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H & P (Final Exam) > Pediatric Exam > Flashcards

Pediatric Exam Flashcards

1
Q

When is the neonatal period?

A

1st day to 28th day

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2
Q

What age is an infant?

A

< 1 year old

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3
Q

What is the name for the blue cast to hands and feet when exposed to cold in an infant?

A

Acrocyanosis

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4
Q

With acrocyanosis, if blue coloration persists >8hrs or doesn’t disappear with warming or central cyanosis (tongue oral mucosa are blue) what should you suspect?

A

congenital heart disease

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5
Q

When should jaundice resolve by in newborn infants?

A

about 1 week

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6
Q

Which common skin finding has red macules with central pinpoint vesicles scattered over body and disappears in about a week?

A

Erythema toxicum

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7
Q

Pustular melanosis

A

small vesiculopustules over brown base

*more common in black infants

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8
Q

Milia

A

common skin finding with pinhead-sized smooth white raised area without erythema on nose, chin, forehead: due to retention of sebum in openings of sebaceous glands

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9
Q

Fontanelle

A

Area where major sutures intersect

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10
Q

What will a suture feel like on palpation?

A

ridge

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11
Q

When does the anterior fontanelle (4-6 cm at birth) close?

A

4-26 months

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12
Q

When doees the posterior fontanelle close (1-2cm at birth)?

A

2 months

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13
Q

What suggests possibility of neglect between child and caregiver?

A

lack of eye contact

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14
Q

What is defined as tachypnea in a child older than 1?

A

> 40 breaths per min

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15
Q

How is a pulse obtained from a child?

A
  1. Direct auscultation
  2. Palpation of heart
  3. Brachial/radial pulse (peripheral arteries)
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16
Q

In a child, for every 1 degree of fever what happens to HR?

A

HR is 10-20 beats faster with every degree warmer

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17
Q

Is sinus arrhythmia common in children?

A

Yes, rate is faster with inspiration and slower with expiration

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18
Q

In children how do you count respirations?

A

rise and fall of abdomen

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19
Q

How long do you observe respirations in children?

A

2, 30 sec intervals
or
1 full minute

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20
Q

What are some signs of increased respiratory effort in children?

A
  • Retraction (ribs, supraclavicular notch)
  • Use of sternocleidomastoid
  • Flaring nostrils
  • Paradoxical breathing
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21
Q

When does routine measurement of blood pressure begin?

A

3 years old

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22
Q

If blood pressure is consistently above the 95th percentile what should be on the differential?

A
  • Kidney disease

- Coarctation of the aorta

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23
Q

Where will blood pressure be higher and lower if there is coarctation of the aorta?

A

High: above point of coarctation

Low: Beyond point of coarctation

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24
Q

What is the temperature of the TM in relation to oral temperature?

A

TM is ~1 degree higher than oral temp

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25
Q

What is the technical definition for fever in rectal/ear vs. oral vs. armpit?

A

rectal, ear (TM) or temporal artery: 100.4 or higher

oral: 100 degrees or higher
armpit: 99 degrees or higher

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26
Q

When measuring height how do you tell that the patient is oriented correctly and looking forward?

A

outer canthus of eye aligned with external auditory canal

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27
Q

When should BMI start to be recorded?

A

age 2

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28
Q

Describe growth pattern for infants

A
  • Growth of trunk predominates

- Fat increases until 9 months

29
Q

Describe childhood growth pattern

A
  • Legs grow fastest

- Prepubertal growth spurt around age 7

30
Q

Describe adolescence growth pattern

A
  • Trunk and legs elongate

- organs and skeletal mass double in size

31
Q

Simian crease, single line across palm of hand is associated which what?

A
  1. Down syndrome

2. Fetal alcohol syndrome

32
Q

Where will eczema (atopic dermatitis) be on young children versus older children?

A 
young children:
-face
-elbow
-knees
EXTENSOR SURFACES

older children/adults:
-hands, neck, elbows, knees
FLEXOR SURFACES

33
Q

Impetigo

A
  • highly contagious staph or strep infection of skin
  • itching, burning

“honey colored crusts”

34
Q

Ring worm is a yeast infection of the skin caused by what?

A
  • Tinea capitis (on head)

- Tinea corporis (on body)

35
Q

What are some of the facial characteristics of fetal alcohol syndrome?

A
  • Smooth philtrum
  • wideset eyes
  • mild ptosis (lid drooping)
  • hirsute forehead
  • short nose
  • thin upper lip
36
Q

Which lymph node region enlargement is always considered abnormal

A

supraclavicular

37
Q

When are visual acuity tests with the snellen E chart started?

A

age 3

38
Q

Which chart is used to assess distance vision?

A

Snellen

39
Q

What is the name for reduced vision in an eye that appears structurally normal?

A

ambyopia “lazy eye”

40
Q

By what age would you anticipate a child have 20/20 vision?

A

6 years old

41
Q

If you elict a white reflex instead of a red eye reflex what should you be concerned for?

A

retinoblastoma

42
Q

What is the name for a convergent eye pointing inward?

A

esotropic

43
Q

What is the name for a divergent eye pointing outward?

A

exotropic

44
Q

What could low or poorly shaped auricles suggest?

A
  • renal disorder

- congenital abnormalities

45
Q

What is the treatment for mastoiditis?

A

This usually results from untreated otitis media -should treat with IV antibiotics

46
Q

What does a red and inmobile tympanic membrane suggest?

A

infection in the middle ear

47
Q

Saddle -shaped nose with collapse of the bony portion may be associated with what?

A

congenital syphilis

48
Q

Strawberry tongue is a feature of what illness?

A

Scarlet fever (group A strep)

49
Q

What does an adherent white patch in the mouth suggest?

A

Candidiasis (thrush)

50
Q

Which virus causes Mononucleosis?

A

Epstein-Barr virus

most common in teens

51
Q

What symptoms are associated with epiglottitis?

A
  • Sudden high fever
  • Drooling ***
  • croupy cough
  • Respiratory distress. Tripod position 2 neck extended

NO TONGUE BLADE!!!!

52
Q

Auscultation of lungs: children

A
  • breath sounds louder, harsher and more bronchial

- Hyperresonance is common

53
Q

Where is the apical impulse observed in a child?

A

4th and 5th left intercostal space

-heart lays more horizontal

54
Q

Venous hum

A

benign heart finding

  • caused by turbulent blood in the internal jugular vein
  • Louder in diastole

Best heard: supraclavicular space

55
Q

Still’s murmur

A

-Most common benign murmur
-grade 1-2/6, musical, early-mid systolic
Best heard: mid or lower left sternal border (2nd pulmonic, tricuspid)

56
Q

If abdomen is hard during both inspiration and expiration (should be soft during inspiration) what should you suspect?

A

peritoneal irritation

57
Q

What do spider nevi indicate?

A

liver disease

58
Q

Diastasis recti

A

midline separation of the rectus abdominus

59
Q

Wilms tumor

A

Wilms tumor = nephroblastoma (kidney!)

  • Most common intraabdominal tumor of childhood
  • Malignant
60
Q

What does a sausage-shaped mass in the left or right upper quadrants indicate?

A

Intussusception

*most common abdominal emergency in children <2 yrs

61
Q

What does a sausage-shaped mass in the left lower quadrant suggest?

A

feces in sigmoid colon

62
Q

Dance sign

A

right lower quadrant feels empty - movement of cecum from normal position

63
Q

What is the main reason for sports physicals?

A

prevent sudden cardiac death

64
Q

Which 4 sports are more commonly associated with sudden cardiac death?

A
  1. football
  2. basketball
  3. track
  4. soccer
65
Q

Most common cause of sudden cardiac death in athletes?

A

hypertrophic cardiomyopathy

66
Q

When does heart reach adult postion?

A

age 7

67
Q

Child will have abdominal respirations until age….?

A

6/7

68
Q

Which temperature is the gold standard for infants?

A

RECTAL

69
Q

Osgood-Schlatter disease

A

osteochondritis of tibial tubercle

(from repetitive quadriceps contraction leading to subacture fractures or tendon inflammation)

(most common: 9-14)

H & P (Final Exam) (3 decks)

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