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PC1 > Test 1 > Flashcards

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

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2
Q

how many calories does a infant need

A

100-105 kcal/kg/day

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3
Q

how many calories are in formula

A

20kcal per ounce

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4
Q

what two factors are important in formula for CNS development

A

AA and DHA

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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

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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
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7
Q

who should be given soy formula

A

galactosemia or congenital lactase deficiency

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8
Q

who should not be put on soy formula

A

premies

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9
Q

when does lactose intolerance normal show up

A

12 months unless it is true ige mediated allergy

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10
Q

what is a sign of ige milk protein allergy

A

blood in stool

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11
Q

what do you do for baby gerd

A

nothing they will grow out of it

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12
Q

when will colic correct itself

A

4-6 months

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13
Q

what two reasons should a mother not breastfeed

A

hiv positive and galactosemia

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14
Q

in the first 2 months a breast fed baby should be given what to supplement

A

200iu of vit d per day

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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

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16
Q

when does breast milk expire

A

rule of 5s
room temp is 5 hours
fridge is 5 days
freezer is 5 months

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17
Q

when does formula mixed expire

A

rule of 1
room temp 1 hour
fridge 1 day
frezzer never should be done

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18
Q

what are the three types of screeing with a well exam

A

primary- preventing
secondary- specific disease screening
tertiary- treat known disease

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19
Q

when should tylenol be given with a flu shot

A

afterward, before can reduce immunity

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20
Q

what is special about first time flu shots

A

give them 2 2 weeks apart

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21
Q

is fever okay when getting a flu shot

A

yes as long as they are acting okay

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22
Q

what 7 things should be checked on any well child exam

A

ht/wt head size, heent, heart, lungs, abd

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23
Q

what charts are used for growth at what ages

A

world health organization under 2 years old and cdc after 2

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24
Q

when is a hearing test done

A

before 1 month

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25
Q

how often should a baby poop/ pee

A

6-8 wet diapers and 3-4 poops a day

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26
Q

how much water should a baby have by day 3

A

100ml/kg/day water or milk

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27
Q

when should baby body weight be doubled by

A

4-5 months

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28
Q

when should baby body weight be tripled by

A

1 year

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29
Q

when should baby height be doubled

A

4 years

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30
Q

how big is the average 4 year old

A

40 inches and 35 pounds

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31
Q

how fast should a babies head grow

A

2cm a month then 1/2 cm a month after 6 months

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32
Q

what 6 newborn screenings are done and when

A

at birth and at 2 weeks, hypothyroidism, PKU, sickle cell, galactosemia, congenital adrenal hyperplasia, hemoglobinopathies

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33
Q

what five items are part of the apgar

A

heart rate, respritory effort, muscle tone, reflex, color

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34
Q

what is part of the eye exam in a newborn

A

red reflex

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35
Q

when does a child develope 20/20 vision

A

6 year old

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36
Q

3 nero exam on a 1-2 month old

A

lift head, follow objects from 2 feet, fading morrow reflex

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37
Q

3 nero exams on a 3-5 month old

A

reaches and puts things in the mouth, sits with support, rolls from back to side, laughes and coos

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38
Q

2 nero exams on a 6-8 month old

A

sits, scoops small objects

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39
Q

two nero exams on a 9-11 month old

A

pick up object, walk with support

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40
Q

2 nero exams for a 12-15 month old

A

stacks two blocks, walks

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41
Q

1 nero exam for a 15-20 month old

A

feeds self

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42
Q

3 nero exam for a 2 year old

A

copy lines, kick ball, potty train

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43
Q

1 nero exam for a 30 month old

A

walk backward

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44
Q

what is the drug lactation rating scale

A

l1-l5 l5 is bad

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45
Q

what should total serum bili be in a newborn

A

under 20

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46
Q

what should a newborn blood sugar be

A

over 40

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47
Q

describe a strain

A

muscle or tendon injury normaly hurts over a muscle

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48
Q

describe a sprain

A

ligament injury, hurts over a joint

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49
Q

what is considered tachypnea in a newborn

A

over 60 breaths per min

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50
Q

what exam should not be done on an ankle

A

posterior drawer

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51
Q

what is finkelstein

A

flex the thumb check for abductor problem, form overuse, give nsaids and rest

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52
Q

what needs to be pumped and dumped to avoid med crossing over

A

5 times the half life of the drug

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53
Q

when does bp screeing start

A

once a year after 3 years old

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54
Q

what is the primary concern on a cbc in pediatrics

A

hemoglobin

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55
Q

what should be concern if baby has purelent nose drainage at birth

A

syphillis

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56
Q

what disorder is neck webbing common in

A

turners syndrome

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57
Q

what are the grade definitions for reccomindations

A 
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
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58
Q

what shots are needed at 12 years old

A

flu, tdap, hpv, mcv4,

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59
Q

when do men get the hpv vaccine

A

3 doses between 19-21 and 22-26

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60
Q

when does baby say mama and dada

A

12 months

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61
Q

when does baby trun suprine to prone

A

6 months

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62
Q

when does baby respond to name

A

months something

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63
Q

when does baby walk and stoop

A

15-18 months

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64
Q

when does baby say 15-20 words

A

3 years

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65
Q

when does baby stand on 1 foot

A

4-5 years

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66
Q

when does baby throw a ball overhead

A

3 years

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67
Q

what are the 5 stages of change in global health model

A

precontemplation, contemplation, decision, action, maintenace

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68
Q

how long should ottitis media be watched for before anitbiotxs

A

48-72 hours

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69
Q

what drug is best for ottitis media

A

amoxicillin 80 to 90 mg/kg per day

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70
Q

if the red reflex is not present in a newborn the concern is what

A

retinoblastoma

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71
Q

what is inward turning of the eye

A

esotropia

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72
Q

what is outward turning of the eye

A

exotrpia

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73
Q

if the ear infection itches its normaly from what

A

fungus

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74
Q

if the ear infection hurts its normaly from what

A

bacteria

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75
Q

what med is avoided with TM rupture

A

steroids

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76
Q

what should always be charted on a HEENT exam

A

neck supple showing no nucal ridgidity

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77
Q

what is leucocoria

A

a blocked retina like glacoma

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78
Q

when do you start using eye charts for exams

A

3 years

79
Q

what is used for a nasolacrimal duct obstruction

A

erythromycin ointment and massage

80
Q

what is the diagnosis when mom has std and baby has conjunctivitis, what is the worst cause, treat with what

A

opthalmia neonatorum, gonorrhea, erythromycin

81
Q

what are the three types of strabismus

A

restrictive- its stuck
paretic- one muscle is weak like 6 nerve palsy
sensory- just wont stay straight

82
Q

what is the fancy name fir the light reflex test, used to check what

A

hirschberg, strabismus

83
Q

what should never be given to possible herpes simplex infection

A

steroids

84
Q

what is uveitis

A

inflamation of any part of the uveal tract, iris, ciliary body, or choroid

85
Q

what is flame shaped hemorrages and cotton wool spots due to thickening of the arterioles

A

hypertensive retinopathy

86
Q

what is major cause of blindness, increased retinal hemmorages, and exudates and edema

A

diabetic retinopathy

87
Q

leading cause of vision loss in elderly painless loss of central vision acuity

A

macular degeneration

88
Q

sudden loss of aquious humour flow, leads to increased IOP, occular pain is severe, blurred vision, colored halos, refer immediatly

A

acute angle closure glacoma

89
Q

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

A

open angle glaucoma

90
Q

wing like growth that extends onto the cornea

A

pterygium

91
Q

eye is “turned off” and you must correct the cause before the eye will correct

A

amblyopia

92
Q

what measures intraoccular pressure

A

tonometer

93
Q

what is fluorescein and woodslamp used for

A

seeing corneal abrasions

94
Q

what does it mean when black is seen with opthalmoscopy

A

vitreous hemorrhage

95
Q

what is infection of the lacrimal sack

A

dacryocyctitis

96
Q

what is a gland infection on the eyelid

A

hordeolum

97
Q

what is inflamation of the sebaceous gland on the eyelid

A

chalazion

98
Q

what is a dna assay used for in with eye infections

A

concern about possible chlamydia

99
Q

what is common cause of bacterial conjunctivitis

A

staph in adults and strep in kids

100
Q

what is pink eye normaly caused by

A

adenovirus

101
Q

what three signs show allergic rhinitis

A

clear draiange, itching, sneezing

102
Q

what is year round allergies with post nasal drip, congestion, less itching, headache, facial pain, dark circles around eyes

A

perennial allergic rhinitis

103
Q

what can nasal steroids cause

A

nosebleeds

104
Q

if nasla polyps are present what must be ruled out

A

CF

105
Q

what does the pharynx look like with post nasal drip

A

cobbelstoning

106
Q

at what age can antihistamines and decongestents be used

A

6 years old

107
Q

what allergy medication is not sedating

A

zyrtec

108
Q

what is caused often by piercing the ear, treat with axb drops

A

perichondritis

109
Q

if the ear is swollen shut, like swimmers ear, do what

A

use a ear wick

110
Q

what is otitis externa maligna, what is key sign

A

necrotizing even to skull, normaly in immunocomprimised and DM, you will see granulation tissue

111
Q

what are the two classifications for ear infection

A

length of illness 8 weeks is key, etiology like bacterial, mycosis, traumatic

112
Q

how long is acute ottitis media

A

3 weeks or less

113
Q

what normaly causes acute ottitis media

A

strep, flu

114
Q

how many infections are needed to consider ear tubes

A

6 or hearing loss

115
Q

what med should be used if the TM is perforated

A

fluroquinilones

116
Q

what is 90% of oral cancer

A

squamous cell carcinoma

117
Q

pharyngitis is normaly caused by

A

flu or strep

118
Q

very common painful mucosa lessions less than 1 cm use axb and local anesthetic

A

aphthous ulcers

119
Q

medial deviation of the uvula is a sign of what caused normaly by what

A

peritonsilar abscss from staph

120
Q

what are the three keys to asthma

A

obstruction by mucous, airway constriction by inflamtion, muscle tighteing

121
Q

what tool must you have to diagnose asthma

A

spirometry

122
Q

what is the strongest predisposing factor for developing asthma

A

atopy, ige mediated response to allergins

123
Q

what are the four essentials of asthma

A
  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
Q

peak flow meters do you and dont do what with asthma

A

they monitor they dont diagnose

125
Q

what could be the only asthma symptom in some kids

A

asthma

126
Q

using a peak flow meter after a bronchodilator an increase of what shows asthma

A

10-15% and 200ml

127
Q

what is needed to be known before asthma treatment can begin

A

severity

128
Q

what are the two main goals of asthma treatment

A

decrease impairment, decrease risk in order to decrease the number of times symptom treatment is needed

129
Q

what are the numbers for the three types of classifications for asthma as far as neededing oral systemic corticosteroids, what is significant about this

A

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
Q

what should kids always use with astham medications

A

a spacer

131
Q

intermitent asthma is how often a week

A

less than 2 times

132
Q

what should every asthma patient have

A

an action plan for when it gets bad

133
Q

what is the gold standard test for sleep apnea

A

in hospital overnight polysonography

134
Q

what is considered sleep apnea, the number of times

A

more than 10 second pause more than 5 times an hour

135
Q

what are the two types of copd

A

chronic bronchitis, emphysema

136
Q

what is the nick name for chronic bronchitis

A

blue bloater

137
Q

what is the nick name for emphysema

A

pink puffer

138
Q

what defines chronic bronchitis

A

chronic productive cough for 3 years in each of 2 successive years

139
Q

what defines emphysema

A

abnormal and permanent enlargement of air spaces that are distal to the terminal bronchioles with destruction of the airspace walls without fibrosis

140
Q

what numbers are indicative of copd

A

FEV1 / FVC ratio is less than 0.7

FEV1 is less than 80%

141
Q

wha tis the fev1 / FVC ratio

A

the amount of air that can be expired in one sec

142
Q

what is the key statemnt according to the professor about copd

A

that the exacerbation of sympotoms is worse beyond day to day

143
Q

how is chronic bronchitis diagnosed

A

clinicaly

144
Q

how is emphysema diagnosed

A

ct and mri

145
Q

what will bronchodilators do for copd

A

nothing

146
Q

what blood test is needed if copd is suspected in under 35 year olds

A

alpha 1 antitrypsin

147
Q

with copd what is seen on x ray

A

flatened dyaghram from hyperinflation

148
Q

what is immpared with emphysema

A

elastic recoil

149
Q

describe the first stage of GOLD for COPD

A

stage 1 mild copd
fev1/fvc less than 70%
fev1 greater than 80% predicted value

150
Q

describe the seconed stage of GOLD for copd

A

stage 2 moderate copd
fev1/fvc less than 70%
fev1 50-80% predicted value

151
Q

describe the third stage for copd

A

stage 3 severe copd
fev1/fvc less than 70%
fev1 30-50% predicted value

152
Q

describe the fourth stage of gold for copd

A

stage 4 very severe copd
fev1-fvc less than 70%
fev1 less than 30% predicted value

153
Q

what is the only drug to improve the natural history of people with copd

A

oxygen

154
Q

what is required for home o2 use prescription

A

less than 88%

155
Q

when should screening for major deprssive order begin

A

12-18yo

156
Q

what is at risk on the framingham screening tool, for what risk

A

10 year greater than 20% for cvd

157
Q

when should carotid artery stenosis screening be done

A

it is caragory d

158
Q

when should men be screened for lipid disorders

A

over 35 and over 20 if at risk

159
Q

when should women be screened for lipid diorders

A

45 and 20 if at risk

160
Q

when is cervical cancer screening done

A

every 3 years between 21-65

161
Q

when is hpv test done

A

every 5 years between 21-65

162
Q

when should prostate cancer screen be done

A

no reccomendation its I but D after 75

163
Q

what is the tool for family violence screening

A 
hits
hit
insult
threaten
scream
0-5 and 5 is high
164
Q

what tool is used for counseling

A 
5 A's
asses
advise
agree on goals
assist
arrange follow up
165
Q

when should obesity be screened for and when should it be treated

A

all adults, treat bmi over 30

166
Q

what should all 1st visit preg patients be screened for

A

bacteriuria

167
Q

what is the best dementia screening tool

A

mmse

168
Q

how much calcium is needed in adult women

A

1200mg

169
Q

how much vit d is needed at what age in adult women

A

under 70 is 400iu over 70 is 600iu

170
Q

what is a mucocele, what should be done

A

mucous retention cyst in the mouth do not drain it

171
Q

what is a ranula

A

blocked sublingual gland congenital mucous retention cyst

172
Q

what is leukoplakia, and key

A

white lession that will not rub off in mouth

173
Q

what is a erythroplakia, and key

A

white lession that will not rub off, with reddish tint

174
Q

what is special about erythroplakia

A

90% are dysplastic or carcinoma

175
Q

oral cancer is 90% what type

A

squamous cell

176
Q

describe the three grades of microtia

A
  1. just small ear
  2. missing parts of the ear
  3. “peanut ear”
177
Q

what is acute bronchitis typicaly caused by in adults

A

virus

178
Q

what is the main cause of bronchiolitis in kids under 2

A

rsv

179
Q

what is another name for croup and what is it

A

laryngotracheitis

180
Q

what is an emergent form of croup

A

bacterial tracheitis, it will have purelent drainage

181
Q

describe the wesley croup score

A

0-17
under 2 is mild
3-7 moderate
8-17 severe

182
Q

another name for whooping cough

A

pertussis

183
Q

what causes 65% of pneumoia and what is a sign of it

A

strep, rusty purelent sputum

184
Q

under what age dosnt get the flu vaccine

A

6 months

185
Q

What does chromolin sodium and nedocromil med do

A

Stabilize mast cells, an alternative but not preferred treatment for asthma step 2

186
Q

What are immunomodulators like omalizumab, what are they used for

A

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
Q

LABAs are used for what and how

A

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
Q

3 groups of quick relief meds for asthma

A

Anticholinergics, SABA, systemic corticosteroids

189
Q

Name a anticolinergic bronchodilator, used when

A

Short acting emergent asthma relief, called atrovent, won’t affect heart rate

190
Q

After initial asthma treatment in office when should the next evaluation be

A

In 2-6 weeks

191
Q

When should an asthma step down be considered

A

After 3 months of good control

192
Q

How often should asthma be evaluated in office

A

1-6 months

193
Q

How much and how often can ICS be reduced

A

25-50% every 3 months

PC1 (3 decks)

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