Health Supervision Flashcards
Failure to thrive definition
growth rate of less than expected fora child
Failure to thrive affected first
weight affected before length. Head circumference initially spared.
Regain birthweight by
2 weeks
Double birthweight by
4-6 months
Triple birthweight by
12 months
Birth length increases by 50% at
12 months
Birth length doubles by age
4 years
Birht length triples by age
13 years
Most common cause failure to thrive =
inorganic or disturbed parent child bond
By 1 year of life head circumference
increases to 75% of adult
what is cephalohematoma and problem of it?
subperiostal hemorrhage of newborn cranium after trauma delivery. Messes up head measurements
By 1 year of life centimeters increase in head circumference
12 cm since birth
congenital vs acquired microcephaly
congenital is from abnormal creation/movement of brain tissue
acquired = cerebral insult in third trim, pregnancy, 1st year
Craniosynostosis
premature closure of one of the cranial sutures
Two syndromes with craniosynostosis
Crouzon and apert syndromes
Cranial sutures open until
Open till 2 years when 90% is completed
Close at age 5
Most common surture to close early in craniosynostosis
sagittal suture causing dolichocephaly or scaphocephaly
TORCH bugs
toxoplasmosis, syphallus (other), rubella, CMV, HSV
Premature coronal suture closure causes
brachycephaly or shortened skull
What is plagiocephaly
asymmetry of infant head not associated with premature closing of suture
Positional plagiocephaly is what? Associated with what?
flattening of occiput, prominence of ipsilateral frontal area
associated with congenital muscular torticollis
sotos syndrome
overgrowth syndrome where all growth parameters are enlarged
Live vaccines
oral polio, varicella, MMR,
Advantage of live attenuated over inactivated
It gets excreted in stool and can then immunize more people
Mumps associated most with
parotitis but can also do meningoencephalitis and orchitis
Pneumovax vs prevnar in terms of purpose
Pneumovax useless for under 2. More for asplenic people and elderly.
Prevnar is for kids under 7
Difference in pneumovax and prevnar in terms of coverage
Pneumovax covers 23 pneumo subtypes
Prevnar covers only 7
Contraindication to DTaP
encephalopathy or other neuro problems
Pregnant patients don’t get what vaccines?
Live vaccines
If you got immunoglobluins don’t give vaccines because
Don’t give vaccine within 3-11 months because it might interfere with body making immune response
How to screen newborn for hearing
Brainstem auditory evoked response - uses EEG
evoked otoacoustic emission - uses microphone in ear
Most accurate hearing test?
Brainstem auditory evoked response
What is phimosis and paraphimosis
Phimosis = can’t retract skin
paraphimosis - retracted skin gets stuck and is tourniquet
What is balanitis and what is it associated with?
inflammation fo glans of penis. associated w candida or gram neg
where does tooth eruption normally occur?
Usually lower central incisors
How late is delayed dental eruption
primary eruption afte 16 months
What are effects of flourosis and which teeth does it affect
mostly affects permanent teeth
cosmetic changes only. Most vulnerable 2-4 years
where do teeth erupt that occur natal or neonatal
Mostly mandibular central incisors
Most common bacteria in nursing or bottle caries
Streptococcus mutans. Kids get it from parent or sibling because it only colonizes once teeth erupt
Nursing or bottle caries affect which teeth?
Mostly upper teeth bc lower teeth protected by tongue
Best way to save a tooth that was removed by trauma
Keep tooth in liquid and replace soon!
Rear facing seat until?
1 year and 20lbs
Small head circumference at birth indicates
congenital. TORCH, exposure to drugs/toxins, chromo abnormalities,.
spit sutures plus bulging fontanelle =
Increased ICP.
When should cow milk be added and why?
Not introduced until 9 months otherwise can cause iron-deficiency anemia. Whole milk has less bioavailable iron and causes stool blood loss.
Effects of lead intoxication and who is at risk
Usually asymptomatic. Children under 6 at risk
phimosis normal until
6 years of age
Lead intoxication common symptoms
neurocog impairment, lethargy, anemia, vomiting, irritability.
Vit D supplement for?
Kids who are not exposed to much sunlight.
Treatment of torticollis
range of motion stretching exercises, repositioning head in sleep, increased “tummy time”
