Test 1 Flashcards
1
Q
term babies lose how much weight in the first week and why
A
5-10% from extra cellular water loss
2
Q
how many calories does a infant need
A
100-105 kcal/kg/day
3
Q
how many calories are in formula
A
20kcal per ounce
4
Q
what two factors are important in formula for CNS development
A
AA and DHA
5
Q
calculate the feedings for a newborn under 36 weeks
A
80ml/ kg/ day times the number of Kg divided by 8 feedings divided by 30ml/oz gives the number oz per feeding, that times 8 gives you the kcal per day
6
Q
calculate the feedings for a newborn over 36 weeks
A
baby is 3.2kg 150ml x 3.2kg= 480ml 480ml / 8 feedings= 60ml/ feed 60ml/ 30ml/oz= about 2 ounces per feed about 320kcal a day
7
Q
who should be given soy formula
A
galactosemia or congenital lactase deficiency
8
Q
who should not be put on soy formula
A
premies
9
Q
when does lactose intolerance normal show up
A
12 months unless it is true ige mediated allergy
10
Q
what is a sign of ige milk protein allergy
A
blood in stool
11
Q
what do you do for baby gerd
A
nothing they will grow out of it
12
Q
when will colic correct itself
A
4-6 months
13
Q
what two reasons should a mother not breastfeed
A
hiv positive and galactosemia
14
Q
in the first 2 months a breast fed baby should be given what to supplement
A
200iu of vit d per day
15
Q
how should a mother feed with colostrum and how long
A
5-7 days feed every 2-3 hours on each breast for 15 min
16
Q
when does breast milk expire
A
rule of 5s
room temp is 5 hours
fridge is 5 days
freezer is 5 months
17
Q
when does formula mixed expire
A
rule of 1
room temp 1 hour
fridge 1 day
frezzer never should be done
18
Q
what are the three types of screeing with a well exam
A
primary- preventing
secondary- specific disease screening
tertiary- treat known disease
19
Q
when should tylenol be given with a flu shot
A
afterward, before can reduce immunity
20
Q
what is special about first time flu shots
A
give them 2 2 weeks apart
21
Q
is fever okay when getting a flu shot
A
yes as long as they are acting okay
22
Q
what 7 things should be checked on any well child exam
A
ht/wt head size, heent, heart, lungs, abd
23
Q
what charts are used for growth at what ages
A
world health organization under 2 years old and cdc after 2
24
Q
when is a hearing test done
A
before 1 month
25
how often should a baby poop/ pee
6-8 wet diapers and 3-4 poops a day
26
how much water should a baby have by day 3
100ml/kg/day water or milk
27
when should baby body weight be doubled by
4-5 months
28
when should baby body weight be tripled by
1 year
29
when should baby height be doubled
4 years
30
how big is the average 4 year old
40 inches and 35 pounds
31
how fast should a babies head grow
2cm a month then 1/2 cm a month after 6 months
32
what 6 newborn screenings are done and when
at birth and at 2 weeks, hypothyroidism, PKU, sickle cell, galactosemia, congenital adrenal hyperplasia, hemoglobinopathies
33
what five items are part of the apgar
heart rate, respritory effort, muscle tone, reflex, color
34
what is part of the eye exam in a newborn
red reflex
35
when does a child develope 20/20 vision
6 year old
36
3 nero exam on a 1-2 month old
lift head, follow objects from 2 feet, fading morrow reflex
37
3 nero exams on a 3-5 month old
reaches and puts things in the mouth, sits with support, rolls from back to side, laughes and coos
38
2 nero exams on a 6-8 month old
sits, scoops small objects
39
two nero exams on a 9-11 month old
pick up object, walk with support
40
2 nero exams for a 12-15 month old
stacks two blocks, walks
41
1 nero exam for a 15-20 month old
feeds self
42
3 nero exam for a 2 year old
copy lines, kick ball, potty train
43
1 nero exam for a 30 month old
walk backward
44
what is the drug lactation rating scale
l1-l5 l5 is bad
45
what should total serum bili be in a newborn
under 20
46
what should a newborn blood sugar be
over 40
47
describe a strain
muscle or tendon injury normaly hurts over a muscle
48
describe a sprain
ligament injury, hurts over a joint
49
what is considered tachypnea in a newborn
over 60 breaths per min
50
what exam should not be done on an ankle
posterior drawer
51
what is finkelstein
flex the thumb check for abductor problem, form overuse, give nsaids and rest
52
what needs to be pumped and dumped to avoid med crossing over
5 times the half life of the drug
53
when does bp screeing start
once a year after 3 years old
54
what is the primary concern on a cbc in pediatrics
hemoglobin
55
what should be concern if baby has purelent nose drainage at birth
syphillis
56
what disorder is neck webbing common in
turners syndrome
57
what are the grade definitions for reccomindations
```
a-benifit is substatial
b-net benifit is moderate
c- some patients may have some benifit
d-no benifit or harm is too great
i- not enough information
```
58
what shots are needed at 12 years old
flu, tdap, hpv, mcv4,
59
when do men get the hpv vaccine
3 doses between 19-21 and 22-26
60
when does baby say mama and dada
12 months
61
when does baby trun suprine to prone
6 months
62
when does baby respond to name
months something
63
when does baby walk and stoop
15-18 months
64
when does baby say 15-20 words
3 years
65
when does baby stand on 1 foot
4-5 years
66
when does baby throw a ball overhead
3 years
67
what are the 5 stages of change in global health model
precontemplation, contemplation, decision, action, maintenace
68
how long should ottitis media be watched for before anitbiotxs
48-72 hours
69
what drug is best for ottitis media
amoxicillin 80 to 90 mg/kg per day
70
if the red reflex is not present in a newborn the concern is what
retinoblastoma
71
what is inward turning of the eye
esotropia
72
what is outward turning of the eye
exotrpia
73
if the ear infection itches its normaly from what
fungus
74
if the ear infection hurts its normaly from what
bacteria
75
what med is avoided with TM rupture
steroids
76
what should always be charted on a HEENT exam
neck supple showing no nucal ridgidity
77
what is leucocoria
a blocked retina like glacoma
78
when do you start using eye charts for exams
3 years
79
what is used for a nasolacrimal duct obstruction
erythromycin ointment and massage
80
what is the diagnosis when mom has std and baby has conjunctivitis, what is the worst cause, treat with what
opthalmia neonatorum, gonorrhea, erythromycin
81
what are the three types of strabismus
restrictive- its stuck
paretic- one muscle is weak like 6 nerve palsy
sensory- just wont stay straight
82
what is the fancy name fir the light reflex test, used to check what
hirschberg, strabismus
83
what should never be given to possible herpes simplex infection
steroids
84
what is uveitis
inflamation of any part of the uveal tract, iris, ciliary body, or choroid
85
what is flame shaped hemorrages and cotton wool spots due to thickening of the arterioles
hypertensive retinopathy
86
what is major cause of blindness, increased retinal hemmorages, and exudates and edema
diabetic retinopathy
87
leading cause of vision loss in elderly painless loss of central vision acuity
macular degeneration
88
sudden loss of aquious humour flow, leads to increased IOP, occular pain is severe, blurred vision, colored halos, refer immediatly
acute angle closure glacoma
89
gradual loss of aquious humour flow, leads to increased IOP, loss of peripheral vision, screen after 40 every 3-5 years yearly for DM and family history
open angle glaucoma
90
wing like growth that extends onto the cornea
pterygium
91
eye is "turned off" and you must correct the cause before the eye will correct
amblyopia
92
what measures intraoccular pressure
tonometer
93
what is fluorescein and woodslamp used for
seeing corneal abrasions
94
what does it mean when black is seen with opthalmoscopy
vitreous hemorrhage
95
what is infection of the lacrimal sack
dacryocyctitis
96
what is a gland infection on the eyelid
hordeolum
97
what is inflamation of the sebaceous gland on the eyelid
chalazion
98
what is a dna assay used for in with eye infections
concern about possible chlamydia
99
what is common cause of bacterial conjunctivitis
staph in adults and strep in kids
100
what is pink eye normaly caused by
adenovirus
101
what three signs show allergic rhinitis
clear draiange, itching, sneezing
102
what is year round allergies with post nasal drip, congestion, less itching, headache, facial pain, dark circles around eyes
perennial allergic rhinitis
103
what can nasal steroids cause
nosebleeds
104
if nasla polyps are present what must be ruled out
CF
105
what does the pharynx look like with post nasal drip
cobbelstoning
106
at what age can antihistamines and decongestents be used
6 years old
107
what allergy medication is not sedating
zyrtec
108
what is caused often by piercing the ear, treat with axb drops
perichondritis
109
if the ear is swollen shut, like swimmers ear, do what
use a ear wick
110
what is otitis externa maligna, what is key sign
necrotizing even to skull, normaly in immunocomprimised and DM, you will see granulation tissue
111
what are the two classifications for ear infection
length of illness 8 weeks is key, etiology like bacterial, mycosis, traumatic
112
how long is acute ottitis media
3 weeks or less
113
what normaly causes acute ottitis media
strep, flu
114
how many infections are needed to consider ear tubes
6 or hearing loss
115
what med should be used if the TM is perforated
fluroquinilones
116
what is 90% of oral cancer
squamous cell carcinoma
117
pharyngitis is normaly caused by
flu or strep
118
very common painful mucosa lessions less than 1 cm use axb and local anesthetic
aphthous ulcers
119
medial deviation of the uvula is a sign of what caused normaly by what
peritonsilar abscss from staph
120
what are the three keys to asthma
obstruction by mucous, airway constriction by inflamtion, muscle tighteing
121
what tool must you have to diagnose asthma
spirometry
122
what is the strongest predisposing factor for developing asthma
atopy, ige mediated response to allergins
123
what are the four essentials of asthma
1. worse at night or early morning
2. complete or partial reversibility of obstruction using bronchodilators
3. prolonged expiration and wheezes
4. limitation of PFT or positive bronchoprovocation challenge
124
peak flow meters do you and dont do what with asthma
they monitor they dont diagnose
125
what could be the only asthma symptom in some kids
asthma
126
using a peak flow meter after a bronchodilator an increase of what shows asthma
10-15% and 200ml
127
what is needed to be known before asthma treatment can begin
severity
128
what are the two main goals of asthma treatment
decrease impairment, decrease risk in order to decrease the number of times symptom treatment is needed
129
what are the numbers for the three types of classifications for asthma as far as neededing oral systemic corticosteroids, what is significant about this
well controlled is 0-1 a year
not well controlled is 2-3 a year
very poorly controlled in more than 3 a year
this can increase there classification
130
what should kids always use with astham medications
a spacer
131
intermitent asthma is how often a week
less than 2 times
132
what should every asthma patient have
an action plan for when it gets bad
133
what is the gold standard test for sleep apnea
in hospital overnight polysonography
134
what is considered sleep apnea, the number of times
more than 10 second pause more than 5 times an hour
135
what are the two types of copd
chronic bronchitis, emphysema
136
what is the nick name for chronic bronchitis
blue bloater
137
what is the nick name for emphysema
pink puffer
138
what defines chronic bronchitis
chronic productive cough for 3 years in each of 2 successive years
139
what defines emphysema
abnormal and permanent enlargement of air spaces that are distal to the terminal bronchioles with destruction of the airspace walls without fibrosis
140
what numbers are indicative of copd
FEV1 / FVC ratio is less than 0.7
| FEV1 is less than 80%
141
wha tis the fev1 / FVC ratio
the amount of air that can be expired in one sec
142
what is the key statemnt according to the professor about copd
that the exacerbation of sympotoms is worse beyond day to day
143
how is chronic bronchitis diagnosed
clinicaly
144
how is emphysema diagnosed
ct and mri
145
what will bronchodilators do for copd
nothing
146
what blood test is needed if copd is suspected in under 35 year olds
alpha 1 antitrypsin
147
with copd what is seen on x ray
flatened dyaghram from hyperinflation
148
what is immpared with emphysema
elastic recoil
149
describe the first stage of GOLD for COPD
stage 1 mild copd
fev1/fvc less than 70%
fev1 greater than 80% predicted value
150
describe the seconed stage of GOLD for copd
stage 2 moderate copd
fev1/fvc less than 70%
fev1 50-80% predicted value
151
describe the third stage for copd
stage 3 severe copd
fev1/fvc less than 70%
fev1 30-50% predicted value
152
describe the fourth stage of gold for copd
stage 4 very severe copd
fev1-fvc less than 70%
fev1 less than 30% predicted value
153
what is the only drug to improve the natural history of people with copd
oxygen
154
what is required for home o2 use prescription
less than 88%
155
when should screening for major deprssive order begin
12-18yo
156
what is at risk on the framingham screening tool, for what risk
10 year greater than 20% for cvd
157
when should carotid artery stenosis screening be done
it is caragory d
158
when should men be screened for lipid disorders
over 35 and over 20 if at risk
159
when should women be screened for lipid diorders
45 and 20 if at risk
160
when is cervical cancer screening done
every 3 years between 21-65
161
when is hpv test done
every 5 years between 21-65
162
when should prostate cancer screen be done
no reccomendation its I but D after 75
163
what is the tool for family violence screening
```
hits
hit
insult
threaten
scream
0-5 and 5 is high
```
164
what tool is used for counseling
```
5 A's
asses
advise
agree on goals
assist
arrange follow up
```
165
when should obesity be screened for and when should it be treated
all adults, treat bmi over 30
166
what should all 1st visit preg patients be screened for
bacteriuria
167
what is the best dementia screening tool
mmse
168
how much calcium is needed in adult women
1200mg
169
how much vit d is needed at what age in adult women
under 70 is 400iu over 70 is 600iu
170
what is a mucocele, what should be done
mucous retention cyst in the mouth do not drain it
171
what is a ranula
blocked sublingual gland congenital mucous retention cyst
172
what is leukoplakia, and key
white lession that will not rub off in mouth
173
what is a erythroplakia, and key
white lession that will not rub off, with reddish tint
174
what is special about erythroplakia
90% are dysplastic or carcinoma
175
oral cancer is 90% what type
squamous cell
176
describe the three grades of microtia
1. just small ear
2. missing parts of the ear
3. "peanut ear"
177
what is acute bronchitis typicaly caused by in adults
virus
178
what is the main cause of bronchiolitis in kids under 2
rsv
179
what is another name for croup and what is it
laryngotracheitis
180
what is an emergent form of croup
bacterial tracheitis, it will have purelent drainage
181
describe the wesley croup score
0-17
under 2 is mild
3-7 moderate
8-17 severe
182
another name for whooping cough
pertussis
183
what causes 65% of pneumoia and what is a sign of it
strep, rusty purelent sputum
184
under what age dosnt get the flu vaccine
6 months
185
What does chromolin sodium and nedocromil med do
Stabilize mast cells, an alternative but not preferred treatment for asthma step 2
186
What are immunomodulators like omalizumab, what are they used for
Prevent binding of Ige to basophils and mast cells, step 5 or 6 asthma control over 12 years old with bad allergies, be prepared for anaphylaxis
187
LABAs are used for what and how
Long acting beta 2 agonist in asthma, not to be used alone, provides 12 hours of coverage, use with ICSs (inhaled corticosteroids) for moderate to severe asthma,
188
3 groups of quick relief meds for asthma
Anticholinergics, SABA, systemic corticosteroids
189
Name a anticolinergic bronchodilator, used when
Short acting emergent asthma relief, called atrovent, won't affect heart rate
190
After initial asthma treatment in office when should the next evaluation be
In 2-6 weeks
191
When should an asthma step down be considered
After 3 months of good control
192
How often should asthma be evaluated in office
1-6 months
193
How much and how often can ICS be reduced
25-50% every 3 months
