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H&P IV > Pediatric exam > Flashcards

Pediatric exam Flashcards

1
Q

What age defines a newborn?

A

recently born

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2
Q

What age defines a infant/

A

birth-12mo

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3
Q

What age defines a preschooler?

A

1-5yrs

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4
Q

What age defines a school-aged?

A

6-10yrs

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5
Q

What age defines a adolescent?

A

11-20yrs

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6
Q

Who is the primary history provider through preschooler years?

A

caregiver

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7
Q

What 3 thigns are checked on physical exam for the assessment of growth and developemnt?

A

height
weight
BMI

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8
Q

How long do u have to check the head circumfrence?

A

every visit until 3 y/o

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9
Q

What 2 vitals do u do in kids?

A

pulse, RR

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10
Q

What age do u start doing BP’s?

A

2 y/o

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11
Q

What screening method do u use for newborns?

A

APGAR

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12
Q

What 3 thigns must u do for a comprehensive Hx for a newborn?

A

Full maternal, family, and prenatal Hx

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13
Q

What does a Full maternal, family, and prenatal Hx help identify?

A

Exposure/risks
Abnormlitis
Medical conditions

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14
Q

What 4 things must u get in the maternal Hx?

A

current pregnancy
past pregnancies
maternal medical conditions
maternal medications

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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
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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

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17
Q

What weeks do u screen for newborn sepsis?

A

34-36

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18
Q

If u get a + result for newborn sepsis, what do u give during labor?

A

Intrapartum antibiotic prophylaxis (IAP)

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19
Q

What are the components to the APGAR score?

A 
Appearance
Pulse
Grimace
Activity
Respiration
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20
Q

What 2 times do u do an APGAR score?

A

1 and 5 mins post delivery

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21
Q

What is the scoring for each category in the APGAR score?

A

0-2

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22
Q

What total APGAR score indicates a poor condition?

A

<2

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23
Q

What total APGAR score indicates a fair condition?

A

3-7

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24
Q

What total APGAR score indicates a good condition?

A

8+

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25
Q

What gives a 0, 1, and 2 for Appearance on the APGAR?

A

0-central and peripheral pallor or cyanosis
1- peripheral cyanosis
2- no cyanosis

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26
Q

What gives a 0, 1, and 2 for Pulse on the APGAR?

A

0- no pulse
1- < 100
2- > 100

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27
Q

What gives a 0, 1, and 2 for Grimace on the APGAR?

A

0- no response
1- weak response
2- strong response with crying

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28
Q

What gives a 0, 1, and 2 for Activity on the APGAR?

A

0- absent tone
1- some flexion
2- flexion against resistance

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29
Q

What gives a 0, 1, and 2 for Respiration on the APGAR?

A

0- no respirations
1-weak respirations
2- strong respirations

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30
Q

What is the avg temperature, RR, and HR for newborns?

A

Temp: 36.1-37oC (97-98.6oF)
RR: 40-60
HR: 120-160

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31
Q

When should a BP be taken for a newborn?

A

Only when cardio or renal abnormalitis are suspected

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32
Q

What is the classifications of weight for a newborn?

A

appropriate, large, or small

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33
Q

What position do u measure length of a newborn?

A

prone

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34
Q

What do u state the head circumfrence in?

A

max diameter

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35
Q

What 2 things do u use to assess the overall nutritional state estimate?

A

amt of SQ fat

presence of Wharton jelly

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36
Q

What type of breathing is seen in infatns where the abdomen is going outward and the chest inward?

A

paradoxical breathing

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37
Q

Tachypnea, nasal flaring, cyanosis, and accessory muscle use are signs of what?

A

Respiratory distress

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38
Q

If there are diminished breath sounds over the L lower lobe, what is the condition that is indicated?

A

diaphragmatic hernia

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39
Q

This is when there is mild perioral cyanosis and cyanosis of the hands and feet, and is common in the first few days?

A

Acrocyanosis

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40
Q

What do u suspect if there is ecchymosis in an infant?

A

trauma

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41
Q

What do u suspect if there is pallor in an infant?

A

anemia

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42
Q

What do u suspect if there is erythema in an infant?

A

Polycythemia

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43
Q

What do u suspect if there is jaundice in an infant?

A

hyperbilirubinemia

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44
Q

What color is meconium?

A

green

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45
Q

This is the waxy white coating, most commonly in flexure surfaces and skin creases and composed of secaceous material and skin exfolation?

A

Vernix caseosa

46
Q

This is the fine hair covering body, and is shed in first few weeks?

A

Lanugo

47
Q

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?

A

Milia

48
Q

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?

A

Mongolian spots

49
Q

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?

A

Nevus simplex (stork bite)

50
Q

These are filated capillaries, do not resolve, may be progressive, and may be evident of Sturge-Weber or KTW syndrome.

A

Port-wine stain (nevus flemmeus)

51
Q

What is the most common cause of murmur at brith?

A

PDA

52
Q

Which ventricle dominates on PMI in newborns?

A

RV

53
Q

Forceps delivery may cause problems with which CN?

A

VII

54
Q

What facial abnormalities might be seen with VII dmg?

A

nasolabial fold and drooping of corner of mouth

best seen when infant cries

55
Q

This is the swelling that crossses suture lines, edema related to presenting part of head at delivery, and resolves.

A

Caput succedaneum

56
Q

This is an area of subperiosteal bleeding, stops at suture line and resorbs over several weeks?

A

Cephalohematoma

57
Q

Retraction of fontanelles is a sign of what?

A

dehydration

58
Q

Buldging of fontanelles is a sign of what?

A

↑ ICP

59
Q

Bony deformity of fontanelles is a sign of what?

A

craniosynostosis

60
Q

A webbed neck is a sign of what problem?

A

Turners

61
Q

What can cause toticollis?

A

intrauterine positioning or birth trauma

62
Q

If there is widely spaced eyes, what should u look for next?

A

Other signs of syndromal conditions

63
Q

This is the eye deviation on light reflex.

A

Strabismus

64
Q

Epicanthal folds is a sign of what?

A

Down syndrome

65
Q

What mg/dl of hyperbilirubinemia affects the following areas?

scleral icterus
face
upper thorax
below umbilicus

A

scleral icterus- 2
face- 5
upper thorax- 10
below umbilicus- 20

66
Q

True or False: jaundice at birth is always pathologic.

A

True

67
Q

Blue sclera is a sign of what disorder?

A

Osteogenesis imperfecta

68
Q

Corneal clouding is a sign of what disorder?

A

↑ ICP

69
Q

Absence/symmatrical red reflex is a sign of what disorder?

A

retinoblastoma, or congenital disorder (cataract)

70
Q

Asymmetrical brachial pulses is a sign of what disorder?

A

Coartaction of thoracic aorta

71
Q

Is breast enlargemnt and a thin, white discharge problematic?

A

no, it’s usually from mom’s hormones

72
Q

A flat abdomen is a sign of what disorder?

A

diaphragmatic hernia

73
Q

A distended abdomen is a sign of what disorder?

A

intaabdominal ascites, bowel obstruction, enlargment of liver/spleen/kidneys

74
Q

This is the defect in development of muscle of the abdominal wall, the viscera protrude through umbilicus, WITH A SAC of peritoneum?

A

Omphalocele

75
Q

What is an omphalocele without a sac?

A

Gastroschisis

76
Q

What is associated with 1 umbilical a?

A

other congenital anomalies

77
Q

Scrotal enlargement is a sign of what disorders?

A

Hydrocele, inguinal hernia

78
Q

What is the condition where there is a urethral opening on the ventral surface?

A

Hypospadias

79
Q

What is the condition where there is a urethral opening on the dorsalsurface?

A

epispadias

80
Q

True or False: a thin white vaginal discharge in ♀ is common.

A

true

due to mom’s hormones

81
Q

The intergluteal fold may hide what defects?

A

neural tube defects

82
Q

What does large sacral dimples indicate?

A

neural tube defects

83
Q

Low set ears is indicative of what 2 problems?

A

Downs or Turners

84
Q

External ear malformation is assoacited with what abnormalities?

A

Renal

85
Q

What is the position for the otoscopic exam for kids?

A

Down, back, and out

86
Q

What ages should u get well-baby visits?

A

9
18
14
30mo

87
Q

When should the umbilical cord fall off?

A

within first 2 weeks

88
Q

When should the posterior fontanelle close?

A

2mo

89
Q

When should the anterior fontanelle close?

A

4mo-2years

90
Q

When does excessive tearing from obstruction of the nasolacrimal duct typically resolve?

A

by age 1

91
Q

What are the only sinuses preset at birth?

A

Ehtmoid

92
Q

When do teeth develop?

A

after 6mo

93
Q

When do u get massive guns?

A

6mo

94
Q

When should testicles fully drop?

A

1yr

95
Q

What is an innocent murmur?

A 
<3
heard at LSB
normal S2
Crescendo-Decrescendo
lack of Sx
96
Q

persistence of newborn reflexes after 6mo shwos what problem?

A

cerebral palsy

97
Q

This is the reflex where the newborn is supine, rotate head to 1 side, extremities on chin side EXTEND, opposite extremities FLEX.

A

Asymmetric tonic neck reflex

98
Q

Asymmetric tonic neck reflex is from what age?

A

birth-2mo

99
Q

This is the reflex where u lightly touch the palms, and it results in grasping of the area touched.

A

Palmar grasp reflex

100
Q

Palmar grasp reflex is from what age?

A

birth-4mo

101
Q

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.

A

Moro reflex

102
Q

Moro reflex is at what age?

A

birth-8mo

103
Q

This is the reflex where u tap plantar surface of feet, and they should grasp.

A

Plantar grasp reflex

104
Q

A Plantar grasp reflex after 1yo shows what problem?

A

brain injury and development delay

105
Q

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.

A

Babinski reflex

106
Q

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.

A

Walking reflex

107
Q

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.

A

Placing reaction

108
Q

Absence of the Placing reaction may indicate what?

A

brain dmg

109
Q

What does the Ortolani maneuver test?

A

Post. dislocation

110
Q

Describ the Ortolani maneuver

A

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
Q

What doe sthe Barlow maneuver test for?

A

unstable hip

112
Q

Describe the barlow maneuver

A

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

H&P IV (6 decks)

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