlight causing deficiency = rickets

78
Q

When should you recommend vitamin D supplementation and how much?

A

2 months to adolescence at 400 IU

79
Q

Who should you recommend iron for , what age and how much?

A

Breast-fed infants because it’s not available in human milk at 6 months
1mg/kg/day

80
Q

Who needs fluoride supplementation

A

Those who have low fluoride in water supply
Varnish Q6 months
@1st tooth -5 years

81
Q

How often should I pediatrician check a child’s weight

A

Each visit until two years of age and then annually

82
Q

What is the recommended amount of whole milk per day

A

16 to 20 ounces

83
Q

What should a child drink whole milk?

A

1 years of age, 2% skim at 2years

84
Q

First primary teeth come in at what age

A

6m-2 years

85
Q

First permanent teeth come in at what age?

A

6 years-12 years

86
Q

Order of teeth coming in

A

Come little children munch meat

Central, lateral, cuspids/bicuspids, first molar, second molar

87
Q

Car seats safety

A

Rear facing till 2years

5 point harness

88
Q

Apgar stands for what

A

Appearance, pulse, grimace, activity, respirations

89
Q

Apgar scoring

A

5 areas = 10 points = 3PTS/piece

Appearance, pulse, grimace, activity, respirations

90
Q

Trust versus mistrust

A

Birth to one year
Erickson psych development
Erickson=viking

91
Q

Autonomy versus shame and doubt

A

1-3 years

Erickson psych development
Erickson=viking

92
Q

Initiative versus guilt

A

3-6 years

Erickson psych development
Erickson=viking

93
Q

Industry versus inferiority

A

6-12 years

Erickson psych development
Erickson=viking

94
Q

Identity versus role confusion

A

12-18 years

Erickson psych development
Erickson=viking

95
Q

Jean Piaget cognitive theorist

A

Senisormotor birth-2 years. REFLEX
Preoperational/pre-concept 2-4 years; Fantasy
Intuitive /pre operational 4-7 years ; Causation
Concrete 7-11 years; Memory
Formal operational 11-15 years ; Logical complex

96
Q

ID

A

Freud psych sexual the principle of pleasure

97
Q

Ego

A

Freud psych sexual the principle of reality

98
Q

Super ego

A

Freud Psychosexual the principle of morality

99
Q

Septic work up a fever of unknown origin until what age

A

3 month

100
Q

Dosage for Tylenol

A

15 mg/kg a 4-6

101
Q

Dosage for Motrin

A

DONT GIVE < 6 months

10 mg/kg Q6-8 hours

102
Q

Let’s screens are performed at _____.

A

12 months and 24 months and in high risk

103
Q

At what lead level is chelation therapy recommended?

A

45

104
Q

At what age is blood pressure screening started?

A

3 years

105
Q

At what age is anemia screening

A

HGb 4m , High risk or early cows milk

Hct 2 years

106
Q

At what age does the AAP recommend screen time

A

No screen time until 18 months of age and no more than 2 hours /day

107
Q

Normal newborn vital signs

A

120 to 170 heart rate
30 to 80 respirations
<112/74 blood pressure

108
Q

What is gynecomastia and when does it resolve?

A

Enlarged breast tissue in MAles resolves 12 to 18 months

109
Q

Breast development starts at what age

A

9 to 10 years

97% by 12 years of age

110
Q

Developmental milestones 2 month old

A

MOTOR
2 months=2 ways 180 degrees turn head
Pulls up prone = tummy time

SOCIAL
Social smile/coo

111
Q

Developmental milestones for a 4 month old

A

MOTOR
Good head control, roll over, grasp shake rattle

SOCIAL
Imitate
Laugh

Four month old sitting on his parents lap , rolling over laughing shaking that rattle

112
Q

Developmental milestones for a 6 month old

A

MOTOR
Passes objects one hand to other
Reach out grab object - raking grasp
Sit

COG
Turn to voice

LANG
Babbles ma ma ma , daDA
STRANGER ANXIETY

113
Q

Developmental milestones for a 9 month old

A

MOTOR

7-9 mFinger grasp
8-10m pincer grasp

COG
Object permanence play peekaboo

LANG
Bye mama dada

114
Q

Developmental milestones for 1 year old

A

MOTOR
Points with one finger
Walking at one year
Can mark on paper

SOCIAL
“NO”
1 more word than mama and dada
COG

LANG

No
One more word than mama and dada

115
Q

Developmental milestones for a 15-month-old

A

MOTOR
Drink from cup
Walk on own

SOCIAL
3-6 words

COG
Follows single command

LANG

116
Q

Developmental milestones for an 18-month-old

A 
MOTOR
Stacks 3 blocks
Start step walking 
Use utensils 
Hand dominance

SOCIAL

COG
Scribble
Point to body part
1 step command

LANG

117
Q

Development milestones for a 22 to 24 month old

A 
MOTOR
Walks up stairs 
6 cubes (2x3= 6 every year 3 more cubes) 
Kick a ball
Jump

SOCIAL

Pretend play

LANG

30-50 words (1/2 @ 2 years)
50% what they say is intelligible

118
Q

Development milestones for a 3-year-old( 36 months)

A

MOTOR
9 cubes
Tricycle ‘copy circle

SOCIAL
Good/bad concepts

COG
Imitate vertical line
Knows a friends name

LANG
75% intelligible

119
Q

Developmental milestones for a 4-year-old

A

MOTOR
Draw 4 part person

SOCIAL
Pretend play advanced

COG
Knows 4 colors
Dress self

LANG
100 % speech intelligible

120
Q

Developmental milestones for a 5 year old

A

MOTOR
Skip alternate feet
Walk backwards —-away from kindergarten

SOCIAL
Role play a story

COG
Count 5 bocks
Knows colors

LANG
Define words

121
Q

Developmental milestones for a 6 year old

A

MOTOR
Rides a bike
Tie shoes

SOCIAL

COG

Knows right to left
Can counting 10 objects

LANG

122
Q

Peak incidence of sudden infant death syndromes _____ . Uncommon before ___(age) and after ____ (age).

A

2 to 4 months; uncommon before 2 weeks/after 6 months

123
Q

Developmental delay diagnostic tool questionnaire for ages 4 months- 5 years

A

Ages and stages

124
Q

The Denver to screening for risk for developmental delay it’s from ages ___ to ___.

A

Birth to 6 years

125
Q

The M chat screens for what?

A

16 months to 30 months for autism spectrum disorder

126
Q

Dubowitz Ballard estimates what?

A

Gestational age of a newborn

127
Q 
Elasticity of Cartlidge in ears
Plantar creases over sole of feet (AA) 
Thickness and size of breast tissue
Hypertonic flexion of knees
Eyes fused or open
A

Dubowitz Ballard

128
Q

Primitive reflexes

A

Rooting, sucking, Moro, grasp (Palmer; plantar), placing/stepping, tonic neck, Babinski

129
Q

Primitive reflexes that disappear by 3 to 4 months

A

Rooting, sucking, moral, grasp, tonic Neck

130
Q

Primitive reflex that disappears first?

A

Placing/stepping

Disappears at 1 to 2 months

131
Q

Primitive reflex that disappears at 12 months

A

Babinski

After this is concern for Neuro

132
Q

What age should you be using household items

A

15 to 18 months “sipper cup”

133
Q

Hand dominance is established by

A

18 months

134
Q

Mandatory screening of specific metabolic disorders in all states:

A

PKU, hemoglobinopathoes, congenital hypothyroidism, galactosemia

135
Q

First tooth eruption

A

6 month; Central around 8 to 12 months

136
Q

Primary tooth eruption sequence complete at___years.

A

Three years

137
Q

Papapular granular enlargement of male breast a crane and healthy adolescent

A

Gynocomastia

138
Q

Influence of too little androgens or too much estrogen a mammory tissue affects 40 to 66% of males

A

Pubertal gynecomastia

139
Q

Pubertal gynecomastia on sets at what age____?peak is at ____(years). And resolves by____.

A

10 to 12 years Onset; peaks at 13 to 14 years; resolved by 16 to 17 years

140
Q

When will neonatal gynecomastia resolve

A

Results in 2 to 3 weeks;

usually bilateral asymmetric as a result of crossing the placenta maternal hormones

141
Q

How do you differentiate pathological versus pubertal gynecomastia

A

Pubertal gynecomastia has a movable, disc shaped below the areola, can be tender, 3 cm diameter

Pathological: delayed sexual maturation, asymmetric/hard/fixed breast tissue, signs of chronic disease

142
Q

Primary Amenorrhea is the failure to onset menses in females ____ years with normal pubertal growth.

Or ____years with absence of normal pubertal growth.

Or girls who have not started menses _____years S/P sexual maturity.

A

16 years

14 years

Or 2 years after sexual maturity

143
Q

Primary Causes of amenorrhea

A

Familiar, obstruction of flow, ovarian tumor, androgen excess, estrogen deficiency (ovarian failure)

144
Q

Absence of menses >3 cycles or at least six months after mensuration has started

A

Secondary amenorrhea

145
Q

Causes a secondary amenorrhea

A

Pregnancy, medication, significant stress, hysterectomy, uterine dysfunction after abortion/infection/C-section, hypothalamus/pituitary/adrenal disorder

146
Q

Diagnosis and treatment for amenorrhea

A

Pregnancy test/treat underlying cause

147
Q

Treatment of Central precocious puberty

A

Gonadotropin releasing hormone

148
Q

Thelarche

A

Breast development

149
Q

Pubarche

A

Pubic hair development

150
Q

Lack of secondary sexual characteristics in males

A

Hypogonadism—-abnormal testicular maturation after 17 years

151
Q

Breast development occurs at what age

A

8 to 10.4 years (Caucasian); 6.6 to 9.5 (black)

152
Q

A mother of a 14-year-old girl indicates she is concerned because the girl has not yet started to Menstrate. The PE/ history is normal. Breast development and pubic hair have been present for 12 months. The most appropriate initial step would be to:

Do a pregnancy test
Reassure, educate the family, and follow up
Draw LH and FSH levels
Obtain a buccal smear for chromosomal analysis

A

Reassure educate the family and follow up

Breast buds are the first sign of puberty and girls, 1.5 -3 years after thelarche to menses

Pregnancy test would be indicated for secondary amenorrhea

153
Q

11 month old African-American boy has just started walking and is found to have severely bowed legs. In the history learned that he is exclusively breast-fed with very little other food intake. You must consider:

Trauma
Developmental variation
Chromosomal abnormality
Rickets

A

Rickets are often connected to nutrition by 11 months of age babies need a variety of foods, breastmilk is lower in vitamin D

Children with trauma may present with a past history of falls or accidents. Developmental variations like physiologic genu verum, common in children younger than 18 months and usually resolved by three years
Chromosomal abnormality‘s can affect bone in tooth development but would also present with other abnormal

154
Q

Parent completed child monitoring system for children 4 to 48 months

A

Ages and stages

155
Q

Screens in personal social, fine motor adaptive, language, and gross motor domains and children’s birth to six years

A

Denver 2

156
Q

Repetition or prong prolongation of sound syllables or short words
Pauses
Signs of physical tension and struggling with speech
Avoidance of words that are hard

What does this describe?

A

S/s stuttering

157
Q

Solids start

A

6 months

Cereal, veggies, fruit, meat

158
Q

Temp > what C is fever

A

> 38 C

159
Q

Ballard and dubowitz tests what

A

Gestational age

Elasticity of cartilage in ears, eyes fused, hypertonic flexion, plantar creases over sole, flat areola = preterm

160
Q

When do you refer for stuttering?

A

> 6 months stuttering
Stops speaking altogether
6 years at onset

Usually resolves on own

161
Q

Tests if hip is easily subluxable and can be dislocated from acetabulum

A

Barlow

Bring leg inward push down

162
Q

Both feet held together one leg at a time examiner abducts (leg outward) and brings up and inward

A

Ortalani maneuver — hip is outside acetabulum and CLICk is felt putting back into place

163
Q

Newborn blood sugar

A

<40= infection, IDM, LGA

> 80= stress

164
Q

When do you screen for depression

A

11 to 21 years

165
Q

When do you screen for autism

A

18 and 30 months

166
Q

When do you screen for anemia HGB/HCT

A

9 to 12 months and 1 to 5 years for at risk children

CPNP EXAM PREP (17 decks)

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