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DNP Peds > Test 1 > Flashcards

Test 1 Flashcards

1
Q

When would you expect an infant to double their birth weight?

A

Between 4-5 months

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2
Q

Return to birth weight

A

7–10 days of age

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3
Q

Triple birth weight

A

1 year

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4
Q

At what age should the anterior fontanelle close?

A

2 years

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5
Q

Posterior fontanelle should close by

A

2 months

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6
Q

The moro reflex should be gone by

A

3-4 months.

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7
Q

The rooting reflex should be gone by

A

3-4 months

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8
Q

The neck reflex should be gone by

A

2 months

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9
Q

infants should walk by ______ and sit up by _______

A

1 year; 9 months

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10
Q

hold neck by age

A

3 months

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11
Q

roll over by

A

5 months

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12
Q

sit with own support by `

A

6 mos

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13
Q

sit without support by `

A

8 mos

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14
Q

stand holding on

A

9 m

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15
Q

creep well; stand w/o support by

A

12 m

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16
Q

walk alone; creep upstairs by

A

15 m

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17
Q

run by

A

18 m

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18
Q

walk up and down stairs by

A

2 yrs

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19
Q

ride tricycle by

A

3 yrs

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20
Q

hop on one feet; alternate foot on stairs

A

4 yrs

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21
Q

effects of excess lead in developing children

A

Decreased intelligence, impaired neurobehavioral development, and decreased growth.

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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

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23
Q

two key characteristics of a patent ductus arteriosus

A

Wide pulse pressure; Bounding pulses (quincke pulse on fingertips)

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24
Q

first sign of CHF seen in children

A

Tachycardia

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25
Q

three features of Marfan’s Syndrome

A 
Pectus excavatum
Positive wrist and thumb sign
Pes planus (flat feet)
Scoliosis
Arm span > height
Tall and thin
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26
Q

major criteria for acute rheumatic fever

A

Clinical and/or subclinical carditis (Seen on echocardiography)
Monoarthritis, polyarthritis and/or polyarthralgia
Chorea
Erythema marginatum (squiggly rash)
Subcutaneous nodules

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27
Q

In a child with Hypertrophic Cardiomyopathy (HOCM), what maneuver(s) will make the patient’s murmur increase in intensity and duration?

A 
Sudden standing (decreases afterload)
Valsalva maneuver (decreases preload)
Exercise (increases contractility)
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28
Q

In a child with Hypertrophic Cardiomyopathy (HOCM), what maneuver(s) will make the patient’s murmur decrease in intensity and duration?

A 
Squat or hand-grasp (increases afterload)
Leg raise (increases preload)
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29
Q

The posterior fossa and brainstem are best appreciated using this imaging method

A

MRI is best for imaging posterior fossa and brainstem.

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30
Q

best for imaging after trauma (can detect blood pooling)

A

CT scan

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31
Q

You observe increased tone in someone with a neuromotor delay. This suggests upper or lower motor neuron disease?

A

upper motor neuron disease

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32
Q

example of upper nueron motor disease

A

cereberal palsy

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33
Q

Low tone/hyporeflexia is associated w/

A

spinal muscular atrophy

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34
Q

Red flags for motor nueron disease

A 
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
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35
Q

What is the most likely diagnosis in a two-month-old infant with hyporeflexia and respiratory problems?

A

abnormal muscle function
progressive proximal muscular weakness
increase in CK and transaminases
delays in attainment of developmental milestones

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36
Q

signs and symptoms that might suggest a diagnosis of autism

A

social interaction defecit; restricted, repetitive pattern of behavior, interest or activities

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37
Q

screens for autism

A

Screen with MCHAT-R at 18 & 24 months

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38
Q

SMA type 1 characteristics

A

onset < 6 mos. symmetrical weakness, absent tendon reflexes, unable to sit inden

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39
Q

SMA type II characteristics

A

onset 6-18 mos, sit unsupported, don’t walk independently

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40
Q

most common pathogens that cause acute otitis media (AOM)

A

H. Influenza; Strep pneumonia; M. Catarrhalis

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41
Q

Amoxicillin liquid suspension

A

400 mg/5 ml

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42
Q

common signs and symptoms of allergic rhinitis

A

allergic shiners, allergic facies
nasal mucosa pale or bluish, turbinates swollen, polyps
cobbelstone throat, serious fluid behind TM

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43
Q

the most common organism that causes croup

A

Parainfluenza

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44
Q

croup treatment

A

dexamethasone

45
Q

croup presentation

A

barking cough, URI with fever, hoarseness, stridor wheeze

46
Q

signs and symptoms of GABHS (bacterial) pharyngitis

A

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
Q

treatment of GABHS (bacterial) pharyngitis

A

Obtain rapid test/throat culture (culture is gold standard!)

Amoxicillin 50 mg/kg per day x 10 days

48
Q

What causes systolic murmur?

A

turbulence in ventricular outflow; av valve regurg; abnormal vent or arterial comms

49
Q

what causes diastolic murmurs

A

turbulence in ventricular inflow; semilunar valve regurg

50
Q

normal murmurs in first few days of life

A

PPS, pulmonary flow, closing PDA, transient tricuspid regurg

51
Q

abnormal murmurs in the first days of life

A

outflow ob-AS, PS, coarctation, abnormal comms - VSD, PDA

52
Q

transitional murmurs

A

closing PDA and transient tricuspid regurg

53
Q

PDA gets _______ as it gets smaller

A

louder

54
Q

When does PDA generally close

A

12-28 hours

55
Q

Where to hear Transient tricuspid regurg

A

LLSB

56
Q

which septal defect can lead to CHF?

A

ventricular

57
Q

which defect causes decreased pluse and BP in lower extermities?

A

coarctation of aorta

58
Q

what is the problem if someone has an unrepaired ASD?

A

increased risk of stroke

59
Q

what disease can lead to myocarditis?

A

cocksackie b

60
Q

ASD characteristics

A

exercise intolerance, no CHF, wide, fixed splitting of s2

61
Q

what could aortic dissection be associated with?

A

Marfan

62
Q

Patients prefer to lean forward, may refuse

to lie down when they have

A

pericarditis

63
Q

which sound can you hear with pericarditis

A

friction rub or distant heart sounds (if effusion)

64
Q

90% of endocarditis cases are caused by _________

A

gram positive cocci

65
Q

clincial features of endocarditis

A

fever, tachy, CHF, dysrhytmia, murmur, petichiae, splenomegaly

66
Q

clincial features of bacterial endocarditis

A

fevers, conjunctival hem, slpinter, janeways lesons,

67
Q

what can developin 20% of kawasaki cases

A

coronary artery aneurysms

68
Q

Kawasaki disease diagnostic criteria

A 
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
Q

Signs of Moeblus

A 
lack facial expressions
micrognathia and microstomia
weird tongue or palate
missing teeth
strabismus
70
Q

diagnostic test that measures changes in cereberal blood flow

A

fMRI

71
Q

diagnostic test that evaluates brain chemistry

A

MRS

72
Q

diagnostic test that images blood flow in large arteries and veins and vessel patency

A

MRA

73
Q

macrocephaly assessment components

A 
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
Q

duchenne muscular distrophy treatment components

A

steriod, nocturnal ventilation, cardiac support

75
Q

spinal muscular atrophy is characterized by

A

degeneration of brainstem and spinal cord motor neurons resulting in progressive weakness and muscle atrophy.

76
Q

what is the most likely diagnosis of 2 mo with hyporeflexia and resp problems?

A

SMA1

77
Q

Many prescription drugs can unmask or worsen symptoms of

A

myasthenia gravis

78
Q

extreme episode of weakness that culminates in respiratory failure and the need for mechanical ventilation is ___________

A

myasthenic crisis

79
Q

what can you elicit in the office with hyperventilation

A

absence

80
Q

which seizures Will not usually remit without anticonvulsants

A

Juvenile Myoclonic Epilepsy

81
Q

early signs of CP

A

alterned tone
persistence of primitive reflexes
abnormal posturing

82
Q

Cerebral Palsy Associated Disabilities

A 
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
Q

diagnostic test for CP

A

MRI

84
Q

reflexes associated with CP

A

landau, parachute, propping reflex

85
Q

which condition presents with limited or absent mobility of TM,

A

AOM

86
Q

Chronic suppurative OM:

A
  • Persistent inflammation of the middle ear or mastoid cavity
  • Recurrent or persistent otorrhea through a perforated tympanic membrane
87
Q

Side Effects of Antihistamines

A

anticholinergic, CNS stim in children

88
Q

decongestants s/e

A

irritablity, nervousness, headache, urinary hesitancy, tachy, HTN

89
Q

80% of pharyngitis cases are ________

A

viral

90
Q

bacterial vs. viral sx of pharyngitis

A

bacterial: whitis spots, gray furry tongue, swollen uvula; both: red swollen tonsils and throat redness

91
Q

infectious mono present w/ the triad of

A

fever, pharyngitis and lymphadenopathy

92
Q

what causes majority of mono?

A

epstein-barr (also cytomegalovirus)

93
Q

why should mono patients avoid sports?

A

hepatosplenomegaly

94
Q

differential presentaiton of diphterhia pharyngitis

A

bull’s neck membrae, pseudo membrane exudate

95
Q

PANDAS presentation

A

abrupt onset or exacerbation of OCD or tic behavior (related to strep infection)

96
Q

Recurrent GABHS: Treatment

A

clinda, amox/ca, add rifampin to benzathine penicillin G

97
Q

Peritonsillar Abscess presentation

A

Fever, chills, malaise, halitosis, toxic appearing, ‘hot potato” voice, drooling

98
Q

Peritonsillar Abscess mgmt

A

refer to ED or ENT

99
Q

Epiglotitis presentation

A

severe odynophagia, dysphagia, fever, drooling, SOB, distress, stridor

100
Q

tacnypnea defintion Younger than two months

A

> 60 breaths/min

101
Q

tacnypnea 2-12 mos

A

> 50 breaths/min

102
Q

Tachypnea 1-5 years

A

> 40 breaths/min

103
Q

greater than 5

A

> 20 breaths/min

104
Q

1st line tx for pneumonia

A

amox 90 mg/kg 2 divided doses

105
Q

most common cause of bronchiolitis

A

RSV

106
Q

who is a happy wheezer?

A

someone with bronchiolitis

107
Q

what ages to give 2 flu shots?

A

6 months to 8 years

108
Q

no live vaccines for thoseI

A 
under 2
over 50
with asthma or COPD
contact with immunosupprssed
recent use of steroids
recent live vaccine

DNP Peds (1 decks)

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