Pediatric Physical Exam Flashcards
When do you start measuring blood pressure?
Age 2, use appropriate cuff size
What should the pediatric history include?
- details of pregnancy/birth
- Developmental Hx
- Immunization Hx.
- Growth chart
- Nutrition
- Social Hx: 2nd hand smoke, caregivers, daycare, school
- Safety assessment: lead, car seat, guns
What are the age ranges for the following:
Newborn, infancy, early, middle childhood. Adolescence?
Newborn = newborn Infancy = under 1 year Early childhood = 1 - 4 Middle children hood = 4 - 10 Adolescence = 11 - 20 with early, middle, late
Which type of temperature measurement is most accurate.
Rectal though over 2 months, tympanic measurement is typically accurate
How do you identify seriously ill children quickly?
social interaction and eye contact absent, RR effort labored, skin color poor, cap refill prolonged
What is HR typically in Young infant vs. infant vs. toddler vs. preschool vs. school age
Mean for young infant: 140, infant: 135, toddler: 120, preschool: 110, school age: 85-100 (adult is 80)
What is RR in young infant vs. infant vs. toddler vs. preschool vs. school age
young infant: 30-60
infant: 30-50
toddler: 24-40
preschool: 22-34
school: 14-25
Lower limit of systolic BP in young infant vs. infant vs. toddler vs. preschool vs. school age
young infant: 60 infant: 70 toddler: 75 preschool: 80 school age: 80-90
How does weight and height change in the first year of life?
weight triples and height increases by 50%
When do teeth come in?
6-26 months, 1 tooth/month.
When do the fontanelles close?
Anterior fontanelle closes between 4 and 26 months, posterior fontanelle closes by 2 months of age
What is craniosynosistosis?
premature suture closure
Which sinuses are present at birth?
Only the ethmoid sinuses
How long are infants obligate breathers?
first two months of life
Where is PMI in children?
1 interspace higher in children
4th intercostal space instead of 5th
is S3 heard in children?
yes, due to rapid filling
When should testes descend into scrotal sac?
age 6 months
When should umbilical cord remnant disappear?
2 weeks
What is leukocoria?
An abnormal red reflex of the eye, “white cornea”, indicates possible retinoblastoma or cataract.
How can corneal light reflex diagnose strabismus?
By shining a light in both eyes at the same time, you should see where the penlight hits and it should be the same place in each eye.
When you palpate the abdomen, should you feel liver and spleen?
Yes, 1-2cms below costal margin is liver and should feel tip of spleen
What are the four developmental domains according to the Denver developmental screen?
- Gross motor (large muscle groups) 2. Fine motor (small muscles of hand) 3. Personal-social 4. Language - communication and speech. It is used to determine if intervention is necessary PT, OT, Speech therapy.
What should happen to weight in development?
Doubles at 5 months
Triples at one year
Gains 25% more in year 2
By 18 months, overweight - chance of obesity is 35%, at end of puberty overweight, 75% chance of obesity
How do you determine height in boys and girls?
Boys: (Mom’s Ht + 5inches + dad’s Ht)/2
Girls: (Dad’s Ht - 4 inches + mom’s ht)/2
Also, double height at 2 years old = final height
