Test 1 Flashcards
1
Q
When would you expect an infant to double their birth weight?
A
Between 4-5 months
2
Q
Return to birth weight
A
7–10 days of age
3
Q
Triple birth weight
A
1 year
4
Q
At what age should the anterior fontanelle close?
A
2 years
5
Q
Posterior fontanelle should close by
A
2 months
6
Q
The moro reflex should be gone by
A
3-4 months.
7
Q
The rooting reflex should be gone by
A
3-4 months
8
Q
The neck reflex should be gone by
A
2 months
9
Q
infants should walk by ______ and sit up by _______
A
1 year; 9 months
10
Q
hold neck by age
A
3 months
11
Q
roll over by
A
5 months
12
Q
sit with own support by `
A
6 mos
13
Q
sit without support by `
A
8 mos
14
Q
stand holding on
A
9 m
15
Q
creep well; stand w/o support by
A
12 m
16
Q
walk alone; creep upstairs by
A
15 m
17
Q
run by
A
18 m
18
Q
walk up and down stairs by
A
2 yrs
19
Q
ride tricycle by
A
3 yrs
20
Q
hop on one feet; alternate foot on stairs
A
4 yrs
21
Q
effects of excess lead in developing children
A
Decreased intelligence, impaired neurobehavioral development, and decreased growth.
22
Q
How do we treat the patient with between 10-14 g/dL of lead in their body?
A
Dietary and environmental changes, follow up with blood lead monitoring in one month, and report the incident to the state
23
Q
two key characteristics of a patent ductus arteriosus
A
Wide pulse pressure; Bounding pulses (quincke pulse on fingertips)
24
Q
first sign of CHF seen in children
A
Tachycardia
25
three features of Marfan’s Syndrome
```
Pectus excavatum
Positive wrist and thumb sign
Pes planus (flat feet)
Scoliosis
Arm span > height
Tall and thin
```
26
major criteria for acute rheumatic fever
Clinical and/or subclinical carditis (Seen on echocardiography)
Monoarthritis, polyarthritis and/or polyarthralgia
Chorea
Erythema marginatum (squiggly rash)
Subcutaneous nodules
27
In a child with Hypertrophic Cardiomyopathy (HOCM), what maneuver(s) will make the patient’s murmur increase in intensity and duration?
```
Sudden standing (decreases afterload)
Valsalva maneuver (decreases preload)
Exercise (increases contractility)
```
28
In a child with Hypertrophic Cardiomyopathy (HOCM), what maneuver(s) will make the patient’s murmur decrease in intensity and duration?
```
Squat or hand-grasp (increases afterload)
Leg raise (increases preload)
```
29
The posterior fossa and brainstem are best appreciated using this imaging method
MRI is best for imaging posterior fossa and brainstem.
30
best for imaging after trauma (can detect blood pooling)
CT scan
31
You observe increased tone in someone with a neuromotor delay. This suggests upper or lower motor neuron disease?
upper motor neuron disease
32
example of upper nueron motor disease
cereberal palsy
33
Low tone/hyporeflexia is associated w/
spinal muscular atrophy
34
Red flags for motor nueron disease
```
elevated CK
fasiculations
facial dysmorphism, organomegaly, HF signs, early join contractures
MRI brain abnormalities
resp insuff with generalized weakness
loss of motor milestones
motor delays during minor acute
```
35
What is the most likely diagnosis in a two-month-old infant with hyporeflexia and respiratory problems?
abnormal muscle function
progressive proximal muscular weakness
increase in CK and transaminases
delays in attainment of developmental milestones
36
signs and symptoms that might suggest a diagnosis of autism
social interaction defecit; restricted, repetitive pattern of behavior, interest or activities
37
screens for autism
Screen with MCHAT-R at 18 & 24 months
38
SMA type 1 characteristics
onset < 6 mos. symmetrical weakness, absent tendon reflexes, unable to sit inden
39
SMA type II characteristics
onset 6-18 mos, sit unsupported, don't walk independently
40
most common pathogens that cause acute otitis media (AOM)
H. Influenza; Strep pneumonia; M. Catarrhalis
41
Amoxicillin liquid suspension
400 mg/5 ml
42
common signs and symptoms of allergic rhinitis
allergic shiners, allergic facies
nasal mucosa pale or bluish, turbinates swollen, polyps
cobbelstone throat, serious fluid behind TM
43
the most common organism that causes croup
Parainfluenza
44
croup treatment
dexamethasone
45
croup presentation
barking cough, URI with fever, hoarseness, stridor wheeze
46
signs and symptoms of GABHS (bacterial) pharyngitis
Fever, chills, fatigue, malaise, myalgia
Sudden onset of sore throat w/painful swallowing
Tonsillar exudate (white spots), palatal petechiae, uvular swelling
Anterior cervical adenopathy
Hairy tongue, halitosis
47
treatment of GABHS (bacterial) pharyngitis
Obtain rapid test/throat culture (culture is gold standard!)
| Amoxicillin 50 mg/kg per day x 10 days
48
What causes systolic murmur?
turbulence in ventricular outflow; av valve regurg; abnormal vent or arterial comms
49
what causes diastolic murmurs
turbulence in ventricular inflow; semilunar valve regurg
50
normal murmurs in first few days of life
PPS, pulmonary flow, closing PDA, transient tricuspid regurg
51
abnormal murmurs in the first days of life
outflow ob-AS, PS, coarctation, abnormal comms - VSD, PDA
52
transitional murmurs
closing PDA and transient tricuspid regurg
53
PDA gets _______ as it gets smaller
louder
54
When does PDA generally close
12-28 hours
55
Where to hear Transient tricuspid regurg
LLSB
56
which septal defect can lead to CHF?
ventricular
57
which defect causes decreased pluse and BP in lower extermities?
coarctation of aorta
58
what is the problem if someone has an unrepaired ASD?
increased risk of stroke
59
what disease can lead to myocarditis?
cocksackie b
60
ASD characteristics
exercise intolerance, no CHF, wide, fixed splitting of s2
61
what could aortic dissection be associated with?
Marfan
62
Patients prefer to lean forward, may refuse
| to lie down when they have
pericarditis
63
which sound can you hear with pericarditis
friction rub or distant heart sounds (if effusion)
64
90% of endocarditis cases are caused by _________
gram positive cocci
65
clincial features of endocarditis
fever, tachy, CHF, dysrhytmia, murmur, petichiae, splenomegaly
66
clincial features of bacterial endocarditis
fevers, conjunctival hem, slpinter, janeways lesons,
67
what can developin 20% of kawasaki cases
coronary artery aneurysms
68
Kawasaki disease diagnostic criteria
```
fever > 5 days and
non-purulent conjunctivitis
oral mucosal changes (red cracked lips, pharyngitis, strawberry tongue)
extremity changes (swelling or peeling)
rash (in many perineal)
cervical adenopathy
```
69
Signs of Moeblus
```
lack facial expressions
micrognathia and microstomia
weird tongue or palate
missing teeth
strabismus
```
70
diagnostic test that measures changes in cereberal blood flow
fMRI
71
diagnostic test that evaluates brain chemistry
MRS
72
diagnostic test that images blood flow in large arteries and veins and vessel patency
MRA
73
macrocephaly assessment components
```
transilumniate head w/ light
listen for cranial bruits
look for sings of increased ICP
look at skin; cafe au lait, nevi, hypopigmented macules
extraocular movement
bony abnormalities
```
74
duchenne muscular distrophy treatment components
steriod, nocturnal ventilation, cardiac support
75
spinal muscular atrophy is characterized by
degeneration of brainstem and spinal cord motor neurons resulting in progressive weakness and muscle atrophy.
76
what is the most likely diagnosis of 2 mo with hyporeflexia and resp problems?
SMA1
77
Many prescription drugs can unmask or worsen symptoms of
myasthenia gravis
78
extreme episode of weakness that culminates in respiratory failure and the need for mechanical ventilation is ___________
myasthenic crisis
79
what can you elicit in the office with hyperventilation
absence
80
which seizures Will not usually remit without anticonvulsants
Juvenile Myoclonic Epilepsy
81
early signs of CP
alterned tone
persistence of primitive reflexes
abnormal posturing
82
Cerebral Palsy Associated Disabilities
```
Mental retardation 1/3 Normal while about 1⁄2 have some intellectual impairment.
Epilepsy 20-50% > generalized.
Speech disorders 50% delay/dysarthria.
Vision and hearing 25%.
Behavior abnormalities.
Learning difficulties.
```
83
diagnostic test for CP
MRI
84
reflexes associated with CP
landau, parachute, propping reflex
85
which condition presents with limited or absent mobility of TM,
AOM
86
Chronic suppurative OM:
* Persistent inflammation of the middle ear or mastoid cavity
* Recurrent or persistent otorrhea through a perforated tympanic membrane
87
Side Effects of Antihistamines
anticholinergic, CNS stim in children
88
decongestants s/e
irritablity, nervousness, headache, urinary hesitancy, tachy, HTN
89
80% of pharyngitis cases are ________
viral
90
bacterial vs. viral sx of pharyngitis
bacterial: whitis spots, gray furry tongue, swollen uvula; both: red swollen tonsils and throat redness
91
infectious mono present w/ the triad of
fever, pharyngitis and lymphadenopathy
92
what causes majority of mono?
epstein-barr (also cytomegalovirus)
93
why should mono patients avoid sports?
hepatosplenomegaly
94
differential presentaiton of diphterhia pharyngitis
bull's neck membrae, pseudo membrane exudate
95
PANDAS presentation
abrupt onset or exacerbation of OCD or tic behavior (related to strep infection)
96
Recurrent GABHS: Treatment
clinda, amox/ca, add rifampin to benzathine penicillin G
97
Peritonsillar Abscess presentation
Fever, chills, malaise, halitosis, toxic appearing, ‘hot potato” voice, drooling
98
Peritonsillar Abscess mgmt
refer to ED or ENT
99
Epiglotitis presentation
severe odynophagia, dysphagia, fever, drooling, SOB, distress, stridor
100
tacnypnea defintion Younger than two months
>60 breaths/min
101
tacnypnea 2-12 mos
> 50 breaths/min
102
Tachypnea 1-5 years
> 40 breaths/min
103
greater than 5
> 20 breaths/min
104
1st line tx for pneumonia
amox 90 mg/kg 2 divided doses
105
most common cause of bronchiolitis
RSV
106
who is a happy wheezer?
someone with bronchiolitis
107
what ages to give 2 flu shots?
6 months to 8 years
108
no live vaccines for thoseI
```
under 2
over 50
with asthma or COPD
contact with immunosupprssed
recent use of steroids
recent live vaccine
```
