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Step2CK > Pediatrics Stepup > Flashcards

Pediatrics Stepup Flashcards

1
Q

when is birth weight regained

A

by 2 weeks

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2
Q

when is birth weight regained

A

by 2 weeks

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3
Q

what weight is considered fialure to thrive

A
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4
Q

hoes does height increase in first year of life

A

50%
doubles 4 years
triples 13

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5
Q

greater than normal height assoc with what

A

familial, precocious puberty, gigantism, hyperthyroidism, klinefelter, marfan or obesity

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6
Q

lesser than normal height assoc with what

A 
familial
neglect
turners
constitutional growth delay
chronic renal failure
asthma
CF
IBD
immunologic disease
growth hormone deficiency
hypothyroidism
glucocorticoid excess
kskeleteal dysplasias
neoplasm
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7
Q

when do you meausre head circumgerence

A

first -3 years

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8
Q

growth that declines after birth

A

post natal onset

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9
Q

growth that is anormal from time of birth

A

prenatal

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10
Q

growth that is consistently low

A

genetic

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11
Q

doctor visits in 1st month

A

one at 2 weeks

one at 1 month

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12
Q

doctor visit schedule 2 mo to 2 years

A

2,4 and 6 months
then 9,12,15,18
then after age 2 annual visits

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13
Q

when is the H flu b vaccine not necessary

A

children >5 that were never vaccinated because low risk of infection at this age

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14
Q

which children should always always receive Hflu-b and pneumococcal vaccines

A

asplenic

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15
Q

when do children socially smile

A

2 months

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16
Q

when do children coo

A

2 months

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17
Q

when do children laugh

A

4 months

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18
Q

when do children have stranger anxiety

A

6 months

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19
Q

motor skills at 6 months

A

roll over and holds up with hands

sits without support

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20
Q

when do children babble

A

6 months

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21
Q

milestones of 9 month olf

A

interactive games, separation anxiety
crawls, and pulls to stand
grasp with thumb
first words begin

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22
Q

milestones for 1 year

A

separation anxiety
walks with help, pincer grasp, makes twoer of 2 blocks
5-10 vocab

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23
Q

milestones for 18 months

A 
parallel play
walks forward and backward
makes tower 4 blocks and uses cup or spoon
10-50 words
2 word sentence
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24
Q

milestones for 2 year old

A

dresses with help
runs, climbs stairs
tower 6 blocks
50-75 words and 3 word sentences

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25
Q

milestones 3 year old

A 
magical thinking
gender identity
climbs and descends stairs
makes tower 9 blcoks
draws circle
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26
Q

milestones for 6 year old

A

skips, draws a person

fluent speech

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27
Q

milestones for 6 year old

A

skips, draws a person

fluent speech

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28
Q

what weight is considered failure to thrive

A

less then 5th percentile

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29
Q

hoes does height increase in first year of life

A

50%
doubles 4 years
triples 13

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30
Q

greater than normal height assoc with what

A

familial, precocious puberty, gigantism, hyperthyroidism, klinefelter, marfan or obesity

How well did you know this?
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2
3
4
5
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31
Q

lesser than normal height assoc with what

A 
familial
neglect
turners
constitutional growth delay
chronic renal failure
asthma
CF
IBD
immunologic disease
growth hormone deficiency
hypothyroidism
glucocorticoid excess
kskeleteal dysplasias
neoplasm
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32
Q

when do you meausre head circumgerence

A

first -3 years

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33
Q

growth that declines after birth

A

post natal onset

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34
Q

growth that is anormal from time of birth

A

prenatal

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35
Q

growth that is consistently low

A

genetic

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36
Q

doctor visits in 1st month

A

one at 2 weeks

one at 1 month

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37
Q

doctor visit schedule 2 mo to 2 years

A

2,4 and 6 months
then 9,12,15,18
then after age 2 annual visits

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38
Q

when is the H flu b vaccine not necessary

A

children >5 that were never vaccinated because low risk of infection at this age

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39
Q

which children should always always receive Hflu-b and pneumococcal vaccines

A

asplenic

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40
Q

when do children socially smile

A

2 months

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41
Q

when do children coo

A

2 months

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42
Q

when do children laugh

A

4 months

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43
Q

when do children have stranger anxiety

A

6 months

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44
Q

motor skills at 6 months

A

roll over and holds up with hands

sits without support

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45
Q

when do children babble

A

6 months

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46
Q

milestones of 9 month olf

A

interactive games, separation anxiety
crawls, and pulls to stand
grasp with thumb
first words begin

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47
Q

milestones for 1 year

A

separation anxiety
walks with help, pincer grasp, makes twoer of 2 blocks
5-10 vocab

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48
Q

milestones for 18 months

A 
parallel play
walks forward and backward
makes tower 4 blocks and uses cup or spoon
10-50 words
2 word sentence
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49
Q

milestones for 2 year old

A

dresses with help
runs, climbs stairs
tower 6 blocks
50-75 words and 3 word sentences

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50
Q

milestones 3 year old

A 
magical thinking
gender identity
climbs and descends stairs
makes tower 9 blcoks
draws circle
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51
Q

milestones 4 year old

A

plays with others
hops on 1 foot
draws a cross and triangle
4 word sentences

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52
Q

milestones for 6 year old

A

skips, draws a person

fluent speech

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53
Q

moro reflex

A

extension head causes extension and flexion of limbs
startle reflex
up until 3 months old

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54
Q

grasp reflex

A

placing finger in palm causes grasping

up until 3 months old

55
Q

rooting

A

rubbing cheek turns mouth

up until 3months old

56
Q

placing reflex

A

rubbing foot dorsum causes foot to step up

up until 2months

57
Q

screening in newborn/1 week old

A 
PKU
hypothyroid
maple syrup urine disease
CF
hearinb, visual mobility and red reflex
58
Q

when do teens have increased confidence and more open relationship with parents

A

17-21

59
Q

when do you introduce solid foods like pureed and vegetables

A

4-6 months

60
Q

when do kids start teething

A

4 months

61
Q

when do check for anemia in kids

A

9 months

62
Q

when to check lead exposure and PPD in kids if in high risk area

A

1 year

63
Q

when do kids transition from crib to bed

A

around 2 years old

64
Q

screening in 3 year old

A

visual acuity, cholesterol

routine dental checkups

65
Q

when to start checking hearing in children

A

4 years old

66
Q

Hep B series

A

birth
1-2 mo
6-18 mo

67
Q

Rota virus series

A

2,4,6

68
Q

DTaP series

A

2,4,6,15-18
4-6yr
Tdap at 11-12 yr

69
Q

Hib series

A

2,4,6 and 12-15

70
Q

PCV series pneumococcal

A

2,4,6,12-15

71
Q

IPV series

A

2,4,6-18 4-6yr

72
Q

MMR series

A

12-15

4-6 yr

73
Q

VZV series

A

12-15

4-6 yr

74
Q

Hep A series

A

1st at 12 mo

2 given at least 6 mo apart

75
Q

MCV meningococcal series

A

11-12 yr and 16-18 yrs

76
Q

HPV series

A

can start around 11/12

do 3 doses over 6 month period

77
Q

Tanner 1 in men

A

small genitals

78
Q

Presentation Wiskott Aldrich

A

susceptible to encapsulated bacteria and opportunistic infections
eczema and thrombotyopenia
easy bleeding, decreased IgM
WASP gene

79
Q

Tanner 3 in men

A

penile enlargement and further testicular growth

more hair growth

80
Q

Tanner 4 men

A

penile glans enlargement and darkening scrotal skin

hair becomes coarser

81
Q

Tanner 5 men

A

adult

82
Q

adolescence

A

10-19 years

83
Q

when do teens desire independence and start having sexuality

A

14-16 years

84
Q

when can doctor break confidentiality with teen patient

A

life threatening concerns like suicidal ideation, homicidal ideation, life threatening disease

85
Q

main cause of death for teens

A

accidents

86
Q

why do immune disorders not present early after birth

A

still have maternal Ab for around 3 months

87
Q

What are the congenital T cell disorders

A

DiGeorge and Chronic mucocutaneous candidiasis

88
Q

DiGeorge characteristics

A 
tetany
facial abnormalities
decreased Ca
congenital heart disease
no thymid shadow
22q11
89
Q

Tx DiGeorge

A 
Ca
Vit D
thymic transplant
bone marrow transplant
surgery for heart
IVIG or prophylactic antibiotics
90
Q

Dx chronic mucocutaneous candidiasis

A

poor reaction to C albicans anergy test

decreased IgG

91
Q

What are the congenital B cell disorders

A

X linked agammaglobulinemia
IgA deficiency
Hyper IgM disease
Common variable Immunodeficiency

92
Q

presentation X linked agammaglobulinemia

A 
low B cell and Ab levels
X linked so more common in boys
recurrent bacterial infections after 6 months old
no B cells in peripheral smear
total Ig levels are low
93
Q

presentation IgA deficiency

A

increased respiratory and GI infections

normal level other Ig

94
Q

Presentation IgM disease

A

defect in CD40 L on T cell causing bad interaction with M cells
low IgG and high IgM
possible anemia and thrombocytopenia and lymphopenia

95
Q

infections in IgM disease

A

encapsulated bacteria (pulmonary and GI)

96
Q

risk of trisomy increases significantly after what age of woman

A

35

97
Q

presentation common variable immunodeficiency

A

low Ig lvels
increased resp and GI illnesses in second decade of life
increased risk neoplasm and autoimmune disorders

98
Q

poor response to vaccines

A

common variable immunodeficiency

99
Q

T cells in common variable immunodeficiency

A

decreased CD4:CD8 T cell ratio

100
Q

Combined T and B cell congenital disorders

A

SCID
Wiskott Aldrich
Ataxia-Telangiectasia

101
Q

Presentation SCID

A

abset T cells
significant recurrent infections
fatal at any age
decreased WBCs and Ig

102
Q

Tx for SCID

A

IVIG
antibiotics
BM transplant
no live or attenuated vaccines

103
Q

Presentation Wiskott Aldrich

A

susceptible to encapsulated bacteria and opportunistic infections
eczema and thrombotyopenia

104
Q

Tx for wiskott aldrich

A

splenectomy
antibiotics
IVIG
BM transplant

105
Q

Presentation ataxia-telangiectasia

A

auto recessive
cerebellar dysfunction, cutaneous telangiectasias after 3 years old
increased risk CA
impaired WBC and IgA development

106
Q

Congenital phagocytic disorders

A

chronic granulomatous disease
Hyper IgE disease
Chediak Higashi syndrome
Leukocyte adhesion deficiency

107
Q

Presentation and problem in chronic granulmoatous disease

A

Neutrophils cannot digest bacteria
recurrent bacterial and fungal infections
cutaneous, pulmonary and perirectal abscess
chronic lymphadenopathy

108
Q

Tx chronic granulomatous disease

A

prophylactic antibitoics
gamma IFN
corticosteroids
BM transplant

109
Q

Hyper IgE syndrome “Jobs”

A

defect in netrophil chemotaxis
T cell signaling and overproduction IgE
chronic dermatitis, recurrent skin abscesses and pulmonary infections
!! retained first teeth and coarse faicalfeatures
increase esosinophils

110
Q

Tx hyper IgE syndrome

A

prophylactic antibiotics, skin hydration and emollient use

111
Q

Chediak Higashi syndrome

A 
auto recessive
dysfunction neutrophils
recurrent staph, strep and gram - and fungal infections
abnormal platelets. Albinism!!!!
neurologic dysfunction
112
Q

Dx Chediak Higashi

A

large granules in granulocytes on peripheral smear

113
Q

Tx chediak higashi syndrome

A

prophylactic antibiotics

BM transplant

114
Q

Leukocyte Adhesion deficiency

A 
inability neutrophils to leave circulation from integrin malfunciton (type 1) or E selectin malfucntuin (type2)
recurrent infections URI and skin
delayed separation umbilical cord
short stature
abnomral facies
cognitive impairment
115
Q

diagnosis leukocyte adhesion deficiency

A

increased serum neutrophils

defective chemotactic response upon stiulation

116
Q

Tx leukocyte adhesion deficiency

A

prophylactic antibiotics
BM transplant
type 2 Tx with fructose

117
Q

complement deficiencies are predisposed to what

A

SLE

118
Q

Turners

A

45XO
usually end in abortion
female has short stature, infertility, abnormal genital formation, coarctation, craniofacial abnormalities (neck webbing)

119
Q

47 XXY

A 
klinefelter
male with testicular atrophy
tall and thind body
gynecomastia
infertility
mild mental retardation
120
Q

when do most trisomies occur

A

nondisjunction during meiosis of maternal germ cells

121
Q

characteristics of down

A 
mental retardation
craniofacial abnormalities
vision and hearing loss
simian crease on hanfs
cervical spine instability
increased space in 1st and 2nd toes
increased risk duodenal atresia
alzheimers disease
ALL
cardiac defects
122
Q

Characteristics edwards

trisomy 18

A 
mental retardation, small mouth, rocker bottom feet
overlapping fingers
cardiacdefects
GI abnormalities
fatal in first year usually
123
Q

characteristics trisomy 13

A 
cleft lip and palate
cardiac defects
CNS defects
severe mental retardation
polydactyly
fatal in first year usually
124
Q

What is used to Dx deletion syndromes

A

FISH and karyotyping

125
Q

Fragile X syndrome genetics

A

X linked mental retardation
males > females
high terminal cGG codon repeats

126
Q

characteristics fragile X

A 
large face with prominent jaw and large ears
mild hand and foot abnormlaites
large testicles
mental retardation
hyperactiivty with possible seizures
127
Q

Most common cause familial mental retardation in men

A

fragile X syndrome

128
Q

cri du chat

A 
entire 5p deletion
high pitched cat like cry
small head
small birth weight
early mortality from failure to thrive
129
Q

wolf hirschhorn

A

4p16 deletion

metnal retardation and cranial abnormalities

130
Q

prader willi

A

15q11 and 15q13 deletion paternal allele

overeating obesity and decreased muscular tone in infancy

131
Q

angelman

A

15q11-q13 deltion on maternal allele
get puppet like movement
happy mood and unprovoked laugher
mental retardation and seizures

132
Q

velocardiofacial

A

22q11 deletion
cleft palate, cardiac, speech disorders, significant overbite
T cell deficiency
Di George like Sx

133
Q

Williams deletion in kids

A 
7q11.23
look like an elft with short upturned nose and long philtrum wide mouth
mental retardation
cheerful personality
cardiac defects

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