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Pediatrics Module > General Peds > Flashcards

General Peds Flashcards

1
Q

Primary vs secondary vs tertiary prevention

A

primary = avoid disease/injury

secondary = early detection; screenings

tertiary = reduce negative impact of already established disease

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2
Q

Fever in children is ____ deg F.

A

100.4 F

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3
Q

Normal systolic BP for infant, child, and adolescent

A

infant: 70-90
child: 90-110
adolescent: 90-120 (closer to adults)

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4
Q

Normal HR for infant, child, and adolescent

A

Infants: 140-160

children: 100-140
adolescents: <100

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5
Q

Tachycardia and bradycardia in in pediatric patients?

A

> 200 (usually SVT)

< 60

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6
Q

Elevated BP, pre-HTN, HTN in children

A

Elevated > 120
Pre-HTN >130
HTN >140

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7
Q

What are the age ranges of terms newborn, infant, child, adolescent?

A

Newborn: < 2 months
Infant: 2 to 24 months
Child: 2-4 yo (toddler/pre-school) AND 5-11 yo (school age)
Adolescent: 12-18 yo

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8
Q

Define developmental delay

A

child does not reach milestone (skill development) by expected time period

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9
Q

Why is infant head circumference so important?

A

Microcephalic needs to be picked up early to prevent lifelong problems

height and weight associated with malnourishment can be fixed without lifelong effects

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10
Q

Fine motor development from birth to 12 months

A

6 mon: rake
7 mon: inferior-scissors grasp
10 mon: pincer grasp
12 mon: fine pincer grasp

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11
Q

When should scribbling start?

A

1-2 yo

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12
Q

Developmental milestones at 1 yo

A

1st words
1st steps
Uses ONE word at a time
Follows a ONE step command

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13
Q

Developmental milestones at 2 yo

A

Uses 2-3 word phrases (“2 words together at 2”)
Follows 2 step commands
50% of what said (2/4) is understandable by strangers
Two for two points
Copies lines
Two for towers
Begin to stack blocks

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14
Q

Guidance to parents at 1 year old

A

Stop bottle and binkie
Begin whole milk
First dental visit

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15
Q

Guidance to parents at 2 year old

A

Car seat flipped

Use time outs

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16
Q

Developmental milestones at 3 yo

A

Uses 3 word sentences
Others can understand 3/4 of what he says
Rides TRI-cycle
Draws Circle

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17
Q

Developmental milestones at 4 yo

A

40 pounds
40 inches tall
Can draw a four sided figures
Spoken words 100% (4/4) understandable

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18
Q

Adolescent Risk Assessment

A

HEADS

Home
Education/Eating
Activities
Drugs
Safety/Sex/Suicide
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19
Q

Tanner Staging

A

sexual maturity rating (SMR) from 1 (prepubescent) to 5 (adult)

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20
Q

How is height of child estimated with calculation?

A

Boys:
(Father’s ht. + mother’s ht. + 13) / 2

Girls:
{(father’s ht. – 13) + mother’s ht.} / 2

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21
Q

Normal etiologies of short stature

A

constitutional growth delay

familial short stature

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22
Q

How is Constitutional growth delay different than Familial short stature?

A
  • short parents in familial
  • delayed puberty and bone lag (2-3 yrs) in constitutional delay
  • adult height normal in constitutional and short in familial
  • both have +fhx and normal growth velocity, PE, and labs
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23
Q

Examples of pathological short stature

A

Turners syndrome, fetal alcohol syndrome, hypothyroid, renal tubular acidosis, Celiac’s Disease

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24
Q

Abnormal variants of tall stature

A

Klinefelter syndrome: chromosome XXY; small testes, delayed puberty, gynecomastia, long legs, low testosterone

Marfan syndrome: autosomal dominant

Excessive GH: gigantism (before closure), acromegaly (after epiphysis closure)

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25
Q

screening test vs diagnostic test

A

screenings done in absence of signs or symptoms

26
Q

5 traditional pediatric screening tests

A
  1. Anemia
  2. Lead
  3. Hearing
  4. Vision
  5. Developmental milestones/language
27
Q

AAP Guidelines for anemia screening

A
  • H&H at 12 mon
  • starting in adolescence, all non-pregnant women every 5 to 10 yrs
  • annually for women with high risk (heavy menses, low intake, +hx)
28
Q

High risk factors for anemia in infants

A
  • Prematurity
  • Untreated maternal anemia
  • Use of non-iron fortified formula and cereal
  • Exclusive breastfeeding after 4 months
  • Early use of cows milk before 12 months
  • Overconsumption of milk
  • Lead exposure
29
Q

Most common cause of anemia in childhood (6 months-2 yrs)

A

iron deficiency

30
Q

Characteristics of blood in lab that would indicate iron deficiency

A

microcytic, hypochromic

Low Hgb/Hct, low MCV, low serum ferritin, high RDW

31
Q

How can iron deficiency be prevented?

A

Breastfed infants should have iron supplements at 4 mon and start iron-fortified cereals at 6 mon

Non-breast feeding infants should receive iron-fortified formula

Supplement iron drops for preterm infants

32
Q

ADR of iron treatment

A

GI bleeds, constipation

33
Q

CDC acceptable blood lead level

A

< 10 mcg/dL

34
Q

Affects of lead at low levels (+10) and higher levels (+40)

A

Abd pain, constipation, hearing loss, osteopenia and decreased bone growth, microcytic anemia, dental caries, cognitive delays
>40: spontaneous abortions, renal disease, seizures, encephalopathy, and death

35
Q

AAP recommendations for lead screening

A
  • Universal screening at 6 mon
  • Lead level at 1 and 2 yrs old
  • Sooner/more frequent if RFs: language delay, chronic anemia, pica, high risk geographic area, any yes responses on screening questionnaire
36
Q

Lead toxicity treatment

A
  • Reduce Environmental Exposure
  • Maximize Nutrition (Calcium, zinc) to inhibit lead effects
  • Above 45 mcg/dL treated with chelation
37
Q

AAP guidelines of hearing screens?

A
  • All newborns
  • Universal objective screen by 4 yo
  • then 5, 6, 8, 10 yo
38
Q

Who is at higher risk of hearing loss and needs more frequent/earlier screenings?

A
  • Parental concerns about hearing, speech, language or dev. delays
  • +FHX of childhood hearing loss
  • Craniofacial anomalies
  • Syndromes associated with hearing loss
  • H/O recurrent otitis media or otitis effusion
39
Q

Vision testing done in infancy

A

Object tracking
Red reflex
Corneal light testing

40
Q

Vision testing in toddler/preschool

A

Cover Test
Red reflex
Corneal light testing

41
Q

Vision testing in school-aged children

A

Pediatric Eye Chart
AAP Guidelines: Universal screen beginning at 36 months
Then 4, 5, 6, 8, 10, 12, 15, 18 years

42
Q

strabismus

A

“Crossed Eyes”
General term for misalignment or deviating eye
Esotropia = inward
Exotropia = Outward

43
Q

amblyopia

A

“Lazy Eye”

The lack of clear vision in one eye will cause it to developAmblyopia

44
Q

Vision testing for adolescents

A

Snellen Eye Chart, same as adults

45
Q

AAP Guidelines for developmental screening

A
  • Objective Standard Developmental Screening at 9, 18, and 30 months
  • Objective M-CHAT screening test at 18, 24, 36 months
  • Regular psychosocial and behavioral assessment at every well check

Earlier screening or referral for risk factors

46
Q

Denver II Development Screening Test

A

Enables tester to compare a child’s development with that of over 2,000 children who were in the standardized population

Provides broad variety of standardized items to give quick over-view of the child’s development

Also contains behavior rating scale

47
Q

Main signs of Autism

A
  • Social interaction impairment
  • Communication impairment
  • Repetitive, stereotyped behaviors
48
Q

AAP Guidelines for BP checks

A

screening at 3 yo and every visit thereafter

49
Q

AAP Guidelines for cholesterol checks

A

screening at 11-12 yo and between 17-21

50
Q

AAP Guidelines for GC/Chlamydia checks

A

annually for all sexually active females

males if UV shows +leuks

51
Q

SMR stages of females

A

Stage I: prepubescent

Stage II: Hair: Sparse, long, lightly pigmented hair along labia
Breast: Budding

Stage III: Hair: Darker, coarser, curly hair along pubic region
Breast: Fullness of breast tissue

Stage IV: Hair: Adult type, less distribution
Breast: Secondary mound (areola development)

Stage V: Hair to medial thighs
Breast: Darkening of tissue, mature

52
Q

SMR stages of males

A

Stage I: prepubescent

Stage II: Sparse, long, lightly pigmented hair along base of penis; generalized enlargement of penis and testes

Stage III: Darker, coarser, curly hair along pubic region; further enlargement of phallus length and testes; scrotal texture changes

Stage IV: Adult type hair; penis increases in circumference, darkening of scrotal skin

Stage V: hair to medial thighs; adult size, length, and color of genitals

53
Q

Process of screening and referring hearing in newborns

A
  1. Pass or not pass newborn screen
  2. If not pass do confirmatory test w/i 3 months
  3. if still no pass, then dx with congenital permanent hearing loss
  4. Refer for intervention within 6 months
54
Q

How is ADHD diagnosed?

A

1) hyperactivity, impulsivity, or inattentiveness before age 12
2) symptoms must occur in 2 settings
3) at least 6 sx’s of inattention of hyperactivity for 6 months (careless mistakes, difficulty organizing, doesn’t complete assignments, fidgets, restless, talks excessively, difficulty waiting turn, interrupts others, etc.)

55
Q

parental and teacher rating scale for ADHD

A

Conners’ scale

56
Q

Treatment for ADHD

A

1st line: CNS stimulants (Methylphenidates, amphetamines) in combo with behavior therapy

others: Atomoxetine (SNRI), other anti-depressants

57
Q

Brain dysfunction in ADHD

A

frontal lobe is smaller and under-responsive to stimulation

58
Q

ADD vs ADHD

A

ADD just has inattentive component whereas ADHD also has hyperactivity

59
Q

AAP guidelines for iron supplements

A

3 months old

60
Q

1 ounce = _____ kcal.

61
Q

normal daily intake for infant born full term

A

100-120 kcals/day

Pediatrics Module (15 decks)

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