Peds Flashcards
Car Seat
Infant/Toddler
Rear Facing
Rear Seat
Car Seat
Preschool
Rear Seat
Forward facing
Harness
Car Seat
School Age
Rear Seat
Booster seat
until 4’9” (145cm) and >8yo
Car Seat
Front Seat
13 yo
Development
1 month
Looks at face
Responds to voice
Moves extremities equally
Lifts head
Development
2 months
Vocalizes
Smiles
Follows TO midline
Responds to sounds
Development
4 months
Holds head at 90 degress
Laughs
Follows PAST midline
NO persistent fist clenching
Development
6 months
No head lag Bears weight on legs Rolls over Turns towards voice Transfers hand to hand
Development
9 months
Sits w/o support Stands holding on Cruises Imitates speech/single syllables Thumb finger grasp Dada, Mama Peek-a-boo
Develpment
1 year
Stands alone Walks w/ help Babbles Specific dada, mama Responds to no Pincer grasp Waves bye-bye Bangs 2 blocks together
Development
18 months
Walks backwards Knows 1 body part Drinks from cup Imitates household chores Speaks 3-6 words Scribbles Stacks 2 blocks Understands simple commands
Development
2 years
Kicks ball Takes off clothes 2 words together Speaks 50 words Understands 2 part command Uses own name Stacks 4 blocks Knows 6 body parts
Development
3 years
Washes hands Draws vertical line Names 4 pictures Throws ball Tricycle "why?"
Development
4 years
Dresses self Play games Understandable speech 4 colours First and last name Stairs with alternating feet Balance on each foot Draws circle
Autism screening
18 and 24mo visits
+family hx
MCHAT
Interventions = improve outcomes
Fluoride
6 mo supplement if deficient water supply
Apply at tooth eruption to 5yo
Refer to peds ophtlamology if:
<20/50 age 3 or <20/30 age 5
Asymmetry
Stabismus >3-6 months
Abnormal red reflex
Amblyopia 2/2 strabismus leading cause of monocular vision loss in children
Childhood Obesity
Screen >6 yo
Overwheight BMI 85th-94th percentile
Obese BMI > 95th percentile
Class II obesity BMI > 35 or >120% 95th percentile
Class III BMI > 40 or >140% 95th percentile
Lead screening
Ages 1-5yo
Iron screening/supplementation
6-12 months
Peds Microcytic Anemia
Likely Iron def
Treat presumptively and confirm with +1 Hg after 1month of therapy
Parental Guidance
2-4 weeks
Sleep position, feeding, crying, growth
Safety: car seat, smoke exposure, shaking
Parental Guidance
2 months
sleep position, feeding, growth
Burns, sun expo, car seats, smoking, shake
Parental Guidance
4 months
Introducing solid food, sleep, talking to baby
Falls, car seat
Parental Guidance
6 months
Introduce solid foods
Child proofing, posions, car seats
Parental Guidance
9 months
Introduce table food, cup use, teeth care
Drowning, burns, car seat
Parental Guidance
12 months
Weaning, brushing teeth
Child proofing, choking, car seat, drowning
Parental Guidance
15mo
feeding self, nutrition
Parental Guidance
18 months
TV, toilet training, language
Traffic, guns, drowning, poison
Parental Guidance
2 years
toilet training, TV
Parental Guidance
3 years
hand washing, TV, stranger danger, dentist
Helmets
Discipline
Positive reinforcement
Ignore bad behavior
Time out
Written contracts
NO: spanking
Screen time
none <18mo
18-24mo High quality
2-5 years <1hr, high wuality
>6 yo consistent limits
Toilet training
when able to pull clothes up/down
can follow 2 step commands
~2-3yo when express interest
Enuresis
> 5yo
M>F
usually self resolves
Tx: alarms, desmopressin (short term)
Encopresis
M>F
MC of constipation
Reward system
Peds Constipation
Functional
Miralax -0.3 to 1.5g/kg/day
No effect from fiber supplementation
Adolescent Screening
BiHEADS Body image Home/health Education/Employment Activities Drugs/Depression Safety/Sexuality
Adolescent Vaccinations
11-12 yo: HPV, Tdap, Meningococcal (MCV4) #1
16-18 yo : MCV4 #2, meningitis type B, Influenza (even with egg allergy)
BP Ages 1-13yo
Normal < 90th percentile
Elevated BP > 90th to 95th percentile, or > 120/80
Stage 1 HTN >90th to 95th percentile +12 mm or 130/80 to 139/89
Stage 2 HTN > 95th percentile +12mm hg or > 140/90
BP >13 yo
Normal < 120/<80
Elevated BP 120/<80 to 129/<80
Stage 1 HTN 130/80 - 139/89
Stage 2 HTN > 140/90
Peds HTN general
MCC Primary HTN
Confirm 3times
Tests all: b/l UE and LE, UA and BMP, Lipids, UDS, Ambulatory BP
Peds HTN
Obese
Test TSH, A1C, LFTs, ?sleep study
HTN <6yo
Renal u/s (1st choice imaging)
Reasons: renal parenchymal disease, glomerulonephritis, congenital, reflux nephropathy
If tx: do ECHO
Peds HTN Tx
Stage 1 lifestyle changes, 2-3wk f/u
Stage 1 + end organ damage or persistence or Stage 2:
Thiazide/ACE-I/ARB/CCB - give adolescent contraception
No parental consent needed for:
Contraception, STI, rape, pregnancy
Drug/etoh, mental health
Emergency
Unintentional death adolescents
73% all death MVA Homicide 13% Suicide 11% Cancer 6% Heart dz 3%
