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Clin Med Peds > Peds Growth and Development > Flashcards

Peds Growth and Development Flashcards

1
Q

what is more important than a child’s actual size?

A

the rate of growth of a child

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2
Q

what measurements of growth are the best indicators of general health in children?

A

serial measurements

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3
Q

what helps to identify children at risk in terms of growth and development? if any measurement is off the curve, what do you do?

A

failure to conform to expected patterns of growth

RECHECK

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4
Q

when do children get their well child checks?

A

(1) a 2 weeks and/or 1 month
(2) 2, 4, 6 month (shots)
(3) 9 months
(4) 12, 15 months (shots)
(5) 18 months
(6) 2 y/o (shots)
(7) annually after 2 y/o
(8) 4 y/o (shots)

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5
Q

is it easy to deflect a normal child from their own target growth curve?

A

NO!! - it’s very difficult!!

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6
Q

what should be measured at ALL office visits for children?

A

weight

height

head circumference (FOC - frontal-occipital circumference) for children < 2/yo

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7
Q

what is the best index of nutrition and growth for children?

A

weight

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8
Q

how much weight loss can you expect a child to lose during the first 3-4 days of life? why?

A

10% weight loss

b/c they poop out meconium (green poop) - can be dispelled inside the motor if baby is stressed

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9
Q

at what day of life should infants regain their birth weight?

A

day of life (DOL) 14

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10
Q

how should infants be weighed?

A

wearing only a dry diaper

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11
Q

how should older children be weighed?

A

without shoes and stuff in their pockets

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12
Q

at age 0-3 months, what should be their monthly weight gain (kg and lb)?

A

1 kg (2 lb)

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13
Q

at age 3-6 months, what should be their monthly weight gain (kg and lb)?

A

0.6 kg (1.25 lb)

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14
Q

at age 6-9 months, what should be their monthly weight gain (kg and lb)?

A

0.5 kg (1 lb)

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15
Q

at age 9-12 months, what should be their monthly weight gain (kg and oz)?

A

0.4 kg (12 oz)

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16
Q

at age 1-3 years, what should their monthly weight gain (kg and oz)?

A

0.25 kg (8 oz)

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17
Q

how should children’s height be measured?

A

without shoes

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18
Q

if a height measurement doesn’t plot appropriately, what should you do?

A

remeasure

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19
Q

what is a reliable indicator of brain growth up to 2 y/o?

A

head circumference (FOC)

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20
Q

head circumference (FOC) is a reliable indicator of what?

A

brain growth up to 2 y/o

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21
Q

at what age do most cranial sutures close by?

A

6 months of age

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22
Q

at what age does the anterior fontanel close by?

A

9-18 months of age

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23
Q

if an FOC doesn’t plot appropriately, then do what?

A

remeasure

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24
Q

if the skull doesn’t grow, what can happen to the brain?

A

the brain will herniate thru the foramen magnum (uncle herniation)

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25
Q

what is the purpose of the BMI for children?

A

to provide a measure/predictor for obesity and its associated health risks

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26
Q

what BMI is a significant risk factor for obesity?

A

> 95%

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27
Q

what are the 5 important routine screening tests for children?

A

(1) Lead
(2) Iron Deficiency
(3) Cholesterol
(4) Tb
(5) STD

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28
Q

when do you do the routine screening tests?

A

during a well child check

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29
Q

at what ages is the Lead screening test required?

A

at 9 and 12 months, and again at ages 2 and 3

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30
Q

at what ages is the Iron Deficiency screening test required?

A

Hgb or Act at 12 months and again at 2, 3, 4, 5 and 6 y/o

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31
Q

what is the best formula for iron deficiency children?

A

breast milk (if possible)

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32
Q

what can be an early sign of lead poisoning in children?

A

iron deficiency

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33
Q

development definition

A

the acquisition of skills or “milestones” considered appropriate for a given age, based on population standards

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34
Q

at what age do children start to change from concrete thinking to abstract thinking?

A

15 y/o

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35
Q

what is the importance of developmental screening?

A

(1) identify delays and their etiologies
(2) maximize potential of a child with appropriate interventions when available (MOST IMPORTANT)
(3) provide support and reassurance to the family

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36
Q

what are the 4 part of development?

A

(1) Gross motor
(2) Fine motor
(3) Language
(4) Social

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37
Q

good screens make a correction decision how often?

A

70% of the time

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38
Q

when do children have their greatest progress of gross motor and fine motor skills?

A

during the first 3 years of life

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39
Q

at what age do children have rapid acquisition of gross and fine motor skills?

A

first year

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40
Q

what early gross motor milestone occurs at 4-10 months of age?

A

rolls back to stomach

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41
Q

what early gross motor milestone occurs at 6-9 months?

A

sits steadily

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42
Q

what early gross motor milestone occurs at 7-12 months?

A

pulls to standing

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43
Q

what early gross motor milestone occurs at 9-16 months?

A

stands alone

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44
Q

what complex gross motor skill occurs at 13 months?

A

walks well

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45
Q

what complex gross motor skill occurs at 15 months?

A

stoops and recovers

46
Q

what complex gross motor skill occurs at 2 years?

A

kicks ball forward

47
Q

what complex gross motor skill occurs at 3 years?

A

throws ball overhand

48
Q

what complex motor skill occurs at 4 years?

A

balances on 1 foot, 2 sec, hops

49
Q

what complex motor skill occurs at 5 years?

A

catches a ball

50
Q

what fine motor skill occurs at 5-7 months?

A

rake

51
Q

what fine motor skill occurs at 8-10 months?

A

radial-digital grasp b/w thumb and side of index finger (lobster claw)

52
Q

what fine motor skill occurs at 10-12 months?

A

perfection of pincer grasp b/w fingertips of fingernails of thumb and index finger

53
Q

what is a sign of Gowers Musc. Dystrophy?

A

walks hands up on legs after stooping

54
Q

what fine motor task occurs at 15 months?

A

scribbles

55
Q

what fine motor task occurs at 24 months?

A

imitates vertical or circular strokes, tower of 6 cubes

56
Q

what are the 2 universal screening tests for hearing?

A

Auditory Brainstem Response (ABR)

Otoacoustic Emissions (OAE)

57
Q

what is the Auditory Brainstem Response (ABR)?

A

Hearing screening test

used in newborns and infants

sounds are played to the baby’s ears and test measures the brain responding to sounds

58
Q

what is the Otoacoustic Emissions (OAE)?

A

Hearing screening test

used in newborns and infants to assess cochlear fracture

sounds are played into the ear and cochlear response is measured
-if baby hears normally, an echo is reflected back to the microphone

59
Q

at 0-3 months, what is the assessment of hearing?

A

does your baby startle to loud noises?

60
Q

at 4-6 months, what is the assessment of hearing?

A

does your baby turn his eye or head at the sound of your voice?

61
Q

at 7-9 months, what is the assessment of hearing?

A

does baby make string of sounds like “ba ba ba, da, da, da”?

62
Q

what is the #1 cause of speech delay in children/

A

hearing loss

63
Q

when should a child be referred for a professional speech and/or language assessment? (5 criteria)

A

(1) not talking by 2 y/o
(2) unintelligible speech by 3 y/o
(3) no sentences by 3 y/o
(4) child is embarrassed by his/her speech at any age
(5) other known d/o is present like hearing loss, mental retardation, autism, dysarthria, stuttering

64
Q

at what age is stuttering normal?

A

b/w 2 1/2 - 4 y/o

65
Q

what is the most important finding on assessment of vision for an infant?

A

presence of red reflex

66
Q

what’s an indication of retinoblastoma?

A

white reflex on fundoscopic exam

67
Q

what exams are involved in assessment of vision for children?

A

red reflex (infants)

corneal light reflex

cover/uncover test

68
Q

what does the corneal light reflex assess for?

A

to help assess for misalignment

69
Q

what does the cover/uncover test, assess for?

A

tests tracking in younger children and checks for strabismus

70
Q

how can you fix a lazy eye if caught early?

A

with patching - patch non-lazy eye

71
Q

what does a full-term newborn focus on and track in terms of vision?

A

focuses one ace and briefly tracks objects

72
Q

at 2 months, what is the vision assessment like?

A

tracks across midline, responsive smile, follows movement 6 feet away

73
Q

at 4-5 months, what is the vision assessment like?

A

reaches for object 12 inches away, notices raisin 1 foot away, familiar smile

74
Q

what is the personal-social skill at 2 months?

A

social smile

75
Q

what is the personal-social skill at 6 months?

A

reaches for objects

76
Q

what is the personal-social skill at 9 months?

A

feeds self, passes object hand to hand

77
Q

what is the personal-social skill at 12 months?

A

plays appropriately with toy

78
Q

what is the personal-social skill at 18 months?

A

drinks from cup (without spilling)

79
Q

what is the personal-social skill at 2 years?

A

uses spoon

80
Q

what is the personal-social skill at 4 years?

A

puts on T-shirt

81
Q

what is the ONE VOICE mnemonic?

A

mnemonic device on communicating with children

82
Q

what does O stand for in ONE VOICE?

A

one voice should be heard during procedure

83
Q

what does N stand for in ONE VOICE?

A

need parental involvement

84
Q

what does E stand for in ONE VOICE?

A

educate patient before the procedure about what is going to happen

85
Q

what does V stand for in ONE VOICE?

A

validate child with words

86
Q

what does the second O stand for in ONE VOICE?

A

offer the most comfortable, non-threatening position

87
Q

what does the I stand for in ONE VOICE?

A

individualize your game plan

88
Q

what does the C stand for in ONE VOICE?

A

choose appropriate distraction to be used

89
Q

what does the second E stand for in ONE VOICE?

A

eliminate unnecessary people not actively involved with the procedure

90
Q

what is it important to account for in a premature infant when assessing their growth and development?

A

their degree of prematurity

91
Q

a premature infant may only have what skills?

A

those skills appropriate to his/her adjusted gestational age

92
Q

infants that have a complicated neonatal course (like ventilator support, infection), may have more ___

A

delays as a result

93
Q

what’s the age of an early adolescence?

A

10-13 y/o

94
Q

what changes are seen in early adolescence?

A
  • rapid physical change
  • concerned if different than peers
  • concerte thinking (vague, unrealistic goals)
95
Q

what’s the age of a middle adolescence?

A

14-16 y/o

96
Q

what changes are seen in middle adolescence?

A
  • more comfortable with bodies (or NOT!) - see eating d/o’s at this age
  • concerte thinking changes to abstract thinking
  • sense of omnipotence (sex, drugs, and rock-n-roll)
97
Q

at what age do you want to talk to adolescence w/out parents in the room? what if parents won’t leave the room?

A

14-16 y/o (middle adolescence)

-if parents won’t leave room, then that’s a red flag

98
Q

wha’s the age of a late adolescence?

A

17 years and older

99
Q

what changes are seen in late adolescence?

A
  • less self-centered

- realistic future plans

100
Q

what are the 3 leading causes of death in adolescence?

A

(1) unintentional (accidents) - #1 cause of death at this age (no seat belts, helmets)
(2) suicide
(3) homicide

101
Q

what are the 4 suicide triage questions?

A

(1) in the past few weeks, have you wished you were dead?
(2) in the past few weeks, have you felt that you or your family would be better off if you were dead?
(3) in the past week, have you been having thoughts about killing yourself?
(4) have you ever tried to kill yourself?

102
Q

what should occur if teen answers YES to 2 of the 4 suicide triage questions?

A

section 12 -> commit them/consult

103
Q

if teen is at risk for suicide, what can you do?

A
  • follow-up
  • formal counseling
  • family and/or community partnership
  • section 12/OPC hospital admission
104
Q

what are adolescents smoking now, cigarettes or e-cigs?

A

e-cigs

105
Q

what are the Preventive Service Guidelines for adolescents?

A

(1) Deter behaviors that jeopardize health
(2) Detect physical, emotional, and behavioral problems early
(3) Discourage unhealthy behaviors

106
Q

what are the 3 mandatory reporting?

A

(1) self-imposed danger
(2) danger to others
(3) abuse victim

107
Q

what is the Mass mature minor rule?

A

minors can consent to medical tx (except for abortion) if the doctor believes the minor can give informed consent to the tx and it is in the minor’s best interest not to notify their parents

108
Q

what is the tanner staging? how many stages?

A

breast development, pubic hair development, and genitalia development

5 stages

109
Q

what stage of tanner staging is breast budding?

A

stage 2

110
Q

at what stage of tanner staging do areola and papilla form secondary mound?

A

stage 4

111
Q

at what stage of tanner staging do mature female breasts form?

A

stage 5

112
Q

at first sign of breast buds, when does menarche develop?

A

usually comes w/in a year

Clin Med Peds (10 decks)

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