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pediatrics Flashcards

1
Q

Most common cause of death in infants

A

birth defects and congenital malformations

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2
Q

most common cause of death children ages 1-4 years

A

drowning- educate parents about water safety- primary prevention

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3
Q

most common cause of death in adolescents

A

MVA’s- educate about seatbelts, helmets for ATVs- primary prevention

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4
Q

fontanels

A

soft spots on baby’s head- openings in the babies skull that allow for the brain to grow

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5
Q

posterior fontanel

A

closes first- 2-3 months

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6
Q

anterior fontanel

A

closes much later 9-18 months

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7
Q

return to birth weight

A

2 weeks

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8
Q

double birth weight

A

6 months

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9
Q

triple birth weight

A

12 months

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10
Q

how much does a newborn lose after delivery?

A

7-10% after delivery

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11
Q

moro reflex

A

startle reflex- resolves at 2 months

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12
Q

stepping reflex

A

resolves at 2 months

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13
Q

palmar grasp

A

infant grasps what is placed in hand- resolves at 6 months

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14
Q

infant goes from back to stomach

A

at 4 months

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15
Q

first tooth

A

4 months

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16
Q

stranger anxiety

A

9 months

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17
Q

unilateral manipulation skills- doing things with one hand or the other

A

9 months

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18
Q

develop true hand dominance

A

10-11 months

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19
Q

saying 2-4 words

A

1 year, mama dada with meaning

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20
Q

walking

A

1 year - 18 mos

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21
Q

full set of teeth

A

2 years

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22
Q

draw a circle

A

3 years

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23
Q

draw a cross

A

4 years

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24
Q

copy a square

A

4 years

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25
Q

what supplementation will the infant need

A

Vitamin D through drops within the first few days of life if the mother chooses to breastfeed

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26
Q

The biggest concern of NP with breastfeeding

A

can the mother breastfeed successfully

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27
Q

audible clicking during BF

A

not a sufficient latch- infant is breaking the seal or the suction

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28
Q

how many wet diapers a day

A

after first few days of life 6-8

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29
Q

weight gain if not back to birthweight by 2 weeks

A

investigate further/ refer to a lactation specialist if breastfeeding

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30
Q

when do we expect puberty to occur

A
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31
Q

precocious puberty

A

too early - refer to an endocrinologist (before 8 in females and 9 in males) will develop sexual characteristics and bodily changes too early

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32
Q

delayed puberty

A

lack of secondary characteristics before age 13 in females and age 14 in males

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33
Q

by age what if females haven’t gotten their period yet

A

15 referral maybe undelying anatomical or endocrine

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34
Q

stage 1 tanner stages

A

nothing

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35
Q

stage 5 tanner

A

have everything

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36
Q

stage 2 tanner females

A

puberty starts
breast budding- period starts in 2 years time

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37
Q

stage 3 tanner females

A

breasts are 1 mount

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38
Q

stage 4 tanner female

A

breast are 2 mounts
period starts officially
close to adult height

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39
Q

stage 2 male

A

enlargement of scrotum and testicles

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40
Q

stage 3 male

A

penis elongate the most and males have their growth spurt
**most important for males because the biggest changes occur

41
Q

stage 4 male

A

penis grows in width

42
Q

infants cannot receive what

A

any live vaccinations until 1 year of age

43
Q

what vaccines are live?

A

MMR
varicella

44
Q

Can pregnant moms receive live vaccines?

A

Not until the baby is born

45
Q

What kind of vaccines can infants receive?

A

inactivated vaccines

46
Q

at birth vaccines

A

Heb B series

47
Q

1-2 month vaccines

A

polio
Hib
rotovirus
Dtap
pneumococcal

48
Q

6 months olsd

A

inactivated flu

49
Q

Dtap when can you get it

A

dwarf- less than 7 years of age- smaller kids
pertussis part is what causes the fever

50
Q

Tdap when can you get it

A

after age 7
“tall”
pertussis component is what causes a fever

51
Q

HPV vaccine

A

can be as early as age 9
but usually age 11
the goal is to be administered before sexual activity begins

52
Q

How does HPV vaccine work?

A

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
Q

meningitis vaccine

A

11 years old usually with HPV vaccine if it wasn’t given at 9

54
Q

older child with unclear vaccination status

A

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
Q

milia

A

whilte papules on nose of infants- totally normal dont pop they will go away

56
Q

Seborrheic dermatitis

A

cradle cap
resolves in a few months soften with oil or shampoo

57
Q

hemangioma

A

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
Q

mongolian spots

A

look like a bruise. usually in lumbo sacral area. African or Asian descent. Benign. Often disappear with first few years of life.

59
Q

jaundice

A

due to a buildup of bilirubin. Cutoff point for phototherapy is > 15 that would indicate phototherapy
fussy and not feed well

60
Q

childhood exanthems are

A

rubella
roseola
rubeola
mumps

61
Q

varicella other name

A

chicken pox

62
Q

chicken pox

A

intensely pruritic vesicles in various stages of healing
contagious until all lesions have crusted over
management- avoid scratching, antipyretics as needed, symptomatic treatment

63
Q

high fever, cough, nasal congestion, pink watery eyes, rash, white spots in mouth

A

rubeola (measles) is the most serious

64
Q

rubeola measle and koplik spots

A

all have one “L”

65
Q

The three C’s of rubeola

A

cough
conjuntivitis
congestions (coryza)
airborne

highly contageous
90% non immunized patients will have measles

66
Q

rubeola compliactions

A

pneumonia
encephalitis
permanent damage
most serious form of measles

67
Q

treatment of rubeola

A

symptomatic which is why the vaccine is so very important

68
Q

Koplik spots

A

very specific to measles (rubeola)
present on the buccal mucosa near the molars specifically before measle rash occurs

69
Q

measles course

A

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
Q

treatment rubeola (measles)

A

antipyretics
hydration
rest

71
Q

best news about rubeola

A

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
Q

child acts fine, mild fever, swollen cervical lymph nodes, pink rash started on face then spread to rest of body

A

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
Q

rubella mneumonic

A

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
Q

treatment of rubella

A

3 day measles
hydration
rest
motrin or Tylenol

75
Q

adenopathy

A

swollen lymph nodes

76
Q

Big time SAFETY alert about rubella

A

pregnant woman infected with rubella- cause miscarriage or can cause birth defects
especially during first trimester

77
Q

high fever
irritable
new rash
rose pink
started on trunk
rash turns white when pressed
spreding to arms, face and legs

A

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
Q

mild symtoms resmeble a cold
been about a week
now rash upon cheeks
lacey rash on trunk
mildly itchy- especially at soles of feet

A

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
Q

fever for a day or 2
sore throat then painful sores in mouth
then a rash on his hands and toes
peeling

A

hand foot mouth coxsackie virus
rash START in mouth and then hands and feet
pilling after rash has occured
symptomatic treatment
no vaccine

80
Q

chicken pox

A

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
Q

if you get a question with “ various stages of healing”

A

chicken pox

82
Q

if you get a question with blanchable lesions

A

roseola

83
Q

Kawasaki disease

A

vasculitis
the leading cause of acquired heart disease in children

84
Q

Kawasaki disease presentation

A

strawberry tongue
fever rash
swelling in hands and feet

85
Q

Kawasaki disease

A

can have a varied rash
erythematous and spread itself across the body
eventually to hands and feet

86
Q

strawberry tongue

A

kawasaki disease

87
Q

When is the only time you would prescribe aspirin to a child?

A

Kawasaki disease because the benefit outweighs the risk of Reyes syndrome
High dose aspirin
maybe admitted to hospital for IVig

DO NOT DELAY

88
Q

Molloscum Contagiosum

A

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
Q

What can happen if kawasakis goes without treatment?

A

heart attacks and aneurysms in children

90
Q

What the biggest thing to remember about molloscum contagioosum

A

if you see them in the groin area of children suspect abuse.

91
Q

atopic dermatitis in infants is found?

A

face, knees, elbows

92
Q

atopic dermatitis in children found?

A

flexural fold, hands,

93
Q

atopic triad

A

asthma, allergies
stress makes it worse

AVOID triggers

94
Q

treatment atopic dermatitis

A

emollients, topical corticosteroids

95
Q

scarlet fever presentation

A

scaletina rash
“sandpaper” maculopapular rash
sorethroat
fver
lymphadenopathy
strawberry tongue

96
Q

what is scarlet fever a complication of?

A

strep throat

97
Q

management of scarlet fever

A

treat underlying strep- amoxicillin

98
Q

strep vs mono
be able to distinguish becaise it will dictate your treatment plan

A

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
Q

if you give a patient a PCN when they have mono…

A

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.

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