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Pediatrics > Ped Final Exam > Flashcards

Ped Final Exam Flashcards

1
Q

LOOK ,play listen

A

Can the patient make eye contact
Are their facial features symmetrical

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2
Q

Look, PLAY, listen

A

Can the child interact with you? Is play appropriate?

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3
Q

Look, Play, LISTEN

A

How clear is their articulation? Is language appropriate?

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4
Q

A thoughough case history includes….

A

Medical history, family history, birth history

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5
Q

What does the APGAR Score assess?

A

Heart rate, respitory effort, refelx irritability, color, muscle tone

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6
Q

What is the number one cause of non genetic hearing loss?

A

CMV

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7
Q

You can get CMV from__?

A

saliva and urine

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8
Q

When diagnosing hearing loss what team of people do you want to have?

A

ENT, PCP, Gentic counselor, SLP, developmental specialist

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9
Q

3 grades of microtia

A

1- normal apperance but small
2- pinna and ossicles are underdevleoped
3- absence of pinna or middle ear structures

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10
Q

Informational Counseling

A

Explains the results and it is often one way

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11
Q

Personal Adjustment Counseling

A

Open conversation, let the person know that their feelings are heard,

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12
Q

Grief cycle

A

Shock, Denial, Anger/guilt, mourning, acceptance, action

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13
Q

3 domains of development

A

social/emotional- reasoning/understanding, cognitive- thought processes, physical- brain development

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14
Q

Symbolic Play

A

18 months using a banana as phone

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15
Q

How do infants communication before language?

A

coo and crying

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16
Q

Language Spurt occurs at what age

A

18 months

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17
Q

How much % of learning is incidental learning?

A

95%

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18
Q

Reflexive vs voluntary responses

A

reflexive- natually responding voluntary- looking for the sound and responding

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19
Q

Differences between adult and child ears

A

Pars flaccida is thicker in children, ossciles are not formed properly in children, children have a smaller ECV, change in tonotopic organization in first 6 months.

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20
Q

Habituation

A

When the baby doesnt respond because it is no longer new

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21
Q

When can babies localize from side to side?

A

4-7 months

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22
Q

Why use behavioral observation?

A

history of prematurity, did not get NHS, cried through ABR

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23
Q

At what age if you catch a child with hearing loss will they develop their language milestones

A

6 months

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24
Q

3 major components of EDHI

A

UNHS, Followup with diagnostic information and enrollment in early intervention.

25
Q

1,3,6

A

screen by 1 month, complete AE by 3 months, intervention by 6 months

26
Q

ANSD testing results

A

absent OAE/Tymp but normal ABR

27
Q

Sensitivity

A

ability to identify someone who has the condition

28
Q

Specificity

A

ability to identify someone without the condition.

29
Q

What is the purpose of newborn hearing screenings

A

to detect a HL not assess HL

30
Q

Why do you need a newborn hearing screening?

A

You are going to target the NICU babies but you will miss the well babies if you do not have universal hearing screening

31
Q

Differnce between JCIH 2019 and 2007

A

2019 (October) Released 1-2-3 timeline, risk factors change, protocol changes for follow-up of ABR reg nursery, supportive services
2007 (2013 supplement): inclusion of ANSD; separate protocols for NICU and well-baby; diagnostic assessment by 24-30 months for at-risk babies

32
Q

Pros and Cons of OAEs

A

PRO- faster, equiptment is easier/readily available CON- Suseptible to noise and obstructions

33
Q

Pros and Cons of ABR

A

PRO- Less susceptible to transient conducive obstructions.
CON-Supplies are more expensive
Slower More susceptible to electric noise.

34
Q

What can you conclude from a pass result

A

Hearing thresholds are within 30 dB of normal (rule out anything greater than a mild hearing loss).

35
Q

What can you conclude from a refer result

A

Diagnostic test is needed to rule out permanent (sensorineural) hearing loss.

36
Q

Benefits of two screenings

A

referal percentages are lower

37
Q

What is the goal of counseling?

A

to guide parents into making practical decisions for thier child to help them cope with the hearing loss

38
Q

5 Reasons why you want to take a case history

A

Complete picture of medical or family history
Helps develop diagnositic impression
Helps plan for auditory remediation
Helps make appropriate referrals
Need to have good understanding of normal auditory function and any disorders

39
Q

Vestibular common problems in peds

A

not holding head up, not crawling or walking, migranes

40
Q

Acquired vs congetial HL and examples

A

aquired- due to a cause (head trauma, menigitus, ear infections)
congenital- from birth (syndromes)

41
Q

Fast mapping

A

the process of rapidly learning a new word simply from the contrastive use of a familiar word and an unfamiliar word
“celedon block” instead of “blue block”

42
Q

What is the gold standard for ped testing?

A

Case history, otoscopy, AC/BC hearing thresholds, speech perception

43
Q

What age is good for VRA and BOA

A

9mon-2.5 yr

43
Q

What age is good for CPA

A

2.5- 4yr

44
Q

When do babies begin to turn their head
directly toward the side of a signal at 40-50
dB SPL?

A

4-7 mon

45
Q

Freq resolution in babies

A

3 months at 500 Hz and 1000 Hz
Later at 4000; but sooner than intensity

46
Q

Gap detection in babies

A

Matures by 6 years

47
Q

Response levels as a function of age

A

Startle response for white noise ~105 dB
SPL
Startle response to speech occurs at
lower levels (~85 dB SPL)

48
Q

What type of VRA reinforcer gets the most amount of responses?

A

complex visual reinforcement

49
Q

What can help habituation?

A

Limiting the amount of time a child is exposed to the
reinforcer can increase the number of responses
obtained before habituation

50
Q

Can filterd sound effects be used in place of pure tones?

A

Yes

51
Q

Limitations to unconditioned BOA

A

habituation can occur quicker
biased observers
response depends on infant state

52
Q

Steps before ped assessment

A

determine cognitive age through case history, evaluate physical status, choose the test room setup

53
Q

What is the goal of speech audiometry?

A

obtain as much as we can about a childs speech perception abilities

54
Q

What are the four response tasks to assess performance?

A

detection, discrimination, identification, comprehension,

55
Q

What levels must you test speech at ?

A

35 and 50

56
Q

Pos predictive value and neg predictive value

A

Positive predictive value: percentage of failed cases that are found with a diagnostic evaluation to have hearing loss.

Negative predictive value: percentage of passed cases that are found with a diagnostic evaluation to have normal hearing.

57
Q

If a baby fails a NBHS, when do you want them to come back?

A

At least 1 month or before they leave hospital

Pediatrics (5 decks)

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