Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Med > Pediatric 1 > Flashcards

Pediatric 1 Flashcards

1
Q

At which age the normal HR range is similar to that of adults?

A

12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Infant visit schedule

A 
Within 1 wk post-discharge
1mo
2mo
4mo
6mo
9mo
12mo
15mo
18mo
24mo
Annually between 2-5 yr
Every 1-2 y between 6-12 yr
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Publicly funded immunization schedule for:

DTaP-IPV-Hib

A

2mo
4mo
6mo
18mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Publicly funded immunization schedule for:

dTaP-IPV

A

4-6 y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Publicly funded immunization schedule for:

Pneu-C-13

A

2mo
4mo
12mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Publicly funded immunization schedule for:

Rot-1

A

2mo

4mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Publicly funded immunization schedule for:
Men-C-C
Men-C-ACYW

A

Men-C-C: 12mo

Men-C-ACYW: Grade7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Publicly funded immunization schedule for:
MMR
Var
MMRV

A

MMR: 12 SC
Var:15 mo
MMRV: 4-6 yr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Publicly funded immunization schedule for:

HepB

A

0-1-6 mo

Grade 7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Publicly funded immunization schedule for:

HPV-4

A

Grade 7

0-2-6 mo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Publicly funded immunization schedule for:

Tdap

A

14-16 y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Publicly funded immunization schedule for:

Inf

A

Yearly, every autumn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Contraindications to DTaP-IPV

A

Evolving unstable neurologic disease

Hyporesponsive/hypotonic following previous vaccine

Anaphylactic reaction to neomycin, streptomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Contraindications to Rot-1

A

Hx of intussusception

ImComp

Abdominal disorder (Meckel…)

Received blood products within 42d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MMR contraindications

A

Pregnancy

ImComp

Anaphylactic reaction to gelatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MMR for HIV + children

A

Allowed if healthy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Var vaccine contraindications

A

Pregnant
Planning to get pregnant within 3 mo
Anaphylactic reaction to gelatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hep B contraindication

A

Anaphylaxis to baker’s yeast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

dTaP contra

A

1st trimester of pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Contraindications to flu vaccine

A

<6mo

ImComp

Egg-allergic (live attenuated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Egg allergy and flu vaccine

A

Live attenuated vaccine not recommended

Trivalent/quadrivalent vaccine can be given in environment where anaphylaxis can be managed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

MenB

A 
Publicly funded only for selected groups:
Asplenia
Ab/Compliment deficiencies
Cochlear implant recipients
HIV
Close contacts with infected individuals

Contra: anaphylactic reaction to components

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Vaccination in case of asplenia/hyposplenia

A

All routine vaccines

Yearly flu (among routines)

Men-C-C at age 2 or older
Men-P-ACYW at least 2 wk later, booster q 2-5y

Pneu-P-23: 2y or older
Pneu-P-23: single booster, at age 3 yr or older

Hib: single booster at age 5 or older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Organisms causing infection more frequently in asplenia

A 
Hib
Pneumococ
Meningococ
E.coli
Klebsiella
Salmonella
GBS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Vaccine injection site in infants
Anterolateral thigh All IM Except: SQ: MMR, Var, MMRV Oral: rota
26
Corrected GA for premature infants is used up to age
2 yr
27
Most lymphatic, gonad, CNS growth time period
CNS: first 2 years Lymphoid: mid-childhood Gonads: puberty
28
Upper/lower body proportion
Newborn: 1.7 Adult: 0.9 male 1 female
29
When does newborn lose and regain weight?
Wt loss, 10%, in first 7 days Regain by 10-14 d of age
30
Infant wt
Birth: 3250 x2: 4-5 mo x3: 1y x4: 2y
31
Height of infant
Birth: 50 cm Growth during 1st yr: 25 cm 2nd yr: 12 cm 3rd yr: 8 cm Then: 4-7 cm/y until puberty Measurement: Supine until 2 Then standing
32
Head circumference
Birth: 35cm 2 cm/mo x 3mo (0-3 mo) 1 cm/mo x 3mo (3-6mo) 0.5 cm/mo x 6 mo (6-12mo)
33
Upgoing plantar reflex in infants
Normal until 2 yr
34
Age of disappearance of moro reflex
4-6 mo
35
Galant reflex
Infant held in ventral suspension and one side of back is stroked along paravertebral line Pelvis moves in the direction of stimulated side
36
Age of disappearance of galant reflex
2-3 mo
37
Age of disappearance of grasp reflex
3-4 mo
38
ANTR reflex (asymmetric tonic neck reflex)
Turn infant’s head to one site Response: fencing posture
39
Age of disappearance of ATNR reflex
4-6 mo
40
Age of disappearance of placing reflex
Variable
41
Age of disappearance of sucking reflex
2-3 mo
42
Age of disappearance of parachute reflex
Never
43
Developmental red flags
Not walking at 18 mo Rolling too early at < 3 mo Hand preference at < 18 mo Speech < 10 words at 18 mo Not smiling at 3 mo Not pointing at 15-18mo
44
Growth motor at 1 mo
Turns head from side to side when supine
45
Fine motor at 1 mo
Hands fisted Thumb in fist
46
Speech/language at 1 mo
Cries Startles to loud noise
47
Adaptive/social skills at 1 mo
Calms when comforted
48
Gross motor at 2 mo
Briefly raises head when prone Holds head erect when upright
49
Fine motor at 2 mo
Pulls at cloths
50
Speech/language at 2 mo
Coos | Gurgles
51
Adaptive and social skills at 2 mo
Smiles responsively Recognizes/calms down to familiar voice Follows movements with eyes
52
Gross motor at 4 mo
Lifts head and chest when prone Holds head steady when supported sitting Rolls prone to supine
53
Fine motor at 4 mo
Briefly holds object when placed in hand Reaches for midline objects
54
Speech/language at 4 mo
Turns head towards sounds
55
Adaptive/social skills at 4 mo
Laughs responsively Follows with eyes Responds to people with excitement
56
Gross motor at 6 mo
Tripod sit Pivots in prone position
57
Fine motor at 6 mo
Transfers objects from hand to hand Bring objects to mouth Ulnar or raking grasp
58
Speech and language at 6 mo
Babbles
59
Adaptive/social at 6 mo
Stranger anxiety Beginning of object permanence
60
Gross motor at 9 mo
Sits well without support Crawls Pulls to stand Stands with support
61
Fine motor at 9 mo
Early pincer grasp with straight wrist
62
Speech/language at 9
Mama, dada Imitates 1 word Responds to no regardless of tone
63
Adaptive/social at 9 mo
Plays games (peek-a-boo) Reaches to be picked up
64
Gross motor at 12 mo
Gets into sitting without help Stands without support Walks while holding on
65
Fine motor at 12 mo
Neat pincer grasp Releases ball with throw
66
Speech and language at 12 mo
2 words Follows 1 step commands Uses facial expression, sounds, actions to make needs known
67
Gross motor at 15 mo
Walks without support Crawls upstairs/steps
68
Fine motor at 15 mo
Picks up and eats finger foods Scribbles Stacks 2 blocks
69
Speech at 15 mo
4-5 words Points to needs/wants
70
Adaptive/social at 15
Looks to see how others react (after falling...)
71
Adaptive/social at 12 mo
Responds to own name Separation anxiety begins
72
Gross motor at 18 mo
Runs Walks forward pulling toys/objects
73
Fine motor at 18 mo
Tower of 3 cubes Scribbling Eats with spoon
74
Speech at 18 mo
10 words Follows simple commands
75
Adaptive/social at 18 mo
Shows affection towards others Points to show interest in something
76
Gross motor at 24 mo
Climb up and down steps with 2 feet per step Runs Kicks ball
77
Fine motor at age 24
Tower of 6 cubes Undresses
78
Speech at 24 mo
2-3 word phrases 50% intelligible I, me, you Understands 2-step commands
79
Adaptive/social at 24 mo
Parallel play Helps to dress
80
Gross at 36 mo
Rides tricycle Climbs 1 foot per step Down 2 feet per step Stands on one foot briefly
81
Fine motor at 36 mo
Copies a circle Turns pages one at a time Puts on shoes Dress/undress fully, except bottoms
82
Language/speech at 36 mo
Combines 3 or more words into sentence Recognizes colors, prepositions, plurals, counts to 10 75% intelligible
83
Adaptive/social at 36 mo
Knows sex and age Shares some of the time Plays make-believe games
84
Gross at 4 yr
Hops on 1 foot Climbs down 1 foot per step
85
Fine motor at age 4 yr
Copies a cross Uses scissors Buttons cloths
86
Speech/language at 4 yr
100% intelligible Uses past tense Understands 3 part directions
87
Adaptive/social skills at age 4
Cooperative play Fully toilet trained by day Tries to comfort someone who is upset
88
Gross motor at 5 y
Skips Rides bicycle
89
Fine motor at age 4
Copies of triangle and square Prints name Ties shoelaces
90
Speech at 5 y
Fluent speech Future tense Alphabet Retells sequence of a story
91
Adaptive skills at age 5
Cooperates with adult requests most of the time Separate easily from caregiver
92
Baby daily calorie needs
<10 kg: 100 kcal/kg/d 10-20: 1000 + 50 kcal/kg/d for each kg above 10 >20: 1500 + 20 kcal/kg/d for each kg above 20 100-50-20
93
Supplements in BF infants
Vit D 400 IU/d Iron (6-12 mo if not receiving fortified cereals/meat/meat alternatives) CDC: start at 4 mo Fluoride (if not sufficient in water)
94
How to introduce solid food?
At 6 mo (don’t delay beyond 9 mo) 2-3 new foods/w At least 2 day in between each food
95
When to introduce highly allergenic foods?
Early
96
Most common allergenic foods
``` Egg Milk Mustard Sesame Wheat See food Tree nuts Soy Peanut ```
97
When to introduce vegetables, fruits, grains, full-fat milk?
After iron-rich foods are given
98
When and how to switch to cow milk?
9-24 mo: Homogenized, 3.25% milk 16 oz/d to NBF infants No more than 24 oz (750 cc) after 1 yr 2-6 yr: 2% milk 500 ml/d
99
Amount of feeding meals
Up to 3 large meals 1-2 smaller snacks
100
When to encourage self-feeding?
By 18 mo
101
Foods to avoid
Honey until past 12 mo Added salt/sugar Excessive milk Limit juice (max: 4-6 oz: 1/2 cup daily) Anything with choking hazard
102
Role of dietary restrictions during pregnancy and breast-feeding in reducing allergy rate in infants
No role
103
Colostrum properties
High protein Low fat High Ig content
104
Mature breast milk content
Whey/casein : 70/30 Fat: dietary butterfat Carb: lactose
105
Advantages of breastmilk
Easily digested Low renal solute load IgA Macrophage Lymphocyte Lysozymes Lactoferrin (inhibits E. Coli growth in intestine) Lower pH (promotes growth of lactobacillus in GI) Parent child bonding Economical Convenient
106
Contraindications to breast-feeding
``` Maternal: Chemo Radioactive compounds HIV Active untreated TB Herpes in breast region Illicit drugs Alcohol > 0.5 g/kg/d Certain meds ```
107
Breast feeding jaundice time
1-2 wk
108
Cause of breastfeeding jaundice
Infant dehydration due to low milk production
109
Breast milk jaundice time
Persists up to 4-6 mo Glucuronyl transferase inhibitor in breast milk Decrease Bil conjugation Increased enterohepatic circulation of Bil Healthy, thriving baby Jaundice resolves
110
Signs of inadequate intake
Jaundice Wt loss > 10% <6 wet diapers/d after 1st week <7 feeds/d Sleepy/lethargic Sleeping throughout the night < 6 wk
111
Normal number of wet diapers/stools in newborn
1 wet diaper/d of age for first wk 1-2 black or dark green stools/d on day 1-2 3+ brown/green/yellow stool/d on day 3-4 3+ yellow, seedy stools/d on day 5+
112
Soy protein milk indications
Galactosemia Desire for vegetarian/vegan diet (Sucrose instead of lactose)
113
Indications for aa formula
Short gut Food allergy (No lactose)
114
Indications for protein hydrolysate formula
Food allergy Malabsorption (100% casein, no lactose)
115
Partially hyrolyzed proteins formula indications
Delayed gastric emptying Cow milk protein allergy (100% whey)
116
Fortified formula indications
LBW Prematurity (Higher calories and vit A, C, D, K) Mainly used in hospital (risk of fat-soluble vit toxicity)
117
Indications for cow’s milk-based formula
Prematurity Transition into breastfeeding Contra to breastfeeding (Lower whey/casein, plant fat)
118
Allergy rate to soy protein in cow’s milk protein allergic children
10-35%
119
Appropriate age for swimming lessons
>4 yr
120
Age of sunscreen use
From 6 mo
121
Age of breath holding spells
6mo-4yr Usually starts during first year of life
122
Trigger of breath holding spells
Anger, injury, fear Holds breath and becomes silent Spontaneously resolves or loses consciousness
123
Breath holding spell types
Cyanotic Following anger/frustration Less commonly pallid Following pain/surprise
124
Mx of breath holding spells
Help child control response to frustration Avoid drawing attention to spell My be associated with IDA (improves with supplemental iron) Usually resolves spontaneously (rarely progresses to seizure)
125
Benefits of circumcision
``` Slightly decreased: UTI STI Balanitis Cancer of the penis ```
126
Contraindications to circumcision
Genital abnormalities Bleeding disorders
127
Definition of infantile colic
Paroxysms of irritability and crying > 3h/d > 3d/w >3w Healthy, well-fed infant
128
Onset and duration of infantile colin
Onset: 10d- 3 mo Peak: 6-8 wk Duration: all resolve, mostly by 3-6 mo
129
Mx of infantile colic
Parental relief, rest, reassurrance ``` Hold baby Soother Car ride Music Vacuum Check diaper ``` Probiotics Maintain breastfeeding but eliminate allergens from mother’s diet (cow’s milk protein, eggs, wheat, nuts) Try casein hydrolysate formula
130
Time of first dentition
5-9 mo Lower incisors Then 1/mo
131
1st assessment by dentist
6 mo after 1st tooth Definitely by 1 yr of age
132
Secondary dentition time and first tooth
6 yr 1st molar then lower incisors
133
Cause of milk caries
Prolonged feeding | Superior front teeth and back molars in first 4 yr
134
Prevention of milk caries
No bottle at bedtime Clean teeth after last feed Minimize juice/sweetened pacifier Clean teeth with soft damp cloth or toothbrush and water Water fluoridation
135
Definition of enuresis
Involuntary urinary incontinence by day and/or night in child > 5
136
When to evaluate enuresis?
``` If: Dysuria Change in urine color, odor, stream Secondary Diurnal Change in gait Stool incontinence ```
137
Primary nocturnal enuresis etiology
Boys> Developmental disorder Maturational lag in bladder control while asleep
138
Mx of primary nocturnal enuresis
Time and reassurance Limiting fluid Voiding prior to sleep Bladder retention exercises Scheduled toileting overnight (limited effectiveness) Conditioning wet alarm (70% success rate) 2nd line: medications: oral DDAVP, imipramine Children > 7 y For sleepovers/camps
139
DDAVP vs Conditioning alarm for nocturnal enuresis
Similar effectiveness Higher relapse rate for DDAVP
140
Secondary enuresis definition
After a period of bladder control >6 mo
141
Etiology of secondary enuresis
Inorganic regression due to anxiety/stress Or Organic causes: UTI, DM, DI, sleep apnea, neurogenic bladder, CP, seizure, pinworm Tx: underlying
142
Diurnal enuresis definition and etiology
Day time wetting Mostly also have night time wetting Etiology: Micturition deferral Structural anomalies: ectopic ureteral site, neurogenic bladder UTI, constipation, CNS disorders, DM
143
Tx of diurnal enuresis
Treat underlying Behavioral (scheduled toileting, double voiding, good bowel program, sitting backwards on toilet, charting/incentive system, relaxation/biofeedback), pharmacotherapy
144
Definition of encopresis
Fecal incontinence in child > 4 yr At least once/mo For 3 mo M>F
145
causes of encopresis
Chronic constipation Hirschprung Hypothyroidism Hypercalcemia Spinal cord lesions Anorectal malformations Bowel obstruction
146
Etiology of retentive encopresis
Painful stooling secondary to constipation Disturbed paren-child relationship Coercive toilet training
147
Mx of encopresis
Complete bowel clean-out: PEG 3350, oral (2nd line: enema, supp) Regular bowel movements Assessing psychosocial stressors Behavioral modification
148
Complications of encopresis
Recurrence Toxic megacolon Bowel perforation
149
Toilet training
Girls earlier than boys Bladder before bowel 98% daytime bladder control by 3 yr
150
Signs of toilet readiness
Ambulating independently Stable on potty Desire to be independent or to please caregiver Sufficient expressive and receptive language skill (2-step command level) Can stay dry for several h Can recognize need to go Able to remove clothing
151
Definition of failure to thrive
Wt < 3rd percentile Or Falls across two major percentile curves, Or < 80% of expected weight for height and age
152
Most common factor in poor wt gain
Inadequate calorie intake
153
Inv for FTT
``` CBC, Blood smear Electrolytes T4,TSH Bone Xray Chromosome, karyotype Chronic illness: CXR, sweat Cl-, ECG, echo, celiac, inflammation, malabsorption, U/A, liver enzymes, alb ```
154
Calculation of mid-parental height
Boys: (Father ht + Mother ht + 13)/2 Girls: (Father ht + Mother ht -13 13)/2
155
FTT with decreased Wt but normal Ht and HC
Insufficient calorie intake Hypermetabolic state
156
FTT with decreased Wt and Ht but normal HC
Structural dystrophy Endocrine disorder Constitutional growth delay (bone age < chronological age) Familial short stature (BA=CA)
157
FTT with decreased Wt, Ht, HC
Intrauterine insult | Genetic abnormalities
158
Mx of FTT
Multidisciplinary Treating underlying Educate about: Age-appropriate foods Calorie boosting Mealtime schedules and environment Goal: to reach 90-110% IBW Correct nutritional deficiencies Promote catch up growth and development
159
Increased upper/lower segment ration DDx
Achondroplasia Short limb syndrome Hypothyroidism Storage diseases
160
Decreased upper/lower segment DDx
Marfan Kleinfelter Kallman Testosterone deficiency
161
Obesity definition
Overweight: BMI > 85th percentile Obesity: BMI >95th for age and Ht
162
Organic causes of obesity
Rare (5%) Prader-Willi Carpenter Turner Cushing Hypothyroidism
163
Complications of obesity
``` HTN Dyslipidemia SCFE DM2 Asthma Obstructive sleep apnea Gynecomastia PCOS Early menarche Irregular menses Psychological trauma ```
164
Inv for obesity
BP Pulse Lipid profile
165
Mx of obesity
Long-term gial: maintain BMI <85th percentile Encouragement Reassurance Engagement of family Diet: Quantitative changes DO NOT ENCOURAGE WEIGHT LOSS (allow linear growth to catchup with wt) DO NOT ENCOURAGE ADULT DIETS OR VERY LOW CALORIE DIET. ``` Behavioral modification: Increase activity Change eating habit/meal patterns Limit juice/sugary drinks Adequate sleep Increase physical activity (1h/d) Reduce screen time (<2h/d) ```
166
Extra management in obese children who have RFs or complications
AST/ALT DM screening Small changes in energy expenditure and intake (lose 1 lb/mo)
167
factors affecting Child wt
Associated with obesity: Maternal smoking during pregnancy, Birth wt Factors negatively associated with obesity: Exclusive breast-feeding for six months, Adequate sleep hours, Being physically active
168
Recommended screen time for children
Not recommended for children under 2 yr <1h for 2-5 yr <2g for 5-17
169
CS in diaper dermatitis
Short-term, low-potency, for severe ICD and SD
170
Limit setting sleep disorder
Bedtime resistance Preschool and older children Exacerbated by child’s oppositional behavior Due to caregiver’s inability to set consistent bedtime rules and routines
171
Sleep-onset association disorder
Infants and toddlers Child learns to fall asleep only under certain conditions or associations During the normal brief arousals of sleep, child cannot fall back sleep because same conditions are not present
172
First-line Tx for OSA
1st line: Adenotonsillectomy Wt Mx CPAP: If adenotonsillectomy is contraindicated Minimal adenotonsillar tissue Residual OSA Mild-mod: Watchful waiting Avoid pollutants, smoke, allergens Avoid CS, AB
173
Effects of adenotonsillectomy on OSA
Improved behavior Improved QOL Improved polysomnographic findings No improvement in: Attention Executive function
174
Mx of sleep disturbances
Set strict bedtimes and wind-down routines Do not send child to bed hungry Positive reinforcement for limit setting sleep disorder Always sleep in own bed, in a dark, quiet, and comfortable room Do not use bedroom for timeouts Systematic ignoring and gradual extinction for: sleep onset association disorder
175
Nightmares
Boys 4-7 yr REM Upon awakening, child is alert and clearly recalls frightening dream. +/- daytime anxiety Mx: reassurance
176
Night terrors
Early hours of sleep, stage 4 sleep Abrupt sitting up, eyes open, screaming. Inconsolable Signs of panic and autonomic arousal No memory of event Stress/anxiety can aggravate them Remits spontaneously at puberty
177
Mx of night terror
Reassurance of parents Ensure child is safe
178
Leading cause of death between 1 to 12 months of age
SIDS
179
Sudden infant death syndrome
M>F Prone position> Peak age (in term infant): 2-4 mo Increased during RSV peak Midnight-8 am
180
RFs for SIDS
Prematurity Early bed sharing (<12 wk) Alcohol during pregnancy Soft bedding LBW Aboriginal Male No prenatal care Smoking in household Prone sleep position Poverty Sibling of infant with SIDS Sleeping on a surface with a fixed wall Sleeping with an infant after consumption of alcohol/drugs or extreme fatigue Infant sleeping with someone other than the primary caregiver
181
Prevention of SIDS
Place infant on back when sleeping Avoid sharing bed Allow supervised tummy time Avoid overheating, overdressing Appropriate infant bedding No smoking Exclusive BF in first month Pacifier NO ALARMS/MONITORS
182
Appropriate bedding for infant
Firm mattress No loose bedding No pillows No stuffed animals No crib bumper pad
183
RFs for child abuse
Social isolation Poverty Domestic violence ``` Caregiver: Personal history of abuse Psychiatrist illness Postpartum depression Substance abuse Single parent family Poor social and vocational skills Below average intelligence ``` ``` Child Difficult temperament Disability Special needs Prematurity ```
184
Mx of child abuse/neglect
Report all suspicions to CAS: request emergency visit if imminent risk to child/siblings Acute medical care Arrange consultation to social work, appropriate F/U May need to discharge child directly to CAS supervision
185
Bruises suspicious if child abuse
Not explained by accidental injury or child development level Locations: Abdomen, buttocks, genitalia, fleshy part of cheek, ears, neck or feet Baby not yet cruising Bruising not on the front of the body and/or overlying bones Large/numerous, clustered/patterned
186
Fx suspicious of abuse
Not explain why history or child’s development level ``` Posterior rib Metaphyseal Scapular Vertebral Sternal ```
187
The most common cause of death and child abuse
Head trauma
188
Inv for child abuse
Document all injuries Photography of skin injuries is ideal (with police or hospital photography) Rule out medical causes: If fx: Ca, Mg, PO4, ALP, PTH, vitD, alb If bruising: CBC, INR, PTT, vWF, F VIII/IX Screen for abd trauma: AST, ALT, amylase CT if required Lytes, U/A Toxicity screen Skeletal survey if <2yr Imaging based on Hx in child > 5yr Neuroimaging (if subdural hemorrhage detected, eye exam by ophthalmologist)
189
Peak age of sexual abuse
2-6y | 12-16y
190
Complications of sexual abuse
As adults: Obesity, sexual problems, IBS, fibromyalgia, STI, substance use disorder More likely to experience intimate partner violence and sexual assault
191
Order of sexual abuse committers
Family member> Non-relative known to victim Stranger
192
Hx taking in sexual abuse
DO NOT TAKE Hx FROM A YOUNG CHILD MUST BE DONE BY TRAINED PERSONNEL
193
PEx findings suggestive of sexual abuse
Recurrent UTI Pregnancy STI Vaginitis Vaginal bleeding Pain Genital injury Enuresis SPECULUM CONTRAINDICATED IN PREPUBERTAL GIRLS
194
Inv for sexual assault
Sexual assault examination kit: Within 24 h if prepubertal Within 72h if pubertal R/O: STI, pregnancy, UTI Consider STI prophylaxis, emergency contraception R/O other injuries R/O drug, alcohol screen
195
Adolescence Hx
HEEADSSS ``` Home Education/Employment Eating Activities Drugs Sexuality Suicide and depression Safety/violence ```
196
Clues to beglect
``` FTT developmental delay Inadequate/dirty clothing Poor hygiene Poor attachment to parents No stranger anxiety ```
197
Findings suggestive of physical abuse
``` Retinal hemorrhage Frenulum tear Patchy hair loss Immersion burns Altered mental status ```

Med (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions