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N7515 > Mod 2 Pediatric History and Exam > Flashcards

Mod 2 Pediatric History and Exam Flashcards

1
Q

brachycephaly

A

coronal sutures fuses, but brain is still developing - widening of the skull/head as head cannot expand front/back

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2
Q

scaphocephaly

A

sagittal suture closes - head grows front to back

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3
Q

plagiocephaly

A

unilateral closure of coronal suture (only on one side)

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4
Q

listening area for aortic stenosis or venous hum

A

URSB

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5
Q

listening area for pulmonary stenosis and pulmonary flow murmurs

A

ULSB

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6
Q

listening area for atrial septal defect or patent ductus arteriosis

A

ULSB

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7
Q

listening area for Still’s murmur

A

LLSB

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8
Q

listening area for ventricular septal defect

A

LLSB

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9
Q

listening areas for tricuspid valve regurgitation

A

LLSB

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10
Q

listening area for hypertrophic cardiomyopathy

A

LLSB

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11
Q

listening area for sub-aortic stenosis

A

LLSB

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12
Q

listening area for mitral valve regurgitation

A

apex

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13
Q

Two layers of skin

A

epidermis

dermis

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14
Q

Dermis functions

A
  • contributes to strength, support, elasticity
  • mechanical barrier
  • regulates heat loss, provides host defenses of the skin, aids in nutrition
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15
Q

3 types of sweat glands / location

A

Eccrine - distributed over entire body; help maintain fluid and electrolyte balance and temperature

Ceruminous - located in external ear canal and secrete cerumen

Apocrine - located primarily in axillary, genital, and peri umbilical areas; thought to be responsible for body odor

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16
Q

3 cutaneous reactions to trauma/infection/inflammation

A

Pigment lability (post inflammatory hypo or hyperpigmentation)

Follicular response (results in prominent papule and folic formation)

Mesenchyma response (often follows procedures that may. cause scars - ex: varicella, ear piercing)

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17
Q

pigment lability

A

cutaneous reaction that occurs post inflammatory as hypopigmentation or hyperpigmentation

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18
Q

examples of disorders that often cause superficial (changes in epidermis only) trauma

A

diaper rash, seborrhea, tines

usually normal pigmentation occurs in about 6 months

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19
Q

examples of disorders that cause dermal changes (usually more longterm or permanent pigmentation changes)

A

excoriated acne, impetigo, varicella, contact dermatitis

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20
Q

scars that thicken and extend beyond the margins of the initial injury

A

keloids

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21
Q

vesicle larger than 1cm

A

bulla

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22
Q

plugged, dilated pore
open = blackhead
closed = whitehead

A

comedome

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23
Q

palpable lesion with definite borders filled with liquid or semisolid material

A

cyst

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24
Q

flat, non palpable, discolored lesion, 1cm or smaller

A

macule

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25
Q

raised, firm, moveable lesion with indistinct borders and deep palpable portion

2cm or smaller

A

nodule

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26
Q

solid, raised lesion of varied color with distinct borders

1cm or smaller

A

papule

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27
Q

macule, larger than 1cm

A

patch

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28
Q

solid, raised, flat-toped lesion with distinct borders

larger than 1cm

A

plaque

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29
Q

raised lesion filled with pus, often in hair follicle or sweat pore

A

pustule

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30
Q

large nodule, may be firm or soft

A

tumor

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31
Q

blister filled with clear fluid

A

vesicle

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32
Q

fleeting, irregularly shaped, elevated, itchy lesion of varied size

pale at center

slightly red at borders

A

wheal

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33
Q

dried exudate or scab of varied color

A

crusts

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34
Q

abrasion or removal of epidermis; scratch

A

excoriation

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35
Q

linear, wedge-shaped cracks extending into dermis

A

fissues

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36
Q

healed lesion of hypertrophied connective tissue

A

keloid

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37
Q

thin, flaking layers of epidermis

A

scales

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38
Q

healed lesion of connective tissue

A

scar

39
Q

fine pink or silver lines in areas where skin has been stretched

A

striae

40
Q

deeper than erosion; open lesion extending into dermis

A

ulcer

41
Q

thinning skin, may appear translucent

A

atrophy

42
Q

papule made of blood vessels

A

angioma or hemangioma

43
Q

bruise

purple to brown colored

macular or papular

varies in size

A

ecchymosis

44
Q

collection of blood from ruptured blood vessel

larger than 1cm

A

hematoma

45
Q

pinpoint

pink to purple macular lesions

do not blanch

1-3mm

A

petechiae

46
Q

purple macular lesion

larger than 1cm

A

purpura

47
Q

collection of macular or raised dilated capillaries

A

telangiectasia

48
Q

high-risk children who have any of the following should be referred to ophthalmologist: (4)

A
  • failed vision screening in primary care
  • vision complaint or observed abnormal visual behavior
  • health or development problems that places child at risk for eye issues (ex: Down syndrome, prematurity)
  • family history of conditions that cause eye issues (ex: retinoblastoma)
49
Q

health issues that place child at risk for eye issues (4 examples)

A

down syndrome
prematurity
juvenile idiopathic arthritis
neurofibromatosis

50
Q

family history associated with eye / vision problems (5)

A 
retinoblastoma
significant hyperopia
strabismus (accomodative esotropia)
amblyopia
congenital cataract or glaucoma
51
Q

age when infants can follow moving objects

A

3 months

52
Q

age when children can indicate visual recognition of familiar objects

A

4 months

53
Q

age when eye growth is completed

A

10-13 years

54
Q

age when adult visual field is obtained

A

about 10 years old

55
Q

visual pathways are amenable to greatest corrective influence until what age?

A

7-8 years old

56
Q

recommended methods for eye screening from newborn to 3 months (2)

A

red light reflex

inspection

57
Q

recommended methods for eye screening age 3-6 months (approximately)

A

fix and follow
red light reflex
inspection

58
Q

recommended method for eye screening age 6-12 months (or until child is able to cooperate for verbal visual acuity)

A 
fix and follow with each eye
alternative occlusion 
corneal light reflex
red light reflex
inspection
59
Q

ability of the lens to focus on close objects by increasing its curvature

A

accommodation

60
Q

convergence and accommodation normally develop by what age

A

3-4 months of age

61
Q

convergence and accommodation without nystagmus or strabismus develop by what age

A

5-6 months

62
Q

things to ask eye assessment history

A
  • general medical history (ex: birth weight, hospitalizations, surgeries)
  • family hx eye issues
  • history of chronic systemic diseases in pt or family
  • allergies
  • ocular history (ex: last eye exam, history of eye injury, prescription glasses, sunglasses)
  • sx of eye dysfunction (ex: itching, excessive tearing/discharge, erythema, burning, strabismus)
63
Q

age when infant can sporadically fix and follow objects

A

2-4 weeks old

64
Q

vision: age when infant recognizes parent’s smile; reaches towards toy

A

3-4 months old

65
Q

age when color vision is near that of an adult

A

4 months old

66
Q

vision: age when infant can fix and follow toy in all directions with smooth movements

A

6-10 months old

67
Q

Eustachian tube functions (2)

A
  1. ventilate the middle ear to equalize middle ear pressure with atmospheric pressure
  2. drain secretion from the middle ear into the nasopharynx
68
Q

things to ask about for ear assessment history

A
  • ear pain (onset, quality, duration)
  • itching or discharge
  • ear condition history
  • history of meningitis
  • tinnitus
  • craniofacial abnormalities
  • prematurity
  • family history
  • developmental milestones for speech
69
Q

red flags for hearing loss during infancy (birth to 1 yr)

A
  • does not startle to loud noises
  • does not turn to the source of sound after 6 months
  • does not say single words like ‘dada’ or ‘mama’ by 1 year
  • turns head when he/she sees you but not just to voice
  • seems to hear some sounds but not others
70
Q

red flags for hearing loss during childhood

A
  • delayed or unclear speech
  • difficulty following instructions
  • teacher concerns about paying attention
  • often saying ‘huh’ or ‘what’
  • turning volume up high on TV or radio
71
Q

normal respiratory rate for age 0-1 years

A

24-38 breaths/min

72
Q

normal respiratory rate age 1-3 years

A

22-30 breaths per min

73
Q

normal respiratory rate age 4-6 years

A

20-24 breaths/min

74
Q

normal respiratory rate age 7-9 years

A

18-24 breaths/min

75
Q

normal respiratory rate age 10-14 years

A

16-22 breaths/min

76
Q

normal respiratory rate age 15-18 years

A

14-20 breaths/min

77
Q

4 unique features of fetal circulation that differ from postnatal circulation

A
  1. oxygenation of blood occurs at placenta
  2. fetal pulmonary Vascular resistance is high and systemic is low (R side of heart is high pressure)
  3. foramen ovale (opening in septum between two atria) permits portion of blood to flow from R to L atrium
  4. patent ductus arteriosis allows blood to flow from pulmonary artery to aorta (bypass fetal lungs)
78
Q

neonate circulatory changes within first few hours-days of life

A
  • increased systemic vascular resistance
  • oxygenation at lungs
  • foramen ovale closes (2/2 high pressure on L heart now instead of R)
  • ductus arteriosus closes
79
Q

at what age do you begin measuring BP in children and how often should this be done

A

3 years

should be measured annually

80
Q

perinatal risk factors suggestive of congenital heart disease

A
  • maternal use of tobacco, drugs
  • maternal infections (CMV, rubella)
  • maternal chronic disease (CHD, lupus, DM)
  • maternal age
  • maternal pregnancy history (gestational DM, weight gain)
81
Q

newborn risk factors for congenital heart defect

A
  • murmur at birth / early infancy
  • trouble feeding (out of breath)
  • HTN
  • cyanosis (with crying, feeding)
  • tachypnea
82
Q

toddler/school age/teenage risk factors for congenital heart defects

A
  • deviation from normal growth/development
  • abnormal activity level (tired easily, can’t keep up)
  • prior murmurs
  • syncope, fainting
  • chest pain
  • frequent resp infections
  • SOB
  • tachycardia or bradycardia (fluttering in chest, racing heart)
83
Q

normal newborn resting HR (awake and asleep)

A

awake: 100-180bpm
asleep: 80-160 bpm

84
Q

normal 1 week to 3 month old resting HR (awake and asleep)

A

awake: 100-220 bpm
asleep: 80-100 bpm

85
Q

normal 3 month to 2 year old resting HR (awake and asleep)

A

awake: 80-150 bpm
asleep: 70-120 bpm

86
Q

normal 2-10 year old resting HR (awake and asleep)

A

awake: 70-100 bpm
asleep: 60-90 bpm

87
Q

normal 10-20 year old resting HR

A

55-90 bpm

88
Q

palpable vibration caused by turbulent blood flow through abnormal structures or defects in the heart

A

thrill

89
Q

murmur barely audible; heard faintly after period of attentive listening

A

grade I murmur

90
Q

murmur soft but easily audible - what grade ?

A

grade 2

91
Q

murmur moderately loud but no thrill - what grade?

A

grade 3

92
Q

murmur loud, present over widespread area with palpable thrill - what grade?

A

grade 4

93
Q

murmur loud, audible with stethoscope barely on chest with precordial thrill present - what grade?

A

grade 5

94
Q

murmur heart without stethoscope - what grade?

A

grade 6 (rare)

N7515 (4 decks)

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