Pediatric Flashcards by Truc Nguyen

Time frame for infancy?

1st year of life

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When is the neonatal period?

Day 1-28

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When is the postneonatal period?

Day 29-1 year

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What are some tips for new born exam?

Swaddle newborn
Dim lights to see the eyes
Observe feeding (nursing) if possible

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What is the key assessment of the newborn immediately after birth?

Apgar Score

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When is Apgar scored? Score ranges? And when would you continue scoring?

Scored at 1 and 5 minutes after birth
Scores range from 0-10
Scoring may continue at min intervals until the score is >7

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What are the AAP recommended well visit schedules?

Birth, 1 mo, 2 mo, 4 mo, 6 mo, 9 mo, 12 mo, 15 mo, 18 mo, 2 yr. Then annually through adolescence

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Describe Vernix Caseosa?

Cheesy white covering
Decreases as term approaches
Made from fetal corneocytes/sebaceous gland
Rich Lipid Matrix

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What is the purpose of sutures? Names of the sutures?

Separates the bones of the skull from on another 
Sagittal 
Coronal 
Lamboid
Frontal

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What is a widely split suture a sign of?

Elevated ICP (meningitis or hydrocephalus)

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A raised, bony ridge at the suture line suggests what?

Craniosynostosis

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Sunken fontanelles suggest what?

Dehydration

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What are fontanelles?

Areas where the major sutures intersect

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What do bulging fontanelles indicate?

Increased ICP (bleed vs. meningitis)

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What is ankyloglossia? How do you treat it?

Congenital short lingual frenulum (tongue tie)

Frenulectomy in neonatal period

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What are some problems associated with ankyloglossia?

Can limit movement of tongue
Can cause pain w/ nursing
May lead to speech difficulty or dental problems
Usually see puckering of the midline tongue tip with movement

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What is Pectus Excavatum?

Sternal depression “funnel chest”

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What is Pectus Carinatum?

“Chicken breast deformity” or “Pigeon chest”

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How many umbilical arteries and veins are there?

2 umbilical arteries

1 umbilical vein

What is an umbilical granuloma? Where does it develop? What can be seen with this?

Pink granulation tissue formed during the healing process
Develops at the base of the navel
Malodorous discharge

What can be present in in female GU due to mom’s estrogen?

Milky white discharge and may be blood tinged (this is normal and okay)

What is the most common cause of childhood blindness?

Amblyopia

When do you check for hemoglobin and why?

9 months or 12 months (textbook is 12)

Screen for iron deficiency

What is the screening for Autism called? And when is it screened?

MCHAT

18 mo and 24 mo well visit

How many vaccines at given with HIB and when would you give it?

4 total vaccines | 2 mo, 4 mo, 6 mo and 12 mo or 15 mo

Head circumference is tracked until when? Why is it important?

2-3 y/o Used to assess for brain growth

What do pediatric growth curves measure?

Height, weight, head circumference, and BMI to population

Classification of Gestation age for: Preterm Term Postterm

Preterm: <37 weeks Term: 37-42 weeks Postterm: > 42 weeks

What is a newborn screen? When is it done?

Used to test for metabolic and genetic diseases Collected by heel stick before discharge, then agin at 7-14 days of life (varies state to state)

Is cyanosis in a baby normal?

May be normal at birth, fingertips can by cyanotic for 1-2 days. Should pink soon thereafter

What is Milia? Where is it found? When does it appear?

Pinpoint white papules w/o surrounding erythema Common on nose, chin, foreheads and cheeks Usually appears w/in 1st few weeks and disappears over several weeks

What are Mongolian Spots? What is another name for them?

Blue patches of pigmentation | Congenital Dermal Melanocytes

Where are Mongolian spots commonly found? Common in which race(s)

Common in lumbar area, buttocks, extremities Asian, Native Americans, Hispanics, East Indian and African descent

What is Erythema Toxicum? When does it appear and how long does it last? Where is it mostly seen?

Yellow eosinophilic papules on a red base May appear on 2nd-4th day of life and typically disappears w/in 1 week of life Mostly seen on trunk

Large fontanelles can be the 1st sign of what?

Hypothryoidism

When does the anterior and posterior fontanelle close?

Anterior fontanelle: ~ 9-18 months | Posterior: ~1-2 months

What is a cephalohematoma? Does it cross suture lines? When does it resolve?

Swelling/collection of blood over 1 or both parietal bones Does NOT cross suture lines Resolves in weeks to months

What is caput succedaneum? Does it cross suture lines? When does it resolve?

Edema of the scalp Can cross suture lines Resolves in days

What are Epstein's pearls? Where is it typically seen? When is it usually seen?

Small, white, benign inclusion cysts Typically seen on palate Usually seen between 2-4 months of

Bohn nodules are seen where?

Gingival ridge

Congenital torticolis "wey neck" results from what? When does it appear?

Bleeding into the SCM during the stretching process of birth Appears as firm fibrous mass w/in 2-3 weeks after birth

Diminished femoral pulses can indicate what?

Coarctation of the aorta

What is hypospadias?

Abnormal ventral placement (need to check for this before circumcision)

What is epispadias?

Abnormal dorsal placement (uncommon)

What is a simian crease associated with?

Associated with Trisomy 21, but can be normal variant

Palmar grasp reflex should occur when?

Birth to 3-4 months

Plantar grasp reflex should occur when?

Birth to 6-8 months