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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
raised, firm, moveable lesion with indistinct borders and deep palpable portion 2cm or smaller
nodule
26
solid, raised lesion of varied color with distinct borders 1cm or smaller
papule
27
macule, larger than 1cm
patch
28
solid, raised, flat-toped lesion with distinct borders larger than 1cm
plaque
29
raised lesion filled with pus, often in hair follicle or sweat pore
pustule
30
large nodule, may be firm or soft
tumor
31
blister filled with clear fluid
vesicle
32
fleeting, irregularly shaped, elevated, itchy lesion of varied size pale at center slightly red at borders
wheal
33
dried exudate or scab of varied color
crusts
34
abrasion or removal of epidermis; scratch
excoriation
35
linear, wedge-shaped cracks extending into dermis
fissues
36
healed lesion of hypertrophied connective tissue
keloid
37
thin, flaking layers of epidermis
scales
38
healed lesion of connective tissue
scar
39
fine pink or silver lines in areas where skin has been stretched
striae
40
deeper than erosion; open lesion extending into dermis
ulcer
41
thinning skin, may appear translucent
atrophy
42
papule made of blood vessels
angioma or hemangioma
43
bruise purple to brown colored macular or papular varies in size
ecchymosis
44
collection of blood from ruptured blood vessel larger than 1cm
hematoma
45
pinpoint pink to purple macular lesions do not blanch 1-3mm
petechiae
46
purple macular lesion larger than 1cm
purpura
47
collection of macular or raised dilated capillaries
telangiectasia
48
high-risk children who have any of the following should be referred to ophthalmologist: (4)
- 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
health issues that place child at risk for eye issues (4 examples)
down syndrome prematurity juvenile idiopathic arthritis neurofibromatosis
50
family history associated with eye / vision problems (5)
``` retinoblastoma significant hyperopia strabismus (accomodative esotropia) amblyopia congenital cataract or glaucoma ```
51
age when infants can follow moving objects
3 months
52
age when children can indicate visual recognition of familiar objects
4 months
53
age when eye growth is completed
10-13 years
54
age when adult visual field is obtained
about 10 years old
55
visual pathways are amenable to greatest corrective influence until what age?
7-8 years old
56
recommended methods for eye screening from newborn to 3 months (2)
red light reflex | inspection
57
recommended methods for eye screening age 3-6 months (approximately)
fix and follow red light reflex inspection
58
recommended method for eye screening age 6-12 months (or until child is able to cooperate for verbal visual acuity)
``` fix and follow with each eye alternative occlusion corneal light reflex red light reflex inspection ```
59
ability of the lens to focus on close objects by increasing its curvature
accommodation
60
convergence and accommodation normally develop by what age
3-4 months of age
61
convergence and accommodation without nystagmus or strabismus develop by what age
5-6 months
62
things to ask eye assessment history
- 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
age when infant can sporadically fix and follow objects
2-4 weeks old
64
vision: age when infant recognizes parent's smile; reaches towards toy
3-4 months old
65
age when color vision is near that of an adult
4 months old
66
vision: age when infant can fix and follow toy in all directions with smooth movements
6-10 months old
67
Eustachian tube functions (2)
1. ventilate the middle ear to equalize middle ear pressure with atmospheric pressure 2. drain secretion from the middle ear into the nasopharynx
68
things to ask about for ear assessment history
- 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
red flags for hearing loss during infancy (birth to 1 yr)
- 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
red flags for hearing loss during childhood
- 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
normal respiratory rate for age 0-1 years
24-38 breaths/min
72
normal respiratory rate age 1-3 years
22-30 breaths per min
73
normal respiratory rate age 4-6 years
20-24 breaths/min
74
normal respiratory rate age 7-9 years
18-24 breaths/min
75
normal respiratory rate age 10-14 years
16-22 breaths/min
76
normal respiratory rate age 15-18 years
14-20 breaths/min
77
4 unique features of fetal circulation that differ from postnatal circulation
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
neonate circulatory changes within first few hours-days of life
- 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
at what age do you begin measuring BP in children and how often should this be done
3 years | should be measured annually
80
perinatal risk factors suggestive of congenital heart disease
- 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
newborn risk factors for congenital heart defect
- murmur at birth / early infancy - trouble feeding (out of breath) - HTN - cyanosis (with crying, feeding) - tachypnea
82
toddler/school age/teenage risk factors for congenital heart defects
- 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
normal newborn resting HR (awake and asleep)
awake: 100-180bpm asleep: 80-160 bpm
84
normal 1 week to 3 month old resting HR (awake and asleep)
awake: 100-220 bpm asleep: 80-100 bpm
85
normal 3 month to 2 year old resting HR (awake and asleep)
awake: 80-150 bpm asleep: 70-120 bpm
86
normal 2-10 year old resting HR (awake and asleep)
awake: 70-100 bpm asleep: 60-90 bpm
87
normal 10-20 year old resting HR
55-90 bpm
88
palpable vibration caused by turbulent blood flow through abnormal structures or defects in the heart
thrill
89
murmur barely audible; heard faintly after period of attentive listening
grade I murmur
90
murmur soft but easily audible - what grade ?
grade 2
91
murmur moderately loud but no thrill - what grade?
grade 3
92
murmur loud, present over widespread area with palpable thrill - what grade?
grade 4
93
murmur loud, audible with stethoscope barely on chest with precordial thrill present - what grade?
grade 5
94
murmur heart without stethoscope - what grade?
grade 6 (rare)

N7515 (4 decks)

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