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Quarter 2 > Peds Exam 1 > Flashcards

Peds Exam 1 Flashcards

1
Q

one of the most imp aspects of visit since child can’t talk

A

History

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2
Q

Schedule for maintenance visits

A

newborn, 1, 2, 4, 6, 9, 12, 15, 18 Months
2, 2.5 Years
3-6 Annually
6-adol every 2 Yrs

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3
Q

Add behavioral-developmental screening to routine

A

9 months, 18 months, 2 yr, 2.5 yr

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4
Q

5 Developmental categories

A 
Fine motor skill
Gross motor skill
Personality/social skill
Speech/communication skill
Neuro landmarks
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5
Q

M-CHAT test

A

modified checklist to check for Autism in toddlers

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6
Q

Denver developmental screen

A

great for getting referrals

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7
Q

AZEIP

A

AZ Early Intervention Program. Healthcare worker comes to house to do an evaluation for free to see what intervention child needs

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8
Q

AHCCCS Form

A

AZ Healthcare Cost Containment System. “Medicaid for Kids”

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9
Q

Measurements to take from 0-2 yrs of age

A

Height, Weight, Head circumference

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10
Q

Who makes normal growth chart for age 0-2

A

WHO, World Health Organization

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11
Q

Measurements to take starting at age 2

A

Height, Weight, Head circumference, + BMI, weight for length

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12
Q

Who makes normal growth chart for age 2 and older?

A

CDC, Center for Disease Prevention

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13
Q

Measuring Weight for Infant

A

take to nearest .01 kg or 1/2 oz

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14
Q

Normal weight for infant

A

5th-85th percentile

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15
Q

When to take BMI

A

2 yr and older
85-95th percentile: overweight
>95th percentile: obese

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16
Q

Head Circumference

A

Measure 0-3 y.o.

Head circumference percentile should match length percentile on respective normal growth chart

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17
Q

“Failure to Thrive”

A
  • Height or weight <3rd percentile

- Drop of 2 or more major percentile lines on standard growth chart

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18
Q

Congenital Viral Infections cause “TORCH”

A

Toxoplasmosis
Rubella
Cytomegalovirus CMG
Herpes

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19
Q

Prematurity

A

subtract wks of prematurity from postnatal age when plotting growth
Head: 18 mo
Weight: 24 mo
Height: 40 mo

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20
Q

HTN in peds

A

Systolic and/or Diastolic >/ 95th percentile on 3 separate occasions
Further categorized into 2 stages:
Stage 1: <5 mmHg above 99th percentile
Stage 2: >5 mmHg above 99th percentile

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21
Q

When to start screening BP regularly?

A

3 YEAR OLD

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22
Q

What is persistent HTN?

A

> 6 mo in a row, requires further evaluation

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23
Q

Most common disorders among children & adults

A

Language, Learning, Intellectual

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24
Q

When to do screening for developmental-behavioral

A

9, 18 months, 2 & 2.5 y.o.

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25
Q

Red Flag

A

painful, unilateral solitary adenopathy >2cm in diamater, weight loss

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26
Q

When to get tonsillectomy

A

3-5 documented strep in one year or obstruction @ night

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27
Q

50% children have innocent murmur

A

should be grade 1 or 2, anything above not normal

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28
Q

Tanner Sexual Maturity

A

used for devel of secondary sex characteristics

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29
Q

Vision Screening test that start at 3 y.o.

A

Fundoscopic and Visual Acuity

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30
Q

preschooler less than 20/40

A

refer

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31
Q

6 yr or younger less than 20/30

A

refer

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32
Q

Hearing screening

A

infant by 1 mo

comprehensive by 3 mo if OAE are not passed

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33
Q

AABR test

A

Automated Auditory Brainstem Response

3 electrodes on baby’s head, measure how nerves respond to stimuli

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34
Q

OAE test

A

Otoacoustic Emissions

tiny probe in ear canal- measure sound waves in inner ear

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35
Q

Cholesterol & Lipids

A

screen recommended if BMI is >85th percentile or children @ high risk for hyperlipidemia

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36
Q

When to perform Formal Hearing Screening

A

4,5,6,8, 10 y.o.

unless children at risk for hearing loss, do again by age 2-2.5

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37
Q

Lead levels usually peak @

A

18-24 months

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38
Q

Hgb and Hct levels

A

9-12 mo

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39
Q

Estblsh dentist by age

A

2

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40
Q

SIDS

A

peak age 2-4.

90% cases happen before 6 month

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41
Q

Plagiocephaly

A

misshapen head

after 6 mo- send to cranail technicion

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42
Q

Colic

A 
starts 2-3 wks
ends ~12 wks
"Rules of 3":
3 hours
3 days/week
3 weeks

Treat cause and can try Ranitidine

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43
Q

Introduce potty chair

A

18 months

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44
Q

Daytime potty control achieved

A

2-4 yrs old

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45
Q

Nighttime potty control achieved

A

5-7 yrs old

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46
Q

When is a stutter concerning?

A

if it last more than 6 months

if it occurs w/tics or extreme self consciousness

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47
Q

Autism screening

example: M-CHAT

A

screen two diff times

18 and 24/30 months

48
Q

Main complaint with ASD

A

Language Delay

49
Q

Red flags indicating evaluation for ASD

A

12 mo: no babbling, pointing, or gestures
16 mo: no single words
24 mo: no 2 word phrases
any age: loss of skill once had

50
Q

2 Months

A 
Lift &amp; turn head
Track past midline
Primitive Reflexes present
Turns head towards sound
Alert to voices, follow objects w/eyes
Begin to SMILE responsively
51
Q

Most common time of SIDS occurence

A

2-4 months

sleep on BACK

52
Q

Diapers at 2 months

A

5-8 wet

3-4 stools

53
Q

4 Months

A

Hold head steady
Rolls stomach to back (1 way)
Laugh & squeal
Start tummy time

54
Q

6 Months

A 
Sit supported (unsupported @ 6-8 mo)
Reach for object --> bring to mouth
Roll over BOTH WAYS
Vowel &amp; consonant sounds
Respond to other's emotions
55
Q

Rice cereal

A

4-6 months

56
Q

Teething

A

6-9 months

57
Q

9 months

A 
Crawling (many versions)
Pull to stand, Cruising
"Mama" "Baba" "Dada" without meaning
Understands "no"
Peek-a-boo, object dominance
Stranger danger
58
Q

12 Months

A 
takes steps
stands alone 2 seconds
beings to walk alone
simple gestures
"Mama" "Dada" WITH meaning
copies gestures
59
Q

15 Months

A

walks well, stoops down to pick stuff up
5+ words
knows purpose of ordinary things & attempt to use (brush, spoon, phone)

60
Q

18 Months- Birm’s son

A 
run, kick ball
eats well with spoon, feeds self
over 6 words (5-20 word vocab)
knows importance of ordinary objects
Introduce Potty Chair!
61
Q

24 Months- 2 yrs old

A 
throw ball overhead
stand on tip toes
short phrases 
*repeats overheard words
Emphathy
Helps undress and put things away
complete familiar sentences &amp; rhymes
might start to establish Hand dominance (R or L)
62
Q

36 Months- 3 yrs old

A 
Stand on 1 foot
understandable 50% of time
speak in sentences
pretend play &amp; simple games
imagination
make believe
63
Q

3 yr old

A

stand on 1 foot
draw circle
3 word sentence

64
Q

4 yr old

A

Hop on 1 foot
draw square
Why? Why?

65
Q

5 yr old

A

Skips
draw triangle
respond to Why Qs

66
Q

6-12 yr old

A

5-7 word sentences
5 step commands by age 10
concentrate for 15 minutes
concentrate for 1 hour by age 9

67
Q

APGAR

A 
Activity
Pulse
Grimace (w/stimulation)
Appearance (skin color)
Respiration
68
Q

When to take APGAR

A

1 and 5 minutes
1: <4 score needs immediate resuscitation
7-10 is normal
5: 6 score high risk CNS/organ system dysfx- Intervention needed!!
>/ 7 score: proceed w further testing

Continue every 5 minutes until score is greater than or equal to 7 and you can then proceed

69
Q

Differentiation of 1 pt and 2 pt with respirations

A

<100 bpm or >100 bpm

70
Q

Neonate

A

1-28 days

71
Q

Infant

A

29 days-12 months

72
Q

What is considered premature

A

before 37 weeks

73
Q

Transitional period

A 
first 4-6 hours of life
every 30-60 min, take these measurements:
-Heart rate (120-160 is normal)
-Respirations (40-60 is normal)
-Temperature (97.5-99.5 is normal)
74
Q

Ballard Scoring System

A

pretty accurate way to estimate gestational age within 2 weeks
Measuring: Neuromuscular & Physical maturity

75
Q

Normal time for birth

A

37-42 weeks

76
Q

Normal birth weight

A

greater than or equal to 2500 g

77
Q

Birth weight

A 
<2500= low
<1500= very low
<1000= extremely low
78
Q

Hypothyroidism

A

Screened for in AZ

One of the most preventable causes of mental retardation

79
Q

Be concerned if baby doesn’t pass stool within 24 hours

A

concerned for Meconium Ileus- bowel obstruction

80
Q

Sweat Chloride Testing

A

most important diagnostic test for Cystic Fibrosis

should f/u with newborn screening

81
Q

Anterior Fontanelle

A

the LARGER one (4-6 cm)

closes b/w 4 and 26 months

82
Q

Posterior Fontanelle

A

smaller (1-2 cm)
closes @ 2 months
Larger hints at Hypothyroidism

83
Q

Rooting Reflex

A

sucking

Birth–> 3-4 months

84
Q

Moro/Startle Reflex

A

drop baby

Birth –> 5-6 months

85
Q

Palmar Grasp

A

Birth –> 4-6 months

86
Q

Plantar Grasp

A

Birth –> 6-8 months

87
Q

Asymmetric Tonic Reflex

A

Birth –> 2-3 months

88
Q

Positive Support Reflex

A

Birth/2 mo –> 6 months

89
Q

Small weight for gestational age

A

<10th percentile

90
Q

Normal weight for gestational age

A

10-90th percentile

91
Q

Large weight for gestational age

A

> 90th percentile

92
Q

Risk for sepsis

A 
mother temperature >100.4
membrane rupture >18 hours before delivery (water broke >18 hours before delivery)
delivery <37 wks (gestation)
Chorioamnionitis
Maternal group B strep colonization
93
Q

Chorioamnionitis

A

intra-amniotic infection- inflammation of fetal membranes d/t bacterial infection
usually from bacteria descending from vagina into uterus: often associated w/prolonged blabor

94
Q

Prophylactic Erythromycin Eye ointment 0.5%

A

Prevent gonococcal ophthalmia

95
Q

Wet diapers and stools by day 5

A

6-8 wet diapers/day

3-4 yellow, seedy stools per day

96
Q

D/c from hospital
Insurance covers:
up to 48 hrs for vaginal delivery
up to 96 hrs for C section

A

F/u visit:
If d/c before 48 hrs: come back within 48 hours!
If d/c after 48 hrs: come back within 3-5 days

97
Q

Vernix caseosa

A

thick, white, gooey substance covering skin of baby

98
Q

Milia

A

smooth, white, raised areas pinpoint papules
on nose and cheeks of baby
retention of keratin and sebaceous material
appears w/in first few weeks
disappears over several weeks

99
Q

neonatal acne

A

starts 2-3 wks

gone by 4-6 wks

100
Q

Miliaria Rubra

A

scattered vesicles on erythematous base
face, neck, and trunk
obstruction of sweat glands- “heat rash”
disappears spontaneously w/in weeks

101
Q

Erythema Toxicum

A

usually appears on 2-3 day ols
gone within 1st week

erythematous macules w/pinpoint vesicles –> progress to pustules

scattered diffusely

102
Q

Acrocyanosis

A

bluish coloration but only on hands and feet

103
Q

Central Cyanosis

A

** Associated w/congenital heart disease **

around the mouth and nose

104
Q

Pustular Melanosis

A 
more common in black infants
3 stages
superficial white pustules
unroof macules w/surrounding scale
hyperpigmented macules gradualy face
can last several months
105
Q

congenital hairy nevus

A

hairy mole

significant malignant potential

106
Q

Neonatal Jaundice

A

problem if BEFORE 24 hours or AFTER 2 weeks

“Non physiologic Jaundice”

107
Q

Worry with Jaundice

A 
Acute Bilirubin Encephalopathy ABE- reversible
Kernicterus- neurologic dysfx
Cerebral Palsy
Hearing loss
Gaze abnormalities
Dental enamel dysplasia
108
Q

Cephalohematoma

A

if you suction baby’s head too much at birth
does not cross suture line
Resolves on own within ~3 wks

109
Q

Choanal atresia

A

excessive growth of tissue in nares - unilateral or bilateral episodes of cyanosis

110
Q

Epstein’s Pearls

A

Benign!
in baby’s mouth
clustered at midpoint of junction b/w soft and hard palate

111
Q

Cryptorchidism

A

undescended testicles

most cases, testes will descend by 1 year

112
Q

Hydroceles in testes

A

check for swelling on exam

113
Q

Hypospadias

A

opening of urethra on ventral surface of penis

114
Q

Hypergrowth of hymen

A

closed vagina at birth

115
Q

Spina Bifida occulta

A

hair patches, deep pits, dimple, pigmented spots

116
Q

Hips

A

look for dysplasia of the hip
Galeazzi test- femoral shortening
Ortalani- test for presence of posteriorly dislocated hip
Barlow test- ability to sublux or dislocate an intact but unstable hip

Quarter 2 (16 decks)

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