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H&P Final Exam- Children & Adolescents Flashcards

1
Q

What to assess at well visit? (10)

A

1- VS *vision & hearing
2- Health habits
3-Development
4-SHx
5-FHx
6- P/E
7-Assessment
8- Anticipatory guidance
9- Immunizations
10-Plan for F/u

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2
Q

Motor/Physical
4y

A
  • hops & stands on 1 foot (2sec)
  • catches/bounces a ball
  • pours
  • cuts w/scissors
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3
Q

Motor/Physical
5y

A
  • stands on 1 foot (>10sec)
  • hops & skips
  • uses fork/ spoon well
  • toilet trained
  • swings & climbs
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4
Q

Language
4y

A

“he” & “she”
songs/poems from memory
tells stories
1st & last name

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5
Q

Language
5y

A

Speaks clearly
tells simple story using full sentences
uses future tense
names & addresses

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6
Q

Social/Emotional
4y

A

Plays “mom” & “dad”
make believe play
cooperates w/other kids
-rather play with others
cant tell real from make believe

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7
Q

Social/Emotional
5y

A

Can tell real from make believe
wants to please friends
aware of gender
independence

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8
Q

Cognitive
4y

A

colors & numbers
understands counting
understands same & different
copying some capital letters
board games

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9
Q

Cognitive
5y

A

Counts 10+
person w/ 6 body parts
print some letter & numbers
copies triangle

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10
Q

Development
5-7y

A
  • School begins
  • increased sensorimotor coord
  • fine motor pen & paper
  • cognitively preoperational (focus on 1 variable at a time)
  • recognize numbers, letters, words, start to write
  • MAGICAL THINKING
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11
Q

Development
7-11

A
  • latency years (school & peers)
  • achievement in school
  • acceptance by peers
  • sports & inc. coord w/organized teams
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12
Q

Sleep Req 3-5y

A

10-14hrs/night naps disappear

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13
Q

Sleep Req 5-7y (school aged)

A

10-14hrs/night

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14
Q

Sleep Req Adolescents

A

9-9.5 hrs/night

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15
Q

Nightmare v Night terror (5 points)

A

Appearance/Behavior
NT- screaming, thrashing, crying, appears not awake
NM- bad dream-awakens scared

Age?
NT- 4-5y
NM-toddlers & up

Timing
NT-w/in 2 hrs of going to bed
NM- 2nd part of night dur intense dreamig

Return to Sleep
NT- Back to sleep quickly
NM- May have trouble

Memory of Experience
NT- no memory
NM- may remember & talk about it next day

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16
Q

Toilet training usually completed by

A

4-5y

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17
Q

How often should kids be stooling?

A

up to Q3D NL

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18
Q

Constipation: 3 ways to help
Have a low threshold to start on.______.

A

1- Diet (fiber, bran, whole what, fruits & veggies, H2O)
2-Behavior (toilet after meals-gastrocolic reflex)
3-Medications
- Miralax!

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19
Q

what is it called when you hold your stool for inappropriately long times to the pt that the rectum strectches out

A

Encopresis

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20
Q

what is bed wetting called? what type of dizorder?
when should it completely resolve by?

A

Nocturnal Enuresis
Maturational Disorder
resolves by 15y

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21
Q

Adolescent Immunizations (3)

A

TDaP
Menigococcal
HPV

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22
Q

2 Brain systems that continue to develop through adolescence

A

Pre-frontal cortex (decisions, planning, inhibitive behavior, self-awareness, social interactions

Limbic System (emotional processor, ‘reward center’, hyper-sensitive!!!!)

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23
Q

Puberty hormones - Males

A

GnRH- LH & FSH

  • LH stimulates testosterone
  • FSH stimulates sperm maturation
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24
Q

Puberty hormones- Females

A

GnRH- LH, FSH
- FSH stimulates secretion of estrogen from ovaries

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25
How many Tanner Stages? What do they assess
5 Male GU Female GU Female Breast
26
Tanner Stage 1
prepubertal | (all)
27
Tanner stage 2
Male-testis enlarge, scrotal reddens, straight hair female breast- bud, elevation of breast and papilla female GU- sparse, lightly pigmented, straight
28
Tanner Stage 3
Male- penis grows length, hair coarse, curly, dark female breast- further enlargement, no separation of contour female gu- darkening, curl, inc pubic hair to symphysis
29
Tanner Stage 4
male- penis grows width, darker scrotum, hair full but LIMITED Female breast- secondary mound above breast Female GU- coarse, curly hair, abundant
30
Tanner Stage 5
Male- mature adult, hair to medial thighs Female Breast- Mature stage, projection of papilla only Female GU- mature adult, hair to median thighs
31
Precocious puberty
before 8 in girls, 9 in boys
32
Delayed puberty
after 13 in girls, no menarche 16 in girls after 14 in boys
33
Confidentiality (2 instances)
Sex- any age (ie Birth Control, STIs, Addiction) Mental Health \>15yo in Colorado
34
History (H.E.E.A.D.S.S)
H- Home E- Education E- Eating A-Activities D-Drugs S-Sexual Hx S- Suicide & Depression
35
CRAFFT
Assessment for Drugs in adolescents C-car with a high driver? R-use drugs to relax? A-drugs or alcohol alone? F- forget things you did at school? F- friends/family ask you to 'cut down'? T- gotten in trouble for using drugs/alcohol?
36
Adolescent Screening Tools? (5)
Bright Futures Guidelines Cholesterol 9-11y Hgb/Hct STI Questionnaire Screens-depression/substance abuse
37
Most common STD in US?
HPV
38
Classic Symptoms of Depression
FATIGUE lack of interest boredom irritability sleep/appetitie changes muscle aches HA stomach aches
39
are comorbidities common in adolescent depression
yes! ADHD, conduct disorders, anxiety, eating disorders, substance abuse
40
Best Tx for depression
CBT
41
# reversed prompt 1- VS \*vision & hearing 2- Health habits 3-Development 4-SHx 5-FHx 6- P/E 7-Assessment 8- Anticipatory guidance 9- Immunizations 10-Plan for F/u
What to assess at well visit? (10)
42
# reversed prompt - hops & stands on 1 foot (2sec) - catches/bounces a ball - pours - cuts w/scissors
Motor/Physical 4y
43
# reversed prompt - stands on 1 foot (\>10sec) - hops & skips - uses fork/ spoon well - toilet trained - swings & climbs
Motor/Physical 5y
44
# reversed prompt "he" & "she" songs/poems from memory tells stories 1st & last name
Language 4y
45
# reversed prompt Speaks clearly tells simple story using full sentences uses future tense names & addresses
Language 5y
46
# reversed prompt Plays "mom" & "dad" make believe play cooperates w/other kids -rather play with others cant tell real from make believe
Social/Emotional 4y
47
# reversed prompt Can tell real from make believe wants to please friends aware of gender independence
Social/Emotional 5y
48
# reversed prompt colors & numbers understands counting understands same & different copying some capital letters board games
Cognitive 4y
49
# reversed prompt Counts 10+ person w/ 6 body parts print some letter & numbers copies triangle
Cognitive 5y
50
# reversed prompt - School begins - increased sensorimotor coord - fine motor pen & paper - cognitively preoperational (focus on 1 variable at a time) - recognize numbers, letters, words, start to write - MAGICAL THINKING
Development 5-7y
51
# reversed prompt - latency years (school & peers) - achievement in school - acceptance by peers - sports & inc. coord w/organized teams
Development 7-11
52
# reversed prompt 10-14hrs/night naps disappear
Sleep Req 3-5y
53
# reversed prompt 10-14hrs/night
Sleep Req 5-7y (school aged)
54
# reversed prompt 9-9.5 hrs/night
Sleep Req Adolescents
55
# reversed prompt Appearance/Behavior NT- screaming, thrashing, crying, appears not awake NM- bad dream-awakens scared Age? NT- 4-5y NM-toddlers & up Timing NT-w/in 2 hrs of going to bed NM- 2nd part of night dur intense dreamig Return to Sleep NT- Back to sleep quickly NM- May have trouble Memory of Experience NT- no memory NM- may remember & talk about it next day
Nightmare v Night terror (5 points)
56
# reversed prompt 4-5y
Toilet training usually completed by
57
# reversed prompt up to Q3D NL
How often should kids be stooling?
58
# reversed prompt 1- Diet (fiber, bran, whole what, fruits & veggies, H2O) 2-Behavior (toilet after meals-gastrocolic reflex) 3-Medications - Miralax!
Constipation: 3 ways to help Have a low threshold to start on.\_\_\_\_\_\_.
59
# reversed prompt Encopresis
what is it called when you hold your stool for inappropriately long times to the pt that the rectum strectches out
60
# reversed prompt Nocturnal Enuresis Maturational Disorder resolves by 15y
what is bed wetting called? what type of dizorder? when should it completely resolve by?
61
# reversed prompt TDaP Menigococcal HPV
Adolescent Immunizations (3)
62
# reversed prompt Pre-frontal cortex (decisions, planning, inhibitive behavior, self-awareness, social interactions Limbic System (emotional processor, 'reward center', hyper-sensitive!!!!)
2 Brain systems that continue to develop through adolescence
63
# reversed prompt GnRH- LH & FSH - LH stimulates testosterone - FSH stimulates sperm maturation
Puberty hormones - Males
64
# reversed prompt GnRH- LH, FSH - FSH stimulates secretion of estrogen from ovaries
Puberty hormones- Females
65
# reversed prompt 5 Male GU Female GU Female Breast
How many Tanner Stages? What do they assess
66
# reversed prompt prepubertal | (all)
Tanner Stage 1
67
# reversed prompt Male-testis enlarge, scrotal reddens, straight hair female breast- bud, elevation of breast and papilla female GU- sparse, lightly pigmented, straight
Tanner stage 2
68
# reversed prompt Male- penis grows length, hair coarse, curly, dark female breast- further enlargement, no separation of contour female gu- darkening, curl, inc pubic hair to symphysis
Tanner Stage 3
69
# reversed prompt male- penis grows width, darker scrotum, hair full but LIMITED Female breast- secondary mound above breast Female GU- coarse, curly hair, abundant
Tanner Stage 4
70
# reversed prompt Male- mature adult, hair to medial thighs Female Breast- Mature stage, projection of papilla only Female GU- mature adult, hair to median thighs
Tanner Stage 5
71
# reversed prompt before 8 in girls, 9 in boys
Precocious puberty
72
# reversed prompt after 13 in girls, no menarche 16 in girls after 14 in boys
Delayed puberty
73
# reversed prompt Sex- any age (ie Birth Control, STIs, Addiction) Mental Health \>15yo in Colorado
Confidentiality (2 instances)
74
# reversed prompt H- Home E- Education E- Eating A-Activities D-Drugs S-Sexual Hx S- Suicide & Depression
History (H.E.E.A.D.S.S)
75
# reversed prompt Assessment for Drugs in adolescents C-car with a high driver? R-use drugs to relax? A-drugs or alcohol alone? F- forget things you did at school? F- friends/family ask you to 'cut down'? T- gotten in trouble for using drugs/alcohol?
CRAFFT
76
# reversed prompt Bright Futures Guidelines Cholesterol 9-11y Hgb/Hct STI Questionnaire Screens-depression/substance abuse
Adolescent Screening Tools? (5)
77
# reversed prompt HPV
Most common STD in US?
78
# reversed prompt FATIGUE lack of interest boredom irritability sleep/appetitie changes muscle aches HA stomach aches
Classic Symptoms of Depression
79
# reversed prompt yes! ADHD, conduct disorders, anxiety, eating disorders, substance abuse
are comorbidities common in adolescent depression
80
# reversed prompt CBT
Best Tx for depression

Finals (24 decks)

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