PEDS

Question 1

first eruption (central mandibular incisors)

Answer 1

6-10 mo

Question 2

critical ages for developmental screening:

Answer 2

9, 18, and 30 mos

Question 3

autism-specific screening should occur

Answer 3

at the 18-month visit

Question 4

Bed-wetting is normal up to age …

Bowel control is achieved by

Answer 4

4 in girls and age 5 in boys.

age 4.

Question 5

Enuresis (Bed-wetting)

Answer 5

twice a week for 3 months

in children 5

Question 6

Encopresis

Answer 6

each month for 3 months

in children 4

Question 7

if <2 yo, measure length with the child in ..

Answer 7

supine

Question 8

Weight for length measures

Answer 8

adiposity

Question 9

Head circumference is routinely measured during

Answer 9

the first 24 mos of life

Question 10

Small for gestational age (SGA)

Question 11

Appropriate for gestational age (AGA)

Answer 11

P10 to P90

Question 12

Large for gestational age (LGA)

Answer 12

P90

Question 13

Mortality rates are highest for

Answer 13

preterm SGA and preterm AGA infants

Question 14

Mortality rates are lowest for

Answer 14

for term AGA infants

Question 15

Symmetrical SGA (Weight, length and HC all < P10) causes

Answer 15

Chromosomal abnormality
Maternal drug oralcohol use
Congenital viral infections

Question 16

Asymmetrical SGA (Only weight < P10) causes:

Answer 16

Gestational hypertension

Placental insufficiency

Question 17

The prognosis for normal growth and development is better in asymmetric or symmetric SGA infants.

Answer 17

asymmetric

Question 18

SGA complications (name at least 3)

Answer 18

• Hypoglycemia (smaller glycogen stores)
• Polycythemia - compensatory
• Hypothermia

Hypoxia, perinatal asphyxia, meconium aspiration, hypocalcemia

Question 19

LGA complications (name at least 3)

Answer 19

Birth trauma
Hip subluxation
Talipes calcaneovalgus - foot excessively dorsiflexed

Low blood sugar

Question 20

Normal heart rate infant:

Irregularly irregular rhythm:

Answer 20

120- 160 beats/min

premature atrial contractions

Question 21

Normal resp rate:

Answer 21

30 – 60 breaths/min

Diaphragmatic breathing is predominant in infancy and early childhood

Question 22

Acrocyanosis and Cutis marmorata are common in

Answer 22

premature bbies, Down syndrome, hypothyroidism

Question 23

Milia

Answer 23

Tiny epidermal cysts filled with keratinous material

1- to 2-mm white papules

Question 24

Neonatal acne

Answer 24

Inflammatory papules and pustules

occurs between 2 and 4 weeks of age

Question 25

Erythema toxicum neonatorum (ETN)

Answer 25

Blotchy, erythematous macules 2–3 cm that develops yellowish-whitish pustules Onset: 24-48 hours of life numerous eosinophils

Question 26

Mongolian spots (congenital dermal melanocytosis)

Answer 26

blue-gray patches - LUMBAR SACRAL REGION- BACK OR ARM most fade by age 2

Question 27

Physiologic jaundice Clinical features

Answer 27

Visible after 24 h of age Visible jaundice resolves by 1 wk in the full term infant, by 2 wk in the preterm ↓UDPGT activity

Question 28

Pathologic unconjugated hyperbilirubinemia

Answer 28

``` Visible before 24 h of age Pathophysiology: -Overproduction of bilirubin: Hemolytic/ Nonhemolytic causes -Decreased conjugation of bilirubin -Unknown or multiple factors ```

Question 29

Hemolytic: ↑reticulocyte count

Answer 29

ABO blood group incompatibility G6PD deficiency Sepsis

Question 30

Non-hemolytic: normal reticulocyte count

Answer 30

↑↑enterohepatic circulation of bilirubin: bowel obstruction, functional ileus Breast-feeding–associated jaundice

Question 31

Decreased conjugation of bilirubin are seen in (3)

Answer 31

Criggler-Najjar syndrome, Gilbert syndrome, hypothyroidism

Question 32

Unknown or multiple factors

Answer 32

Breastmilk jaundice | Breastfeeding-associated jaundice - the lack of milk jaundice (dehydrated)

Question 33

Upslanting palpebral fissures, epicanthal folds; midface hypoplasia;

Answer 33

Down syndrome (Trisomy 21)

Question 34

Lymphedema (swollen hands and feet) Coarctation of the aorta and GU malformations Webbed neck in picture

Answer 34

Turner syndrome

Question 35

Cephalohematoma

Answer 35

Limited to the surface of one cranial bone

Question 36

Caput succedaneum

Answer 36

Crosses suture lines

Question 37

maternal folate intake of 0.4 mg preconception and 1st 3 mos of pregnancy prevents

Answer 37

Encephalocele (Scalp mass)

Question 38

Posterior fontanelle closes in

Answer 38

Closed by 2 mo

Question 39

Anterior fontanelle

Answer 39

13.8 mos

Question 40

Anterior fontanelle Open, bulging:

Answer 40

↑ICP or intracranial tumors

Question 41

Early closure of Anterior fontanelle with ↑ICP produces

Answer 41

Macewen’s sign (a ‘cracked-pot’ sound; dull, lacking resonance) on percussion

Question 42

Anterior fontanelle Large size or delayed closure is bc of

Answer 42

achondroplasia, hypothyroidism, Down syndrome, ↑ICP, and rickets

Question 43

Anterior fontanelle Open, sunken:

Answer 43

dehydration

Question 44

Congenital Horner Syndrome (4)

Answer 44

Anisocoria Ptosis Heterochromia- Anhidrosis

Question 45

Dacryostenosis (4) dx?

Answer 45

Epiphora Mucoid discharge Eyelash matting Eyelid erythema Diagnosis: Reflux of salin/fluorescein dye

Question 46

Choanal atresia (Uni/bilateral)

Answer 46

tongue moves up to palate and blocks oral airway - when blocked with nasal airway - accessory muscles will be in use and will be in cyanosis When baby cry it resolves

Question 47

Pierre Robin syndrome

Answer 47

- small mandible and retraction of the tongue with cleft palate - respiratory difficulty

Question 48

midline mass:

Answer 48

thyroglossal duct cysts

Question 49

mass anterior to the SCM:

Answer 49

branchial cleft cyst

Question 50

mass within the SCM:

Answer 50

hematoma, torticollis

Question 51

mass posterior to the SCM:

Answer 51

cystic hygroma

Question 52

PMI in babies is located

Answer 52

1 interspace higher than in adults

Question 53

- soft, systolic; upper left sternal border, lung fields, axillae

Answer 53

Pulmonary flow murmur (innocent ?)

Question 54

Galeazzi or Allis sign:

Answer 54

unequal upper leg length or knee levels | different height of knees +

Question 55

Ortolani-Barlow sign

Answer 55

(+) Ortolani sign: palpable movement of the femoral head into the acetabulum in hip dysplasia (hip ‘clunk’) (+) Barlow sign: palpable movement of the femoral head out onto the posterior lip of the acetabulum

Question 56

Red flags of dysplasia of the hip

Answer 56

Limited hip abduction (< 60⁰) Positive Ortolani test Dislocated hip

Question 57

“Hang on for life” reflex—abduct/extend arms when startled, and then draw together

Answer 57

Moro (3mo)

Question 58

Movement of head toward one side if cheek or mouth is stroked (nipple seeking)

Answer 58

Rooting less seen after 1mo

Question 59

Movement of head toward one side if cheek or mouth is stroked (nipple seeking)

Answer 59

Rooting - less seen after 1mo

Question 60

Curling of fingers if palm is stroked

Answer 60

Palmar 4mo

Question 61

Dorsiflexion of large toe and fanning of other toes with plantar stimulation

Answer 61

Plantar 8mo

Question 62

Stroking along one side of the spine while newborn is in ventral suspension (face down) causes lateral flexion of lower body toward stimulated side

Answer 62

Galant 2mo

Question 63

undescended testes in scrotal sac after age 1

Answer 63

abnormal

Question 64

Sphenoid sinuses present by age

Answer 64

8