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Old Peds > Lecture 10/1 > Flashcards

Lecture 10/1 Flashcards

1
Q

when can kids become front facing in a car seat?

A

2 years old

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2
Q

when can you screen for ADHD well?

A

School aged, particularly 2nd and 3rd grade

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3
Q

what is the most common type of deaths for children?

A
  1. motor vehicle accidents

2. drownings/ smoke or fire

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4
Q

what ages have the highest risk of drowning?

A

ages 1-3

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5
Q

when should children start getting teeth?

A

7-12 months

they should have them by 15 months old

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6
Q

What teeth usually fall out first?

A

Fall out in pairs

bottom front teeth usually come out at same time

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7
Q

What is the main appropriate test to evaluate cognition. Usually done by a developmental psychologist.

A

Bayley scores

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8
Q

what is used for intelligence testing?

A

Standford Binet

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9
Q

when is colic common?

A

First few weeks of life up to 6 months. Predictable pattern

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10
Q

What type babies is colic common in?

A

Formula-fed babies

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11
Q

severe and paroxysmal crying that occurs mainly in the late afternoon. Difficult to console.

A

Colic

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12
Q

What can you do for colic?

A

Reassure the parents
rule out other issues
preventative, try to stop it before it starts

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13
Q

when does colic peak?

A

2-3 months

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14
Q

what is the rule of 3s for colic?

A

Healthy and well fed but cries > 3 hours/day for > 3 days a week, for > 3 weeks

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15
Q

What drugs helps to reduce gas? Doesn’t really help prevent colic

A

Simethicone

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16
Q

what is commonly used for reflex, but may not be helpful.

A

Zantac

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17
Q

What is one of the most common reasons for shaken baby syndrome?

A

colic

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18
Q

Who is food refusal common in?

A

Toddlers/ school aged children

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19
Q

what can food refusal be an underlying sign of?

A

thrush
esophageal dysmotility
infection (ear infection, etc)
pyloric stenosis (only in infancy)

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20
Q

what’s the first thing you should do when you see food refusal?

A

Look at growth chart to make sure they aren’t falling off of it

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21
Q

what is a way to increase calorie intake for children doing food refusal?

A

have them butter all their foods
avoid fruit juices (excessive juice)
fortify with high calorie drinks (pediasure drinks)

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22
Q

What study can show constipation?

A

radiographic studies

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23
Q

when do most babies start to sleep through the night?

A

6 months

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24
Q

when is sleeping disorders a problem due to separation anxiety

A

9 months

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25
Q

2hrs after sleeping, during NREM, screaming thrashing, tachycardia, sweating… ends after 30min… no memory of it.

A

Night terrors

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26
Q

– during REM, later in the night, typically followed by awakening. Typically 3-5yr old. 25-50%

A

night mares

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27
Q

when are temper tantrums common

A

12 months- 4 years

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28
Q

how do you avoid temper tantrums?

A

chid-proof the environment
pick your battles
distraction

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29
Q

what can you do to stop breath-holding?

A

nothing really

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30
Q

what can breath holding lead to rarely?

A

seizure

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31
Q

when are temper tantrums the highest?

A

2 years of age

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32
Q

what is a function problem?

A

Not related to a physical problem

ex- holding stool, eating low fiber diet

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33
Q

what is an organic issue?

A

Related to anatomic or neurologic problems

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34
Q

incontinence beyond “maturity” - typically age 4

A

Enuresis

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35
Q

when is nighttime dryness usually achieved?

A

6 years old

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36
Q

Never been contient

A

primary enuresis

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37
Q

Dry at least 6 months but now have incontinence episodes again

A

secondary enuresis

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38
Q

what is the ddx for enuresis

A

developmental difficulties
organic illness
psychological distress

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39
Q

what type of nocturnal enuresis is most likely to have a family history and no identified problem
up to 6-8 years old

A

primary nocturnal enuresis

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40
Q

type of enuresis that is more likely to have an organic etiology: UTI, DM, DI
happens in day and night

A

secondary diurnal and nocturnal

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41
Q

More likely to have a neurodevelopmental disorder or bladder problem

A

primary diurnal and nocturnal enuresis

42
Q

type of enuresis that is more likely to have psychosocial stressor or sleep disorder

A

secondary nocturnal

43
Q

what labs do you get for enuresis?

A

Clean catch urinalysis
urine culture (if indicated)
RUS (renal US)
VCUG (voiding cystourogram)

44
Q

3 was to treat enuresis

A

conditioning (bladder training) go on scheduled basis
imipramine (tricyclic antidepressant, nocturnal enuresis)
desmopressin (drug- good for diabetes insipidus)

45
Q

decreased BM frequency, hard stools

A

constipation

46
Q

regular voluntary or involuntary passage of feces somewhere other than the toilet after 4 yrs : often occurs with constipation

A

encorperesis

47
Q

involuntary passage of feces ; typically associated with fecal impaction

A

soiling

48
Q

when should you only use drug therapy for enuresis

A

primary enuresis

49
Q

when will you do a rectal exam for constipation?

A

For chronic constipation

check to see if they can willingly contract

50
Q

what is a cremaster reflex?

A

scrotum lifts up if inner thigh stroked

51
Q

Will most constipation resolve?

A

Yes 50-60% resolve with proper education, diet, behavioral therapy + laxative

52
Q

How long will treatment for constipation last?

A

Lots of times over 6 months

sometimes have to give them diarrhea to teach them it won’t hurt to poop

53
Q

what are the 3 major nutritional components accounting for calories in all food?

A

Protein
Fatty Acids
Carbohydrates

54
Q

What are other nutritional components not accounting for calories?

A

Vitamins
Minerals
trace elements

55
Q

what nutrient has the highest requirement in infancy and is necessary for physical growth and development.

A

protein

56
Q

are there body stores of protein in infancy?

A

no, all must be supplemented and synthesized

57
Q

essential amino acids

A

can’t be synthesized in body, but be injested

58
Q

what is the main infant dietary source (but not main energy source) needed for cellular respiration, energy to maintain normal body processes.

A

fatty acids, main caloric content

59
Q

where are fatty acids stored well and used for long term energy?

A

adipose tissue

60
Q

what is the majority of breast milk?

A

Fat

61
Q

what is brain development mostly reliant on?

A

Fatty acids and carbs

62
Q

what type fat is the majority in breast milk?

A

Poly-unsaturated fats

63
Q

when are the requirements for calcium increased

A

from infancy to age 1-3 and again at age 8

64
Q

when does most bone density develop

A

8-10 years of life

65
Q

when is potassium intake not encouraged?

A

renal failure

66
Q

what can potassium deficiency cause?

A

muscle weakness
mental confusion
cardiac arrhythmias

67
Q

are deficiencies in trace elements common?

A

No, most foods are fortified w/ these

68
Q

where is potassium found

A

readily available in most unprocessed foods

69
Q

What vitamin do infants need to be supplement with?

A

Vitamin D (breast-fed babies) formula already fortified

70
Q

when do you get vitamin A and E deficiencies

A

malabsorption issues

prematurity

71
Q

what are the water soluble vitamins

A

B and C

72
Q

What are the fat soluble vitamins

A

A D E K

73
Q

this vitamin play role in fat and carbohydrate metabolism, immune development. Folic acid prevents intrauterine neural tube defects

A

B vitamins

74
Q

acts at antioxidant, has role in collagen synthesis.

A

Ascorbic Acid (vitamin C)

75
Q

what is the primary source of carbs?

A

Lactose

76
Q

what is the predominate source of energy in childhood?

A

carbs

77
Q

when is the most rapid growth in an infant?

A

first month of life then decreases

78
Q

a healthy baby from birth to one year old should ____ their birth weight.

A

triple

79
Q

main dietary energy source in infancy, accounts for up to 50% of caloric energy in breast milk

A

Fats

80
Q

is the second most abundant energy source followed by protein

A

Carbs

81
Q

Caloric needs ______ as the infant ages.

A

decreases

82
Q

Does breast milk or formula have more protein.

A

Formula, but it is less bioavailable, so that is why there is more
protein from breast milk is more efficient

83
Q

what is the biggest benefit of breast milk?

A

Passive immunity through first 6 months of life

84
Q

what is the normal number of feedings per day?

A

8-10 feedings on demand schedule (every 2-3 hours)

becomes less as they get older

85
Q

when can you start supplementing w/ cereals and baby foods?

A

6 months

can be ready as soon as baby can support then head w/o bobbling

86
Q

how many new foods should you add per week?

A

1 new food (good to make sure they don’t have a food allergy)

87
Q

when do you start table and solid foods?

A

not until a year, allergy is the highest risk until then

88
Q

when can a baby receive cows milk?

A

Not until 1 year old, can prevent binding of iron and cause allergies

89
Q

when can a baby drink water?

A

infants shouldn’t have free water before 6 months of age. Don’t real need water- getting it from their formula/ breast milk

90
Q

what babies may require higher calorie formulas? 24-26 kcal/oz

A

under 1500 grams

prematurity or SGA

91
Q

how long do you use these higher calorie formulas?

A

Get them above 3rd percentile and see which growth curve percentile they stabilize on and normalize on.
Once you have 2-3 data points on that curve you can switch to normal sources

92
Q

what causes nonprojectile emesis that is usually a result of weakness in the lower esophageal sphincter.

A

GER (gastroesophageal reflux)

93
Q

what can help with GER?

A

formulas fortified with rice carbohydrate to thicken or may partially break down milk proteins to avoid emesis

94
Q

If a baby presents with FTT, vomiting, acidosis, seizures, hepatomegaly what should you suspect?

A

Metabolic disease/ malabsorption

95
Q

Can GER be present with breastfed moms?

A

Yes, mom’s diet could be the source (high acid)

96
Q

what babies are you more likely to see a milk protein allergy?

A

formula-fed babies

97
Q

what are some common symptoms with milk protein allergy?

A

fussiness/ flatus
diarrhea- bloody or mucousy
FTT

98
Q

What do you do for milk protein allergy?

A

Give a different formula- the more processed though the least the infant will like it

99
Q

what is the order of nutrients that an older child should intake be?

A

carbs
proteins
fats

100
Q

what is obesity in kids?

A

> 95%

101
Q

what are the most common allergies in children?

A 
peanuts
tree nuts
fish
eggs (might also have a poultry allergy) 
dairy (might also have a beef allergy) 
soy

Old Peds (15 decks)

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