Pediatric exam Flashcards
1
Q
What age defines a newborn?
A
recently born
2
Q
What age defines a infant/
A
birth-12mo
3
Q
What age defines a preschooler?
A
1-5yrs
4
Q
What age defines a school-aged?
A
6-10yrs
5
Q
What age defines a adolescent?
A
11-20yrs
6
Q
Who is the primary history provider through preschooler years?
A
caregiver
7
Q
What 3 thigns are checked on physical exam for the assessment of growth and developemnt?
A
height
weight
BMI
8
Q
How long do u have to check the head circumfrence?
A
every visit until 3 y/o
9
Q
What 2 vitals do u do in kids?
A
pulse, RR
10
Q
What age do u start doing BP’s?
A
2 y/o
11
Q
What screening method do u use for newborns?
A
APGAR
12
Q
What 3 thigns must u do for a comprehensive Hx for a newborn?
A
Full maternal, family, and prenatal Hx
13
Q
What does a Full maternal, family, and prenatal Hx help identify?
A
Exposure/risks
Abnormlitis
Medical conditions
14
Q
What 4 things must u get in the maternal Hx?
A
current pregnancy
past pregnancies
maternal medical conditions
maternal medications
15
Q
What things must u get on the Hx of delivery?
A
duration of labor rupture of membranes mode of delivery newborn condition at delviery need for recussitaiton
16
Q
Group B strep colonization of mother, fetal fever, tachypnea/cardia, materanl fever, prolonged rupture of membranes, premature delviery, and chorioamnionitis are all risk factors for what?
A
Newborn sepsis
17
Q
What weeks do u screen for newborn sepsis?
A
34-36
18
Q
If u get a + result for newborn sepsis, what do u give during labor?
A
Intrapartum antibiotic prophylaxis (IAP)
19
Q
What are the components to the APGAR score?
A
Appearance Pulse Grimace Activity Respiration
20
Q
What 2 times do u do an APGAR score?
A
1 and 5 mins post delivery
21
Q
What is the scoring for each category in the APGAR score?
A
0-2
22
Q
What total APGAR score indicates a poor condition?
A
<2
23
Q
What total APGAR score indicates a fair condition?
A
3-7
24
Q
What total APGAR score indicates a good condition?
A
8+
25
What gives a 0, 1, and 2 for Appearance on the APGAR?
0-central and peripheral pallor or cyanosis
1- peripheral cyanosis
2- no cyanosis
26
What gives a 0, 1, and 2 for Pulse on the APGAR?
0- no pulse
1- < 100
2- > 100
27
What gives a 0, 1, and 2 for Grimace on the APGAR?
0- no response
1- weak response
2- strong response with crying
28
What gives a 0, 1, and 2 for Activity on the APGAR?
0- absent tone
1- some flexion
2- flexion against resistance
29
What gives a 0, 1, and 2 for Respiration on the APGAR?
0- no respirations
1-weak respirations
2- strong respirations
30
What is the avg temperature, RR, and HR for newborns?
Temp: 36.1-37oC (97-98.6oF)
RR: 40-60
HR: 120-160
31
When should a BP be taken for a newborn?
Only when cardio or renal abnormalitis are suspected
32
What is the classifications of weight for a newborn?
appropriate, large, or small
33
What position do u measure length of a newborn?
prone
34
What do u state the head circumfrence in?
max diameter
35
What 2 things do u use to assess the overall nutritional state estimate?
amt of SQ fat
| presence of Wharton jelly
36
What type of breathing is seen in infatns where the abdomen is going outward and the chest inward?
paradoxical breathing
37
Tachypnea, nasal flaring, cyanosis, and accessory muscle use are signs of what?
Respiratory distress
38
If there are diminished breath sounds over the L lower lobe, what is the condition that is indicated?
diaphragmatic hernia
39
This is when there is mild perioral cyanosis and cyanosis of the hands and feet, and is common in the first few days?
Acrocyanosis
40
What do u suspect if there is ecchymosis in an infant?
trauma
41
What do u suspect if there is pallor in an infant?
anemia
42
What do u suspect if there is erythema in an infant?
Polycythemia
43
What do u suspect if there is jaundice in an infant?
hyperbilirubinemia
44
What color is meconium?
green
45
This is the waxy white coating, most commonly in flexure surfaces and skin creases and composed of secaceous material and skin exfolation?
Vernix caseosa
46
This is the fine hair covering body, and is shed in first few weeks?
Lanugo
47
These are whit epapules on the nose and cheeks, is a transient lesion composed of keratin and sebaceous material in pilaceous follicles, and resolves within the first few weeks?
Milia
48
These are macules of patches of dermal melanocytes in blue or brown hues, typically on the back and butt, and typically sene in black and asians?
Mongolian spots
49
This is the erythematous macules on the face and back of neck, resolve within 18mo, and look like a hitler stache in the ppt picture?
Nevus simplex (stork bite)
50
These are filated capillaries, do not resolve, may be progressive, and may be evident of Sturge-Weber or KTW syndrome.
Port-wine stain (nevus flemmeus)
51
What is the most common cause of murmur at brith?
PDA
52
Which ventricle dominates on PMI in newborns?
RV
53
Forceps delivery may cause problems with which CN?
VII
54
What facial abnormalities might be seen with VII dmg?
nasolabial fold and drooping of corner of mouth
best seen when infant cries
55
This is the swelling that crossses suture lines, edema related to presenting part of head at delivery, and resolves.
Caput succedaneum
56
This is an area of subperiosteal bleeding, stops at suture line and resorbs over several weeks?
Cephalohematoma
57
Retraction of fontanelles is a sign of what?
dehydration
58
Buldging of fontanelles is a sign of what?
↑ ICP
59
Bony deformity of fontanelles is a sign of what?
craniosynostosis
60
A webbed neck is a sign of what problem?
Turners
61
What can cause toticollis?
intrauterine positioning or birth trauma
62
If there is widely spaced eyes, what should u look for next?
Other signs of syndromal conditions
63
This is the eye deviation on light reflex.
Strabismus
64
Epicanthal folds is a sign of what?
Down syndrome
65
What mg/dl of hyperbilirubinemia affects the following areas?
scleral icterus
face
upper thorax
below umbilicus
scleral icterus- 2
face- 5
upper thorax- 10
below umbilicus- 20
66
True or False: jaundice at birth is always pathologic.
True
67
Blue sclera is a sign of what disorder?
Osteogenesis imperfecta
68
Corneal clouding is a sign of what disorder?
↑ ICP
69
Absence/symmatrical red reflex is a sign of what disorder?
retinoblastoma, or congenital disorder (cataract)
70
Asymmetrical brachial pulses is a sign of what disorder?
Coartaction of thoracic aorta
71
Is breast enlargemnt and a thin, white discharge problematic?
no, it's usually from mom's hormones
72
A flat abdomen is a sign of what disorder?
diaphragmatic hernia
73
A distended abdomen is a sign of what disorder?
intaabdominal ascites, bowel obstruction, enlargment of liver/spleen/kidneys
74
This is the defect in development of muscle of the abdominal wall, the viscera protrude through umbilicus, WITH A SAC of peritoneum?
Omphalocele
75
What is an omphalocele without a sac?
Gastroschisis
76
What is associated with 1 umbilical a?
other congenital anomalies
77
Scrotal enlargement is a sign of what disorders?
Hydrocele, inguinal hernia
78
What is the condition where there is a urethral opening on the ventral surface?
Hypospadias
79
What is the condition where there is a urethral opening on the dorsalsurface?
epispadias
80
True or False: a thin white vaginal discharge in ♀ is common.
true
due to mom's hormones
81
The intergluteal fold may hide what defects?
neural tube defects
82
What does large sacral dimples indicate?
neural tube defects
83
Low set ears is indicative of what 2 problems?
Downs or Turners
84
External ear malformation is assoacited with what abnormalities?
Renal
85
What is the position for the otoscopic exam for kids?
Down, back, and out
86
What ages should u get well-baby visits?
9
18
14
30mo
87
When should the umbilical cord fall off?
within first 2 weeks
88
When should the posterior fontanelle close?
2mo
89
When should the anterior fontanelle close?
4mo-2years
90
When does excessive tearing from obstruction of the nasolacrimal duct typically resolve?
by age 1
91
What are the only sinuses preset at birth?
Ehtmoid
92
When do teeth develop?
after 6mo
93
When do u get massive guns?
6mo
94
When should testicles fully drop?
1yr
95
What is an innocent murmur?
```
<3
heard at LSB
normal S2
Crescendo-Decrescendo
lack of Sx
```
96
persistence of newborn reflexes after 6mo shwos what problem?
cerebral palsy
97
This is the reflex where the newborn is supine, rotate head to 1 side, extremities on chin side EXTEND, opposite extremities FLEX.
Asymmetric tonic neck reflex
98
Asymmetric tonic neck reflex is from what age?
birth-2mo
99
This is the reflex where u lightly touch the palms, and it results in grasping of the area touched.
Palmar grasp reflex
100
Palmar grasp reflex is from what age?
birth-4mo
101
This is the reflex where lift the baby until back of head begins to flex, release hand like ur dropping it, extension of back, extension an abduction of arms, fanning of digits, follwed by flexion and adduction of arms and closing of fingers symmetrically.
Moro reflex
102
Moro reflex is at what age?
birth-8mo
103
This is the reflex where u tap plantar surface of feet, and they should grasp.
Plantar grasp reflex
104
A Plantar grasp reflex after 1yo shows what problem?
brain injury and development delay
105
This is the reflex wher eu stroke the bottom of each foor from heal, laterally along the side oand across the ball, and the toes shoudl fan.
Babinski reflex
106
This is where u hold the baby over the table and lower the feetin just above the surface, touchign the feet lightly should make them attempt to walk.
Walking reflex
107
This is when u hold the infant upright, touch the anterior/distal tibia against the edge of table should cause the infant to lift foot, flex knee, and hip.
Placing reaction
108
Absence of the Placing reaction may indicate what?
brain dmg
109
What does the Ortolani maneuver test?
Post. dislocation
110
Describ the Ortolani maneuver
newburn supine --> flex hips/knees to 90 --> with pads of index and middle fingers on greater trochanters and thumbs medially on distal femurs--> anterior pressur on trochanters --> legs slowly abducted using thumbs --> shouldnt click
spread them outwards
111
What doe sthe Barlow maneuver test for?
unstable hip
112
Describe the barlow maneuver
newborn supine --> knees/hips at 90 --> hips abducted, legs adducted while applying pressure through leg to back --> click shows femur head sliding out of acetabulum
pull their leg up
