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Phys and Pharm > Peds > Flashcards

Peds Flashcards

1
Q

What are calming techniques for newborns

A

pacifier
feeding
sucking on finger

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2
Q

What are you observing in newborns?

A

color
size
body proportions
nutritional status
posture
respiration
movements of head and extremities

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3
Q

Under the age of 2 use the __________ chart for growth

A

WHO

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4
Q

macroencepholy

A

bigger head circumference

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5
Q

Microencephaly

A

a smaller head circumference

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6
Q

What is considered failure to thrive ?

A

-growth <5th percentile for age
-drop > two quartiles in 6 months
-weight for length < 5th percentile

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7
Q

What does APGAR stand for and what is a score at 1 and 5 minutes

A

Activity
Pulse
Grimace
Appearance
Respiration
may continue in 5 minute intervals until score is > 7

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8
Q

APGAR score at 1 minute

A

8-10 normal
5-7 some nervous system depression
0-4 severe depression

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9
Q

APGAR 5 minute score

A

8-10 normal
0-7 at risk for CNS and other organ system dysfunction

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10
Q

SGA

A

small for gestational age <10%

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11
Q

AGA

A

appropriate for gestational age
10-90%

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12
Q

LGA

A

large for gestational age
>90%

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13
Q

Gestational age: Preterm

A

<37 weeks

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14
Q

Gestational age: late preterm

A

34-36 weeks

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15
Q

Gestational age: term

A

37-41 weeks

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16
Q

Gestational age: postterm

A

> 42 weeks

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17
Q

Weight

A

extremely low birth weight: <1,000
very low birth weight < 1500 g
low birth weight < 2500 g
normal birth weight greater to or equal to 2500 g

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18
Q

Most accurate route for temperature in infants

A

rectal, average rectal temp in infancy than adolescence is 99F

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19
Q

Fever in infants

A

equal to or higher than 38 degrees C

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20
Q

T/F infants body temp is less consistent than in adults

A

True

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21
Q

HR for newborns

A

birth to 1 month: 140bpm
1month-6months: 130 bpm
6months-12 months: 115bpm

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22
Q

What is a normal respiratory rate

A

newborn: 30-68 bpm
6-12 mo: 25-60 bpm

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23
Q

Tachypnea respiration rate

A

RR > 60

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24
Q

Periodic breathing

A

short pauses in breathing (usually 5-10 seconds) common in newborns and are considered normal

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25
Q

Apnea

A

pause in breathing 20 seconds or longer OR a pause in breathing
resulting in cyanosis/bradycardia
abnormal finding in term infants

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26
Q

Fever can raise respiratory rates in infants by up to _________respirations per
minute for each degree centigrade of fever

A

10

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27
Q

Systolic BP gradually _________throughout childhood

A

increases

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28
Q

BP readings from the thigh are approximately __________ mmHg higher than those from the upper arm. If they are the same or lower what should be suspected?

A

10, coarctation of the aorta should be suspected

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29
Q

O2 saturation

A

Measure hgb saturation
● Non-invasive method
● Two beams of light are shined through a pulse point
● Detects change of pulsing arterial blood color

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30
Q

Heart failure signs in infants

A

tachy tachypnea and liver failure

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31
Q

What are you observing when it pertains to lungs in newborns?

A

Tachypnea
○ Nasal flaring
○ Retractions
○ Grunting
○ Head bobbing

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32
Q

Rales (crackles)

A

crunching, crackling; associated with fluid

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33
Q

Wheezes

A

high pitched musical quality; associated with bronchospasm

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34
Q

Rhonchi

A

rattling; associated with mucus/secretions in airways

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35
Q

Stridor

A

audible high pitched wheezes indicating a narrowed airway

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36
Q

Pulses are graded as ________, __________, and ______

A

absent, 1+ (weak), 2+ (strong)

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37
Q

Persistently weak femoral pulses can be a sign of
_______________

A

aortic coarctation

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38
Q

Caput succedane

A

Swelling of the scalp over the occipital region. It results from capillary distention and extravastation of blood and fluid resulting in vacuum effect of rupture of the amniotic sac. crosses the suture line can resolve in one and 2 days

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39
Q

cephalohematoma

A

Localized swelling caused by subperiosteal hemorrhage from trama of birth. this swelling doesnt cross over the suture lines and can take 3 weeks to resolve

40
Q

Large frontanelle =

A

Hypothyroidism, OI

41
Q

Small frontanelle =

A

IUGR

42
Q

Plagiocephaly

A

flat spot on one side of the head or entire back of the head

43
Q

Oxycephaly

A

premature closure of all sutures

44
Q

Brushfields spots

A

seen in kids with down syndrome and can sometimes be normal

45
Q

Preauricular sinus

A

ear pit can be with renal conditions

46
Q

Ear tag

A

usually benign

47
Q

Choanal atresia

A

nasal passages are narrowed or blocked by soft tissue or bone
if its bilateral, the baby becomes cyanotic
if its unilateral can get air through other nasal passage but can have recurrent sinus infections

48
Q

Epstein pearls

A

Tiny white or yellow, rounded mucous retention cysts
● Located along posterior midline of hard palate
-disappear within months

49
Q

diastesis recti

A

separation of two rectus abdominal muscles, its benign

50
Q

For the abdomen, if there are any Hypo/silence sounds it indicates

A

obstruction

51
Q

For the abdomen, if there are any Hyper sounds it indicates

A

gastroenteritis

52
Q

Abnormal olive shaped mass palpated in RUQ or midline

A

pyloric stenosis
often found between 4-6 mo of age common in first born males when feeding may see peristaltic wave

53
Q

In males, you want to watch out for hydroceles and inguinal hernias. How can you tell the difference?

A

hydrocle will transmuilimiunate while inguinal will not

54
Q

Ambiguous genitalia in a female indicates

A

mascularization of a female

55
Q

Polydactly

A

6 fingers

56
Q

Syndactyl

A

webbed fingers

57
Q

Two tests for hip dysplasia

A
  1. Orolani- abduct hip while applying an anterior force on the femur to reduce the hip joint a palpable movement of femoral head back into place is a + sign)
  2. Barlow- adduct the hip while applying a posterior force on the knee to promote dislocation. + sign is indicates laxity and dislocateable hip, the baby needs to go to ultrasound (head of femur slipping onto the posterior lip of acetabulum is a + sign)
58
Q

Sacral dimple

A

if hair associated/ want to investiage for spina bifida

59
Q

Single plamar crease associated with

A

T21 and has to do with down syndrome

60
Q

Arthrogryposis

A

Thin, weak, stiff or missing
muscles.
*Stiff joints due to extra
tissue→fibrosis
*Differences in the skin around their
joints, such as webbing

Causes:
fetal abnormalities, CT disorders, trauma, drugs, maternal disorders/illnesses in mother, mechnical limitation for uterus

61
Q

Vernix caseosa

A

cheesy white substance seen on newbrosn made of proteins water and lipids and is a protective barier. may have edema with this on hands and feet that will resolve. the cheesy substance can last up to 10 days

62
Q

Cutis marmorata

A

response to cold, just the way circulation catched up can last for few months in infants

63
Q

Milia

A

new born acne, obstruction of sweat glands

64
Q

Erythemia Toxicum

A

can be a normal finding appear usually 2-3 days, resolves on its own, unknown cause. its little pustules and erythematous

65
Q

Preauricular sinus

A

due to a renal condition

66
Q

Hypotonia/Hypertonia is indicative of

A

intracranial disease

67
Q

Hypotonia

A

frog-leg position, arms flexed, hands near ears

68
Q

DTR’s are present in newborns but difficult to elicit
○ Typical little diagnostic significance unless:

A

■ Response different from prior exam
■ Extreme Reponses
■ Asymetrical

69
Q

If there is an asymetric DTR think of

A

PNS or CNS lesion

70
Q

● Triceps/Brachioradialis and Abd Reflex— difficult to illicit before

A

6 months

71
Q

Anal Reflex/Wink- present at birth->

A

important to exclude if spinal cord injury suspected

72
Q

Babinski (+) _______ in newborns

A

normal

73
Q

Primitive Reflexes

A

Develop during gestation
● Demonstrable at birth then disappear at defined ages
● Abnormalities can suggest neurologic disease or developmental abnormality

74
Q

Palmar grasp

A

they should grasp around you
birth -4 months (hands)
6-8 monthds (foot)

75
Q

Rooting reflex if ythey fdont have this think of

A

central nerveous system disease

76
Q

Rooting reflex

A

Stroke perioral skin at the corner of
the mouth
⦿ Mouth will open and infant will turn
toward the stimulated side and suck
present from birth to 3-4 mo

77
Q

Moro Reflex

A

⦿ Hold infant supine, support head,
back and legs then abruptly lower
the entire body 1 foot
⦿ Arms will Abduct and extend, hands
will open, and legs will flex
⦿ Infant will cry!
⦿ Birth to 4 months

78
Q

Asymmetric Tonic Neck Reflex

A

Supine infant, turn head to one side,
holding jaw over shoulder
⦿ Arms/legs on side to which head is
turned will extend while the
opposite leg will flex
⦿ Repeat on other side
⦿ Birth until 2-3 months

79
Q

Trunk Incurvation (Galant) Reflex

A

Support infant prone and stroke one
side of the back 1cm from midline
from shoulder to buttock
⦿ Spine will curve toward stimulated
side
⦿ Birth to 3-4 months
spinal cord lesion or injury if not present

80
Q

Landau Reflex

A

Suspend the infant prone with 1
hand
⦿ Head will lift up and spine will
straightem
⦿ Birth -> 6 months
if still there, prolonged, may be develomental delay

81
Q

Parachute Reflex

A

Suspend prone and slowly lower
head to surface
⦿ Arms/legs will extend in a
protective fashion
-8months and beyond

82
Q

Positive Support Reflex

A

Hold infant around trunk until feet
touch a flat surface
⦿ Hips, knees, ankles will extend the
infant will stand up, partially
bearing weight, sagging after 20-
30seconds
⦿ Birth or 2 months until 6 months

83
Q

a newborn who is breeched may not have placing and stepping reflexes rihght away if its completely absent, worried about __________

A

paralysis

84
Q

Placing and Stepping Reflexes

A

Hold upright, have one sole touch
the tabletop
⦿ Hip and knee of that foot will flex
and other foot will step forward
⦿ Alternate stepping will occur
⦿ Birth until variable age

85
Q

AAP recommends infants < 1 year to be seen at:

A

Birth
* 3-5 days
* 1, 2, 4, 6, 9, 12 + 15 and 18 months then yearly

86
Q

Obtaining an adequate psychosocial history: HEEADSS

A

⦿Home Environment
⦿ Education and Employment
⦿ Eating
⦿ Activities
⦿ Drugs and Alcohol
⦿ Sexuality
⦿ Suicide, depression, self-harm
⦿ Safety from injury/violence

87
Q

Crying can cause an erythematous

A

TM

88
Q

Femoral pulses are easier to palpate than __________, brachial easier than _______ on infants

A

brachial, radial

89
Q

Tanner staging females:

A

difference between 4-5…..

90
Q

Boys sexual maturity rating

A

……

91
Q

18 m/o male with Acute otitis media, what drug are you going to use?

A

amoxicillin
< 2 years of age = 10 days
greater than 2 years of age = 5-7 days

92
Q

Patient weights 20 lbs, what do we need to do to convert it

A

20/2.2 = 9.09 kg, would give 5.11 ml/dose

93
Q

Patent ductus arteriosus (PDA)

A

Continuous “washing machine” murmur

94
Q

The infants ear canal is directed ____________ from the outside, therefore pull the ear downward and outward not upward for the best view of the eardrum

A

downward

95
Q

Mongolian blue spots

A

bluish/gray skin markings that commonly appear at birth or shortly after. They appear commonly on base of the spine, buttocks and back. They are benign and not associated with any condition.

96
Q

Jaundice

A

occurs during days 2-5 of life, and progresses from head to toe as it peaks. Extreme jaundice may signify a hemolytic process of biliary or liver disease

Phys and Pharm (16 decks)

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