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NP course > Pediatrics/Growth and Development > Flashcards

Pediatrics/Growth and Development Flashcards

1
Q

Hep B schedule

A 
#1 - Birth
#2 - 1-2 months - at least one month after first dose
#3 - Age 6 months - but at least 2 months after 2nd dose
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2
Q

Tdap for adolescents

A

Tdap booster Age 11-12

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3
Q

Hib vaccine - when do you no longer give?

A

after 5 years of age

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4
Q

When is it okay to give live vaccines?

A

after 1 year of age

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5
Q

When do you give the MCV4 booster

A

Age 16

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6
Q

What is appropriate spacing for vaccines?

A

4 days prior is okay, any earlier is invalid and must be repeated.

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7
Q

ADHD characterized by

A

Hyperactivity
Impulsivity
Inattention

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8
Q

What is a common assessment scale for ADHD

A

Connors’ - Long and short form

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9
Q

Asthma tx in 0-4 year olds

A

Use Nebulizer!
Inhaled corticosteroids (only one approved for young children is budesonide)
SABA - albuterol
leukotrine receprot agonist - montelukast

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10
Q

Asthma tx in 5-11 year olds

A

Can use inhaler as appropriate
Inhaled corticosteroids (fluticasone, budesonide)
SABA - albuterol
leukotrine receprot agonist - montelukast

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11
Q

What type of pneumonia is common in children under 5?

A

viral, treat empirically

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12
Q

What is the most sensitive sign of pneumonia in children?

A

Increased resp

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13
Q

Sx RSV

A 
URI 1-3 days which progresses to lower resp tract infection
Paroxysmal wheezing
Increased RR 40-60
Fever
Cough
Thick purulent nasal secretions
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14
Q

What is the most common organism for croup?

A

Parainfluenza types 1,2,3
Adenovirus
Influenza virus

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15
Q

Westley Croup score

A 
Mild disease (can keep with PCP) - barking cough, hoarse cry, no stridor at rest
Moderate (ER) - Stridor at rest, mild retractions, sx resp distress
Severe (ER) - Significant stridor at rest, retractions are severe.
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16
Q

Tx mild croup

A

Hydration, cool mist, antipyretics

Single dose of dexamethasone

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17
Q

Organism with epiglottitis

A

Hib

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18
Q

Cystic fibrosis

A

Mutation of chromosome 7

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19
Q

Enlarged nodes “rules”

A

10mm is enlarged unless…
Epitrochlear - >5mm
Inguinal - > 15mm
Cervical - > 20mm

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20
Q

Criteria for febrile seizures

A 
Temp >38C
Age < 6yo
Absence of CNS infection
No metabolic abnormality
No hx of febrile seizures
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21
Q

Pyloric stenosis sx

A

3-6 week old male with projectile vomiting

Olive like mass better palpated after vomiting

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22
Q

GER

A

frequent regergitation in the absence of pathology
Resolves before 1 year of age
Place supine to sleep

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23
Q

Red flags with reflux in infants

A 
GI bleeding
Refusal to feed
Forceful vomiting
Constipation/Diarrhea
Abd tenderness
Fever
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24
Q

Intussusception

A

Vast majoity under 2 yo
Sausage like mass
Classing child crys and pulls legs up to chest

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25
Q

Dx Intussusception

A

KUB, Abd US

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26
Q

Intussusception classic triad

A

Intermittant colicky abd pain, vomit, bloody mucus stool (currant jelly)

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27
Q

Encopresis

A

Involuntary stooling over 4 yo. More common in males. Constipation often underlying problem.

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28
Q

Replacement mild dehydration

A

5 tsp per pound over 4 hours

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29
Q

Replacement moderate dehydration

A

10 tsp per pound over 4 hours

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30
Q

Cryptorchifism

A

testes not in scrotum and can’t be manupulated there (usually found in infants)

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31
Q

Retractile testes

A

Move between scrotum and inguinal ring (5-6 yo)

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32
Q

When do you refer with undecended testes?

A

6 months

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33
Q

Most common cause of UTI in children

A

bowel and bladder dysfunction

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34
Q

What test for first fibrile UTI

A

renal and bladder ultrasound for all infants 2-24 months

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35
Q

Dx Kawasaki’s disease

A 
Fever for 5 days with (4 of 5):
Bilat cunjunctival injection without excudate
Polymorphus rash
Inflamm changes of lips or oral cavity
Changes in extremities
Cervical lymphadanopathy
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36
Q

Dx studies with Kawsaki disease

A

CBC, ESR, CRP, ALT/`AST, UA throat culture

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37
Q

Osgood schlatter disease

A

Osteochondritis on tibial tubercle
Common cause of adolesant knee pain
More common in athletes

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38
Q

Sx Osgood schlater disease

A

Swelling affected knee
Bilat symptoms
Prominent tibial tubercle

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39
Q

Trendelenberg sign

A

Standing on affected side causes pelvic tilt. POsitive in SCFE, Legg-Calve Pertes, ansd Dev Dysplasia

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40
Q

Roseola

A

Human Herpesvirus 6

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41
Q

Fifth Disease

A

Parvovirus B19

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42
Q

Rubella

A

Rubella virus

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43
Q

Rubeola (measles)

A

Rubeola virus

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44
Q

Chicken pox

A

Herpes virus

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45
Q

Hermangina

A

Coxsackie A virus

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46
Q

Hand Foot and mouth disease

A

Coxsackie virus A16

47
Q

Measles

A

Maculopapular brick red rash. Starts on the head and neck and then spreads to trunk and extremities

48
Q

Fifth disease (Erythema infectiosum)

A

Slapped cheek rash. Lacy macular rash

49
Q

Rubella

A

Maculopapular rash. Looks like measles rask. Remarkable lymphadonopathy, macules on soft palate

50
Q

Roseola (exanthem subitum)

A

High fever for 2-4 days then abrupt cessation of fever with appearance of maculopapular rash but not on the face

51
Q

Chicken pox

A

vesicular lesions on erythematous case appearing in crops

52
Q

What are the 3 C’s in Rubeola?

A

conjunctivitis, coryza, cough

53
Q

Koplik’s spots

A

Resemble grains of sand on the oral mucosa and precede rash. Common with measles (rubeola)

54
Q

When should you have post-partal visit?

A

2-3 days after birth

55
Q

Milia

A

What papules on the nose and cheeks

56
Q

Mongolian spots

A

Congenital with indefinite borders. Buttocks and base of spine. Pred. in AA and Asian infants.

57
Q

Nevus simplex

A

Stork bite. pink red capillary on face or neck

58
Q

Nevus flammeus

A

Port wine stain anywhere on malformation body

59
Q

Anterior fontanelle closes?

A

9-12 months

60
Q

Posterior fontanelle closes?

A

2 months

61
Q

Hypertelorism

A

eyes spaced far apart

62
Q

When should red reflex be present?

A

bilat at birth

63
Q

Normal resp infant

A

40-60 breaths/min

64
Q

Murmurs in infants

A

almost universal

65
Q

Deep sacral dimples, hemangioma, discoloration of sacrococcygeal area, can indicate

A

neural tube defect

66
Q

When finger foods?

A

8-10 months

67
Q

Iron needs infant

A

1mg/kg/day

68
Q

When start floride baby?

A

6 months

69
Q

Who needs vit D

A

Exclusively breastfed babies

70
Q

Eye eval newborn-3months

A

red reflex, inspection

71
Q

Eye eval 0 3-6 mo

A

fix and follow, red reflex, inspection

72
Q

Eye eval - 6-12 months

A

fix and follow each eye, corneal light reflex, red reflex, inspection

73
Q

Eye eval > 3 years

A

visual acuity, corneal light reflex, cover/uncover, red reflex, inspection, attempt ophthalmology

74
Q

What does the cover/uncover test check for?

A

Stabismus

75
Q

Normal HR infant

A

120-160 with marked sinus arrhythmia

76
Q

Normal HR 3 yo

A

80-120

77
Q

Normal HR 6 yo

A

70-110

78
Q

When BP screening children

A

3yo

79
Q

Kernicterus

A

What happens to the infants brain with increased bilirubin. Deposits in brain leading to delay and damage.

80
Q

POsitive galeizzi test indicates?

A

hip dysplasia

81
Q

What is considered scoliosis

A

> 10 degree curvature

82
Q

Female Turner stage 1

A

Prepubertal. Papilla elevated above chest wall.

83
Q

Female Tanner stage 2

A

Breast bud stage (8-13yo) Breast and papilla form small mound, areola increases in diameter.

84
Q

Female Tanner stage 3

A

Breast and areola enlarge. No seperation of contours

85
Q

Female Tanner stage 4

A

Secondary mound formed by areola and papella at level of breast

86
Q

Female Tanner stage 5

A

Adult breasts

87
Q

Male Tanner Stage 1

A

testes 1cm, scrotum and penis are size seen early childhood

88
Q

Male Tanner Stage 2

A

Slight enlargement of testes 2-3cm, scrotum becomes reddened and textured

89
Q

Male Tanner Stage 3

A

Further testicular growth (3-4cm) slight enlargement of penis

90
Q

Male Tanner Stage 4

A

Penis enlarges in length and diameter. Testes enlarge 4-5cm

91
Q

Male Tanner Stage 5

A

Adult genitalia

92
Q

Adolescence 11-14

A 
Egocentric, moody behavior
Eating disorders emerge
Focus is on concrete and present
Risk taking behaviors
Death secondary MVI - think seatbelt
93
Q

Adolescence 15-17

A

Peer groups
Seek privacy
Transition from concrete to operational behavior
Risk taking escalates

94
Q

Adolescence 18-21

A

Key developmental task focus is achieving
Emotional intimacy
Risky behaviors peak
Death secondary to MVI, suicide, homicide

95
Q

Development - 2 months

A

Focuses on face
Grasps rattle if placed in hand
Smiles, coos
Able to lift head 45 degrees

96
Q

Development - 4 months

A 
Able to hold and control head when held upright
No head lag when pulled upright
Raises body on hands
Rolls prone to supine
Follows light 180 degrees
97
Q

Development - 6 months

A 
Able to place object in opposite hand and in mouth
Sits with support
Rolls supine to prone
Bears weight
Recognizes parents
Says dada or baba
Babbles
Smiles, squeals, laughs, imitates sounds
98
Q

Development - 9 months

A 
Pulls to stand
Bangs, shakes, and throws objects
Able to feed self with finger foods
Says 2-4 words
Looks for hidden objects
Responds to name and a few words
Feeds self and drinks from cup
Waves and says bye bye, dada, mama
Imitates vocalizations
99
Q

Development 15 months

A 
Walks well and is able to stoop
Can point to body part
Says 3-6 words
Stacks 2 blocks
Follows simple commands
POints, grunts, and pulls to show what they want
Listens to a story
100
Q

Development - 18 months

A 
Able to walk backwards
Can throw a ball
Says 15-20 words
Uses 2 word phrases
POints to multiple body parts
101
Q

Development - 2 years

A 
Able to walk up and down stairs one step at a time
Can kick a ball
Says at least 20 words
Imitates adults
Follows 2 step commands
Stacks 5 blocks
102
Q

Development - 3 years

A 
Able to jump
Can stand on one foot
Able to ride a tricycle
Says name, age, and gender
Knows gender of others
Able to copy a circle and cross
Able to recognize colors
103
Q

Development - 4 years

A 
Able to ding a song
Able to hop on one foot
Able to throw a ball overhand
Able to draw a person with 3 parts
Able to cut and paste
Albe to build a tower with 10 blocks
Counts to 5
Able to copy a square
Able to dress self with supervision
104
Q

Development - 5 years

A

Able to draw a person with body, head, arms, legs
Able to recognize most letters and can print some
PLays make believe
Learns address and phone number
Can define at least one word

105
Q

Anticipatory guidance - Birth

A

Feed every 2-3 hours, awaken if more than 4 hours
Does not need Vit D unless no sunlight
Back for sleeping
Do not use baby powder

106
Q

Anticipatory guidance - One month

A

Do not place bottle in bed with baby
No solids until 4 months
Discus colic and comfort measures

107
Q

Anticipatory guidance - 2 months

A

No solid foods or cereal in bottle

Do not give honey or water in bottle

108
Q

Anticipatory guidance - 4 months

A

Childproof home
Introduce solid foods
Have syrup of ipecac available

109
Q

Anticipatory guidance - 6 months

A

Solids 2-3 times a day
Avoid choking hazards
Start using a cup
Floride supplements

110
Q

Anticipatory guidance - 9 months

A

Mashed foods and finger foods
Wean from bottle
Brush teeth

111
Q

Anticipatory guidance - 12 months

A

Start on whole milk

Allow to feed self

112
Q

Anticipatory guidance - 18 months

A

Allow to feed self with spoon or hands

Toilet training can start

113
Q

Anticipatory guidance - 3 years

A

Time out can start - 1 minute for each year

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