Pediatrics

Question 1

what are general s/sx of abuse and neglect in children (3)

Answer 1

frightened/cries when time to go home
sudden unexplained difficulty walking or sitting
injuries that don’t match explanations of changing history

Question 2

what is physical abuse

Answer 2

intentional bodily/physical injury inflicted upon child, or puts them at harm

Question 3

what are sx of physical abuse in children (4)

Answer 3

unexplained bruises, lacerations or welts
suspicious patterns of bruising
unexplained fx
unexplained scalding or burns

Question 4

what is sexual abuse in children

Answer 4

any sexual activity or assisting any other person in sexual activity with a child

Question 5

what are sx of sexual abuse in a child (6)

Answer 5

unexplained difficulty walking/sitting
unexplained pain in groin
unexplained STIs
pregnancy
behavior or knowledge inappropriate for child’s age
inappropriate sexual contact w other children

Question 6

what is emotional abuse in children

Answer 6

any behavior that impairs child’s emotional development or self-esteem

Question 7

what are sx of emotional abuse (5)

Answer 7

delayed or inappropriate emotional development
social withdrawal
non-communicative
avoidance and nervousness
loss of previously acquired skills

Question 8

what is neglect

Answer 8

failure to provide necessary care

Question 9

what are sx of neglect in children (6)

Answer 9

poor/improper hygiene
malnutrition/dehydration
poor growth
lack of clothing/supplies
hiding food (to save it)
unsanitary/unsafe living conditions

Question 10

what is medical abuse

Answer 10

intentional refusal of needed care, giving false info, or insisting on unnecessary care
- do they follow up on POC
- are they going to a lot of medical providers

Question 11

HR in infants-1yo and where to take it

Answer 11

120-160bpm
brachial a.

Question 12

HR in 1-10yo

Answer 12

70-120bpm

Question 13

HR in >10yo (adolescents)

Answer 13

60-100bpm (adult values)

Question 14

when should respiratory rate be taken in infants and why

Answer 14

observe while awake and calm, or sleeping

crying will change respiratory rate

Question 15

RR in preterm infants

Answer 15

40-70/min

Question 16

RR in infants-1yo

Answer 16

24-40/min

Question 17

RR in 1-3yo

Answer 17

20-30/min

Question 18

RR in 4-9yo

Answer 18

20-24/min

Question 19

RR in >10yo

Answer 19

14-20/min (adult values)

Question 20

when is BP starting to be assessed

Answer 20

3yo

Question 21

when is BP taken <3yo (4)

Answer 21

only if needed:
- premature
- congenital heart dz
- low birth weight
- ICP issues

usually in inpatient settings

Question 22

preterm SBP and DBP

Answer 22

SBP: 55-75
DBP: 35-45

Question 23

infants-1yo SBP and DBP

Answer 23

SBP: 60-90
DBP: 30-60

Question 24

1-3yo SBP and DBP

Answer 24

SBP: 80-130
DBP: 45-90

Question 25

>3yo SBP and DBP

Answer 25

SBP: 90-140 DBP: 50-80

Question 26

how is temp taken <3mo

Answer 26

digital rectal

Question 27

how is temp taken 3mo-3yo

Answer 27

rectal or axillary

Question 28

how is temp taken 4-5yo

Answer 28

oral or axillary

Question 29

what is a fever in rectal temp

Answer 29

>100.4 deg F

Question 30

what is hypothermia in rectal temp

Answer 30

<95 deg F

Question 31

oral vs axillary vs rectal temp conversions

Answer 31

oral is 0.5F< rectal axillary 1F < rectal

Question 32

when does posterior fontanel close

Answer 32

6-8wks

Question 33

when does anterior fontanel close

Answer 33

12-18mo

Question 34

what can the fontanel tell you if it is sunk in or bulging

Answer 34

can assess hydration status - sinking = dehydration bulging = inc intracranial pressure

Question 35

from newborn to 6mo, how does head circumference inc

Answer 35

0.6in/mo

Question 36

from 6mo-1yo, how does head circumference inc

Answer 36

0.2in/mo

Question 37

what is the avg head circumference at 6mo vs 12mo

Answer 37

6mo = 17in 12mo = 18in

Question 38

how does wt inc from birth to 6mo

Answer 38

doubles

Question 39

how does wt inc from 6mo-3yo

Answer 39

inc 4-6lb/yr

Question 40

how does wt inc from 3-5yo

Answer 40

inc 5lb/yr

Question 41

how does height inc from birth to 6mo

Answer 41

inc 1in/mo

Question 42

what is the relevance of the height of child at 2yo

Answer 42

~1/2 of adult final height

Question 43

from 2-5yo, where is the inc in height see mostly in

Answer 43

LE height

Question 44

what scale is used for assessing pain in pre-verbal children and what does it look like

Answer 44

FLACC scale physiologic parameters (HR, BP), crying, facial expressions, and observational parameters

Question 45

for children older than 4yo, what measure is used to assess the amt of pain child is in

Answer 45

self report scales w faces - bieri faces pain scale - wong-baker pain scale

Question 46

for children >7yo, what assessment(s) are used to measure amt of pain

Answer 46

numeric rating scales - VAS - numeric pain intensity scale

Question 47

what are the categories of the FLACC

Answer 47

Face Legs Activity Cry Consolability

Question 48

developmental activity benchmark at 3mo

Answer 48

reaching to grasp toy

Question 49

developmental activity benchmark at 4mo

Answer 49

rolling from back to side

Question 50

developmental activity benchmark at 9mo (2)

Answer 50

sitting w/o support pull to stand

Question 51

developmental activity benchmark at 12mo (2)

Answer 51

pincer grasp limited number of clear words

Question 52

developmental activity benchmark at 2yo (2)

Answer 52

climbing stairs walking on tip toes

Question 53

developmental activity benchmark at 3yo (2)

Answer 53

couple word sentences hopping on one foot

Question 54

what is a common congenital MSK deformity/issue in children

Answer 54

congenital hip dysplasia

Question 55

what are common acquired MSK deformities/issues in children (2)

Answer 55

legg calve perthes dz slipped capital femoral epiphysis

Question 56

what are 3 sx of slipped capital femoral epiphysis

Answer 56

limp limited hip flex, IR, ABD pain from hip down ant to knee

Question 57

what are 3 risk factors of slipped capital femoral epiphysis

Answer 57

7-12yo overweight active

Question 58

what are 2 delivery issues in children

Answer 58

erb's palsy (brachial plexus injury) congenital hip dysplasia

Question 59

what are s/sx of erb's palsy in children

Answer 59

difficulty w shoulder movement: - ant brachium - delt - rotator cuff

Question 60

what are 4 signs in abuse screen of children

Answer 60

bruising fx multiple healthcare practitioners moving around a lot

Question 61

when is a leg length discrepancy more significant and why

Answer 61

if also limping - true leg length vs something at hip causing leg length (ie SCFE)

Question 62

what are head abnormalities that need NM referral (3)

Answer 62

microcephaly macrocephaly fontanels change

Question 63

what are muscle tone changes that need NM referral (3)

Answer 63

tremors fasciculations lack of coordination

Question 64

what are bulbar signs originating from and what are 2 examples

Answer 64

CN9-12 swallowing, clearing throat

Question 65

what are gait changes that need NM referral (3)

Answer 65

ataxia hemi gait (+) Gower's sign

Question 66

where can fine motor changes be seen that need NM referral (3)

Answer 66

tremors handwriting self care

Question 67

what are 2 abnormal eye movements that need a NM referral

Answer 67

nystagmus upward gaze

Question 68

where will cerebrospinal fluid leak from

Answer 68

ear or nose

Question 69

what are 6 signs of inc ICP

Answer 69

bulging fontanel HA lethargy projectile vomiting irritability distended scalp v.

Question 70

what are 2 tests and measures for CP screening

Answer 70

breathing pattern assessment chest deformities

Question 71

what is a chest deformity seen and what is the significance of this

Answer 71

pectus excavatus lower sternum dips in can affect heart function and dec vital capacity if significant enough

Question 72

what are 4 clinical sx of a congenital heart defect

Answer 72

tachypnea cyanosis fatigue poor circulation - cold hands/feet, weak pedal pulses

Question 73

what are signs of GI distress in babies

Answer 73

knees to chest crying

Question 74

what are signs of dehydration in babies

Answer 74

sunken fontanels dry skin/lips crying w/o tears turgot test - on lower arm or abdomen

Question 75

what is the concern w an infant who has diarrhea

Answer 75

rapid loss of electrolytes and dehydration

Question 76

what are normal BMs for infants

Answer 76

typically soft, frequent stools

Question 77

what is GER

Answer 77

reflux, spit up immaturity in ms tone of GI tract

Question 78

s/sx of GER in infants

Answer 78

uncomfortable after feeding not gaining wt or growing regularly

Question 79

treatment for GER ?

Answer 79

resolves on its own by 12-18mo

Question 80

what is GERD in infants

Answer 80

chronic form of GER

Question 81

what is GERD associated with in infants

Answer 81

respiratory issues

Question 82

what infants is GERD more common in

Answer 82

premies

Question 83

what is an aggravating factor for GERD in infants

Answer 83

rear facing car seats

Question 84

what is colic

Answer 84

crying that lasts longer than 3hr/day on >3days/wk, >3wks will usually pass before official dx

Question 85

etiology of colic

Answer 85

unknown - can be affected by GI dysfunciton

Question 86

why should a cleft lip or palate be treated

Answer 86

affects ability to eat and gain weight effectively

Question 87

why should an umbilical hernia be addressed soon

Answer 87

colon can enter hernia and get stuck - tissues can become necrotic

Question 88

what is the importance of treating UTIs in children

Answer 88

prevent renal injury and scarring

Question 89

who are more susceptible to UTIs

Answer 89

children w NM disorders

Question 90

upon integ screen, what may indicate a referral for further assessment

Answer 90

moles >6mm

Question 91

cafe au lait

Answer 91

hyper pigmented lesions varying from light to dark brown

Question 92

how common is newborn jaundice

Answer 92

60%

Question 93

why is newborn jaundice a red flag if detected and undiagnosed

Answer 93

can lead to brain damage if left untreated - need immediate blood tests to eval serum bilirubin levels

Question 94

what should be looked for in cafe au lait spots and why

Answer 94

5 spots that are >1/2'' may mean possible neurofibromatosis - progress to bone deformities, learning disabilities, elevated bp, tumors on brain/SC

Question 95

what is juvenile idiopathic arthritis

Answer 95

chronic inflammatory disorder

Question 96

dx criteria for juvenile idiopathic arthritis

Answer 96

arthritis in 1+ joints for >6wks in <16yo

Question 97

what tools can be utilized to dx juvenile idiopathic arthritis (7)

Answer 97

WBC count ESR Hgb Hct urinalysis RF assay CRP

Question 98

what is a common hx for juvenile idiopathic arthritis (6)

Answer 98

of joints involved small joint involvement symmetrical involvement uveitis risk systemic sx family hx

Question 99

treatment for juvenile idiopathic arthritis?

Answer 99

aggressive treatment w new meds shows improved outcomes - immunosuppressive and biologic side effects to monitor

Question 100

triage suspected juvenile idiopathic arthritis

Answer 100

yellow flag - refer back to PCP