Peds Flashcards
1
Q
neonatal pd
A
1st day-28th day
2
Q
postnatal pd
A
29 days-1year
3
Q
infancy
A
0-12MO aka 1st yr of life
4
Q
early childhood
A
1-4YO
5
Q
middle childhood
A
5-10YO
6
Q
adolescence
A
11-20YO
7
Q
when do we exam newborn
A
- first one is immediately after birth
2. comprehensive is done w/in 24 hrs after birth
8
Q
what can encourage eye opening in newborn
A
light dimmed
slight rocking
9
Q
APGAR
- minutes?
- what are we scoring
A
1 min
5 min
HR (>100) Resp effort muscle tone reflex irritability (virgorous cry, sneeze, cough) color
10
Q
preterm
A
<34 weeks
11
Q
late preterm
A
34-36 weeks
12
Q
moms with DM can have?
A
larger babies
-hypoglycemia is an concern with them
13
Q
define failure to thrive
A
inadequate weight gain for age
14
Q
APGAR scoring
A
HR:
absent=0
<100= 1
>100= 2
Resp effort:
Absent= 0
SLow and irreg= 1
Good/strong= 2
Muscle tone:
flaccid=0
Some flexion of arms/legs=1
active movement= 2
Reflex irritability
no response=0
grimace=1
cry virogoursly, sneeze, cough= 2
Color
blue/pale=0
pink body, blue extrems=1
pink all over=2
15
Q
1 min APGAR score
0-4=?
5-7=?
8-10=?
A
0-4= severe depression, requirring immediate resuscitation
5-7= some NS depression (should improve by 5 min APGAR)
8-10= normal
16
Q
5 min APGAR score
0-7=?
8-10=?
A
0-7= high risk for subesquent central nervous system and other organ system dysfunction
8-10= normal
17
Q
what period of life is the most rapid rate of growth }?
A
infancy (0-12MO)
- birth wt triples
- height increases by 50% by end of year one
18
Q
by end of year one:
- bright weight____
- height increases by?
A
weight triples
height incrs by 50%
19
Q
sequence of exam for infancy
A
- perform non-disturbing maneuvers early
- most imp indicator of infant health is measurement of growth
- measure
- height (length <2)
- weight
- head circumference
20
Q
postterm infants are at risk for
A
perinatal mortality and morbidity
- asphyxia
- meconium aspiration
21
Q
MC complication for LGA newborns
A
hypoglycemia—- s/s= jitteriness, irritability, cyanosis and other health issues
22
Q
etiology for SGA infants
A
- fetal, placental and maternal factors
* maternal smoking **
23
Q
preterm appropriate for gestational age AGA are at risk for?
A
- resp distress
- apnea
- PDA with R—>L shunt
- infection
24
Q
preterm SGA infants are at risk for
A
asphyxia
- hypoglycmia
- hypocalcemia
25
Physical
Cognitive/language
social/emotional
* *birth
* *1 MO
* *2 MO
* *3 MO
Birth:
physical: focuses, fixes/follows
cognitive: responds to sounds
social: regards face
1-2MO
physical: head control
cognitive/language: coos
Social: smiles
3MO:
* physical: rolls over, grasps rattle, works for toys
* language: babbles
26
Physical
Cognitive/language
social/emotional
* *4MO
* *5 MO
* *7-8 MO
4MO
Language: squeals
Emotional/social: laughs
5MO:
physical: sits
7-8MO
* cognitive/language: dada/mama
* social/emotional: feeds self (more so puts food to their mouth) and indicates wants
27
Physical
Cognitive/language
social/emotional
* *9MO
* *11-12MO
9 MO
- physical: pulls to stand, crawls
- social/emotional: waves and plays peek-a-boo
11-12MO
- physical: walks
- language: 2-3 words
- social/emotional: uses spoon
28
at what age do we start taking BP
3 YO
29
RR of newborn
30-60
30
HR for newborn, 1-6MO, 6-12MO
newborn: 140
1-6MO: 130
6-12MO: 115
31
how to take newborn temp (unitl wht age)
rectal
| until 2MO
32
central cyanosis in infant suggests?
incr suspicion of congenital heart disease
33
acrocyanosis
blueish, discoloration of palms/soles
34
lanugo
fine
| downy growth of hair
35
jaundice can suggest?
normal finding (common)--physiologic jaundice
OR
hemolytic dz of the newborn (yellowing persisting past first 24 hours following birth)
36
milia
white raised areas
size of pinhead
sebaceous glands are still open
*common skin finding
37
Milia rubra
scattered vesicles on erythematous base-face/trunk
- sweat gland duct obstruction
- resolves in few weeks
38
Neurofibromatosis
yellowing of skin
-starts in first five days of life
HEAAD TO TOE presentation
39
cafe au lait spots
- describe
- pathologic or benign?
- assoc with ?
pigmented brown lesions with unifrom borders
* can be normal on its OWN
* more than 5.... considered to be assoc with neurofibromatosis
40
Pustular melanosis
small vesiculopustules
- benign
- MC in AA pts
41
Salmon patch
- also called?
- describe
- benign or pathologic?
also called "stork bite" or "angel kiss"
- vascular marking
- splotchy pink mark
- fades with age
42
best areas to loook for central cyanosis
tongue and oral mucosa
NOT: nail beds, lips or extrems
43
skin desquamation
normal in full term newborns
rarely can be a sign of placental circulatory insuff or congenital ichthyosis
44
midline hair tufts over the lumbosacral spine suggests?
possible spinal cord defect
45
jaundice persistenting over 2-3 weeks suggest q
biliary obstruction or liver dz
46
common source of jaundice in the firt couple weeks?
breastfeeding jaundice-- resolves aorund 10-14 days
47
significant edema of hands/feed of newborn suggests
| and/or webbed neck
turner syndrome
48
molloscum contagiosum
- describe
- benign or pathologic?
dome shaped
fleshy lesions
painless
viral infection
49
impetigo
bac infection
appears crusty yellow
"honey crusted lesion"
50
slate blue patch
common in darker skinned PT
blue pigment cells
not be mistaken for bruise
51
sutures?
membranous tissue spaces separating bones of the skull
52
Fontanelles?
Areas where major sutures intersect
53
anterior fontanelle closes b/w?
2-26 MO
54
Posterior fontanelle closes?
by 2 MO
55
depressed anterior fontanelle
dehydration
56
enlarged posterior fontanelle
congenital hypothyroidism
57
bulging or tense fontanelle
increased ICP--from CNS infections (meningitis), neoplastic dz, hydrocephalus
58
early closure of fontanelles
microcephaly
craniosynostosis
metabolic dz
59
delayed closure of fontanelle
hypothyroidism
megalocephaly
rickets
incr ICP
60
dilated scalp veins
long standing increased ICP
61
plagiocephaly
```
positional common cause
basically flat head
-infant lies mostly on one side resulting in flattening of the parieto-occipital region
-prominence on ipilaterla side
****why we do tummy time for babies
```
But can be pathologic due to torticolis from injury to the SCM at birth or lack of stimulation of infant (being on its back too much)
62
congenital hypothyroidism
coarse facial features
low set hairlinfe
enlarged tongue---- macroglosia
63
what is the name of the eye reflex in first 10 days of life
dolls eye reflex
-if infants head is turned in one direction, w/o moving the body, eyes may stare in one direction
64
what eye finding is common for babies born vaginally
subconjunctival hemms
65
nystagmus
- define
- sugests?
wandering/shaking eye movement
| -persistent after a few days---- suggests poor vision and/or CNS dz
66
persistent occular discharge/tearing suggests?
dacryocystitis or nasolacrimal duct obstruction
67
Leukokoria
white retinal reflex may suggest cataract, retinal detachement or retinoblastoma
68
myopia
nearsightedness (diff seeing far)
| MC visual disorder in kids
69
what is MC visual disorder in kids
myopia--near sightedness aka cannot see far
70
brushfield spots
- describe
- suggests?
abnormal speckling on iris
| suggests down syndrome
71
Strabismus
- describe
- can lead to?
misalignment of the eyes
| leading to visual impairment
72
small, deformed, low-set auricles may indicate
congenital defects
| esp: renal disease ***
73
most newborns in US undergo....
hearing screenings in nursery
| MADATORY in us
74
what direction to pull on the ear to view eardrum of newborn? oldr children?
pull DOWN for newborns
pull upwards and backawrds for oldr kids
75
pneumatic otoscope used to assess?
mobility of TM
76
decreased TM mobility suggests
OM with effusion
77
mastoid bone is tender, swollen,
mastoiditis
78
auricle protruding forward.outward suggests
mastoidits
79
which ear infection is very common in kids
Acute otitis media
80
ear pain + TM red, bulging, dull or absent light reflex with decrease movement on pneumatic otoscopy
Acute OM
81
moving the auricle or pushing on tragus elicits pain
otitis externa
82
pale, boggy nasal mucous membranes
allergic rhinitis
83
foul smelling, purulent, unilateral discahrge
| MC seen in young preschool kids
FB in nose
84
flesh colored growths in the nares
Nasal polyps
85
```
purulent rhinorrhea (unilateral) for more than 10 days
+HA
+sore throat
+fever
+tenderness over sinuses
```
sinusitis
86
what age do babies say "mamma/dada"
9 MO
87
what age do babies start to pull to stand
9MO
88
pulling to stand and baby saying "mamma/dada" would be what age
9 MO
89
milestones for 6MO (gross motor, fine motor, language, social/emotional)
GROSS MOTOR:
1. sits propped on hands
2. lateral protection
3. bounces when held
FINE MOTOR:
1. transfers objects from hand-hand
2. reaches out with one hand
3. feeds self crackers
Language:
1. babbles--consonant sounds
2. understands "no"
Social-emotional:
1. enjoys reflection in mirror
2. looks from object to parent and back when wanting help--indicating want
90
baby with meningitis would show _____ or ____ fontanelles
bulging or tense
91
swelling/discoloration below eyes
| + grimacing to relieve nasal itching
allergic shiners
92
transverse line on nose
| child keeps pushing back on their nose
allergic salute
93
short frenulum limitig the protrusion of the tongue
ankyloglossia
| or tongue tie
94
when does first tooth appear
6-12MO
95
how many primary teeth do kids have
20
96
shrill or high pitched crying in newborns suggest?
they were born to narcotic addicted moms
97
white plaques that do not rub/scape off
thrush
| *common in newborns
98
Tender ulcerations on oral mucosa surrounded by erythema
herpetic stomatitis
99
posterior pharynx is erythematous with palatal petechial foul smelling exudate
streptococcal pharyngitis aka strep throat
| *very common in children
100
what can prolonged bottle feeding lead to
teeth erosion
101
what is the most common health problem in children
teeth erosion
102
list intrinsic cause of teeth staining
tetracyclines bfore age of 8
| teeth can look yellow, gray or brown
103
list extrinsic cause of teeth staining
iron preparations--black stains
| fluoride--white stain
104
what can thumb sucking lead to in older children
malocclusion and misalignment of teeth
105
portion of the tongue has rough, unusual apperance
- benign
- chronic condition
geographic tongue
106
at what age is strep throat uncommon?
<3
107
describe PE findings for strep throat
strawberry tongue
white/yellow exudates on tonsils
beefy red uvula
palatal petechia
108
scarlet fever is caused by?
group A strep
109
PE findings for scarlet fever
strawberry tongue
sandpaper rash--fine bumps that feel like sandpaper
when the rash resolves--- skin may begin to peel/desquamate---- esp on hands and feet
110
```
asymmetric enlargemnt of one tonsil
+erythema
+pain
+displacement of uvula
"hot potato voice"
```
peritonsilar abscess
111
is actue epiglotittitis common or rare in US?
rare bc of the H influenza type B vaccine
112
child c/o sore throat, unable to swallow their saliva, they are sitting up stiffly and tripoding
usually hx of no vaccines
acute epiglotititis
113
tonsillitis can be viral or bacterial?
both
114
voice described as "rocks in mouth"
tonsilitis
115
halitosis causes for kids
```
infection
FB in nose
sinusitis
dental dz
GERD
```
116
congenital torticolis also called
wry neck
117
bleeding into the sternocleidomastoid muscle due to stretching process during delivery
congenital torticolis
118
firm, fibrous mass is felt in newborns neck muscles 2-3 weeks after birth
congential torticolis
119
with a difficult arm or shoulder extraction during delivery, what on the neck are you inspecting
clavicles for fx
120
lymphadenopathy is usually viral or bacteria?
can be both
121
is lymphadenopathy common in infancy? childhood?
uncommon infancy
| common in childhood
122
supraclavicular lymph nodes raises suspicion for?
malignancy
123
node is >2cm, hard or fixed and accompanied by systemic s/s like wt loss
malignancy
124
nuchal rigidity suggests?
meningitis
125
enlarged cervical lymph nodes
lymphadenopathy
126
what is tachypnea for
1. birth-2MO
2. 2-12 months
birth-2 MO= >60 breaths/min
2MO-12MO= >50 breaths/min
127
apnea is cessactino of breathing for more than ___ seconds and accompanied by?
*what does apnea indicate
20 seconds
accompanied by bradycardia
indicates: CNS, cardiopulmonary conditions, or res dz
128
infats are ___ breathers
nasal
129
nasal flaring can indicate?
-congestion
or
-more serious pathology like pnm or other seirous resp dz
130
breastbone is sunken into his or her chest.
pectus excavatum
131
child's breastbone protrudes outward abnormally.
pectus carinatum
132
heart rate:
1. 1-2 YO
2. 2-6YO
3. 6-10YO
1. 70-115
2. 68-138
3. 65-125
133
sinus brady
1. infats/toddlers
2. 3-9YO
1. <100
| 2. <60
134
BP readings from ___ are higher than from the ___
thigh has higer BP reading... by 10 mmHg vs upper arm
135
```
wheezing
grunting
nasal flaring
retractions
*signs of?
```
respiratory distress
136
steps to assess infants breathing
1. gen app
2. RR
3. color
4. audible breath sounds
5. work of breathing
137
stridor can indicate
FB
croup
epiglottits
138
noisy work of breathing (stridor) + abnormal findings on auscultation=?
pneumonia
139
best sign to rule out pneumonia is?
absence of tachypnea
140
diminished breath sounds unilaterally
pneumothorax
| diaphragmatic hernia
141
how to tell difference b/w upper and lower airway sounds in infant?
hold scope up to nose and compare
142
common breath sounds in infants?
| -indicates?
wheezes and rhonchi
wheezing most likely has asthma, bronchiolitis
rhonchi--URI
143
what does crackles in an infant indicate
pneumonia
| bronchiolitis
144
List the cyanotic heart lesions
Tetralogy of Fallot
Truncus Arteriosus
Transposiiton of the Great vessels
tricuspid atresia
145
is it common or uncommon for kids to have abdomenal protruberance
common
146
painless mass on testicle
hydrocele
147
babinski response
| -describe
* ****normal finding in infants
- occurs when sole of the foot is stroked--then big toe moves upward or toward the top of the surface of the foot
hyperreflexia
clonus at the wrist, knee, ankle, extensor plantar reflexes
seen in CNS lesions of descending corticospinal tract
-can be transiently + in unconscious states fro drug or ETOH intoxication
148
tanner stages
- define
- scale is based off?
scale of physical development in children, adolescents and adults
-scale defines physical measurements of development based on external primary and secondary sex characteristics---- size of breasts, genitles, testicular volume and devlp of pubic hair
