Pediatric visit and the newborn

Question 1

what are the first 28 days of life considered

Answer 1

newborn/neonates

Question 2

what ages are considered mild childhood

Answer 2

5-10 years old
also known as elementary

Question 3

what is the age group of 1-4 year olds called

Answer 3

early childhood

Question 4

what is the age group of 10-20 year olds

Answer 4

adolescence

Question 5

what is another name for Well Child Check (WCC)

Answer 5

Pediatric Health Supervision Visits

Question 6

what are the goals of pediatric visits?

Answer 6

disease detection
disease prevention
health promotion
anticipatory guidance

Question 7

what is anticipatory guidance

Answer 7

age specific advice
-more parental than child

Question 8

When is developmental surveillance done?

Answer 8

it is an ongoing process
done at every visit
parental history
skilled, experienced observation

Question 9

when is developmental screening done

Answer 9

it is a formal process that uses a standardized tool
universal screenings at specified ages
selective screening when risk assessment raises a concern

Question 10

what are the main differences between adult and pediatric evaluations

Answer 10

getting history from parent
need to get both child’s and parents’ perspectives especially as child gets older
note parent-child interaction
parental emotions and behaviors

Question 11

What is the difference with past medial history for pediatric patients

Answer 11

prenatal history of the mother
birth history
newborn history (included for all children three and under)

Question 12

what is the important components of prenatal history

Answer 12

mothers age at delivery
previous pregnancy history
maternal illnesses during pregnancy
medication exposure during pregnancy
complications of pregnancies

Question 13

what are the important factors of the birth history (perinatal)

Answer 13

duration of pregnancy
kind and duration of labor
type of delivery
use of medications during delivery
condition of child at birth
need for resuscitation at birth
apgar scores
complications of delivery

Question 14

what are components of pediatric health maintenance

Answer 14

feeding/nutrition
growth and development
immunizations
sleep patterns
elimination patters
dental care
safety

Question 15

what is HEADSS

Answer 15

social history in teens
Home
Education and Employment
activities
drug use
sexual activity/sexuality
suicide

Question 16

what is the Apgar score

Answer 16

scoring system to assess the need for resuscitation and the response to resuscitation (if needed)
- done at 1 minute and 5 minutes in ALL newborns

Question 17

what is assessed with the Apgar score

Answer 17

Heart rate (pulse)
Respirations
Muscle tone (activity)
Reflex irritability (grimace)
Color (appearaance)

Question 18

1 minute Apgar score of 0-4 is indicative of

Answer 18

severe depression, requiring immediate resuscitation

Question 19

1 minute Apgar score of 5-7 is indicative of

Answer 19

some nervous system depression

Question 20

1 minute Apgar score of 8-10 is indicative of

Answer 20

normal

Question 21

5 minute Apgar score of 7-10 is indicative of

Answer 21

reassuring

Question 22

5 minute Apgar score of 4-6 is indicative of

Answer 22

moderately abnormal - need close attention

Question 23

5 minute Apgar score of 0-3 is indicative of

Answer 23

low

Question 24

what is lanugo

Answer 24

fine downy growth of hair over the entire body
more prominent in preemies
shed in the first few weeks of life

Question 25

what is vernix caseosa

Answer 25

present at birth - white paste

Question 26

what should be evaluated if there is central cyanosis/mucous membranes

Answer 26

evaluate for congenital heart disease

Question 27

what type of cyanosis is normal after birth

Answer 27

Acrocyanosis (first 24-48 hours) blue hands and feet

Question 28

what is Milia

Answer 28

“newborn acne”
pinhead white raised areas due to retention of sebum in the openings of sebaceous glands
can be present at birth
appear within first few weeks of life
gradually disappear

Question 29

what is Pustular Melanosis

Answer 29

more common in African Americans
small, vesiculopustular lesions with a brown macular base
last for several months

Question 30

what is erythema toxicum

Answer 30

appear on day 2-3
erythematous macules with central pinpoint vesicles
over whole body
unkown etiology
disappear in a week or so

Question 31

what is nevus simplex

Answer 31

aka salmon patch or stork bite

Question 32

what is congenital dermal melanocytosis

Answer 32

aka mongolian spot
most common in asian populations
blue-grey patch, usually in sacral-gluteal region or shoulders
fade during first 1-2 years of life, most disappear completely by age 10 years

Question 33

what is a port wine stain

Answer 33

aka nevus flammeus
capillary malformations in the skin
usually, an isolated patch
growing in proportion to the childs growth
look for underlying disease

Question 34

what is sturge-weber syndrome

Answer 34

rare congenital capillary-venous malformations in the brain and eye

Question 35

what are the primitive reflexes

Answer 35

Moro reflex
Grasp reflex
Stepping reflex
Rooting reflex
babinski
Asymmetrical tonic neck reflex

Question 36

what is the Moro reflex

Answer 36

aka startle reflex
sudden, slight dropping of head from slightly raised supine position: opening of hands, extensions and abduction of arms, then flexion of arms and crying
disappears by 5-6 months

Question 37

when does the palmar grasp reflex disappear

Answer 37

by 5-6 months

Question 38

when does the plantar grasp reflex disappear

Answer 38

by 9-10 months

Question 39

when does the stepping reflex disappear

Answer 39

by 1-2 months

Question 40

when does the rooting reflex disappear

Answer 40

by 2-3 months

Question 41

when does the babinksi sign disappear

Answer 41

between 9-24 months

Question 42

what are the universal newborn screenings

Answer 42

hearing (otoacoustic emissions, automatic auditory brainstem response)
metabolic and genetic disorders (inborn errors of metabolism)
Endocrine disorders (cong. hypothyroidism, or adrenal hyperplasia)
Hemoglobinopathies