The "Well-Child" and Child Development Flashcards
Preterm vs post term baby skin
Preterm – Red, Gellatinous
Post – Leathery, cracked, wrinkled
Non skin physical signs of immaturity
no languo, plantar crease,
Flat/folded Ponna
Scrotum empty w/out rugae/prominent clitoris
Important details for “Cradle Cap”/Seborrhea
Usually self limited
Gentle exfoliation, topical ketoconazole, or weak steroid
Important details for transient neonatal pustular melanosis
Etiology Unknown, Lesions Fade, No treatment needed
Make sure it isn’t herpes
Important details for acropustulosis of infancy
Benign, Distal extremities
First year of life, may reccur
Can use topical steroids
What is Milia?
Retention of keratin in phosphosebaceous units
Resolves in a few weeks
What is Curtis marmorata?
Vascular response to cold caused by especially superficial capillaries
Most common rash?
Erythema toxicum neonatorum
Appears in 1-2 days
Disappears in first week
Port Wine Stain is indicative of…
Sturge Weber Syndrome
Treatment for hemangioma
Laser Ablation
Difference between cephalohematoma and caput secundum
Cephalohema. – Subperiosteal, Doesn’t cross suture lines
Caput – Edema about periosteum, Does cross suture
Signs of glaucoma
Milky anterior chamber
Increased Intraocular Pressue, Abnormal angle
What should you think when you see a white reflex
RB, Congenital Cataracts
Rule of fum for ear placement
Line from inner epicanthal fold should transect upper third of the ear
What does a bifid uvual indicate
Submucosal cleft palate
What are Epstein’s pearls?
Benign inclusion cysts on the palate
What should you be assessing on a newborn chst exam
Clavicles
Symmetry/Pectus
Respiratory Rate
Signs of Distress
On X ray, Respiratory Distress Syndrome should manifest as…
Ground Glass appearance
Most common cause of abdominal mass in newborn
Kidney (hydronephrosis)
Umbilical hernia is also common
Two tests used to assess hip dysplasia
Barlow - Downward Pressure
Ortoloni - Abduct Hips
Newborn reflexes to tes
Moro Plantar/Palmar Rooting Response/Suck Reflex Steppig Response Babinski
Most common autosomal trisomy in live births
Trisomy 21
Important Down syndrome details
Epicanthal folds, upslanted palpebral features
Flat nasal bridge, Protruding tongue, low ears
Sunuab Crease, Excess skin at nape of neck
Important Trisomy 13 details?
Patau syndrome. 6 months survival.
Cleft lip, clenched hand,
overlapping fingers/polydactyl, clubfot
Aplasia cutis congenita, heart defects,
Important Trisomy 18 details?
Edwards Syndrome. Survival to school age.
Prominent occiput, low set ears, rocker bottom feet, heart defects
Important hearing screening?
Oto-acoustic emissions - Seounds sent to ear canal while microphone measures cochlear response inside the ear
Automated aud. brain resp. test - Sounds presented thru earphones. Electrodes measure brainstem activity.
Breastfeed for how long? then what?
6 months
then add in solids
Contraindications for breast feeding?
HIV, HTLV, Untreated TB, Chicken Pox, Herpes
Chemotherapy/Radiation
Alcohol/Street Drugs
Contraindication for the baby to do breastfeeding?
Galactosemia
Role or Prolactin and Oxytocin in breast feeding?
Prolactin - Production
Oxytocin - Letdown
What is the 4 by 4 rule
4 yellow bowel movements by day 4
6 wet diapers is good too
Approximate level of jaundice when infant has yellow…
Face - 5mg/dl)
Umbilicus - 15
Soles of Feet - 20
What is Acute bilirubin encephalopathy
Infant sleepy, but arousable
mild hypotonia, high pitched cry.
Difficult to console, hypertonia, neck/trunk arching.
Seizures, Resp. failure
What is kernicterus?
Chronic/Permanent sequae of bilirubin induced. neuro. dysfxn.
Choreoathetoid cerebral palsy (dystonia, tremor, chorea)
Sensorineural hearing loss
Limited upward gaze
Features of Severe Jaundice
First 24 hours
Bilirubin above 95% on nomogram
Jaundice past 2 weeks
Elevated indirect (conj.) bilirubin
Babys weight doubles by….
triples by…
2 – 5 months
3 – 12 months
What is craniosynostosis?
Premature fusion of the sutures, leading to pathologic abnormal skull shape
When to do a lead screening?
Home built before 1950
Spend time somewhere built before 78, remodeled recently
Any other kids around yours with lead poisoning?
Cholesterol indicator…
Kids aged 9-11 and 17-21 should have a nonfasting cholesterol screen done
Behavioral tasks and problems for a newborn
Sleep problems
Colic
Behavioral tasks and problems for a toddler
Autonomy, Aggression
Temper Tantrum
Toilet Training
Feeding Probs
Developmental milestones at 3 months
Motor - Raises head and chest when on stomach
Social – Social Smile
Developmental milestones at 7 months
Motor - Sits with, then without support of hands, object from hand to hand
Social – Interested in mirror images
Language – Responds to own name
Motor milestone around 9 months
Pincer grasp
Developmental Milestones at 12 months
Motor – 2-3 steps w/out support, Puts objects in container
Language - mama, dada
Cognitive - Finds hidden objects easily
Social – Shy, anxious with strangers, enjoys imitation
Developmental milestones 2yo
Stairs (with support)
Tower of 4+ blocks
2-4 word sentences
Developmental milestones age 3-4
Motor - Hops/stands on one foot, draws with 2-4 appendages
5-6 word sentences
Cognitive - Names colors
