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ICM Block I > Pediatric Physical Exam > Flashcards

Pediatric Physical Exam Flashcards

1
Q

When do you start measuring blood pressure?

A

Age 2, use appropriate cuff size

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2
Q

What should the pediatric history include?

A
  1. details of pregnancy/birth
  2. Developmental Hx
  3. Immunization Hx.
  4. Growth chart
  5. Nutrition
  6. Social Hx: 2nd hand smoke, caregivers, daycare, school
  7. Safety assessment: lead, car seat, guns
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3
Q

What are the age ranges for the following:

Newborn, infancy, early, middle childhood. Adolescence?

A 
Newborn = newborn
Infancy = under 1 year
Early childhood = 1 - 4
Middle children hood = 4 - 10
Adolescence = 11 - 20 with early, middle, late
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4
Q

Which type of temperature measurement is most accurate.

A

Rectal though over 2 months, tympanic measurement is typically accurate

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5
Q

How do you identify seriously ill children quickly?

A

social interaction and eye contact absent, RR effort labored, skin color poor, cap refill prolonged

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6
Q

What is HR typically in Young infant vs. infant vs. toddler vs. preschool vs. school age

A

Mean for young infant: 140, infant: 135, toddler: 120, preschool: 110, school age: 85-100 (adult is 80)

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7
Q

What is RR in young infant vs. infant vs. toddler vs. preschool vs. school age

A

young infant: 30-60

infant: 30-50
toddler: 24-40
preschool: 22-34
school: 14-25

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8
Q

Lower limit of systolic BP in young infant vs. infant vs. toddler vs. preschool vs. school age

A 
young infant: 60
infant: 70
toddler: 75
preschool: 80
school age: 80-90
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9
Q

How does weight and height change in the first year of life?

A

weight triples and height increases by 50%

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10
Q

When do teeth come in?

A

6-26 months, 1 tooth/month.

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11
Q

When do the fontanelles close?

A

Anterior fontanelle closes between 4 and 26 months, posterior fontanelle closes by 2 months of age

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12
Q

What is craniosynosistosis?

A

premature suture closure

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13
Q

Which sinuses are present at birth?

A

Only the ethmoid sinuses

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14
Q

How long are infants obligate breathers?

A

first two months of life

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15
Q

Where is PMI in children?

A

1 interspace higher in children

4th intercostal space instead of 5th

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16
Q

is S3 heard in children?

A

yes, due to rapid filling

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17
Q

When should testes descend into scrotal sac?

A

age 6 months

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18
Q

When should umbilical cord remnant disappear?

A

2 weeks

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19
Q

What is leukocoria?

A

An abnormal red reflex of the eye, “white cornea”, indicates possible retinoblastoma or cataract.

20
Q

How can corneal light reflex diagnose strabismus?

A

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.

21
Q

When you palpate the abdomen, should you feel liver and spleen?

A

Yes, 1-2cms below costal margin is liver and should feel tip of spleen

22
Q

What are the four developmental domains according to the Denver developmental screen?

A
  1. 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.
23
Q

What should happen to weight in development?

A

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

24
Q

How do you determine height in boys and girls?

A

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

25
Q

When do you stop measuring head circumference?

A

2 years

26
Q

Problems at newborn age?

A

Development and evolution of social skills, sleep problems, colic.

27
Q

Problems at toddler age?

A

autonomy, aggression, temper tantrums, toilet training, feeding problems

28
Q

Issues at middle childhood (5-11yo)

A

emerging independence, parents become fallible, secret codes with freinds, control of emotions

29
Q

School age issues?

A

independence, enuresis, attention defecit, encopresis (soiling), bullying

30
Q

How does puberty start for girls and boys?

A

Girls - 2 years ahead of boys
Boys - puberty starts with testicular enlargement
Girl - ovarian enlargement.

31
Q

What is Tanner staging?

A

The development of male genitalia and breasts. Important to determine if there are hormonal development issues

32
Q

What is HEADSS?

A 
Psychosocial interview for adolescents.  
H - home and environment
E - Education & Employment
A - Activities
D - drugs
S - Sexuality
S - suicide/depression
33
Q

What are the 3 things you should always ask about it WCC (well child)

A

Sleep, exercise, Diet

34
Q

What is the percent of mood disorders in adolescents?

A

4.5% have Mood disorders at any time, and 20% of kids have them during adolescence

35
Q

What is occipital positional plagiocephaly?

A

Flat head due to babies laying on back. Treatment is belly play for 5-15 minutes 4/day

36
Q

What developmental milestones are reached at 2 months

A

2 months - smiling, cooing, no longer clenches fists tightly

37
Q

What developmental milestones are reached at 4 months

A

4 months - laughing out loud, squealing, initiating social interactions, rolls over

38
Q

What developmental milestones are reached at 6 months

A

6 months - displays emotional response of pleasure or negative affect. Recognizes someone is a stranger. babbles, sits unsupported

39
Q

What developmental milestones are reached at 9 months

A

9 months - pull to stand and cruise, walk with 2 hands held, employ immature pincer grasp. Says mama, dada

40
Q

What developmental milestones are reached at 12 months

A

12 months - walk alone, use a mature pincer grasp, release an object to another person upon request. Uses 2 words other than mama dada

41
Q

What developmental milestones are reached at 15 months

A

15 months - playing ball, giving and taking a toy, walking independently, stopping to the floor and recovering, making a line with a crayon, building 2 cube tower. 4-6 words

42
Q

What developmental milestones are reached at 24 months

A

24 months - child can run well, walk up and down steps one at a time, hump in place, make tower of 7 cubes, scribble in circular pattern, and imitate a horizontal stroke. Parallel play. 50 word vocabulary

43
Q

What developmental milestones are reached at 3 years

A

3 years - play with others, copies circle, pedal tricycle, knows full name, age, gender

44
Q

What developmental milestones are reached at 4 years

A

buttons clothing, dresses self completely, tells tales, copies square

45
Q

What developmental milestones are reached at 5 years

A

uses knife, copies triangle

46
Q

What can baby do at one month visit?

A

follow to midline, lift head off table, regard face, assess hearing - variable responses to noice , asses vision - blinks to light

ICM Block I (5 decks)

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