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General Pediatrics > Gen Peds > Flashcards

Gen Peds Flashcards

1
Q

Advantages to Mother for Breastfeeding

A
  • improves weight loss
  • delayed onset of menses
  • decreased breast and ovarian cancer, heart disease and risk factors
  • cheaper

Risk for stopping BFing early

  • unmarried
  • less educated
  • lower SES
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2
Q

Advantages of Infant to Breastfeeding

A
  • decreased incidence of SIDS
  • improved cognitive development
  • decreased obesity later in life
  • decreased infectious diseases (meningitis, gastro, bacteriemia, acute OM and UTI)
  • decreased childhood malignancies - lymphoma and leukemia
  • decreased Type 1 and 2 DM
  • decreased allergic disease: atopy and asthma
  • decreased IBD
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3
Q

Breast milk casein to whey ratio?

A

40/60 = more whey is easier to digest

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4
Q

Introduction of solids for high risk infants (infant with first degree relative with an allergic condition)

A
  • some allergy guidelines favour earlier introduction of solids secondary to a theoretical window (4 - 6 months) where introduction may be protective
  • do not delay introduction of any specific foods
  • regular ingestion of newly introduced foods is important to maintain tolerance
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5
Q

When to use BMI in children

A
  • use BMI in children >/ 2 yrs

- use weight for length or percent ideal body weight < 2 yrs old

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6
Q

Definition of Obesity according to the CPS

A

Over weight:
birth - 2 yr = >97
2 - 5 yrs = >97
5 - 19 yrs = > 85th

Obesity
birth - 2 yrs = >99,9
5 - 9 yrs = > 99.9
5 - 19 yrs = >97

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7
Q

Canadian Physical Activity Recommendations

A

Preschoolers (0 - 4)
-Infants up to 1 yr = physically active several times a day

-Children over 1 yr = 180 minutes of intense activity

School aged Children ( 5 - 11) and Adolescents (12 - 17)

  • 60 minutes of moderate to vigorous activity /daily
  • vigorous activity at least 3x/wk
  • activities that strengthen muscle and bone at least 3x/wk
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8
Q

Canadian Guidelines for Sedentary Activity

A
  • children < 4 yrs - less than 1 hour at a time sitting/restrained in stroller/high chair
  • no screen time for children < 2 yrs
  • limit screen time for children 2 - 5 yr to 1 hour/day
  • limit screen time for school aged children to 2 hours/day
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9
Q

Safest place for a baby to sleep in first year of life?

A
  • in their own crib and in the parents room for the first 6 months
  • should sleep on their back on a firm surface
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10
Q

Most (70-80%) of infants sleep through the night (uninterrupted for 6 - 8 hours by) :

A

after 6 months

-most infants can sleep at least 5 hours through the night by 3 - 4 months

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11
Q

When does positional plagiocephaly peak?

A
  • 4 months

occurs when infant spends increased time in the supine position, causing the occiput or one side to become flat

  • tummy time 10 - 15 minutes 3x/day
  • helmets for severe asymmetry - may improve rate of improvement but not final outcome
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12
Q

Median Daily Crying Times

A
  • 2 week infant: 1 3/4 hours
  • 6 weeks: 2 3/4 hours
  • 12 weeks: < 1 hour

Colic

  • paroxysm of irritability, fussiness or crying that starts and stops without obvious cause
  • episodes last for at least 3 hours/day at least 3 days/week for at least 1 week
  • no FTT
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13
Q

Toilet Learning

A
  • incidence of daytime continence in toddlers is 98% by 36 months
  • 24-48 months
  • 3-6 months to attain full control
  • need to walk to the potty
  • sit with stability
  • remain dry for several hours
  • have appropriate lang skills
  • have a desire independence
  • respond to positive reinforcement
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14
Q

Primary Nocturnal Enuresis

A
  • primary if never achieved control
  • secondary if reoccurs after 6 mon of continence
  • must persist beyond 5 yrs of age, more than 2x/week
  • more common in boys
  • still 1 - 2% by 15 yrs
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15
Q

Oral Health Care

A
  • all children establish a dental home w/n 6 month of their first tooth and no later than 1 yr
  • preventative measures for ECC:
    1) promoting proper feeding practices and good diet
    2) water fluoridation
    3) increase use of topical fluorides and dental sealants
    4) Use of fluoride containing toothpaste and rinses

-strep mutans non-classic infectious disease - vertical transmission from caregiver to infant well documented

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16
Q

What does Fluoride do?

A
  • inhibits plaque by killing/inhibiting bacteria
  • inhibits demineralization by making teeth more resistant to acid
  • enhances remineralization

-risk of fluorosis which impairs biosynthesis of dental matrix causing mottling and pitting

  • > 3 yrs brus teeth 2x/day with a pea sized portion of tooth paste
  • can consider supplementation with fluoride if not added to water in children > 6 month
  • consider sealants
17
Q

How to screen vision

A

Newborn - 3 months:

  • examination of the external eye structures
  • red reflex
  • high risk infants = optho referral

6 - 12 months:

  • as above plus ocular alignment for strabismus
  • fixation and following a target

3 - 5 yrs
-as above plus visual acuity testing

6 - 18 yrs

  • screen as above as part of routine health examination
  • examine whenever complaint occurs
18
Q 
Define:
normal hearing
profound hearing loss
Sensorineural Hearing loss
Conductive Hearing loss
A

Normal hearing:
-0 -20 dB

Profound hearing loss:
> 80 dB

Sensorineural:

  • most common form of neonatal hearing loss with a known genetic cause in 50%
  • cochlear hair cell dysfunction, congenital infections, hyperbili, ototoxic meds

Conductive

  • occurs when there is a problem conductive sound waves
  • can occur in the outer ear, tympanic membranes or ossicles
19
Q

What are the two types of hearing screening

A

Otoacoustic Emission (OAE)

  • energy measured as sound which is generated by the outer hair cells of the human cochlea in response to auditory input
  • probes in the baby’s ear canal - send sound stimulus and then simultaneously records emission returning from the outer hair cell of the cochlea via the middle ear
  • OAEs can be recorded in 99% of normally hearing ears
  • if there is a loss of >/30 dB - response is absent

Automated Auditory Brainstem Response

  • records brainstem electrical activity in response to sounds present via earphones
  • evaluates the auditory pathway from the external ear to the level of the brainstem

Do OAE first then if it fails, do AABR

General Pediatrics (19 decks)

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