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Med Screening > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

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

A

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

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2
Q

what is physical abuse

A

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

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3
Q

what are sx of physical abuse in children (4)

A

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

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4
Q

what is sexual abuse in children

A

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

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5
Q

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

A

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

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6
Q

what is emotional abuse in children

A

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

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7
Q

what are sx of emotional abuse (5)

A

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

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8
Q

what is neglect

A

failure to provide necessary care

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9
Q

what are sx of neglect in children (6)

A

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

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10
Q

what is medical abuse

A

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

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11
Q

HR in infants-1yo and where to take it

A

120-160bpm
brachial a.

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12
Q

HR in 1-10yo

A

70-120bpm

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13
Q

HR in >10yo (adolescents)

A

60-100bpm (adult values)

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14
Q

when should respiratory rate be taken in infants and why

A

observe while awake and calm, or sleeping

crying will change respiratory rate

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15
Q

RR in preterm infants

A

40-70/min

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16
Q

RR in infants-1yo

A

24-40/min

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17
Q

RR in 1-3yo

A

20-30/min

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18
Q

RR in 4-9yo

A

20-24/min

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19
Q

RR in >10yo

A

14-20/min (adult values)

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20
Q

when is BP starting to be assessed

A

3yo

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21
Q

when is BP taken <3yo (4)

A

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

usually in inpatient settings

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22
Q

preterm SBP and DBP

A

SBP: 55-75
DBP: 35-45

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23
Q

infants-1yo SBP and DBP

A

SBP: 60-90
DBP: 30-60

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24
Q

1-3yo SBP and DBP

A

SBP: 80-130
DBP: 45-90

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25
Q

> 3yo SBP and DBP

A

SBP: 90-140
DBP: 50-80

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26
Q

how is temp taken <3mo

A

digital rectal

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27
Q

how is temp taken 3mo-3yo

A

rectal or axillary

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28
Q

how is temp taken 4-5yo

A

oral or axillary

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29
Q

what is a fever in rectal temp

A

> 100.4 deg F

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30
Q

what is hypothermia in rectal temp

A

<95 deg F

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31
Q

oral vs axillary vs rectal temp conversions

A

oral is 0.5F< rectal
axillary 1F < rectal

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32
Q

when does posterior fontanel close

A

6-8wks

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33
Q

when does anterior fontanel close

A

12-18mo

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34
Q

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

A

can assess hydration status
- sinking = dehydration

bulging = inc intracranial pressure

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35
Q

from newborn to 6mo, how does head circumference inc

A

0.6in/mo

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36
Q

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

A

0.2in/mo

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37
Q

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

A

6mo = 17in
12mo = 18in

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38
Q

how does wt inc from birth to 6mo

A

doubles

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39
Q

how does wt inc from 6mo-3yo

A

inc 4-6lb/yr

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40
Q

how does wt inc from 3-5yo

A

inc 5lb/yr

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41
Q

how does height inc from birth to 6mo

A

inc 1in/mo

42
Q

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

A

~1/2 of adult final height

43
Q

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

A

LE height

44
Q

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

A

FLACC scale

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

45
Q

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

A

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

46
Q

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

A

numeric rating scales
- VAS
- numeric pain intensity scale

47
Q

what are the categories of the FLACC

A

Face
Legs
Activity
Cry
Consolability

48
Q

developmental activity benchmark at 3mo

A

reaching to grasp toy

49
Q

developmental activity benchmark at 4mo

A

rolling from back to side

50
Q

developmental activity benchmark at 9mo (2)

A

sitting w/o support
pull to stand

51
Q

developmental activity benchmark at 12mo (2)

A

pincer grasp
limited number of clear words

52
Q

developmental activity benchmark at 2yo (2)

A

climbing stairs
walking on tip toes

53
Q

developmental activity benchmark at 3yo (2)

A

couple word sentences
hopping on one foot

54
Q

what is a common congenital MSK deformity/issue in children

A

congenital hip dysplasia

55
Q

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

A

legg calve perthes dz
slipped capital femoral epiphysis

56
Q

what are 3 sx of slipped capital femoral epiphysis

A

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

57
Q

what are 3 risk factors of slipped capital femoral epiphysis

A

7-12yo
overweight
active

58
Q

what are 2 delivery issues in children

A

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

59
Q

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

A

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

60
Q

what are 4 signs in abuse screen of children

A

bruising
fx
multiple healthcare practitioners
moving around a lot

61
Q

when is a leg length discrepancy more significant and why

A

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

62
Q

what are head abnormalities that need NM referral (3)

A

microcephaly
macrocephaly
fontanels change

63
Q

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

A

tremors
fasciculations
lack of coordination

64
Q

what are bulbar signs originating from and what are 2 examples

A

CN9-12
swallowing, clearing throat

65
Q

what are gait changes that need NM referral (3)

A

ataxia
hemi gait
(+) Gower’s sign

66
Q

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

A

tremors
handwriting
self care

67
Q

what are 2 abnormal eye movements that need a NM referral

A

nystagmus
upward gaze

68
Q

where will cerebrospinal fluid leak from

A

ear or nose

69
Q

what are 6 signs of inc ICP

A

bulging fontanel
HA
lethargy
projectile vomiting
irritability
distended scalp v.

70
Q

what are 2 tests and measures for CP screening

A

breathing pattern assessment
chest deformities

71
Q

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

A

pectus excavatus
lower sternum dips in

can affect heart function and dec vital capacity if significant enough

72
Q

what are 4 clinical sx of a congenital heart defect

A

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

73
Q

what are signs of GI distress in babies

A

knees to chest
crying

74
Q

what are signs of dehydration in babies

A

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

75
Q

what is the concern w an infant who has diarrhea

A

rapid loss of electrolytes and dehydration

76
Q

what are normal BMs for infants

A

typically soft, frequent stools

77
Q

what is GER

A

reflux, spit up
immaturity in ms tone of GI tract

78
Q

s/sx of GER in infants

A

uncomfortable after feeding
not gaining wt or growing regularly

79
Q

treatment for GER ?

A

resolves on its own by 12-18mo

80
Q

what is GERD in infants

A

chronic form of GER

81
Q

what is GERD associated with in infants

A

respiratory issues

82
Q

what infants is GERD more common in

A

premies

83
Q

what is an aggravating factor for GERD in infants

A

rear facing car seats

84
Q

what is colic

A

crying that lasts longer than 3hr/day on >3days/wk, >3wks

will usually pass before official dx

85
Q

etiology of colic

A

unknown
- can be affected by GI dysfunciton

86
Q

why should a cleft lip or palate be treated

A

affects ability to eat and gain weight effectively

87
Q

why should an umbilical hernia be addressed soon

A

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

88
Q

what is the importance of treating UTIs in children

A

prevent renal injury and scarring

89
Q

who are more susceptible to UTIs

A

children w NM disorders

90
Q

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

A

moles >6mm

91
Q

cafe au lait

A

hyper pigmented lesions varying from light to dark brown

92
Q

how common is newborn jaundice

A

60%

93
Q

why is newborn jaundice a red flag if detected and undiagnosed

A

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

94
Q

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

A

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

95
Q

what is juvenile idiopathic arthritis

A

chronic inflammatory disorder

96
Q

dx criteria for juvenile idiopathic arthritis

A

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

97
Q

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

A

WBC count
ESR
Hgb
Hct
urinalysis
RF assay
CRP

98
Q

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

A

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

99
Q

treatment for juvenile idiopathic arthritis?

A

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

100
Q

triage suspected juvenile idiopathic arthritis

A

yellow flag
- refer back to PCP

Med Screening (17 decks)

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