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1
Q

things that can be done at 2 months old

A

coos vowels, lifts head when prone, smiles

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2
Q

things that can be done at 6 months old

A

can transfer things from one hand to another, able to sit up without support, rolls supine to prone, can say baba or dada,

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3
Q

things that can be done at 9 months

A

plays peek-a-boo, feeds self, pulls self up to stand

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4
Q

things that can be done at 12 months

A

takes steps, wave “bye bye”, says “mama” and “dada”, uses sippy cup, can say 2-4 words, knows first name

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5
Q

things that can be done at 15 months

A

feeds self with spoon, knows 4-6 words, follow commands

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6
Q

things that can be done at 18 months

A

able to walk backwards, knows 10-20 words

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7
Q

avoid giving hard candy in children less than

A

6 years old

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8
Q

infants up to this age should be in a rear-facing car seat

A

age 2

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9
Q

physiologic jaundice starts at ____ and will clear up in _____

A

24 hours; 2-3 weeks

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10
Q

breast milk jaundice shows at ___ and can take up to ____ to clear

A

after 7 days; 1 month

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11
Q

things that can be done at 2 years old

A

speech understood by family, stacks 6 cubes, runs/jumps/climbs, walk up and down stairs

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12
Q

things that can be done at 3 years old

A

speech understood by stranger, can copy a circle (3=circle), can throw a ball overhead, rides a tricycle

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13
Q

When dooes the Oedipal stage (Freud) occur?

A

3-5 years old, the child wants to marry the parent

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14
Q

things that can be done at 5 years old

A

copies a square, can dress self

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15
Q

signs of autism can appear by

A

18 months

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16
Q

s/s of autism

A

does not wave by 12 months; no babbling by 12 months

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17
Q

things that can be done at 4 years old

A

can copy a cross (4 points on cross), hops on one foot

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18
Q

precocious puberty is puberty starts

A

before age 8 in girls; before age 9 in boys

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19
Q

delayed puberty if

A

no breast development by age 12 in girls; if not testicular growth by age 14 in boys

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20
Q

first sign of puberty in boys

A

enlargement of testes

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21
Q

first sign of puberty in girls

A

breast bud (thelarche)

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22
Q

Tanner stage III in boys is

A

elongation of penis

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23
Q

A genetic defect caused by trisomy of chromosome 21

A

Down’s syndrome

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24
Q

s/s of Down’s syndrome

A

round, flat face; palpebral fissures, low set ears, enlarged tongue, short neck

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25
Q

Those with Down syndrome have a high risk of

A

congenital heart defects, hearing and vision problems, cataracts, early onset Alzheimer

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26
Q

s/s of Fetal Alcohol syndrome

A

microcephaly, narrow eyes, flat nasal bridge, thin upper lip

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27
Q

cryptorchidism has a high risk of

A

testicular cancer

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28
Q

Any neonates with acute conjunctivitis presenting within 30 days or less from birth should be tested for

A

chlamydia, gonorrhea, herpes simplex, and bacterial infection

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29
Q

s/s of gonococcal ophthalmia neonatorum

A

red conjunctiva, purulent discharge, swollen eyelids

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30
Q

difference between gonococcal and chlamydial eye infection in newborns

A

gonococcal show within 2-4 days after birth; chlamydia show within 4-10 days after birth

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31
Q

SIDS is common in those less than

A

1 years old

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32
Q

small pustules that are 1-3 mm in size with erythematous base; erupts during 2-3 day of life and last 1-2 weeks; resolve on own

A

erythema toxicum neonatorum

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33
Q

trx for seborrheic dermatitis in newborns (cradle cap)

A

soak in vegetable or mineral oil and scrub gently to remove scales; resolves within a few months

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34
Q

tufts of hair on lumbosacral area

A

Faun tail nevus

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35
Q

Faun tail nevus should warrant a

A

ultrasound to r/o spina bifida

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36
Q

flat, light brown to dark brown spots greater than 5 mm

A

cafe au lait spots

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37
Q

If there are multiple cafe au lait spots noted, then

A

refer to peds neurologist to r/o neurofibromatosis

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38
Q

pink to red flat stain-like skin stains on the upper and lower eyeslids or on face

A

“port wine” stain

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39
Q

trx for “port wine” stain (nevus flammeus)

A

refer to peds opthl to r/o glaucoma

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40
Q

raised vascular lesions that are bright red in color

A

hemangioma

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41
Q

newborn vision is

A

nearsighted (myopia)

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42
Q

amblyopia

A

lazy eye

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43
Q

misalignment of one or both eyes “cross eyed”

A

esotropia

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44
Q

vision of ____ or worse in a child more than ____ years of age should be referred

A

20/30; 6

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45
Q

the red reflex screening is to test for

A

retinoblastoma and cataracts

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46
Q

mnemonic for high-risk factors for hearing loss in newborns

A 
HEARS:
Hyperbilirubinemia,
Ear infections,
Apgar scores low at birth, 
Rubella, CMV, toxoplasmosis
Seizures
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47
Q

test for PKU in newborn

A

after protein feedings (milk or formula) for at least 48 hours

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48
Q

Supplement with this if mother is breasfeeding

A

vitamin D drops because breaskmilk alone does not provide adequate levels.

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49
Q

sticky and thick yellowish fluid that comes before breast milk; contains maternal antibodies and nutrients

A

colostrum

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50
Q

failure to pass meconium in ___ is a sign of intestinal obstruction

A

24 hours

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51
Q

introducing solid foods

A

can start at 4-6 months; start with rice cereal; introduce one food at a time for 4-5 days

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52
Q

“cone-shaped” head in newborn that is self-limited

A

caput succedaneum

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53
Q

Newborns ____ their birth weight by 6 months and _____ their birth weight by 12 months

A

double; triple

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54
Q

head circumference is measured until age

A

3 years old

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55
Q

In newborns chest is ____ than head circumference

A

less

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56
Q

teeth that erupt at 6-10 months of age

A

lower central incisors (lower front teeth)

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57
Q

Infant should have complete set of primary teeth by age

A

2.5

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58
Q

urethral meatus located on the ventral (posterior) aspect of the penis

A

hypospadias

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59
Q

urethral meatus located on the dorsal (anterior) aspect of the penis

A

epispadias

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60
Q

common in newborn males where there is presence of fluid inside the scrotum

A

hydrocele

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61
Q

first permanent tooth erupts at age

A

6 years

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62
Q

____ crosses cranial midline and ____ does not cross midline

A

caput succedaneum; cephalohematoma

63
Q

Avoid cow’s milk when?

A

first 12 months of life

64
Q

moro (startle) reflex disappears by

A

3-4 months

65
Q

step reflex disappears by

66
Q

rooting reflex disappears by

A

3-4 months

67
Q

white papules found on gum line that resemble erupting tooth

A

Epstein’s pearls

68
Q

Education to parents about DTaP vaccine

A

can cause fever, irritability, and swelling at injection site

69
Q

contraindications to administering DTaP vaccine

A

severe allergic reaction, encephalopathy, seizures, fever greater than 105

70
Q

persistent tearing and crusting of one or both eyes; mucoid discharge may be seen when eye is palpated

A

lacrimal duct obstruction

71
Q

s/s of acute dacrocystitis

A

red, warm, tender, and swollen lacrimal ducts

72
Q

trx for acute dacrocystitis

A

lacrimal sac massage

73
Q

s/s of colic

A

occurs for more than 3-4 hours a day for more than 3 days a week in an infant less than 3 months

74
Q

When the hips of a newborn are rotated to hear for a click

A

Ortolani manuever

75
Q

When the knees of a newborn are pushed toward midline

A

Barlow maneuver

76
Q

populations that need Tdap

A

all pregnant females in 1st trimester, elderly greater than 65, those caring with young children

77
Q

dosing for IPV

A

2, 4, 6 months, 4-6 years

78
Q

dosing for PCV13

A

2, 4, 6, 12-15 months

79
Q

these signs after a live vaccine are normal and represent a normal reaction to viral replication

A

fever and rash

80
Q

dosing for varicella vaccine

A

12-18 months, 4-6 years

81
Q

MCV4 is given to those

A

age 11-12; booster at age 16

82
Q

vaccine given ___ before scheduled time is considered valid; but if it’s given ___ before schedule time then it’s an invalid dose.

A

4 days; 5 days

83
Q

why is Tdap administered to every pregnant women?

A

protects mother and infant from pertussis

84
Q

Recommended length of time to monitor a child after rcving immunization

A

15 minutes

85
Q

rash after MMR vaccine is most likely to occur

A

7 days after immunization

86
Q

dosing with multiple live vaccines

A

either give all at same time or wait 4 weeks between

87
Q

hyperactivity and impulsivity are observed by age ___ and decline after age ___

88
Q

These symptoms of ADHD not usually observable by adolescence

A

hyperactivity and impulsivity

89
Q

inattention is usually observed around age

90
Q

DSM-5 criteria for diagnosis of ADHD

A

for those less than 17 more than 6 symptoms;

for those older than 17, more than 5 symptoms

91
Q

difference between management of childhood asthma and adult asthma

A

leukotriene blockers are more effective in children; oral pill is easier to give than inhaler

92
Q

most common pathogen involved with PNA in those 6 months to 5 years

93
Q

s/s of PNA in children

A

fever, increased respirations

94
Q

DOC for PNA in children

A

amoxicillin 90 mg/kg/day

95
Q

for weight based dosing atbx, what weight is a child start to be dosed for an adult?

96
Q

bronchiolitis is common those

A

less than 2 years old

97
Q

common causes of bronchiolitis

A

RSV, adenovirus

98
Q

s/s of bronchiolitis

A

URI for 1-3 days, then wheezing, increased RR, fever, thick nasal secretions

99
Q

trx for bronchiolitis

A

symptomatic; NO bronchodilators or steroids

100
Q

trx for croup

A

single dose of oral dexamethasone

101
Q

s/s of cystic fibrosis

A

recurrent pulmonary infections, greasy stools, weight loss

102
Q

when all blood counts are low in leukemia

A

pancytopenic

103
Q

most common presenting s/s of leukemia

A

fever, bleeding, bone pain, painless lymphadenopathy

104
Q

___ is considered enlarged nodes except in the epitrochlear (greater than 5 mm), inguinal (greater than 15 mm), and cervical (greater than 20 mm)

105
Q

diagnostic in leukemia

A

thrombocytopenia, blast cells

106
Q

characteristics of febrile seizures

A

occur once and don’t recur in 24 hours; occur during illness

107
Q

febrile seizures occur before age

108
Q

ibuprofen is not recommended in those less than

109
Q

medications for fever

A

do not combine or alternate tylenol and ibuprofen

110
Q

gastroesophageal reflux in infants

A

common d/t immature LES

111
Q

how to differentiate GER from GERD in infant

A

GERD will have irritability during reflux episode

112
Q

gastroesophageal reflux in infancy usually resolves by

A

1 year of age

113
Q

intussusception has been associated with ____ and is considered a ____

A

rotavirus vaccine; medical emergency

114
Q

s/s of intussusception

A

3-11 month child cries and pulls legs up to chest, currant jelly stools

115
Q

management of encopresis

A

laxatives (Miralax) daily until normal stools, then taper gradually

116
Q

trx for viral gastroenteritis

A

5-10 teaspoons of commercially prepared electrolyte solutions every 4 hours

117
Q

undescended testicle increases risk of

A

testicular cancer, inguinal hernia, testicular torsion, subfertility

118
Q

hydrocele should be resolved by ____; if not, then consider a ____

A

1 year of age; hernia

119
Q

retrograde passage of urine from bladder to upper urinary tract

A

vesicoureteral reflux

120
Q

long-term complications of UTI in infants are:

A

renal scarring, impaired renal growth, HTN

121
Q

trx for UTI in infants

A

3rd gen cephalosporins

122
Q

common injury in 1-4 year olds caused by annular ligament slipping over the head of the radius

A

nursemaid’s elbow

123
Q

Weight change in newborn

A

Normal to lose 10% of weight in 1st week of life

124
Q

Fetal nutrition is best determined by assessing

A

SQ fat on anterior thighs and gluteal region.

125
Q

Stork bite or pink/red capillary on face or neck is known as

A

nevus simplex

126
Q

anterior fontanelles close by age

A

9-18 months

127
Q

posterior fontanelles close by age

128
Q

normal for _____ to be closed at birth, but abnormal for _____ to be closed early.

A

posterior; anterior

129
Q

eye spacing is far apart

A

hypertelorism

130
Q

low set ears may indicate

A

renal agenesis

131
Q

shortening of sternomastoid muscle

A

torticollis

132
Q

a webbed neck may be associated with

A

Turner Syndrome

133
Q

normal for this in female newborn genitalia

A

milky white discharge

134
Q

testing corneal light reflex should be started by

A

6-12 months

135
Q

at what age should eye alignment occur?

A

2-4 months

136
Q

most common cause of vision problems in children

137
Q

The corneal light reflex and cover/uncover tests are used to assess for

A

strabismus

138
Q

attempt vision screening at age

139
Q

pediatric hearing loss is associated with

A

speech delay

140
Q

normal heart rate of newborn

141
Q

when should routine BP screening begin in children

A

3 years old

142
Q

dyslipidemia screening in children

A

start at 2, 4, 6, 8, 10 then annually.

Get fasting lipid profile at age 18-21.

143
Q

Normal bilirubin level is

A

below 5 mg/dL

144
Q

Hand placement for Ortolani maneuver

A

on greater trochanter

145
Q

Galeazzi test

A

unequal knee heights used to assess for hip dysplasia

146
Q

Talipes equinovarus

A

club foot- urgent ortho referral

147
Q

Refer to ortho for scoliosis if

A

Cobb angle greater than 20 degrees

148
Q

Who would be of greater concern for scoliosis?

A

pre-adolescent who hasn’t had growth spurt yet with Cobb’s angle greater than 20 degrees

149
Q

Correct order of hair maturation in boys

A

pubic, axillary, then facial (works down then up)

150
Q

genu varum up to 20 degrees is considered normal up to what age

151
Q

painful abdominal mass that crosses the midline

A

neuroblastoma

152
Q

asymptomatic abdominal mass that rarely crosses the midline

A

Wilms’s tumor

153
Q

Wilms’s tumor is common in

A

black, female 2-3 year olds.

154
Q

1st and 2nd most common cause of death in adolescents

A

MVA, homocide

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