Pediatric Flashcards
Time frame for infancy?
1st year of life
When is the neonatal period?
Day 1-28
When is the postneonatal period?
Day 29-1 year
What are some tips for new born exam?
Swaddle newborn
Dim lights to see the eyes
Observe feeding (nursing) if possible
What is the key assessment of the newborn immediately after birth?
Apgar Score
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
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
Describe Vernix Caseosa?
Cheesy white covering
Decreases as term approaches
Made from fetal corneocytes/sebaceous gland
Rich Lipid Matrix
What is the purpose of sutures? Names of the sutures?
Separates the bones of the skull from on another Sagittal Coronal Lamboid Frontal
What is a widely split suture a sign of?
Elevated ICP (meningitis or hydrocephalus)
A raised, bony ridge at the suture line suggests what?
Craniosynostosis
Sunken fontanelles suggest what?
Dehydration
What are fontanelles?
Areas where the major sutures intersect
What do bulging fontanelles indicate?
Increased ICP (bleed vs. meningitis)
What is ankyloglossia? How do you treat it?
Congenital short lingual frenulum (tongue tie)
Frenulectomy in neonatal period
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
What is Pectus Excavatum?
Sternal depression “funnel chest”
What is Pectus Carinatum?
“Chicken breast deformity” or “Pigeon chest”
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
