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Pediatrics 1 > Modules 1-3 > Flashcards

Modules 1-3 Flashcards

1
Q

neonate age

A

0-28 days

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2
Q

Infant age

A

1 month - 1 year

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3
Q

Toddler age

A

1 -3 years

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4
Q

School age range

A

4-11 years

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5
Q

Adolescent age

A

12-18 years

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6
Q

Define pediatrics

A

Branch of medicine concerned with the physical, mental, and social health of children from birth to young adulthood

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7
Q

Top 5 causes of infant death in US

A
  1. congenital malformations/chromosome abnormalities/ 2. Short gestation/low birthweight
  2. Maternal complications
  3. SIDS
  4. Accidents
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8
Q

Top 5 causes of death ages 1-4

A
  1. Accidents
  2. Congenital abnormalities
  3. Cancer
  4. Homicide
  5. Heart disease
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9
Q

Top 5 causes of death ages 5-9

A
  1. Accidents
  2. Cancer
  3. Congenital abnormalities
  4. Homicide
  5. Heart disease
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10
Q

Top 5 causes of death ages 10-14

A
  1. Accidents
  2. Suicide
  3. Cancer
  4. Congenital abnormalities
  5. Homicide
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11
Q

Top 5 causes of death ages 15-24

A
  1. Accidents
  2. Suicide
  3. Homicide
  4. Cancer
  5. Heart disease
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12
Q

Define beneficence

A

Maximizing benefit and minimizing burden; acting in the patient’s best interest

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13
Q

Define informed consent

A

Full disclosure to the patient of the facts necessary to make reasonable consent for intervention

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14
Q

What age does assent start?

A

About 7

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15
Q

Elements of informed consent

A

nature of illness, proposed intervention and probability of success, risks/benefits/uncertainties, assess understanding, question/answer, voluntary agreement

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16
Q

Elements of assent

A

help patient achieve awareness of condition, give patient expectations, assessment of understanding and influencing factors, solicit expression of patient’s willingness

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17
Q

Limits of parental autonomy

A

Parents usually cannot refuse life-saving treatment for a child, expected to make decisions in the child’s best interest

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18
Q

Limits of provider authority in pediatrics

A

Providers generally defer to parental preference, but can seek to override parents’ decision if in the child’s best interest

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19
Q

Components of neonatal history

A

Maternal hx, family hx, previous pregnancies and outcomes, labor and delivery, history of pt since birth, history of mother since birth

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20
Q

Components of history for infants and toddlers

A

birth hx, medical hx, family hx, social hx, milestones, feeding, sleeping, stooling/urination, vaccinations

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21
Q

Components of history for school-aged children

A

birth hx if relevant, medical hx, family hx, social hx, milestones, feeding, sleeping, vaccination

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22
Q

Components of history for adolescents

A

medical history, social history, sexual development, family history, vaccinations

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23
Q

Components of neonatal evaluation

A

APGAR, vitals, age and weight, sex, physical exam

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24
Q

Components of APGAR

A

appearance, pulse, grimace, activity, respirations

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25
Q

Appearance scoring

A

central cyanosis 0, acrocyanosis 1, pink 2

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26
Q

Pulse scoring

A

0=no pulse, 1=less than 100, 2=more than 100

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27
Q

Grimace scoring

A

0=none, 1=grimace, 2=cries

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28
Q

Activity

A

0=limp, 1=some, 2=active

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29
Q

Respirations

A

0=none, 1=slow/irregular, 2=strong cry

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30
Q

what score at 5 minutes means high risk?

A

0-7

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31
Q

what is normal birthweight in grams

A

2500

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32
Q

what is normal birthweight in pounds

A

5.5

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33
Q

what is the % range for large for gestational age?

A

> 90

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34
Q

what is the % range for appropriate for gestational age?

A

10-90

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35
Q

what is the % range for small for gestational age?

A

<10

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36
Q

what is the Ballard score

A

Determines gestational age by neuromuscular activity and physical maturity

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37
Q

posterior fontanelle size

A

1 cm or less

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38
Q

when the sutures close prematurely

A

craniosynostosis

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39
Q

anterior fontanelle size

A

1-4 cm

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40
Q

infants are obligate nose breathers until when

A

about 1 month

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41
Q

significance of low-set ears for the purposes of this class

A

Turners Syndrome

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42
Q

signs of congenital heart disease in a newborn

A

increased work of breathing with cyanosis

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43
Q

Primitive reflexes to be checked in a newborn

A

Rooting, sucking, Moro, palmar grasp, Babinski

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44
Q

Babinski reflex disappears at

A

1-2 y/o

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45
Q

Hip examination maneuvers

A

Barlow (adducting) and Ortolani (abducting)

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46
Q

categories of disorders tested for in NM Newborn Screening

A

Amino acids, organic acids, fatty acids, endocrine disorder, hemoglobin, other

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47
Q

When does newborn screening occur for healthy infant

A

24-48 hours or at discharge and then 10-14 days later

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48
Q

When does newborn screening occur for NICU infants

A

on admission, 2-3 days later, then one month or discharge

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49
Q

What is timeframe for hearing test?

A

Prior to leaving hospital or within first month, then 3 months if needed, intervention by 6 months if needed

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50
Q

screening for congenital heart disease

A

pulse oximetry

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51
Q

how many genetic screening test for healthy newborn?

A

2

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52
Q

how many genetic screening tests for NICU

A

3

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53
Q

when does the perinatal period start

A

22 weeks

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54
Q

when does the perinatal period end

A

7 days

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55
Q

what counts as premature

A

less than 38 weeks

56
Q

what do the first trimester screenings look for

A

trisomy 18 and 21

57
Q

when does the quad screen occur

A

2nd trimester

58
Q

what does the quad screen test for

A

trisomy 18 and 21

59
Q

what does the cell free fetal DNA test for

A

trisomy 13, 18, 21 and sex chromosomes

60
Q

what fetal analysis can occur during the first trimester

A

chorionic villus sampling

61
Q

what fetal analysis can occur during the second trimester

A

amniocentesis

62
Q

what fetal analysis can occur during late gestation

A

fetal blood/tissue/urine

63
Q

is a maternal blood analysis screening or diagnostic

A

screening

64
Q

normal HR range for neonate

A

120-160

65
Q

normal RR for neonate

A

40-60

66
Q

normal BP for neonate

A

60-80/30-45

67
Q

when does neonate physical exam occur

A

several hours after birth, after feeding and resting

68
Q

what can usually be felt in the abdomen of a neonate

A

spleen and liver

69
Q

how many babies have birth defects

A

1 in 33

70
Q

what is the most common type of birth defect

A

congenital heart defects

71
Q

how often are serious disease detected through newborn screening

A

about once per week

72
Q

how late can specimens be collected for newborn screening

A

up to 6 months

73
Q

what are signs and symptoms of an emergent condition in neonates

A

cardiac arrest, lethargy, poor feeding, weight loss

74
Q

what lab abnormalities may be present in a newborn with an emergent condition

A

abnormal ammonia, low glucose, acidosis, electrolyte abnormalities, reducing substances in urine

75
Q

what percentage of conditions does the first newborn screening detect

A

90%

76
Q

what is physiologic jaundice

A

benign, transient elevated bilirubin that appears at more than 24 hours after birth due to increased metabolism. Visible jaundice resolves by 1 week in the term infant and 2 weeks in the preterm infant. Peak bilirubin measurement occurs at 3-5 days of age but does not rise by more than 5 mg/dl

77
Q

what is pathologic jaundice

A

jaundice that appears within 24 hours of birth

78
Q

what is the most common infection in utero

A

cytomegalovirus

79
Q

what is hypoglycemia in a newborn less than 4 hours old

A

less than 40

80
Q

what is hypoglycemia in a newborn between 4 and 24 hours old

A

less than 45

81
Q

when should hypoglycemia return to normal

A

within 3 hours

82
Q

what counts as tachypnea in a newborn

A

over 60 breaths/min

83
Q

what comprises the majority of high-risk newborns

A

prematurity

84
Q

what level of prematurity is associated with low levels of surfactant

A

younger than 26 weeks

85
Q

when is the ability to coordinate sucking, breathing, and swallowing developed

A

34-36 weeks

86
Q

what happens if a baby is born before 34 weeks

A

gavage feedings

87
Q

what heart problem is common among premature infants

A

patent ductus arteriosus

88
Q

what are the consequences of immature cerebral vasculature in premature infants

A

subempendymal and intraventricular hemorrhage and periventricular leukomalacia

89
Q

what factors contribute to calculating BSA

A

height, weight, age and sex

90
Q

skin of a baby is ___ than an adult’s

A

thinner

91
Q

increased permeability of blood brain barrier contributes to what in infants

A

increased CNS receptivity

92
Q

gastric pH is what after birth

A

elevated

93
Q

gastric transit times and metabolism are what in infants

A

faster

94
Q

when does gastric pH normalize

A

1-2 months after birth

95
Q

shape of infant thorax is

A

cylindrical

96
Q

what do ribs run in an infant

A

horizontal

97
Q

why do infants have an increased respiratory rate

A

limited chest expansion

98
Q

characteristics of infant head

A

large with short neck and prominent occiput and tongue

99
Q

why do infants have increased heart rate

A

ventricles are less compliant leading to decreased output

100
Q

why do some medications have longer duration of action in infant

A

immature liver

101
Q

psychology less than 6 months

A

usually accept strangers

102
Q

psychology 6 months to 4 years

A

stranger danger

103
Q

psychology school age

A

worry about pain, procedure, how will affect them

104
Q

at what age can children start providing some of their own history

A

4

105
Q

up to when is the WHO growth chart used

A

24 months

106
Q

what are signs of acute bilirubin encephalopathy

A

lethargy, poor feeding, irritability, highpitched cry, arching of the neck and trunk, apnea, seizures, coma

107
Q

what is chronic bilirubin encephalopathy

A

extrapyramidal movement disorder. Gaze abnormality, auditory disturbances, dysplasia of enamel of deciduous teeth

108
Q

who is at risk for hypoglycemia

A

LGA, SGA, preterm, stressed

109
Q

hypoglycemia ssx

A

asymptomatic, lethargy, poor feeding, irritability, seizures

110
Q

what triad is present with cocaine and meth use

A

no prenatal care, premature delivery, placental abruption

111
Q

what ssx of cocaine and meth use

A

possible iugr, irritability

112
Q

ssx of newboard opiate withdrawal

A

CNS excitement: irritability, hyperactivity, hypertonicity, high-pitched cry, tremors, seizures. GI: Vomiting, diarrhea, weight loss, poor feeding, incessant hunger, salivation
Metabolic/respiratory: Nasal stuffiness, sneezing, yawning, sweating, hyperthermia. Often IUGR

113
Q

monochorial twins characteristics

A

always monozygotic and same sex but can be diamniotic or monoamniotic. Risk for twin to twin transfusion and birth abnormalities like CP

114
Q

dichorial twins

A

can be either dizygous or monozygous of either sex. Can have growth restriction but is less likely to have twin-to-twin transfusion and anomalies

115
Q

what is one treatment for apnea in an infant

A

caffeine

116
Q

definition of enuresis and encopresis

A

a child who does not achieve urine and bowel continence by 5-6 years of age and has no underlying implicated pathology

117
Q

2 core features of autism spectrum disorders

A

persistent deficits in social communication and social interaction across multiple contexts, restricted, repetitive patterns of behavior, interests, or activities

118
Q

4 principles of child development

A

development is predictable, range of norms is wide, multiple factors affecting development, H&P is variable

119
Q

intervals for use of standardized screening tools

A

9 month, 18 month, 24/30 month

120
Q

1 month gross motor

A

lift up chin from prone

121
Q

2 month gross motor

A

left chest up from prone

122
Q

4 month gross motor

A

no head lag when pulled to sti

123
Q

6 month gross motor

A

sits briefly

124
Q

8 month gross motor

A

can get into sit position

125
Q

12 month gross motor

A

can stand assisted

126
Q

how much weight does an infant drop in the first week

A

5-10%

127
Q

when will the weight dropped in the first week be regained

A

7-10 days

128
Q

brain weight does what by 4-6 months

A

doubles

129
Q

average head circumference at birth

A

35 cm

130
Q

age for boys puberty

A

12-16

131
Q

age for girls puberty

A

10-14

132
Q

first sign of girls puberty

A

breast development

133
Q

first sign of boys puberty

A

testicle enlargement

134
Q

stage 1 tanner

A

pre-pubescent, no pubic hair

135
Q

stage 2 tanner

A

boys have testicle enlargement, girls have breast enlargement, slight pubic hair

136
Q

stage 5 tanner

A

adult features

Pediatrics 1 (4 decks)

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