Peds Test 2 Flashcards
When does a child’s brain reach 2/3 of its final size?
Age 2-3
Weight change in the first year of life
Birth weight triples
At what age should the weight be at or above the birth weight?
2 weeks
What should the weight be at 2 weeks?
At or above birth weight
At what age does a child regard faces?
2 weeks
Age of rolling from stomach to back
4 months
Age when laughter begins
4 months
Age when head is lifted 90’ without lag
4 months
Age what child babbles or makes “raspberry” sound
4 months
Age when child sits with support
4 months
When should you introduce solids for formula-fed babies?
4 months
When should you check for strabismus?
4 months
Age of reaching/scooping up cheerios using thumb
6 months
Age at which child sits momentarily
6 months
Age child imitates “bye-bye”
6 months
Age when child transfers objects
6 months
Age when child rolls from back to stomach
6 months
Age when AAP recommends floride supplementation
6 months
Age at which you should screen for anemia?
6 months
Age when child stands
12 months
Age when child cruises/begins walking
12 months
Age when child develops a good pincer grasp
12 months
Age when child uses 2-3 words and points to desired things
12 months
Age when child should get table food and milk
12 months
Age when you should screen for lead and anemia
12 months
Age when child should hop on one foot
4 years
Age when child should throw a ball
4 years
Age when child should cut with scissors
4 years
Age when child should copy a circle or cross
4 years
Age when child should count and recognize colors
4 years
Age when child should understand the word “stranger”
4 years
Age when child should dress themselves (except shoes)
4 years
Age when child should self-care at the toilet
4 years
Good to excellent APGAR score
7 - 10
Fair APGAR score
4-6
Poor APGAR score
< 4
APGAR score of < 4
Poor
APGAR score of 4-6
Fair
APGAR score of 7-10
Good-excellent
Normal respiratory rate of a newborn
30-60
Normal HR of a newborn
100-160
Normal BP of a newborn
60/35
Normal temperature of a newborn
99.1
What should you think if you have abdominal distention in a newborn?
Celiac Disease
How does celiac disease usually present under age 2?
- Failure to thrive
- malabsorption
- bloating
- foul, explosive stools
- vomiting
What should you think if you observe an olive-shaped mass to the right of the midline?
Pyloric stenosis
How might pyloric stenosis present?
- With an olive-shaped mass to the right of the midline
- Projectile vomiting
- Sometimes can see visual peristalsis after feeding
What causes pyloric stenosis?
-Hypertrophy of muscles of the pylorus with elongation and thickening leading to obstruction
Evidence of hip dislocation/dysplasia in children > 1 year
-Galeazzi sign
In what age group is knock-knee normal?
2-8 years
In what age group are flat feet normal?
-Infants and toddlers
In what age group is in-toeing common?
Until age 8
Reflex involving the turning of the infant’s mouth toward the stimulus when the cheek is stroked
Rooting
Reflex involving the curling of fingers around an object placed within them, without spontaneously letting go
Palmar grasp-curling
Reflex involving rapid abduction and extension of arms followed by an embracing motion
Moro (startle)
Reflex involving the turning of the infant’s head to one side, leading to extension of the extremities on that side and flexion on the contralateral side
Asymmetric tonic neck
When does rooting disappear?
3-4 months
When does palmar grasp disappear?
3-4 months
When does the Moro (startle) reflex disappear?
4-6 months
When does the asymmetric tonic neck reflex disappear?
4-6 months
When does placing-stepping disappear?
3-4 months
Which reflexes disappear at 3-4 months?
- Rooting
- Palmar grasp
- Place-stepping
Which reflexes disappear at 4-6 months?
- Moro (startle)
- Asymmetric tonic neck
Where is the needle for a lumbar puncture inserted?
Between the 3rd and 4th vertebrae
Describe the cellular, glucose, protein, gram stain, and culture findings for bacterial meningitis
- Cells: 1,000-50,000
- Type: neutrophils
- Glucose: low
- Protein: high
- Gram stain: +/-
- Culture: (+)
Describe the cellular, glucose, protein, gram stain, and culture findings for Viral meningitis
- Cells: < 1000
- Type: lymphocytes
- Glucose: normal
- Protein: normal-high
- Gram stain: (-)
- Culture: (-)
Describe the cellular, glucose, protein, gram stain, and culture findings for TB meningitis
- Cells: <500
- Type: lymphocytes
- Glucose: low
- Protein: high
- Gram stain: (-)
- Culture: (-)
- Cells: <500
- Type: lymphocytes
- Glucose: low
- Protein: high
- Gram stain: (-)
- Culture: (-)
TB meningitis
- Cells: < 1000
- Type: lymphocytes
- Glucose: normal
- Protein: normal-high
- Gram stain: (-)
- Culture: (-)
Viral meningitis
- Cells: 1,000-50,000
- Type: neutrophils
- Glucose: low
- Protein: high
- Gram stain: +/-
- Culture: (+)
Bacterial meningitis
Major problem of the early phase of asthma
Bronchospasm
Major problem of the late phase of asthma
Inflammation
Which phase of asthma is worse?
Late
Cystic fibrosis is due to a mutation on what chromosome?
7
Median survival of CF patients
35 years
Pathology involving:
- Abnormal chloride transport
- Lack of normal exocrine pancreatic digestive enzymes
- Mucoid obstruction of the airways
Cystic fibrosis
Common etiology of pneumonia in older children and adolescents
- Mycoplasma pneumonia
- Chlamydia
- Viral: influenza and measles
- Bacterial: pneumococcus, S. aureus
What should you think if you see:
- Webbed neck
- Swelling of the hands and feet
- Infertility
Turner’s syndrome
What should you think if you hospitalize a FTT infant and find that the infant feeds fine and gains weight?
The diet at home is lacking
What should you think if you hospitalize a FTT infant and find that the infant feeds fine, but doesn’t gain weight?
Malabsorption problems
What can you give infants for prophylaxis against neonatal conjunctivitis (ophthalmia neonatrorum)?
Erythromycin ointment
How can you treat N. gonorrhea conjunctivitis?
Single does of Ceftriaxone
Major cause of blindness world-wide
Chlamydia trachomatis
When does chlamydia conjunctivitis appear in infants?
5 days to several weeks
What’s the big way to prevent anterior epistaxis?
Discourage nose-picking!!!
What’s an appropriate way to treat a vomiting child?
- Ice chips
- Very small sips of ice water
- Ice pops from pedialyte
Congenital condition involving improper nerve impulses to the muscles of the bowel, resulting in large intestinal blockage
Hirschsprung’s
Hirschsprungs treatment
Surgery
When does Hirschsprungs commonly “start”?
Early infancy
Describe the stool of Hirschsprungs disease
Small, ribbon-like
How does a child with Hirschsprungs appear?
Chronically ill
Is FTT common or rare in Hirschsprungs disease?
Common
Describe the anal tone of Hirschsprungs disease
Tight
Chromosome with the abnormality is Puetz-Jegher syndrome
19
Peutz-Jegher syndrome
- Inherited polyps of the small intestine with melanin lips, mucosa, fingers and toes
- Anemia often results from the polyps’ bleeding
Most common UTI pathogen
E. coli
Factors that promote bacterial access to genital tract
- Poor hygiene
- Anatomical obstruction
In which age group is it most common to find FTT and/or feeding problems as a result of a UTI?
Newborn - 1 month
In which age group is it most common to find vomiting/diarrhea as a result of a UTI?
1 month- 2 years
In which age group is it most common to find CNS symptoms as a result of a UTI?
Newborn - 1 month
In which age group is it most common to find unexplained fever that ends up being the result of a UTI?
2-6 years
In which age group is it most common to find strong urine as a result of a UTI?
2-6 years
Cardinal sign of right ventricular failure?
Hepatomegaly
Does JVD appear before or after hepatomegaly in RV failure in children?
- Later
- Because liver is more distensible
Where do you best hear pulmonic stenosis?
ULSB
Where do you best hear ASD?
ULSB
Where do you best hear PDA?
ULSB
Where do you best hear aortic stenosis?
URSB
Where do you best hear venous hum?
URSB
Where do you best hear VSD?
LLSB
Where do you best hear Tricuspid regurgitation?
LLSB
Where do you best hear Mitral regurg?
Apex
How can you determine if persistent hypoxemia is cardiac or pulmonary-related?
100% oxygen test
What should you think if you have persistent hypoxemia in the setting of 100% O2?
Cardiac sources
Color change in skin
Macule
Macule
Color change in skin
Papule
- Solid
- Raised
- < 1cm
- Solid
- Raised
- < 1cm
Papulse
Vesicle
- < 1cm
- Clear serous fluid
Bulla
- > 1cm
- Clear serous fluid
> 1cm, filled with clear serous fluid
Bulla
< 1cm, filled with clear serous fluid
Vesicle
Skin lesion containing purulent exudate
Pustule
Nodule
Mass that elevates the skin
Elevation of the skin from edema (like with uticaria)
Wheal
Wheal
Elevation of the skin from edema (like with uticaria)
Most common pediatric endocrine disease
DM Type 1
Symptoms of DM Type 1 don’t appear until what percentage of pancreatic beta cells have been destroyed?
90%
What is the second-most common chronic illness?
DM Type 1
Disease involving a deficiency of the enzyme Glucocerebrosidase, caused by a genetic mutation received from both parents
Gaucher Disease
Child appears with a rash that’s spread down to the trunk from the face. Rash was preceded a prodrome with a fever. You note Koplik spots.
Rubeola (common measles)
Blueberry muffin baby
Congenital rubella
Triad that accompanies congenital rubella
- Deafness
- Cataracts
- CHD’s
Cause of Roseola
HSV 6 or 7
Which HSV strain tends to cause roseola later in life?
HSV 7
“Dewdrops on rose petals” lesions
Varicella (Chickenpox)
Skin lesions form in “crops” and itch severely
Varicella (chickenpox)
Where do varicella lesions usually begin on the body?
Trunk
Cause of Fifth disease
Parvovirus B19
Numerous, tiny red papules that cause a sandpaper-like feel to the skin
Scarlet fever
Where is the scarlet fever rash the most dense?
On the trunk
What parts of the body are affected last by the rash of scarlet fever?
Palms and soles
Where does the scarlet fever rash begin and travel?
Begins on neck, then travels to the trunk and extremities
Associated with “strawberry tongue” and cervical lymphadenopathy
Scarlet fever
Scarlet fever treatment
- Benzathine Penicillin G
- Penicillin VK
Autoimmune disease in which the arteries throughout the body become inflamed
Kawasaki disease
- Marked erythema of the conjunctivae, oral mucosa, tongue (strawberry tongue), and lips
- Accompanied by cervical lymphadenopathy and lymph edema
Kawasaki disease
How do you confirm the dx of pinworms?
Tape test
Home remedy for head lice
Mayonnaise
Creams/shampoos for head lice
- Permethrine
- Lindane
- Pyrethrins
Is the rash associated with Mono diffuse or focal?
Diffuse
Does Kawasaki disease respond to antibiotics?
No
How should you treat a newborn if Mom is Hep B positive?
- Give HBIG (HepB Immunoglobulin)
- And Hep B ASAP followed by 2 doses of Hep B at 1 and 6 months
How should you treat a newborn if you don’t know if Mom is Hep B positive or not?
-Test the baby, but give baby Hep B vaccine in 12 hours
How should you treat a premature newborn if Mom is Hep B positive?
- Give HBIG at birth
- Give the 3 vaccine Hep B series when weight reaches 2000g (4.4lbs)
