Growth And Development Flashcards
Fetal nutrition is best determined by assessing
Subcutaneous fat on the anterior thighs and gluteal region
White populous on nose and cheeks
Millia
Congenital with infinite borders buttocks and base of spine, predominantly an African American and Asian infants
Mongolian spots
“Stork bite”, pink red capillary on face or neck
Nevis Symplex
Port wine stain anywhere on malformation body
Nevus flammeus
Fontanelles are normally described as
Soft and flat
When does the anterior fontanelle close
9 to 18 months
When does the posterior fontanelle close
2 to 3 months
What is hypertelorism
Eyes set wide apart
If the baby has low-set ears what kind of indicate
Renal issues
A web snack may be associated with
Turner syndrome
What is the respiratory rate for a newborn
40 to 60 breaths per minute
What heart condition makes you check femoral pulses
Coartation of the aorta
How long should a mother breast-feed their infants
Up to six months of age
How long should you delay complementary foods or solid foods
4 to 6 months of age
May reduce the risk of a topic dermatitis and a topic sensitization
What type of food should be introduced first to an infant
Rice cereal
When can food just be given to an infant
Six months of age but no more than 4 to 6 ounces per day
At what age can cows milk be given to an infant
One year old
When can finger foods be introduced to an infant
8 to 10 months of age
When should fluoride supplementation start for an infant
Six months of age
What vitamin does breast-fed babies need
Vitamin D
What type of vitamin does exclusively breast-fed babies of strict vegetarian or vegan mothers need
Vitamin B 12
What test is the corneal light reflex called
Hirschberg test
And one week old infant does not have a red reflex in his right eye. What might this indicate?
Congenital cataracts
At what age should Eye alignment occur?
Two to four months of age
When two eyes don’t focus on the same object, the brain ignores information from one of the eyes. If this is not corrected it can result in loss of vision called
Amblyopia
The corneal light reflex and cover/uncover tests are used to assess
Stabiscus
Start at 6 months to 3 years
At what age should vision screening start with Snellen chart
3 to 4 years old
At what age does a child have 2020 vision
Six years old
When is the best time to do a vision screening
Periodically after a growth spurt is the best time to check Eye vision
What is the Moro reflex
Startle reflex
Checks hearing from newborn to three months of age
At what age does a baby stop and listen to a new sound, stops crying with hearing parents voice
3 to 6 months
At what age does a baby respond to their own name
6 to 12 months
At what age does a baby follow directions without cues
12 to 18 months
50% of speech intelligible to strangers
18 to 24 months
Pediatric hearing loss is associated with which abnormality
Speech delay
What is the purpose of pneumatic Otoscopy
To assess TM mobility
When do central incisors erupted
6 to 10 months
The best way to examine the oral cavity of a small child is
To lie a child on his back on an exam table
What is the purpose of measuring blood pressure’s in all four extremities in the newborn.
To assess for coarctation of the aorta
Higher blood pressure in the upper extremities and lower blood pressure in the lower extremities is indicative of
Coarctation of the aorta
When should routine blood pressure screening begin for children
Three years of age
What is the order of an abdominal exam
Inspect, auscultation, percuds, light palpation then heavy palpation
What is it called when Bilrubin levels increase and there is no treatment for Bilirubin so the Bilirubin goes to the brain and then leads to neurological delays and damage
Kernicterus
When does the Bilirubin level peak in a full-term neonate
On the third or fourth day
What to examinations are used to assess dysplasia of the hip in an infant
Barlow’s and Ortolani’s maneuvers
Which examination for dysplasia of the hip includes external rotation of the hip and you hear a click or a clunk
Ortolani’s maneuver
What examination for dysplasia of the hip in an infant includes the butt and flexing the hip interiorly
Barlow’s maneuver
Where should the examiner second To fifth fingers be placed to perform Ortolani’s test
On the greater trochanter
Which test for hip dysplasia produces unequal knee height
Positive Galeazzi test
What is talipes equinovarus
Club foot
Urgent ortho referal
What is the test for scoliosis
Adams forward bend test
What type of x-ray do you order for scoliosis
Full length PA and lateral standing views C7 to the sacrum and iliac crest
If you find CVA tenderness upon examination of an infant it is indicative of
Pylonephritis
The correct order of maturation of Nails in Tanner staging is
Pubic, axillary, and then facial hair
People growth occurs in what tanner stages in girls
Stages two through three
Pubertal growth occurs in which tanner stages in boys
Stages three through four
The earliest secondary sexual characteristics characteristic in girls is
The onset of breast development, thelarche
The earliest stage of male maturation is
Testicular volume
Female visits the NP because she has a symmetry of her breasts. She is in tanner stage III. The NP knows that this
Will probably resolve by tanner stage five
What causes gynecomastia
Obesity, pot, Tagamet, aldactone
What finding is abnormal in a two month old child
A closed anterior fontanelle
In most children the primary teeth have completely erupted by
24 months or two years old
Normal vision in a child is expected by
Six years of age or first grade
At what age can infant Focus on her face, grasp a rattle if placed in hand, smiles, Coos, able to lift head 45°
Two months
At what age can an infant hold and control their head while held up right, no head lag when pulled up right, raises body on hands, rolls prone to supine, follows like 180°
Four months
At what age can an infant place an object in the opposite hand and in mouth, sit with support maybe unassisted, rolls supine to prone, bears weight, recognize his parents, says dada or baba, babbles, smiles squeals, laughs, imitate sounds
Six months
At what age can an infant pull to stand, bangs, shakes, drops, and throws objects, able to feed self with finger foods, response to own name and understands a few words, stranger anxiety, Crawls, creeps, and scoots
Nine months
At what age does an infant pull to stand, may take a few steps, uses pincer grasp and able to point, says 2 to 4 words, looks for dropped or hidden objects, response to own name and understands a few words, feed self and drinks from Cup, waves and says bye-bye, dada, mama, imitates vocalizations
12 months
At what age does an infant walk well and is able to stoop, Can point To a body part, says 3 to 6 words, stacks two blocks, follow simple commands, points, grunts, pull off to show what he wants, listens to a story
15 months
At what age does an infant walk backwards, can throw a ball, says 15 to 20 words, imitate words, uses two word phrases, points to multiple body parts
18 months
At what age does an infant walk up and down stairs one step at a time, can kick a ball, says at least 20 words, imitates adults, follow two-step commands, Stacks five blocks
Two years
At what age can a child jump, stand on 1 foot, able to ride a tricycle, says name, age, and gender, knows gender of others, able to copy a circle, Cross, able to recognize colors
Three years
At what age can a child sing a song, hop on 1 foot, able to throw a ball overhand, able to draw a person with three parts, able to cut and paste, able to build a tower with 10 blocks, counts to five, able to copy a square, able to dress self with supervision
Four years
At what age can a child draw a person with body, head, arms, legs, able to recognize most letters and can print some, plays make believe, learns address and phone number, can define at least one word
Five years
At what age do you childproof a home, introduce solid foods, cereal first, then puréed vegetables, fruits, have syrup of ipecac available
Four months
At what age do you introduce a cop to an infant and check on fluoride supplements
Six months
At what age do you introduce mashed foods and finger foods, start with start with table foods, discuss weaning from bottle, and brush teeth
Nine months
At what age do you start implementing whole milk and allowing the child to feed them self
12 months
What age do you allow the toddler to feed them self with a spoon and hands, and assess the child’s readiness for toilet training
18 month
At what age do you start using time out as an acceptable behavior and how long should timeout be
Three years of age, and one minute for each year of age
What are you looking for at the one-week visit of a newborn
Weight gain illumination patterns sleep wake cycle continuation of breast-feeding parent infant interaction review hearing test and metabolic screening’s
Fetal nutrition is best determined by assessing
Subcutaneous fat on the anterior thighs and gluteal region
Stork bite. Pink red capillary on face or neck
Nevus simplex
Port wine stain anywhere on malformation body
Nevus flammeus
Fontanelles are normally described as
Soft and flat
When does the anterior fontanelle close
9 to 18 months
When does the posterior fontanelle close
2-3 months
What is hypertelorism
Eyes set wide apart
What does cornea enlargement suggest
Glaucoma
What does it mean if a baby has low set ears
It can indicate read Renal agenesis
What is the method of hearing screening used for universal newborn screening
Evoked otoacoustic emission testing
What is torticollis
Shortening of the sterno mastoid muscle which can affect vision. Physical therapy needed for neck range of motion.
A webbed neck may be associated with
Turner syndrome
How many breaths per minute should A newborn take
40 to 60
When should finger foods be introduced
8 to 10 months
When should fluoride supplementation start
Six months. Not in bottled water. If not, give in vitamins
What vitamin do exclusively breast-feeding infants need
D
What is the Hirschberg test
Corneal light reflex
When is the cover/uncover test performed
Greater than three years old
At what age should Eye alignment occur
2 to 4 months of age
What is amblyopia
Loss of vision
When does vision screening start with the Snellen chart
3 to 4 years old
When is 20/20 vision achieved
Six years old or first grade
When is the best time to check Eye vision
Periodically after a growth spurt
When do you check the Moro reflex
Newborn to three months
Pediatric hearing loss is associated with what abnormality
Speech delay
What is the purpose of pneumatic otoscopy
To assess the TM mobility
By what age is a child speech completely intelligible to a stranger
Four years
When do permanent teeth come in
First at 6 to 8 years old, and last teeth at about 20 years.
At what age should a child start seeing a dentist
One year of age
At what age does oral health risk assessment start
Six months, 18 months, 24 months, 30 months
When do the central incisors erupt
6 to 10 months
What is the best way to examine the oral cavity of a small child
Lie a child on their back on the exam table
What is the normal heart rate at birth
122 160 bpm with marked sinus arrhythmia
What is the heart rate for three year old
80 to 120 bpm
What is the heart rate for a six-year-old
70-110 bpm
When should routine blood pressure screening begin for children
Three years old
When does the does the dyslipidemia risk assessment start
2, 4,6,8,10 years then annually
When does dyslipidemia screening via fasting lipid profile done
18 to 21 years
When do you start measuring BMI
Greater than or equal to two years old
What is the order of abdominal exam
Inspect, auscultate, percuss, light palpation
What is Bhutani Nomogram used for
Bilirubin level tracker
Interior buttock hip flex is what test
Barlow’s maneuver
External rotation of the hip is what test
Ortalani’s maneuver
What is metatarsus adductus
Club foot
What is a positive Galeazzi test
Unequal knee height
A two-month-old patient has suspected hip dysplasia. What might be present on assessment
Positive Galeazzi test
What is the most common type of club foot
Talipes equinovarus
Urgent ortho referral
What x-rays are needed for scoliosis
Full length PA and lateral standing views C7 to the sacrum and iliac crest
What method is used to measure the angle of curvature in a scoliosis patient by the radiologist
Cobb method
When do you go for scoliosis patient
Cobb angle 20-29 degrees in premenarchal girl or boy 12-14 years
Consider referral for any Cobb angle Greater than or equal to 20°.
Cobb angle Greater than 30° in any age
What in office test is done for scoliosis
Adams forward bend test
When should a scoliosis patient be of most concern
A 13 year-old Female with a 20° curve. This is because the growth spurt just started
CVA tenderness means
Pyelonephritis
What tanner staging for female begins from four years old to eight years old
Stage one. Prepubertal. Papilla elevated above chest wall
Breast buds appear in what tanner stage
2
At what tanner stage does pubertal growth occur in girls
2 to 3
In what town are stage does pubertal growth occur in the boys
3 to 4
Body hair forms in males in which pattern
Bottom to top
The earliest secondary sexual characteristic in girls is
The onset of breast development (thelarche)
The earliest stage of male maturation is
Testicular volume
If a 12-year-old female presents with asymmetry of her breasts what does this mean
It will probably resolve by tanner stage five
What drugs can cause gynecomastia
Obesity, pot, Tagamet, Aldactone
At what age does an infant focus on the face, grasp rattle is placed in hand, Smile, cool, able to lift had 45°
Two months
At what age is an infant able to hold and control head when held upright, NO head-lag when pulled upright, raises body on hands, rolls prone to supine, follows light 180 degrees
Four months
At what age get an infant place an object in the opposite hand and in mouth, sit with support maybe unassisted, roll supine to prone, bear weight, recognize parents, says dada or baba, battles, smiles, squeals, laughs, imitate sounds
Six months
At what age can an infant pull to stand, bang, shake, drop, and throw objects, able to feed self with finger foods, response to own name and understands a few words, stranger anxiety, Crawls, creeps, and scoots
Nine months
At what age Can an infant pull to stand and take a few steps, use pincer grass and able to point, says 2 to 4 words, looks for dropped or hidden objects, responds to own name and understands a few words, feed self and drinks from Cup, waves and says bye-bye, dada, mama, imitates vocalizations
12 months
At what age can a child walk well and is able to stoop, Can point To a body part, says 3 to 6 words, stacks two blocks, follows simple commands, points, grunts, pulls to show what he wants, listens to a story
15 months
At what age can a child walk backwards, throw a ball, say 15 to 20 words, imitate words, use two word phrases, points to multiple body parts
18 months
At what age can a child walk up and down stairs one step at a time, kick a ball, say at least 20 words, imitate adults, follow two-step commands, stack five blocks
Two years
At what age can a child jump, stand on 1 foot, ride a tricycle, say their name, age, and gender, know gender of others, copy a circle or cross, recognize colors
Three years
At what age can a child sing a song, hop on 1 foot, throw a ball overhand, draw a person with three parts, cut and paste, build a tower with 10 blocks, count to five, copy a square, dress self with supervision
Four years
At what age can a child 🧒 draw a person with body, hesd, arms, legs, able to recognize most letters and can print some, plays make believe, learns address and phone number, can define at least one word
Five years
Can you use baby powder in an infant
No
When should solids be given to a baby
Four months of age
When do you childproof your home
Four months of age.
When should you introduce solid foods 2 to 3 times per day
Six months. Avoid foods which are choking hazards such as nuts, hotdogs, whole grapes, hard candy. Start using a cup. Fluoride supplements if not in drinking water.
When do you introduce mashed foods and finger foods, start table foods, discuss weaning from bottle, and brushing teeth
Nine months
When do you allow a baby to feed them self
12 month
When do you allow a toddler to feed them self with a spoon and hands. Assess Childs readiness for toilet training
18 months
When do you start using time out for unacceptable behavior
Three years old. One minute for each year of age.
This condition presents with enlarged and painless cervical and supraclavicular lymphadenopathy associated with fever: PEL – Epstein sign and night sweats. May report an episode of severe pain that is located on or over a malignant areas a few minutes after drinking alcohol. The most common cancers in teams aged 15 to 19 years.
Hodgkin’s lymph Oma
What is the diagnostic tool for testicular torsion
Doppler ultrasound
Majority of skeletal growth occurs when in girls
Before menses
Unilateral midcycle pelvic pain that is caused by an enlarged ovarian follicle. Pain may Last a few hours to a few days. May occur intermittently.
Mittelschmerz
This enzyme is normally elevated from puberty to teenage years. Secondary to rapid growth spurts. This enzyme is produced by growing bone or patients healing from major fractures.
Elevated alkaline phosphatase
When does puberty start and end in tanner staging
Starts up Tanner stage two and ends at tanner stage five
What tanner stage in boys is the elongation of the penis
Stage three
How do you obtain a health history from an adolescent
Obtain from both parent and child initially, then the adolescent is interviewed alone without the parents
What is the criteria for an emancipated minor
Legally married and active duty in the Armed Forces
If an adolescent has amenorrhea from more than six months what must be measured
Bone 🍖 density
How do you anorexic patient present
Lanugo, peripheral edema, amenorrhea, weight loss >10% of body weight
What are anorexic patient at increased risk for
Osteoporosis or osteopenia. For birth control avoid Depo-Provera and other progesterone only contraceptives since they can cause bone loss.
What does it mean when an anorexic person has swollen feet
Low albumin level
What is the scoliosis treatments for a 10° curve
Observe and monitor for changes in spinal curvature
What is the difference between gynecomastia and pseudo gynecomastia
Gynecomastia is excessive growth of breast tissue in males. It often resolves spontaneously within six months to two years. Pseudogynecomastia is more common in obese boys
It’s parental consent needed for health services related to sexual activity such as STD testing, pregnancy tests, birth control prescription
No
The developmental task for the family of an adolescent is to
Allow the adolescent increasing freedom and responsibility
Which of the following demonstrates that a 30-year-old male has successfully achieved the developmental task of young adult hood?
Married with two children
Enlargement of the scrotum and testes with little change in the size of the penis characterizes which tanner stage of sexual development?
Tanner stage 2
An 11-year-old female whose breasts are beginning to develop and has a few straight, fine pubic hairs. What Tanner stage is this
Stage two
