module 10. Peds I

Question 1

When are most children ready for toilet training?

Answer 1

Once they show interest, it can be as early as 18 months -4 years of age

Question 2

What is Coxsackie virus? and list its sign and sypmtoms

Answer 2

Hand-Foot-and-Mouth

Low grade fever 1-2 days before oral lesions
Oral cavity small red papules that become vesicles on red bases, then turn into ulcerations at X1 week

Mild GI upset, malaise during prodrome

Question 3

What is the incubation period for coxsackie?

Answer 3

3-5 days

Question 4

What are the symptoms of Kawasaki Disease (vasculitis)

Answer 4

fever 5 + days
Unilateral lymphedanopathy
bulbar conjunctivitis
rash to body
Mucous membrane changes to lips/oral cavity

Question 5

What are the signs and symptoms of Parovirus B12?

Answer 5

Erythematous malar rash (slapped cheek) 2-5 days after symptom onset

Low grade fever
Rhinorrhea/Coryza, headache, nausea, diarrhea

Question 6

why should pregnant women avoid being arround anyone with Parovirus b12?

Answer 6

Because is can cause anemia in the fetus

Question 7

What are the symptoms of Rubeola (red measels)

Answer 7

1. Three C’s Cough, Coryza, Conjunctivitis Enanthem
2. Koplik spots (white spots on base of cheek) develop prior to rash
3. Desquamation
4. High fever X3 days then erythematous, maculopapular, blanching rash

Question 8

How is Rubeola transmitted and is it reportable?

Answer 8

Airborne and yes its reportable

you would order blood work:

Measles IgM and IgG

Question 9

how is Rubella (german measles) transmitted?

Answer 9

droplet

Question 10

what are the signs and symptoms of Rubella (german measles)

Answer 10

low grade fever X5 days prior to rash development
then fine maculopapular rash, starts on face then moves to neck and trunk

Question 11

Why should pregnant women be scare if they are exposed to Rubella (german measels)

Answer 11

because it can lead to congenital rubella syndrome which can lead to a miscarriage

Question 12

What virus causes Rubella (german measels)

Answer 12

its Rubivirus

Question 13

What virus causes roseola?

Answer 13

Human Herpes Virus HHV-6

Question 14

what complications can arise from roseola?

Answer 14

febrile seizures
aseptic meningitis
thrombocytopenia

Question 15

what are the symptoms of Roseola?

Answer 15

Fever without obvious cause for 3-5 days
Once the fever breaks the patient will develop a non-puritic maculopapular rask on neck and trunk

The rash will resolve in about 48 hours

They may also have bilateral TM erythema

Question 16

When should the NP-PHC begin screening for lead poisoning in a child who has significant risk for exposure?

Answer 16

6 months

Question 17

What are the different types of stabismus?

Answer 17

Esotropia (one eye turns inwards)
Exotropia (one eye turns outwards)
Hypotropia (one eye looks downards)
Hypertropia one eye looks upwards

Question 18

What tests can you perform on a child who presents with strabismus?

Answer 18

1. Hirschberg test
2. Cover-uncover test
   3.Alternate cover test

Question 19

What is the peak age of:

Croup
Bronchiolitis
Epiglotitis

Answer 19

Croup peak age =2 (often parainfluenza)
Bronch =6m
Epiglotitis = 7 (caused by h. Influenza)

Question 20

What percentage of weight loss would you see in mild dehydration?

Answer 20

infant 5%
child 3-4%

Question 21

What percentage of weight loss would you see in moderate dehydration ?

Answer 21

Infant 10%
Child 6-8%

Question 22

What percentage of weight loss would you see in severe dehydration?

Answer 22

infant 15%
Child 10%

Question 23

Under what FEMALE circumstances would you need to order a

Voiding Cystourethrogram w floroscopy and abdo ultrasound and DMSA scan?

Answer 23

any child with pyelonephritis

Female infant less than 3 years of age w. UTI
Female infant greater than 3 years of age w. 2nd UTI

1st UTI in any child with fx of kidney issues or HTN or any weird voiding issues

Question 24

under what circumstances would a male infant require a Voiding Cystourethrogram w floroscopy and abdo ultrasound and DMSA scan?

Answer 24

1st UTI in boys of any age
pylonephritis

1st UTI in any child with fx of kidney issues or HTN or any weird voiding issues

Question 25

What is the difference between primary and secondary enuresis?

Answer 25

Nocturnal enuresis is involuntary urination that happens at night while sleeping, after the age when a person should be able to control his or her bladder

Primary – occurring since infancy

Secondary – occurring at least 6 months after child gained bladder control

Question 26

what is ENCOPRESIS?

Answer 26

the soiling of underwear with stool by children who are past the age of toilet training
1%-2% of children younger than 10 years; boys>girls
Usually caused by long term constipation

Question 27

When should the NP-PHC begin screening for lead poisoning in a child who has significant risk for exposure?

Answer 27

6 months

Blood Lead Screening is recommended for children who:

in the last 6 months lived in a house or apartment built before 1960;
live in a home with recent or ongoing renovations or peeling or chipped paint;
have a sibling, housemate, or playmate with a prior history of lead poisoning;
live near point sources of lead contamination;

Question 28

What would you advise a parent with a newborn regarding sun exposure?

Answer 28

Minimize sun exposure. Wear protective clothing, hats, properly applied sunscreen with SPF ≥ 30 for those > 6 months of age.