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Pediatric Questions > GENERAL PEDIATRICS > Flashcards

GENERAL PEDIATRICS Flashcards

1
Q

Which growth charts should be used for children between 0 and 2 years?

A

World Health Organization (WHO) chart

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2
Q

Which growth charts should be used for children
> 2 years?

A

CDC growth charts

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3
Q

Birth weight of newborn usually regained at what
age?

A

10–14 days

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4
Q

Birth weight doubles at what age?

A

5–6 months

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5
Q

Birth weight triples at what age?

A

1 year

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6
Q

Normal weight gain after 2 years of age per year

A

2–3 kg/year approximately

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7
Q

Body mass index (BMI) should be used starting at
what age?

A

2 years

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8
Q

How is BMI calculated?

A

Weight (kg)/[height (m)]2

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9
Q

What is the most common cause of failure to
thrive?

A

Inadequate caloric intake

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10
Q

How much is birth length increased by 1 year of
age?

A

50%

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11
Q

Birth length doubles at what age?

A

3–4 years

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12
Q

What is the average growth length (growth
velocity) per year after 2 years of age (later
childhood)?

A

5 cm/year approximately

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13
Q

What is the approximate range of pubertal peak
growth velocities in boys and girls?

A

7–12 cm/year in boys
6–10.5 cm/year in girls

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14
Q

How much does the head circumference increase
per month in the 1st year?

A

1 cm/month

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15
Q

When does the head grow the fastest?

A

First 60 days of life (0.5 cm/week)

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16
Q

Head circumference should be measured routinely
in each well visit until what age?

A

2 years

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17
Q

What is the risk for a premature infant with an
enlarged head circumference?

A

Hydrocephalus

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18
Q

What is the study of choice for an infant who
presents with macrocephaly?

A

Head ultrasound (US)

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19
Q

What is the study of choice for an infant who
presents with absolute microcephaly?

A

Brain MRI

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20
Q

Child with enlarged head > 98th percentile, similar to the father, no symptoms and normal cognitive function, head imaging study showed prominent subarachnoid space especially in the frontal region

A

Benign familial macrocephaly

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21
Q

Anterior displacement of the occiput on one side and the frontal region on the ipsilateral side and the ear is more anterior on the side of occipital flattening (parallelogram)

A

Positional plagiocephaly

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22
Q

Anterior displacement of the occiput on one side and frontal bossing on the contralateral side and the ear is displaced more posteriorly (trapezoid)

A

Posterior plagiocephaly (craniosynostosis)

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23
Q

The most common type of craniosynostosis

A

Long narrow head (scaphocephaly), which is an early closure of the sagittal sutures

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24
Q

A 6-month-old with progressive head enlargement and crossing percentiles from 25th percentile at 2 months to 98th percentile at 6 months well visits.
The head is elongated in the anterior–posterior diameter and shortened in the biparietal diameter. Ridging of the sagittal suture is palpable

A

Scaphocephaly (craniosynostosis)

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25
Q

What is the next best step in a child with suspected craniosynostosis?

A

Refer to a pediatric neurosurgeon (imaging
studies are not required to make the diagnosis in typical cases)

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26
Q

What is the only vaccine that can be given at birth?

A

Hepatitis B

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27
Q

Infant born to HBsAg positive mom what should be given?

A

Hepatitis B and HepB immunoglobulin in the
first 12 h

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28
Q

What is the maximum age you can give DTaP?

A

DTaP is only for children younger than 7 years old

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29
Q

Encephalopathy within 7 days of administration is an absolute contraindication in which vaccine?

A

DTaP

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30
Q

When can Tdap or Td be given?

A

7 years and older

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31
Q

Rotavirus, measles, mumps, rubella (MMR), oral poliovirus vaccine (OPV), and varicella are

A

Live attenuated virus vaccines

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32
Q

How are MMR, varicella, and inactivated polio (IPV) given?

A

Subcutaneously (IPV can be given either IM or SC)

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33
Q

Can you give MMR vaccine and perform a purified protein derivative (PPD) test at the same time?

A

Yes

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34
Q

If you give only MMR vaccine, how long should you wait to do PPD test?

A

4–6 weeks

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35
Q

Which vaccines are contraindicated to be given to immunocompromised children?

A

Live vaccines, e.g., MMR, varicella, and
rotavirus

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36
Q

Anaphylaxis reaction to neomycin or gelatin is an absolute contraindication to which vaccine?

A

MMR

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37
Q

The child who received MMR vaccine 2 weeks ago is now having pain in the hip joints. Which component of the vaccine is responsible for this reaction?

A

Rubella

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38
Q

When does Haemophilus influenzae type b
vaccination not need to be given to healthy
children?

A

5 years or older

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39
Q

When does pneumococcal (PCV13) vaccination not need to be given to healthy children?

A

5 years or older

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39
Q

For which conditions can you give Haemophilus influenzae type b vaccination at 5 years of age or older?

A

One dose for unimmunized persons with
functional or anatomical asplenia and HIV
infection. 3 doses after hematopoietic stem cell transplant (HSCT) regardless of the history of HIB immunization

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40
Q

Which pneumococcal vaccines should be given to high-risk children 2 years and older, e.g., HIV, sickle cell disease, asplenia, cochlear implant?

A

PCV13, and PPSV23 (PPSV23 is given at least
8 weeks after any prior PCV13)

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41
Q

An 11-year-old female is here for HPV
vaccination; how many doses are recommended?

A

2 doses 6–12 months apart

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42
Q

A 15-year-old female is here for HPV vaccination; how many doses are recommended?

A

3 doses 0, 1–2 months, and 6 months are
recommended

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43
Q

Children younger than 9 years of age, never been vaccinated for influenza before; how many doses should they receive during the first instance of influenza vaccination?

A

2 doses 1 month apart

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44
Q

Child has a severe egg allergy (anaphylaxis). Can he or she receive the MMR vaccine?

A

Yes

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45
Q

Child is allergic to eggs (only hives). Can he or she receive the influenza vaccine today?

A

Yes

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45
Q

Child has a severe egg allergy (anaphylaxis). Can he or she receive the influenza vaccine?

A

Yes. Under the supervision of a health care
provider who can recognize and manage severe allergic conditions

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46
Q

Child with a previous severe allergic reaction
(anaphylaxis) to the flu vaccine. Can he or she receive the influenza vaccine?

A

No

47
Q

A 4-year-old boy has 104 °F fever and ear
infection; can he be vaccinated today?

A

Yes

48
Q

An unimmunized 4-month-old child came for catch-up vaccination. Can he or she receive the rotavirus vaccine?

A

No

49
Q

A 9-month-old boy came for catch-up vaccination, and he had only one dose of rotavirus vaccine at 2 months well visit. Can he receive the rotavirus vaccine?

A

No

50
Q

If a household member is immunocompromised, e.g., HIV, leukemia, or severe combined immunodeficiency (SCID), can you give the 4-month-old who is living in the same house oral poliovirus vaccine (OPV)

A

No

51
Q

A 2-month-old child with complement component deficiency. What are the vaccines that should be given at the 2-months well visit?

A

Routine 2 months vaccines plus meningococcal vaccine

52
Q

A mother declined vaccination of her child. What is the next best step?

A

Explore any misconceptions about the safety and efficacy of vaccines

53
Q

Visual acuity for a newborn is

A

20/400

54
Q

At what age is a social smile seen?

A

1–2 months

55
Q

An infant is able to track an object to 180°

A

2 months

56
Q

Moro reflex disappears by what age?

A

3–6 months

57
Q

An infant is able to roll from front to back and has no head lag

A

4 months

58
Q

An infant is able to roll from back to front,
supports weight with legs and bounces, able to transfer objects from hand to hand, knows familiar faces, knows own name, and begins to have separation anxiety

A

6 months

59
Q

An infant should be able to sit without support

A

7 months

60
Q

An infant pulls to stand, says “mama/dada”
nonspecifically, and imitates sounds

A

9 months

61
Q

An infant is able to stand and take steps, says “mama/dada” specifically, has a mature pincer grasp

A

12 months

62
Q

Child is able to say 3–5 words, turns pages of a book, builds a tower of 3 blocks

A

15 months

63
Q

Child is able to say 10–25 words, throws a ball overhand, builds 4 blocks towers, uses a spoon, and knows 3 body parts

A

18 months

64
Q

At what age are most toddlers able to use a cup well?

A

15–18 months

65
Q

Child says 50 words, 2-word sentences, throws overhand, goes upstairs both feet on each step, engages in parallel play

A

24 months

66
Q

Child copies a circle, three-word sentences,
alternates feet on stairs, knows 2 colors, 75% intelligible speech

A

36 months (3 years)

67
Q

Child copies a square, 5-word sentences, identifies gender, knows 5 colors, 100% intelligible speech

A

48 months (4 years)

68
Q

Child copies a triangle, uses scissors, and can count to ten

A

60 months (5 years)

69
Q

At what age are most children able to copy a
diamond?

A

6–7 years

70
Q

Inability to hold the head steady is a red flag for abnormal motor development at what age?

A

4 months

71
Q

Inability to sit alone and lack of rolling are a red flag for abnormal motor development at what age?

A

9 months

72
Q

Inability to walk independently is a red flag for abnormal motor development at what age?

A

18 months

73
Q

A 1-year-old boy is unable to stand or crawl,
unable to point and is not speaking a single word

A

Motor, cognitive, and language delay

74
Q

An 18-month-old with only 3 words, lack of joint attention, not sharing the interest in an object

A

Screen for autism spectrum disorder and
developmental delay with 2 separate tools, e.g., M-CHAT and ASQ

75
Q

A 2-year-old uses only 5 words. What is the best test to order?

A

Hearing test

76
Q

The American Academy of Pediatrics (AAP)
recommends that universal hearing screening of all infants occur by what age?

A

All infants with significant congenital hearing
loss should be identified by 3 months of age, and necessary intervention initiated by 6 months of age

77
Q

AAP recommends universal screening for anemia with determination of Hb concentration at what age?

A

1 year of age

78
Q

AAP recommends lead screening at what age?

A

All Medicaid-eligible children and those whose families receive any governmental assistance must be screened at ages 1 and 2 years

79
Q

What is the non-hematologic consequence of iron deficiency anemia?

A

Neurocognitive changes

80
Q

AAP recommends autism screening at what age?

A

18 months and 24 months

81
Q

AAP recommends discussing tobacco, alcohol, or drug use with children at what age?

A

11 years

82
Q

The US Preventive Services Task Force (USPSTF) recommended age to begin screening all adolescents for HIV

A

Once between 15 and 18 years (younger if
increased risk, e.g., male-to-male sexual contact)

83
Q

Screening for depression should be done annually starting at what age?

A

Starting at 12 years

84
Q

Screening for dyslipidemia should be done at what ages?

A

Between 9 and 11 years and again between 17 and 21 years, or if there are risk factors (obesity, diabetes, etc.)

85
Q

A 7-year-old boy has a parent with total cholesterol of 300 mg/dL. What is the next best step?

A

Order fasting lipid profile, then repeat after
2 weeks to 3 months

86
Q

Infant is exclusively breastfed. At what age should you recommend daily vitamin D supplementation (400 IU)?

A

First few days of life

87
Q

Infant is feeding more than 1 liter of formula per day in addition to breastfeeding; does he or she need vitamin D supplementation?

A

No (1 liter of formula has 406 IU of vitaminD)

88
Q

Infant is exclusively breastfed. At what age should you recommend daily iron (1 mg/kg/day)?

A

4 months

89
Q

At what age should you recommend starting solid foods in infants?

A

4–6 months

90
Q

What is the reason for starting solid foods between 4 and 6 months of age?

A

May decrease the risk of allergy to that specific food

91
Q

A 4-week-old infant has been exclusively
breastfeeding, and the mother is scheduled for MRI with contrast

A

Continue breastfeeding

92
Q

A 4-week-old infant has been exclusively
breastfeeding, and the mother has mastitis

A

Continue breastfeeding (can continue on the
other side if breast abscess or cellulitis with
direct contact with infant’s mouth)

93
Q

A 4-week-old infant has been exclusively
breastfeeding, and the mother recently diagnosed with active tuberculosis. No treatment yet

A

Discontinue breastfeeding until effective
maternal treatment for the initial 2 weeks or the infant is receiving isoniazid)

94
Q

Newborn with a mother who is HIV positive

A

Breastfeeding is contraindicated (except in
resource-limited settings)

95
Q

What is the age when infants can drink cow’s
milk?

A

12 months

96
Q

At what age can a child be given low-fat milk?

A

> 2 years

96
Q

AAP recommends the initial visit to the dentist at what age?

A

12 months of age

97
Q

What usually are the first teeth to erupt?

A

Lower anterior incisors

98
Q

What is the latest age for first tooth eruption?

A

18 months (after that, dental consult)

98
Q

A 5-year-old boy hit his head and knocked out his 2 primary central incisors 5 min ago. What is the next best step?

A

Reassurance (re-implantation of the primary
tooth may damage the developing permanent
tooth)

99
Q

Child with white lines and spots at the bases of several teeth

A

Referral to a dentist (sign of dental caries)

100
Q

A 10-year-old boy hit his head and knocked out his 2 permanent central incisors 5 min ago. What is the next best step?

A

Re-implant the teeth immediately (best
prognosis if avulsed tooth re-implanted within 15–30 min)

101
Q

If a tooth has been knocked out, it should be placed back into its socket until the child can see the dentist, should that prove impossible, what is the best solution in which to keep it?

A

Cold milk

102
Q

When should the knocked-out tooth be implanted?

A

Immediate treatment is essential

103
Q

At what temperature should you set the water heater at home?

A

120 °F or less

104
Q

What is the safe blood lead level (BLL)?

A

There is no safe BLL, and any detectable lead level must be managed

105
Q

Child with a capillary lead level of > 5 μg/
dL. What is the next best step?

A

Obtain venous sample

106
Q

Children should be secured with a rear-facing seat?

A

Birth to 2–4 years, as long as possible, or until they reach the highest weight or height allowed

107
Q

Children who have outgrown their rear-facing seat should use?

A

Forward-facing car seat until they reach the
highest weight or height allowed or at least
5 years of age

108
Q

Children who have outgrown their forward seating and are less than 57 in. (4 ft 9 in.) tall should use?

A

Booster seat

109
Q

Children who have outgrown their booster (57 in., or 4 ft 9 in. tall) seat should use?

A

Seatbelt; if the seat belts fit properly when the lap belt lays across the upper thighs (not the stomach), and the shoulder belt lays across the chest (not the neck)

110
Q

What is the recommended preventative measure to help prevent drowning?

A

Enclosing the pool with a 4-ft fence

111
Q

What is the recommended measure to prevent accidental gun injuries?

A

Gun and bullets stored in locked and separate locations

112
Q

AAP does not recommend the use of repellents for children at what age?

A

Children younger than 2 months

113
Q

Treatment of a large local reaction after a mosquito bite

A

Antihistamine, ice, and topical hydrocortisone cream

114
Q

What is the significant risk of sunburns?

A

Increases risk of melanoma at all ages

115
Q

What are the long-term complications of artificial ultraviolet rays (e.g., skin tanning)

A

Cataracts, skin aging, and cancer

Pediatric Questions (31 decks)

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