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Clinical Assessment III- Bates Flashcards > Peds Lecture > Flashcards

Peds Lecture Flashcards

1
Q

What do you see with fetal alcohol syndrome?

A 
indistinct philtrum
 micrognathia (smaller chin)
 low nasal bridge
 prominent epicanthal folds
thin upper lip
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2
Q

about when can you get a reliable history form a child?

A

Around 8 years old

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3
Q

What do you need to screen breech babies for?

A

Hip dysplasia

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4
Q

What age is considered neonate?

A

first month of life

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5
Q

What is the early childhood age range?

A

1-4 years

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6
Q

What is the middle childhood age range?

A

5-10 years

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7
Q

What is the adolescent years?

A

11-20 years

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8
Q

About when should children string 2 words together?

A

18 months

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9
Q

When is BMI helpful?

A

Over 2 years of age

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10
Q

When do you start blood pressures in a child?

A

2 years of age

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11
Q

What are the most common causes of HTN in children?

A

Renal artery stenosis

coarctation of the aorta

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12
Q

What would be a sign of coarctation of the aorta?

A

High BP in the upper extremities than lower extremities

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13
Q

What is the most reliable of temperature?

A

Rectal, but usually do tympanic in clinic

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14
Q

What is the cut off for fever in children?

A

100.4 degrees

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15
Q

What normally causes bradycardia in children?

A

neurological condition, heart block, hypoxia, anaphylaxis

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16
Q

Are respiratory rates higher or lower in children?

A

Higher

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17
Q

What does a slow respiratory rate indicate in children?

A

Respiratory failure (impending doom sign)

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18
Q

What is the primary way babies eliminate bilirubin?

A

Feces

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19
Q

Do formula fed or breast fed babies tend to stay jaundice for longer?

A

breast fed (takes longer to be absorbed)

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20
Q

Where is central cyanosis?

A

Lips, chest

Sign of pulmonary complications, sepsis

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21
Q

What is acrocyanosis?

A

On extremities, armpits, neck

More of an issue of temperature regulation

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22
Q

What is direct bilirubin?

A

Normal bilirubin

Being conjugated, but reabsorbed

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23
Q

If you see indirect bilirubin elevation what does it mean?

A

There is a back up , hasn’t been conjugated by liver yet
lysis of RBCs
sign of biliary atresia or acute liver failure

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24
Q

Condition with lots of port wine stains, retardation, trigeminal nerve problems.

A

Sturge- Weber syndrome

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25
Q

What is an uncommon congenital telangiectasias usueally over limbs, can be associated with congenital malformations including glaucoma, syndactyly, renal hypoplasia

A

Cutis marmorata

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26
Q

Common rash in newborns. Over bridge of nose and cheeks. White pink point dots, look shiny. Resolve when pores are largers.

A

Milia; if inflamed (milia rubra)

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27
Q

What is fluffy hair on a fetus than can still be there in infancy. Usually on shoulders/ back

A

Lanugo

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28
Q

What are red swollen bumps on a babies’ face usually due to blocakges on pores. Go away within 2/3 months of life.

A

Erythemia toxicum

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29
Q

What is abnormal shape of head, usually enlarged. Often caused by craniosynostosis?

A

Plagiocephaly

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30
Q

What does a white reflex of the eyes indicate?

A

Detached retina

congenital illness

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31
Q

When do you start with visual acuity exam?

A

Age 3

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32
Q

Babies are obligate ____ breathers.

A

Nose

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33
Q

What is an obstruction of nasal passages- the baby is blue at rest but pinks up when crying.

A

Choanal atresia

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34
Q

What sinuses are present at birth?

A

Ethmoid

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35
Q

What is a white dot on the middle of the palate?

A

Epstein’s pearls

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36
Q

what are the best pulses for infants?

A

Brachial

femoral

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37
Q

Is S3 or S4 normal?

A

S3 is normal

S4 is also abnormal

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38
Q

What is a Stills murmur?

A

LL sternal border
musical sound
holosystolic
normal up to 2-5 yeras

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39
Q

humming noise from jugular vein. Best heard around clavicular area and at juggular

A

Venous Hum

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40
Q

What should the umbilical cord be made of?

A

2 arteries

1 vein

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40
Q

what is the term for knock knees?

A

genu valgum

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40
Q

hard mass in left upper quadrant. Feels like and olive pit. Will have acute vomiting of green substance

A

Pyloric stenosis

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40
Q

Which hernia is normal in infancy: inguinal or umbilical?

A

Umbilical

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40
Q

What is the first sign of puberty in males?

A

Increase in size of test (age 9-13.5)

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40
Q

What is the test where you bend a child’s knees and push straight down into table? (for hip dysplasia)

A

Barlow

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41
Q

What test is where you externally rotate the infants legs to test for hip dysplasia?

A

Ortolani test

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42
Q

what is the term for bow legged?

A

genu varum

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43
Q

What is an internal rotation and inversion at the ankle? unable to bring back towards normal.

A

Club feet

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44
Q

what is a test for weak hip abductors?

A

Trendelenburg-shift (sag to opposite side)

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45
Q

What tests for suspicion of Duchene’s muscular dystrophy?

A

Will do a reverse crab walk in order to get up

can’t go from lying down to standing using just leg muscles

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46
Q

What is the name for the startle reflex? When does it occur/ disappear?

A

Moro reflex

0-4 months/ 6 months

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47
Q

What is the asym tonic neck?

A

When you turn their head, they will turn their heads and feet towards that side.
Present at 0-2 months

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53
Q

hyperreflexia in the lower extremities can be significant for what?

A

muscular dystrophy

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54
Q

What are the main focuses for the 1st week visit in the newborn?

A

Mother’s/Parent’s appearance/interactions or evidence of depression: Newborn jaundice, weight, stool/urine pattern, murmurs, red reflex, hips

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55
Q

What should bath water temp be?

A

120F

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56
Q

Any fever within __________of life is a sign of serious infection.

A

2-3 months

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57
Q

What are pink “bloody” diapers?

A

urate crystals

58
Q

_____ of milestones is always concerning.

A

Loss of

59
Q

What is different for PMH in newborn versus adult?

A

PMH may include birth history and complications

60
Q

When do you screen for hip dysplasia?

A

2-3 months

61
Q

What is enuresis?

A

inability to control urination

62
Q

What does HEEADSS stand for?

A 
Home
Environment
Education
Activities
Drugs
Sexuality
Suicide/depression
63
Q

How is the order of exam different for infants and toddlers versus adults?

A

start with least intimidating to most intimidating (usually start w/ reap/heart and then throat/genitals last)

64
Q

What age can you examine a child without the parent present?

A

> 11 years

65
Q

What does APGAR stand for?

A 
Activity
Pulse
Grimace
Appearance
Respirations
66
Q

If APGAR is between 5-7 at 1 minute it means

A

moderately depressed (some nervous system depression)

67
Q

If APGAR if between 0-4 at 1 minute means

A

Severely depressed (immediate resuscitation)

68
Q

APGAR that is excellent condition at 1 minute has what points?

A

8-10

69
Q

If the 5 minute APGAR score is between 0-7, what is the risk

A

risk for subsequent CNS, other organ system dysfunction

70
Q

What three components help determine GA?

A

weight, lenght, head circumferance

71
Q

Where do you measure head circumference 0-2 years?

A

frontal occipital circumferance or OFC

72
Q

A weight loss of more than _______% in 1st month of life is concerning for failure to thrive

A

10%

73
Q

Why don’t you do a BMI for <2years?

A

most body mass is fat

74
Q

What is failure to thrive related to?

A 
Chronic disease
Congenital disorder
Inadequate calories and protein
Improper feeding methods
Intrauterine growth restriction
Emotional deprivation
75
Q

What is the most common cause of HTN for middle school age?

A

renal artery or renal disease
Coarctation of the aorta
primary HTN

76
Q

What it the most common cause of HTN for infancy-preschool?

A

renal artery or renal disease

Coarctation of the aorta

77
Q

What is the most comon cause of HTN in adolescents?

A

primary HTN
renal disease
drug induced

78
Q

Where should you take temp?

A

tympanic or rectal

79
Q

A fever > _______ in first 3 months of life is a sign of serious infection.

A

> 100.4F

80
Q

How do children affect cardiac output?

A

through rate only (not stroke volume)

81
Q

What is central cyanosis?

A

lips and truncal cyanosis; bad (heart disease/malformation, pulmonary complications, sepsis)

82
Q

What is acrocyanosis?

A

extremities, folds of body, temperature related usually

83
Q

How is bilirubin eliminated as baby? Why?

A

poop/urine; liver is still maturing

84
Q

What can happen if bilirubin persists beyond the 1st weeks of life or have elevated/conjugated bilirubin?

A

can deposit in brain and cause seizure disorders or mental retardation

85
Q

What resembles a bruise, is found in darker skinned populations and goes away within 4-5 years of life?

A

mongolian spot

86
Q

What are multiple Cafe au Lait a sign of?

A

Neurofibrometosis

87
Q

What is an uncommon telangiectasis usually over the limbs that can be associated with congenital malformations (glaucoma, syndactyly, renal hypoplasia)

A

Cutis marmorata

88
Q

What are Milia and where are they found?

A

white pinpoint dots (hair follicle has pouched out and formed cysts); bridge of nose and cheeks

89
Q

What is an inflamed milia called?

A

milia rubra

90
Q

What is fluffy black hair on shoulder and back that goes away?

A

Lanugo

91
Q

What is plagiocephaly?

A

abnormal shape of head; usually enlarged; often caused by craniosynostosis

92
Q

What is craniosynostosis?

A

abnormal closure of sutures

93
Q

Presence of lymph nodes is more commonly associated with this pathogen

A

virus

94
Q

What is torticollis?

A

bleeding into SCM muscle during the stretching process of birth; a firm fibrous mass is felt within the muscles 2-3 weeks after birth and disappears over months

95
Q

What nodes react most quickly to mild stimuli?

A

cervical and postauricular

96
Q

What is the white reflex?

A
  • congenital cataracts or congenital glaucoma, dethatched retina, rubella or varicella
  • Always a bad thing to see this
97
Q

What age do you begin to use charts for visual acuity?

A

> 3 years

98
Q

What is most common visual disorder in children?

A

myopia (nearsightedness)

99
Q

What is the reflex called when child blinks at sudden sharp sound?

A

acoustic blink refle

100
Q

____ and _____ development are usually at the same time

A

eye and kidney

101
Q

A formal hearing exam is recommended by AAP at ____ years

A

4

102
Q

What is an obstruction of nasal passages associated with a baby blue at rest but pinks up when crying? Has difficulty nursing

A

Choanal atresia

103
Q

Tiny white or yellow rounded mucous retention cysts that are found on the hard palate and go away in 6 months

A

Epstein’s pearls

104
Q

Tonsillar hypertrophy is a sign of what

A

sleep apnea

105
Q

What can wheezing be a sign of in infants and young children?

A

RSV, asthma

106
Q

What 2 pulses do you take?

A

brachial

femoral

107
Q

Are thrills normal?

A

can be normal from turbulence in the heart or great vessels

108
Q

Why is S3 often normal in children?

A

can be normal due to rapid ventricular filling

109
Q

What problems are associated with S4/gallop in children?

A

CHF, poor ventricular function

110
Q

What are pathologic murmurs in children?

A

VSD, PDA, Pulmonary/aortic stenosis, AV regurgitation at birth, Aortic stenosis, aortic septal defect

111
Q

What are benign murmurs of later preschool?

A

carotid bruit

112
Q

What are benign murmurs of adolescence?

A

pulmonary flow murmur

113
Q

What are benign murmurs of preschool =?

A

still’s, venous hum

114
Q

What are benign murmurs of infancy?

A

closing ductus, peripheral pulmonary flow

115
Q

What is different about the sound with percussion for children than adults?

A

more tympanic

116
Q

How far below costal margin is liver edge normally?

A

1-2 cm

117
Q

What is the first sign of puberty in girls and what is it in males?

A 
Girls= growth spurt
Males= growth of testes
118
Q

When do you begin breast exams?

A

older adolescence

119
Q

What does candida look like for diaper rash?

A

big red plaques, satellite lesions, painful, after illness or antibiotic use

120
Q

What hernia is normal in infancy?

A

umbilical hernia

121
Q

How long does maturity (puberty) take?

A

1.8 - 5 years

122
Q

When do boys testes increase in size?

A

9-13.5 years

123
Q

When does the growth spurt in girls happen?

A

9.5-14.5 years

124
Q

Explain Ortolani test

A

Flex legs to form right angles at hips and knee

Abduct both hips simultaneously until both knees hit examining table

125
Q

Explain Barlow test

A

Pull leg forward and adduct with posterior force (push hips towards table)

126
Q

What does a positive Barlow mean?

A

dysplastic hip

127
Q

What is the real name for bowlegged?

A

Genu varum

128
Q

When is Genu varum abnormal and what is it a sign for?

A

Always abnormal 5+

Common in babies learning to walk; sign of Rickets

129
Q

What is the real name for knockknee

A

Genu valgum

130
Q

What should Genu valgum go away?

A

4-5 years

131
Q

What foot problem is most common?

A

clubfoot

132
Q

What is characteristic about clubfoot?

A

inversion and medial rotation not correctible by manual manipulation

133
Q

What is Trendelenberg shift?

A

A pelvis that remains level when weight is borne on the unaffected side; positive sign is when the pelvis tilts toward the unaffected hip during weight bearing on affected side

134
Q

What does Gower maneuver test for?

A

Duchenne’s musculodystrophy

135
Q

What is the Gower maneuver?

A

Will rise to standing by rolling and pushing off the floor with arms while legs remain extended

136
Q

What is Moro reflex (startle reflex)

A

Hold baby supine and abruptly lower body about 2 feet; arms abduct and extend, hands open, legs flex —> birth to 4-6 months

137
Q

What is asymmetric tonic neck reflex?

A

Baby is supine turn head to one side, holding the jaw over shoulder; the arms/legs on side to which head is turned will extend while the opposite arm/leg flex —> 0-2 months

138
Q

What is it when you support the baby prone with on hand and stroke one side of the back and the spine curves toward the stimulated side

A

Trunk Incurvation (Galant’s reflex) —> 0-2 months

139
Q

What is when you hold the baby upright and have one foot touch the table. The hip and knee of that foot will flex and the other foot will step forward; alternate stepping will occur?

A

Placing and Stepping Reflex (0-? months)

140
Q

What is when you suspend the baby prone with one hand and the head will lift up and the spine will straighten?

A

Landau 0-6 months

141
Q

What is when you suspend the baby prone and slowly lower the head toward a surface. The arms and legs extend in protective fashion?

A

Parachute Reflex 0-6 months

Clinical Assessment III- Bates Flashcards (14 decks)

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