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pediatrics > Final Material > Flashcards

Final Material Flashcards

1
Q

toddlers (1-3yrs)

A
  • -develop autonomy
  • -explore independence
  • -language development expands
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2
Q

mortality rate for toddlers (1-3)

A
  • -50/50 internal Vs external

- -most external are due to injuries

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3
Q 
word comprehension at:
9 m
12m
2yrs
4yrs
A 
9m = word comprehension
12m = babbling
2yrs = ~270 words, commands
4yrs = ~1,600 words, intelligible speech &amp; <5 word sentences
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4
Q

preschoolers (3-5yrs)

generally =

A
  • -32-40lbs & 36”-45” tall
  • -toilet trained
  • -follows simple directions
  • -cooperative play
  • -brain at 90% adult weight
  • -read one syllable words & write name
  • -gender ID
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5
Q

mortality rate in preschoolers (3-5yrs)

A

external cause 2:1
50% MVA
25% homicide
25% other injuries

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6
Q

gait & stance variations in toddlers & preschoolers

A
  • *most neonates = bowlegged (gene varus)

- -tip-toe gait = common until age 2

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7
Q

gait & stance variations in 3-4years

A
  • *most kids = knock-kneed (gene-valgus) stance that usually spontaneously resolves by age 7
  • -maybe bcuz… metatarsus adducts, internal tibial torsion, or increased femoral anteversion
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8
Q

gait & stance variations

–criteria for referral to ortho =

A

–bowing beyond age 2
–bowing that increases
–unilateral bowing
–knock-knees associated with short stature
(may consider bracing)

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9
Q

causes of toeing in

A
  • -femoral anteversion (MC)
  • -tibial torsion
  • -metatarsus varus (adductus)
  • -talipes equinovarus (clubfoot)
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10
Q

femoral anteversion

A
  • -MC in 2-3y.o.a
  • -causes excessive IR of femur
  • -usually resolves on its own
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11
Q

tibial torsion

A
  • -due to excess IR of tibia
  • -check patella position (patella face out or straight ahead)
  • -if persists beyond 16-18m tx w/ ext rot splint
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12
Q

metatarsus varus (adducteurs)

A
  • -forefoot virus give look of kidney foot.
  • -determine if flexible or rigid
  • -most resolve spontaneously but some may need casting and corrective shoes
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13
Q

talipes equinovarus (clubfoot)

A

3 features:

1) plantar flexion of foot
2) varus/inversion deformity
3) forefoot varus
- -if tx shortly after birth correction is rapid.
- -use manipulation to stretch contracted medial & posterior tissues & splinting

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14
Q

flat feet & arch development

A
  • -birth–> 3-4yrs feet = flat
  • -arch is filled w fat
  • -as lig & tendons get stronger = arch appears
  • -flexible flat feet are usually asymptomatic; younger kids often use toeing-in to compensate
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15
Q

pes planus

–check if rigid or flexible

A
  • —check normal heel cord length (full dorsiflexion/planar flexion should be achieved)
  • -check if there is normal longitudinal arch in non-weight bearing position
  • -if these are normal, it is a flexible flatfoot. = just needs development time.
    • <4 years = no tx
  • -avoid: overuse, walk & play barefoot, passive/active stretch of gastrocs to reduce stress on ligs of longitudinal arch, toe curl & arch curl exercises
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16
Q

rigid flatfoot

A
  • -may be due to tarsal colition
  • -vertical talus or other congenital problems
  • -x-ray or oath referral may be needed.
17
Q

Toddler Fx’s

A
  • -tibial stress Fx seen w/ onset of walking
  • -presents w/ painful limp, normal hip/knee/ankle/LB exams + (+) T palpation of tibia
  • -X-ray show hairline stress Fx (bone scan is better)
  • -Tx = casting, decreased weight bearing for 3-6wks, supportive shoes, decreased hardness of floor/surface.
18
Q

Iron deficiency Anemia (IDA)

A

MC nutritional deficiency in kids

  • -MC @ 6m-2yrs
  • -breast milk not high in Fe
  • -S/Sx: pallor, fatigue, irritability, anorexia, poor muscle tone
  • -Dx: CBC
  • -Tx: iron supplements W/ Vit. C to assist absorption
19
Q

subluxation of radial head

A
  • -infants & toddlers have elbow pain, cry, hold in pronated position, point tenderness
  • -MC = kid lifted by hand (x-ray will be normal)
  • -Tx: elbow in supination & move from full flexion –> ext.
  • -click may be present, may sling, RICE
20
Q

Fever

–pathophysiology

A

–oral temp >99.6
–child is acting ill
–body’s response to viral or bacterial is GOOD!!
MOST FEVERS ARE SELF-LIMITING

21
Q

Fever

–management

A

–resuure parents & kid
–look for SEARCH signs
–ID cause of fever
–home advice: fluids, less clothes
– >102 = tylenol & monitor 1-4hours
– >103 same, wait 30mins sponge bath, wait 30 mins & recheck temp.
IF DOESN’T DROP = REFER

22
Q

SEARCH signs =

A
  • -Social Stimulation
  • -Energy State
  • -Appearance
  • -Reaction to parent
  • -Cry
  • -Hydration
23
Q

Fever

–red flags for referral

A
    • > 104 & acting ill
    • > 102 for >24h
  • -any fever longer than 3days
  • -infants less than 3-6m & >100 & SEARCH signs
  • -febrile seizures
  • -child is irritable, drowsy, lethargic, acts/looks sick
  • -petchial rash, respiratory distress, or other signs of severe illness
24
Q

febrile seizures/convulsions

A
  • -caused by rising body temp; tonic-clonic contractions lasting 2-3min
  • -familial tendency, rare after age 5

pediatrics (4 decks)

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