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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
Q

How many Tanner Stages?
What do they assess

A

5
Male GU
Female GU
Female Breast

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26
Q

Tanner Stage 1

A

prepubertal

(all)

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27
Q

Tanner stage 2

A

Male-testis enlarge, scrotal reddens, straight hair

female breast- bud, elevation of breast and papilla

female GU- sparse, lightly pigmented, straight

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28
Q

Tanner Stage 3

A

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

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29
Q

Tanner Stage 4

A

male- penis grows width, darker scrotum, hair full but LIMITED

Female breast- secondary mound above breast

Female GU- coarse, curly hair, abundant

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30
Q

Tanner Stage 5

A

Male- mature adult, hair to medial thighs

Female Breast- Mature stage, projection of papilla only

Female GU- mature adult, hair to median thighs

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31
Q

Precocious puberty

A

before 8 in girls, 9 in boys

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32
Q

Delayed puberty

A

after 13 in girls, no menarche 16 in girls
after 14 in boys

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33
Q

Confidentiality (2 instances)

A

Sex- any age (ie Birth Control, STIs, Addiction)
Mental Health >15yo in Colorado

34
Q

History (H.E.E.A.D.S.S)

A

H- Home
E- Education
E- Eating
A-Activities
D-Drugs
S-Sexual Hx
S- Suicide & Depression

35
Q

CRAFFT

A

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
Q

Adolescent Screening Tools? (5)

A

Bright Futures Guidelines
Cholesterol 9-11y
Hgb/Hct
STI
Questionnaire Screens-depression/substance abuse

37
Q

Most common STD in US?

38
Q

Classic Symptoms of Depression

A

FATIGUE
lack of interest
boredom
irritability
sleep/appetitie changes
muscle aches
HA
stomach aches

39
Q

are comorbidities common in adolescent depression

A

yes!
ADHD, conduct disorders, anxiety, eating disorders, substance abuse

40
Q

Best Tx for depression

41
Q

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

A

What to assess at well visit? (10)

42
Q

reversed prompt

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

Motor/Physical
4y

43
Q

reversed prompt

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

Motor/Physical
5y

44
Q

reversed prompt

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

A

Language
4y

45
Q

reversed prompt

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

A

Language
5y

46
Q

reversed prompt

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

A

Social/Emotional
4y

47
Q

reversed prompt

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

A

Social/Emotional
5y

48
Q

reversed prompt

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

A

Cognitive
4y

49
Q

reversed prompt

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

A

Cognitive
5y

50
Q

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
A

Development
5-7y

51
Q

reversed prompt

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

Development
7-11

52
Q

reversed prompt

10-14hrs/night naps disappear

A

Sleep Req 3-5y

53
Q

reversed prompt

10-14hrs/night

A

Sleep Req 5-7y (school aged)

54
Q

reversed prompt

9-9.5 hrs/night

A

Sleep Req Adolescents

55
Q

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

A

Nightmare v Night terror (5 points)

56
Q

reversed prompt

4-5y

A

Toilet training usually completed by

57
Q

reversed prompt

up to Q3D NL

A

How often should kids be stooling?

58
Q

reversed prompt

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

A

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

59
Q

reversed prompt

Encopresis

A

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

60
Q

reversed prompt

Nocturnal Enuresis
Maturational Disorder
resolves by 15y

A

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

61
Q

reversed prompt

TDaP
Menigococcal
HPV

A

Adolescent Immunizations (3)

62
Q

reversed prompt

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

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

A

2 Brain systems that continue to develop through adolescence

63
Q

reversed prompt

GnRH- LH & FSH

  • LH stimulates testosterone
  • FSH stimulates sperm maturation
A

Puberty hormones - Males

64
Q

reversed prompt

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

A

Puberty hormones- Females

65
Q

reversed prompt

5
Male GU
Female GU
Female Breast

A

How many Tanner Stages?
What do they assess

66
Q

reversed prompt

prepubertal

(all)

A

Tanner Stage 1

67
Q

reversed prompt

Male-testis enlarge, scrotal reddens, straight hair

female breast- bud, elevation of breast and papilla

female GU- sparse, lightly pigmented, straight

A

Tanner stage 2

68
Q

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

A

Tanner Stage 3

69
Q

reversed prompt

male- penis grows width, darker scrotum, hair full but LIMITED

Female breast- secondary mound above breast

Female GU- coarse, curly hair, abundant

A

Tanner Stage 4

70
Q

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

A

Tanner Stage 5

71
Q

reversed prompt

before 8 in girls, 9 in boys

A

Precocious puberty

72
Q

reversed prompt

after 13 in girls, no menarche 16 in girls
after 14 in boys

A

Delayed puberty

73
Q

reversed prompt

Sex- any age (ie Birth Control, STIs, Addiction)
Mental Health >15yo in Colorado

A

Confidentiality (2 instances)

74
Q

reversed prompt

H- Home
E- Education
E- Eating
A-Activities
D-Drugs
S-Sexual Hx
S- Suicide & Depression

A

History (H.E.E.A.D.S.S)

75
Q

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?

76
Q

reversed prompt

Bright Futures Guidelines
Cholesterol 9-11y
Hgb/Hct
STI
Questionnaire Screens-depression/substance abuse

A

Adolescent Screening Tools? (5)

77
Q

reversed prompt

HPV

A

Most common STD in US?

78
Q

reversed prompt

FATIGUE
lack of interest
boredom
irritability
sleep/appetitie changes
muscle aches
HA
stomach aches

A

Classic Symptoms of Depression

79
Q

reversed prompt

yes!
ADHD, conduct disorders, anxiety, eating disorders, substance abuse

A

are comorbidities common in adolescent depression

80
Q

reversed prompt

CBT

A

Best Tx for depression

Finals (24 decks)

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