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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
screening test vs diagnostic test
screenings done in absence of signs or symptoms
26
5 traditional pediatric screening tests
1. Anemia 2. Lead 3. Hearing 4. Vision 5. Developmental milestones/language
27
AAP Guidelines for anemia screening
- 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
High risk factors for anemia in infants
- 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
Most common cause of anemia in childhood (6 months-2 yrs)
iron deficiency
30
Characteristics of blood in lab that would indicate iron deficiency
microcytic, hypochromic Low Hgb/Hct, low MCV, low serum ferritin, high RDW
31
How can iron deficiency be prevented?
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
ADR of iron treatment
GI bleeds, constipation
33
CDC acceptable blood lead level
< 10 mcg/dL
34
Affects of lead at low levels (+10) and higher levels (+40)
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
AAP recommendations for lead screening
- 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
Lead toxicity treatment
- Reduce Environmental Exposure - Maximize Nutrition (Calcium, zinc) to inhibit lead effects - Above 45 mcg/dL treated with chelation
37
AAP guidelines of hearing screens?
- All newborns - Universal objective screen by 4 yo - then 5, 6, 8, 10 yo
38
Who is at higher risk of hearing loss and needs more frequent/earlier screenings?
- 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
Vision testing done in infancy
Object tracking Red reflex Corneal light testing
40
Vision testing in toddler/preschool
Cover Test Red reflex Corneal light testing
41
Vision testing in school-aged children
Pediatric Eye Chart AAP Guidelines: Universal screen beginning at 36 months Then 4, 5, 6, 8, 10, 12, 15, 18 years
42
strabismus
“Crossed Eyes” General term for misalignment or deviating eye Esotropia = inward Exotropia = Outward
43
amblyopia
“Lazy Eye” | The lack of clear vision in one eye will cause it to develop Amblyopia
44
Vision testing for adolescents
Snellen Eye Chart, same as adults
45
AAP Guidelines for developmental screening
- 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
Denver II Development Screening Test
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
Main signs of Autism
- Social interaction impairment - Communication impairment - Repetitive, stereotyped behaviors
48
AAP Guidelines for BP checks
screening at 3 yo and every visit thereafter
49
AAP Guidelines for cholesterol checks
screening at 11-12 yo and between 17-21
50
AAP Guidelines for GC/Chlamydia checks
annually for all sexually active females males if UV shows +leuks
51
SMR stages of females
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
SMR stages of males
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
Process of screening and referring hearing in newborns
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
How is ADHD diagnosed?
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
parental and teacher rating scale for ADHD
Conners' scale
56
Treatment for ADHD
1st line: CNS stimulants (Methylphenidates, amphetamines) in combo with behavior therapy others: Atomoxetine (SNRI), other anti-depressants
57
Brain dysfunction in ADHD
frontal lobe is smaller and under-responsive to stimulation
58
ADD vs ADHD
ADD just has inattentive component whereas ADHD also has hyperactivity
59
AAP guidelines for iron supplements
3 months old
60
1 ounce = _____ kcal.
20
61
normal daily intake for infant born full term
100-120 kcals/day

Pediatrics Module (15 decks)

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