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pediatrics > Pediatrics Case Hx > Flashcards

Pediatrics Case Hx Flashcards

1
Q

What is the importance of a case history?

A

guides the direction of examination

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2
Q

The case history is…

A

never finished

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3
Q

What insight does a case history provide?

A

ocular and medical health, family Hx, socio-economic considerations, education, lifestyle, development

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4
Q

What is one additional goal of a case history?

A

build rapport with the patient and parent

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5
Q

Who is the most reliable observer?

A

grandmother– hyperaware

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6
Q

During the chief complaint what is the goal of your questions?

A

determine parent and child reliability, determine billing level of examination, make sure to solve the chief complaint with the exam

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7
Q

What are vision codes and what are medical codes?

A

vision 92000 for routine eye exams, medical 99000 ex: flashes of light, headaches

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8
Q

List the common chief complaints in peds

A

routine eye exam/1st eye exam/annual eye exam, failed vision screening, problems seeing the board or seeing up close, perceived eye turn, rubs/blinks eye excessively, FOHx, problems reading, pink eye, headaches

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9
Q

List the HPIs

A

frequency, location, onset, relief, intensity/severity, duration, associated signs and symptoms

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10
Q

What are the main ROS complaints for a peds exam?

A

attention deficit disorder/hyperactivity, asthma, allergies

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11
Q

What are additional ROS complaints for a peds exam?

A

autism, down syndrome, cerebral palsy, diabetes, hypertension, marfan’s, neurofibromatosis, juvenile idiopathic arthritis, sickle cell anemia

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12
Q

What do you need to make sure to include in PMHx?

A

current treatments, prior surgeries

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13
Q

What questions need to be asked about medications?

A

what is taken? why? how long? dose?

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14
Q

POHX questions?

A

LEE, previous Rx, previous Tx, disease, injuries, surgeries

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15
Q

FMHx questions?

A

conditions, ocular hx: refractive error, strabismus, amblyopia, color vision defects, congenital glaucoma/cataracts

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16
Q

What does lazy eye mean?

A

it depends, need parent to elaborate, could be strabismus or amblyopia

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17
Q

How do you determine if a child is an appropriate age for their grade?

A

age-5

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18
Q

What should you ask about academics?

A

favorite and least favorite subject, grades, IEP/504 plan

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19
Q

What is included in a developmental history?

A

length of pregnancy, birth weight, exposure to drugs, delivery, apgar, milestones

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20
Q

What is meant by exposure to drugs (legal and illegal)?

A

often comes up during exam not Hx, Fetal alcohol spectrum, neonatal abstinence syndrome (heroine)

21
Q

What are delivery complications?

A

unplanned c-section, loss of oxygen (increases risk of CP)

22
Q

What are developmental interventions?

A

physical therapy, occupational therapy, speech therapy, vision therapy

23
Q

What does physical therapy work on?

A

gross motor movement

24
Q

What does occupational therapy work on?

A

fine motor movement and activities of daily living

25
Q

What does speech therapy work on?

A

autism, speech delay, reading

26
Q

What does vision therapy work on?

A

binocularity, perception, amblyopia, concussion

27
Q

What does apgar stand for?

A

appearance, pulse, grimace, activity, respiration

28
Q

When is apgar assessed?

A

at 1 and 5 minutes after birth

29
Q

What is appearance?

A

color, 0-pale/blue, 1-pink body and blue extremities, 2- pink body and extremities

30
Q

What is pulse?

A

0-absent, 1- less than 100 bpm, 2- greater than 100 bpm

31
Q

What is grimace?

A

reflex, 0-absent, 1- grimace or facial movement, 2- cough, sneeze or pull away

32
Q

What is activity?

A

muscle tone, 0-absent, 1- some flexion of extremities, 2- active and spontaneous movement of limbs

33
Q

What is respiration?

A

0- absent, 1- slow and irregular, 2-good breathing with crying

34
Q

What is a normal apgar score?

A

7+

35
Q

What is a critically low apgar score?

A

< 3

36
Q

What are the extremes of apgar?

A

0=nonviable, 10=maximum score

37
Q

How are prescription and OTC drugs involved in pregnancy?

A

FDA established pregnancy categories outlining potential risk to fetus, majority of women use prescription or OTC meds at some point during pregnancy

38
Q

What is the effect of illicit drugs during pregnancy?

A

should be discontinued during pregnancy and breastfeeding, may result in birth defects, miscarriage, premature birth

39
Q

What are the old FDA pregnancy categories?

A

A, B, C, D, X

40
Q

What is category A?

A

adequate well controlled studies failed to demonstrate risk to the fetus in the first or additional trimesters

41
Q

What is category B?

A

animal studies failed to demonstrate a risk to fetus, no adequate well controlled studies in pregnant women

42
Q

What is category C?

A

no adequate human or animal studies OR animal studies show adverse effect but there are no studies in pregnant women —– benefit may warrant use despite potential risk

43
Q

What is category D?

A

evidence of human fetal risk based on adverse reaction data —- potential benefits may warrant use despite potential risk

44
Q

What is category X?

A

avoid! human or animal studies have demonstrated risk to human fetus, risk to fetus outweighs potential benefits

45
Q

What are the new 2015 FDA pregnancy categories?

A

pregnancy, lactation, and females and males of reproductive potential

46
Q

What is the pregnancy category?

A

dosing and potential risks to the developing fetus, will require information about whether there is a registry that collects and maintains data on how pregnant women are affected when they use the drug

47
Q

What is the lactation category?

A

the amount of drug in breast milk and potential effect on the child

48
Q

What is the females and males of reproductive potential category?

A

pregnancy testing, contraception, and infertility

49
Q

What is different about the new FDA categories?

A

they are in summary form

pediatrics (22 decks)

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