Peds- Growth & Devo I- Dr. Magie

Question 1

when is routinely the first office visit after a newborn is released from the hospital?

Answer 1

48 to 72 hours

Question 2

what kind of patient should you treat first-time moms or first-time breast feeding mothers like?

Answer 2

“high risk” patient

the mom’s inexperience is a high risk to the infant.

Question 3

what important specifics should be evaluated and recorded on the first office visit?

Answer 3

1. mom’s appearance
2. the infant’s appearance
3. vital signs- Length, weight, head circumference, temperature

Question 4

is the weight of a 5-7 day old important?

Answer 4

it is truly important!! make sure the baby hasn’t lost more than 10% of its weight and that breastfeeding is giving infant proper feeding. (starting to regain its weight)

Question 5

what should you always always always check for on physical exam? HEENT portion

Answer 5

Red Reflex

screening for retinoblastoma

Question 6

what are the things you are checking in the thorax portion of the physical exam?

Answer 6

symmetrical motion with respirations
respiratory pattern
heart rate, PMI (left lower sternal border), rhythm, murmur

Question 7

what should you always check about 3 months using the Ortloni/ Barlow maneuvers?

Answer 7

HIPS

Question 8

questions to ask parents at first office visit?

Answer 8

Sleep pattern of infant
feeds/day, stool production
ask mom is she has concerns
was Hep B vaccine given in hospital to infant

Question 9

what is the best sleep position for infant at this age?

Answer 9

Back is best

Question 10

at one month visit: what should you warn the mother against?

Answer 10

propping up the bottle and feeding the baby in prone position- leads to aspiration!!

Question 11

what feeding concerns should be addressed at one month visit?

Answer 11

baby on Vit. D supplement if breastfed

feeding remains very frequent

Question 12

what are some signs of illness in the infant?

Answer 12

poor feeding
fever (rectal is “gold” standard)
forceful vomiting

Question 13

he said that the baby should be what upon one month visit? and if they aren’t this overall then its concerning to him.

Answer 13

At peace

a very unhappy baby upon visit to office is not a good start to exam

Question 14

what is it good to remind/ advise the parents about?

Answer 14

car seat use

avoid smoking, strong perfumes around baby

Question 15

what stool pattern is seen at two month visit?

Answer 15

stools-highly variable but one every 1-3 days or so should be occuring

Question 16

what major development milestone is at 2 months visit?

Answer 16

baby is lifting head and chest while prone. (like superman while on stomach)

Question 17

at 2 months, what part of the thorax physical exam should be coming apparent by this time?

Answer 17

congenital murmurs. listen closely

Question 18

general precautions at 2 months:

Answer 18

avoid smoke/fumes
car seat use
sun exposure- protective clothing
immunizations

Question 19

what can be introduced into babies diet at four month visit?

Answer 19

Solids.  in this order 
WHOLE GRAIN CEREL (OATMEAL) 
veggies
fruits 
meats

Question 20

development at 4 months, the baby rolls front to back or back to front?

Answer 20

F–> B (front to back)

Question 21

at what age should you pat particular attention to muscle tone and range of motion?

Answer 21

4 months. can start doing stretches 2-4 times/day

Question 22

what age will you begin to see signs of cerebral palsy?

Answer 22

4 months

Question 23

what test is done at 4 month visit to test infants gaze

Answer 23

Cover Test

Question 24

what should you warn the parents of at 4 months?

Answer 24

the infant is “mobile and dangerous”!!!

Question 25

what is a new onset finding at 6 month visit? Grandmas use this as an excuse for many symptoms. Oh they are just ________

Answer 25

Teething.

most eruption of teeth between 5 and 10 months

Question 26

what key developments are seen at 6 months?

Answer 26

baby anticipants spoonfuls (opens mouth, grunts, etc.)
Baby anticipates being picked up
may tolerate strangers but starting to define its own space

Question 27

due to increased mobility and that everything goes in the mouth what first infection is usually seen at 6 months?

Answer 27

first Upper respiratory infection.

Question 28

how long should breastfeeding and/or feeding w/ formula continue until?

Answer 28

One year of age

Question 29

what are the stages of foods available at nine month age?

Answer 29

stage one- fine puree and small jars
stage two- larger jars, still finely pureed
stage three- larger chuncks, often mixed, more have fillers, aimed at parental “tastes”

Question 30

what is the standard testing of development?

Answer 30

Denver II

Question 31

what are the four components that the Denver II test is checking?

Answer 31

1. personal/social development
2. language
3. fine motor
4. gross motor

Question 32

what postural development is seen at 9 months?

Answer 32

baby goes from sitting to prone w/o assistance

Question 33

warn parents that baby gets more dangerous the older they get. start getting curious and can get into anything. kitchen, bathroom

Answer 33

so many dangers

Question 34

at what age does the AAP recommend that weaning begin from the bottle/breast?

Answer 34

12 months

Question 35

how much sleep does a 12 month old still need?

Answer 35

12 to 14 hrs /day

Question 36

what mobility development wise is the infant displaying at 12 months?

Answer 36

moves rapidly, crawls, walks

Question 37

look for social interaction at 12 months

Answer 37

eye to eye contact
does child play with self or others?
does child like being hugged/ touched?
this is checking for signs of autism

Question 38

There is no substitute for watchful, interested adult supervision!!

Answer 38

Bad parents are everywhere

Question 39

what is the recommened educational toy to play with?

Answer 39

balls and blocks

Question 40

what age does the infant begin to imitate parents/caretakers?

Answer 40

15-18 months