General Peds Flashcards
1
Q
Preterm
A
<37 weeks
2
Q
Term
A
37-42 weeks
3
Q
Postterm
A
> 42 weeks
4
Q
extremely low birth weight
A
<1000g (2.2lbs)
5
Q
very low birth weight
A
<1500g (3.3 lbs)
6
Q
low birth weight
A
<2500g (5.5 lbs)
7
Q
nl birth weight
A
> 2500g (5.5 lbs)
8
Q
based on growth curve, what is small for gestational age?
A
< 10th %tile
9
Q
based on growth curve, what is normal for gestational age?
A
10-90th %tile
10
Q
based on growth curve, what is large for gestational age?
A
> 90th %tile
11
Q
neonatal period
A
day 1-28
12
Q
postnatal period
A
day 29-1yr
13
Q
What is the Apgar?
A
key assessment of the newborn immediately after birth, scored at 1 & 5 minutes after birth
scoring continues at 5 min intervals till baby scores >7
14
Q
What is vernix caseosa
A
- cheesy white covering
- decreases as term approaches
- made from fetal corneocytes/sebaceous gland activity
- rich lipid matrix
15
Q
What are milia
A
- pinpoint white papule w/o surrounding erythema
- caused by blocked sebaceous glands
- common on nose, chin, forehead, cheeks
- usually appears in 1st week and disappears over several weeks
16
Q
what is a Mongolian spot
A
- aka congenital dermal melanocytosis
- blue patches of pigment
- common over lumbar area, buttocks, or extremities
- generally fade w/ time
- common in Asian, Native American, Hispanic, East Indian, and African descent
17
Q
What is erythema toxicum
A
- yellow eosinophilic papule on red base
- may appear 2-4th day
- mostly on trunk
- thought to be due to immaturity of the pilosebaceous follicles
- typically disappear w/in 1 week of birth
18
Q
Widely split sutures can be a sign of what?
A
elevated ICP (meningitis or hydrocephalus)
19
Q
Sunken fontanelle may indicate?
A
dehydration
20
Q
Large fontanelle can be the 1st sign of?
A
hypothyroidism
21
Q
When does the anterior fontanelle close and how big should it be?
A
- closes approx 9-18 mo
- 1-4 cm
22
Q
When does the posterior fontanelle close and how big should it be?
A
- closes 1-2 mo
- <1 cm
23
Q
Cepahlohematoma
A
- swelling/collection of blood over one or both parietal bones
- Does NOT cross suture lines
- resolves in wks-months
24
Q
Caput succedaneum
A
- edema of the scalp
- can cross suture lines
- resolves in days
25
Hypertelorism
abnormally widely spaces eyes
26
What do you do to get the best view in a babies ear?
pull the auricle gently downward
27
What are Epstein's pearl? When do they appear and do they need tx?
- small, white benign, inclusion cysts
- typically on palate
- no tx needed, the resolves spontaneously
- usually seen 2-4 mo
28
Nodules seen on the gingival ridge are called?
Bohn nodules
29
Ankyloglossia: what is it and what can it lead to?
Tongue Tie
- congenital short lingual frenulum
- can cause pain w/ nursing
- usually see puckering of the midline of tongue tip w/ movement
- may lead to speech difficulty or dental problems
30
Tx for Ankyloglossia
frenulectomy in neonatal period
31
For infants, what position do you palpate their necks?
lying supine
32
for children, what position do you palpate their necks?
sitting upright
33
What is congenital torticollis?
"wry neck"
- results from bleeding into the sternocleidomastoid muscle during the stretching process of birth
- appears as a firm fibrous mass w/in the muscle 2-3 weeks after birth
- generally disappears over months
34
Pectus excavatum
"funnel chest"
- sternal depression
- M>F
35
Pectus Carinatum
"chicken breast deformity or pigeon chest"
| -M>F
36
Pectus carinatum can also be a/w what abnormality?
scoliosis
37
What is the normal respiratory rate for infants
30-40/min
38
Diminished breath sounds on one side of the chest pf a newborn suggest?
unilateral lesions (ex. congenital diaphragmatic hernia)
39
In Upper Airway sounds:
| inspiratory or expiratory?
inspiratory
40
In Lower Airway sounds:
| inspiratory or expiratory?
expiratory
41
Diminished femoral pulses may indicate?
coarctation of the aorta
42
What are common non cardiac findings in infants w/ cardiac dz?
- poor feeling, failure to thrive, irritability
- tachypnea, hepatomegaly, clubbing
- poor overall appearance, weakness
43
What auscultating an infants/child's heart, what is commonly heard? (HR related to breathing)
HR increasing on inspiration and decreasing on expiration
44
What is the MC dysrhythmia in infants?
paroxysmal supra ventricular tachycardia (PSVT)
45
What is an umbilical granuloma?
- develops at the base of the navel
| - pink granulation tissue formed during the healing process
46
What is hypospadias?
hypo=below
-abnormal ventral placement of urethral opening
(check before circumcision!)
47
What is epispadies?
epi= hits you in the eye
| -abnormal dorsal placement (uncommon)
48
Where is a hydrocele?
MC side?
Reducible?
Resolves?
=overlie the testes and spermatic cord
- MC R side
- Not reducible
- can be transilluminated
- usually resolves by 18 mo
49
Where is a hernia?
MC side?
Reducible?
Resolves?
=separate from the testes
- usually reducible
- does not transilluminate
- does not resolve
50
If a newborn has a sacral dimple, what do you do?
need to US if you cannot see the bottom!
| could be sinus tract or spina bifida
51
Single palmar crease (simian crease) is a/w?
Trisomy 21
52
What are RFs for developmental dysplasia of the hips? (DDH)
- breech, caucasian, 1st born
- fam hx, prior child w/ DHH
- prematurity
53
What test tests for the ability to sublet or dislocate an intact, but unstable hip?
Barlow
54
What test test for posteriorly dislocated hip?
Ortolani
55
Asymmetrical leg creases might indicate? How is it treated?
developmental dysplasia of the hips (DDH)
-ortho eval & pavlik harness
56
At what age is nl for palmar grasp reflex?
3-4 mo
57
What is plantar grasp reflex and what age is it nl?
- touch sole at the base of the toes
- toes will curl
- 6-8 mo
58
What is the Moro Reflex? (Startle reflex)
-hold baby supine supporting head, abruptly lower entire body about 2 ft
- arms should abduct and extend
- hands open
- legs flex
birth-4mo
59
Persistence of Moro reflex beyond normal period suggests?
neurological disease (cerebral palsy)
60
What is the Asymmetric Tonic Neck Reflex?
| When is it nl
- With baby supine, turn head one side, holding jaw over shoulder
- the arms/legs on side which head is turned extend
- the opposite arm/leg flex
birth-2mo
61
What is Positive Support Reflex?
-hold baby around trunk and lower until feet touch flat surface
- the hips, knees, and ankles extend and baby stands up, partially bearing weight
- sags after 20-30 sec
birth or 2mo- 6mo
lack of reflex=hypotonia or flaccidity
62
What is Rooting reflex
- stroke personal skin at the corners of the mouth
- mouth will open and baby will turn head to the stimulated side
birth-3/4 mo
63
What is Trunk Incurvation (Galant's reflex)
- support baby prone w/ one hand
- stroke 1 side of the back 1 cm from midline, from shoulder to buttocks
- spine will curve toward the stimulated side
birth-2mo
64
What is Placing and Stepping reflexes
- hold baby upright from behind
- have one sole touch tabletop
- the hip and knee of that foot will flex and the other foot will step forward
65
Appropriate visual acuity for:
3-5yo?
6 and up?
3-5yo= 20/40
| 6 and up= 20/30
66
MC cause of childhood blindness?
amblyopia
67
When should you start checking BP in child?
3yo
68
When do you screen for iron deficiency?
9 or 12 mo
69
What does the CDC recommend for Lead screening?
universal screening for children ages 1-2
70
When should the 1st dental visit be?
between 12 mo-2 or 3 yo
71
Rear facing car seats till?
Booster seat till?
No front seat till?
Rear facing car seats till= 2yo
Booster seat till= 4'9"
No front seat till= 13 yo
72
What are 1 month milestones? (4)
- fixes/follows on face
- some head control
- responds to sounds
- spontaneous smile
73
What are 2 month milestones? (4)
- responsive smile
- coos/vocalizes
- lifts head when prone
- follows to midline
74
What are 4 month milestones? (5)
- rolls from tummy to back
- good head control
- laughs, squeals
- follows past midline
- grasps toys/objects
75
What are 6 month milestones? (6)
- sits w/ support
- bears weight on legs
- vocalizes "ba, da-da"
- reaches out for toys
- follows 180 degrees
- stranger danger/separation anxiety
76
What are 9 month milestones? (5)
- Crawls
- pulls up to stand and cruise on furnature
- says mama/dada
- immature pincer grasp
- responds to name
77
What are 12 month milestones? (5)
- walks (might be delayed until 18 mo)
- waves bye
- says mama/dad
- points w/ index finger
- self feeds w/ fingers
78
What are 15 month milestones? (4)
- 3-6 words
- walks well
- climbs stairs
- imitates actions
79
What are 18 month milestones? (6)
- 5-15 words
- some 2 word phrases
- uses spoon/fork
- scribbles
- follows simple commands
- runs, walks backwards
80
What are 24 month milestones? (5)
- 20-50 words
- 2 word phrases
- kicks ball
- builds 3-4 block tower
- 50% speech understandable
81
How is Hep B spread? Sx?
- contact w/ blood or body fluids, birth
| - asymptomatic, jaundice, HA, weakness, vomiting, joint pain
82
How is Rotavirus spread? Sx?
- Saliva, oral contact
| - diarrhea, fever, vomiting
83
Leading cause of hospitalization and death from acute gastroenteritis in young children?
Rotavirus
