pediatrics Flashcards
1
Q
Most common cause of death in infants
A
birth defects and congenital malformations
2
Q
most common cause of death children ages 1-4 years
A
drowning- educate parents about water safety- primary prevention
3
Q
most common cause of death in adolescents
A
MVA’s- educate about seatbelts, helmets for ATVs- primary prevention
4
Q
fontanels
A
soft spots on baby’s head- openings in the babies skull that allow for the brain to grow
5
Q
posterior fontanel
A
closes first- 2-3 months
6
Q
anterior fontanel
A
closes much later 9-18 months
7
Q
return to birth weight
A
2 weeks
8
Q
double birth weight
A
6 months
9
Q
triple birth weight
A
12 months
10
Q
how much does a newborn lose after delivery?
A
7-10% after delivery
11
Q
moro reflex
A
startle reflex- resolves at 2 months
12
Q
stepping reflex
A
resolves at 2 months
13
Q
palmar grasp
A
infant grasps what is placed in hand- resolves at 6 months
14
Q
infant goes from back to stomach
A
at 4 months
15
Q
first tooth
A
4 months
16
Q
stranger anxiety
A
9 months
17
Q
unilateral manipulation skills- doing things with one hand or the other
A
9 months
18
Q
develop true hand dominance
A
10-11 months
19
Q
saying 2-4 words
A
1 year, mama dada with meaning
20
Q
walking
A
1 year - 18 mos
21
Q
full set of teeth
A
2 years
22
Q
draw a circle
A
3 years
23
Q
draw a cross
A
4 years
24
Q
copy a square
A
4 years
25
what supplementation will the infant need
Vitamin D through drops within the first few days of life if the mother chooses to breastfeed
26
The biggest concern of NP with breastfeeding
can the mother breastfeed successfully
27
audible clicking during BF
not a sufficient latch- infant is breaking the seal or the suction
28
how many wet diapers a day
after first few days of life 6-8
29
weight gain if not back to birthweight by 2 weeks
investigate further/ refer to a lactation specialist if breastfeeding
30
when do we expect puberty to occur
31
precocious puberty
too early - refer to an endocrinologist (before 8 in females and 9 in males) will develop sexual characteristics and bodily changes too early
32
delayed puberty
lack of secondary characteristics before age 13 in females and age 14 in males
33
by age what if females haven't gotten their period yet
15 referral maybe undelying anatomical or endocrine
34
stage 1 tanner stages
nothing
35
stage 5 tanner
have everything
36
stage 2 tanner females
puberty starts
breast budding- period starts in 2 years time
37
stage 3 tanner females
breasts are 1 mount
38
stage 4 tanner female
breast are 2 mounts
period starts officially
close to adult height
39
stage 2 male
enlargement of scrotum and testicles
40
stage 3 male
penis elongate the most and males have their growth spurt
****most important for males because the biggest changes occur
41
stage 4 male
penis grows in width
42
infants cannot receive what
any live vaccinations until 1 year of age
43
what vaccines are live?
MMR
varicella
44
Can pregnant moms receive live vaccines?
Not until the baby is born
45
What kind of vaccines can infants receive?
inactivated vaccines
46
at birth vaccines
Heb B series
47
1-2 month vaccines
polio
Hib
rotovirus
Dtap
pneumococcal
48
6 months olsd
inactivated flu
49
Dtap when can you get it
dwarf- less than 7 years of age- smaller kids
pertussis part is what causes the fever
50
Tdap when can you get it
after age 7
"tall"
pertussis component is what causes a fever
51
HPV vaccine
can be as early as age 9
but usually age 11
the goal is to be administered before sexual activity begins
52
How does HPV vaccine work?
There are low risk and high risk subtypes of HPV. your body clears the low risk subtypes on its own. High risk ones are the ones that eventually cause cancer
This vaccine protects against the high risk strains that cause genital warts and cervicalcancer. Protects against strain 16&18 which cause cervical cancer
also protects against strains 6 & 11- causing warts
53
meningitis vaccine
11 years old usually with HPV vaccine if it wasn't given at 9
54
older child with unclear vaccination status
It's Time for Many Happy Vaccinations.
IPV, Td/ Tdap, MMR, meningitis, Hep B, HPV, Varicella.
Also consider their age- are they old enough for the meningitis and HPV?
(IPV= inactivated polio)
55
milia
whilte papules on nose of infants- totally normal dont pop they will go away
56
Seborrheic dermatitis
cradle cap
resolves in a few months soften with oil or shampoo
57
hemangioma
usually at birth. Reddened flat or raised mark on skin. May grow initially during the first few months of life. typically will resolve by age 4. Usually don't have to refer unless vision changes or complications. Benign. Usually resiolve on their own
58
mongolian spots
look like a bruise. usually in lumbo sacral area. African or Asian descent. Benign. Often disappear with first few years of life.
59
jaundice
due to a buildup of bilirubin. Cutoff point for phototherapy is > 15 that would indicate phototherapy
fussy and not feed well
60
childhood exanthems are
rubella
roseola
rubeola
mumps
61
varicella other name
chicken pox
62
chicken pox
intensely pruritic vesicles in various stages of healing
contagious until all lesions have crusted over
management- avoid scratching, antipyretics as needed, symptomatic treatment
63
high fever, cough, nasal congestion, pink watery eyes, rash, white spots in mouth
rubeola (measles) is the most serious
64
rubeola measle and koplik spots
all have one "L"
65
The three C's of rubeola
cough
conjuntivitis
congestions (coryza)
airborne
highly contageous
90% non immunized patients will have measles
66
rubeola compliactions
pneumonia
encephalitis
permanent damage
most serious form of measles
67
treatment of rubeola
symptomatic which is why the vaccine is so very important
68
Koplik spots
very specific to measles (rubeola)
present on the buccal mucosa near the molars specifically before measle rash occurs
69
measles course
exposure occurs
1 week later contagious bad bad news
symptoms start day 10- 3 C's high fever
day 12-13 Koplik spots
Day 15 fever subsides/ rash appears
day 22-24 rash resolves
70
treatment rubeola (measles)
antipyretics
hydration
rest
71
best news about rubeola
MMR vaccine
it is a live vaccine
can't give until at least 1 year old or cant give pregnant or immunocompromised
shouldn't get pregnant within 4 weeks of getting this vaccine
2 dose series 2nd dose 4-6 years old
72
child acts fine, mild fever, swollen cervical lymph nodes, pink rash started on face then spread to rest of body
rubella
german measles
much milder commonly called 3 day measles
likely fine in a couple days
symptoms typically are mild
pink rash
mild fever
swollen lymph nodes
73
rubella mneumonic
r stands for rash which is pink
l stands for lymph nodes which are swollen
l stands for little fever
e stands for everything is gonna be ok
74
treatment of rubella
3 day measles
hydration
rest
motrin or Tylenol
75
adenopathy
swollen lymph nodes
76
Big time SAFETY alert about rubella
pregnant woman infected with rubella- cause miscarriage or can cause birth defects
especially during first trimester
77
high fever
irritable
new rash
rose pink
started on trunk
rash turns white when pressed
spreding to arms, face and legs
you note cervical adenopathy
roseola caused by
"rash after fever"
the only one that will blanch upon youch
ROSE COLORED BLANCHABLE RASH
they are contagious while febrile
how long are they contagious- whenever rash appears= they aren't contagious
no vaccine for thids one
symptomatic treatment
78
mild symtoms resmeble a cold
been about a week
now rash upon cheeks
lacey rash on trunk
mildly itchy- especially at soles of feet
Fifths Disease
"erythema Infectiosum"
slapped cheek only occurs with this condition as well as lacey net like body rash
symtomatic treatment
can a pregnant women be around fifths diseas? most women are already immune to it but it can cause sever anemias and draw a titer to see if mom is already immune
79
fever for a day or 2
sore throat then painful sores in mouth
then a rash on his hands and toes
peeling
hand foot mouth coxsackie virus
rash START in mouth and then hands and feet
pilling after rash has occured
symptomatic treatment
no vaccine
80
chicken pox
not all lesions occur at once so they are in various stages of healing
extremely contagious until all lesions crust over
calamine lotion oatmeal baths
81
if you get a question with " various stages of healing"
chicken pox
82
if you get a question with blanchable lesions
roseola
83
Kawasaki disease
vasculitis
the leading cause of acquired heart disease in children
84
Kawasaki disease presentation
strawberry tongue
fever rash
swelling in hands and feet
85
Kawasaki disease
can have a varied rash
erythematous and spread itself across the body
eventually to hands and feet
86
strawberry tongue
kawasaki disease
87
When is the only time you would prescribe aspirin to a child?
Kawasaki disease because the benefit outweighs the risk of Reyes syndrome
High dose aspirin
maybe admitted to hospital for IVig
DO NOT DELAY
88
Molloscum Contagiosum
dome shaped papules that look like they have an indent in the middle of them
very contagious
lasts about 1 year
self resolves over time
89
What can happen if kawasakis goes without treatment?
heart attacks and aneurysms in children
90
What the biggest thing to remember about molloscum contagioosum
if you see them in the groin area of children suspect abuse.
91
atopic dermatitis in infants is found?
face, knees, elbows
92
atopic dermatitis in children found?
flexural fold, hands,
93
atopic triad
asthma, allergies
stress makes it worse
AVOID triggers
94
treatment atopic dermatitis
emollients, topical corticosteroids
95
scarlet fever presentation
scaletina rash
"sandpaper" maculopapular rash
sorethroat
fver
lymphadenopathy
strawberry tongue
96
what is scarlet fever a complication of?
strep throat
97
management of scarlet fever
treat underlying strep- amoxicillin
98
strep vs mono
be able to distinguish becaise it will dictate your treatment plan
group A strep mono FATIGUE
tonsillar exudates Epstein Barr virus
palatine petichiae roof of mouth. enlarged spleen
treat with antibiotics. conservative treatment
u/s of spleen
both
fever
sore throat
lymphadenopathy
if they have both treat with something outside of the PCN like macrolides and cephalospons. PCN VK wont cause the rash
99
if you give a patient a PCN when they have mono...
Morbilliform drug eruption is a rash that develops because of an adverse reaction to a drug. Antibiotics are the usual trigger, but many drugs can trigger this allergic reaction. It may appear right away or a few weeks after you first take the medicine.
