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Pediatrics I, exam 1 > WCE, failure to thrive > Flashcards

WCE, failure to thrive Flashcards

1
Q

List the ages recommended for when a child should get checked for health maintenance

A
  • newborn
  • 1 month
  • 2 months
  • 4 months
  • 6 months
  • 9 months
  • 12 months
  • 15 months
  • 18 months
  • 2 years
  • 2.5 years
  • 3 years
  • anual until age 6
  • every 2 years from age 6 - adolescence
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2
Q

What is the “triad” when taking history of child

A

provider-parent-child

  • used to assess developmental stage of child and cognitive stage of child
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3
Q

how can you, as a provider, encourage child participation

A
  • use child’s name
  • have child state his/her problem
  • use words child can understand
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4
Q

Where should the child be located during the interview at ages (0-2 years); (3-5 yrs); and (6-up)

A
  • 0-2 yrs: parent’s lap or arms
  • 3-5 yrs: freely moving about room
  • 6 and above: exam table
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5
Q

What parameters of growth should be obtained at pediatric visits

A
  • length/height
  • weight
  • weight for length
  • BMI
  • head circumference
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6
Q

what growth chart is used for children 0-2 yrs of age

A

WHO growth charts

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7
Q

What growth chart is used for children 2 years and older

A

CDC growth chart

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8
Q

How should you measure height for a child under 2 yrs? Childen over 2 yrs?

A
  • under 2: measure lying down in supine position
  • above 2: measure standing
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9
Q

How should you weight a infant

A
  • in a clean diaper
  • weigh infant to the nearest 0.01 kg or 1/2 oz
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10
Q

how should you weigh a child 3 years and older

A

without shoes

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11
Q

weights between what percentage points are considered normal

A

5%-85%

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12
Q

What percentile is considered underweight, overweight for youth (2-18 yrs)

A
  • underweight:BMI < 5%
  • overweight: BMI = 85%-95%
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13
Q

what age range should head circumference be calculated

A

0-3 years

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14
Q

what is a good rule of thumb when considering what is normal for head circumference

A

head circumference should correlate with the child’s lenght (if length is 40th percentile; HC should also be 40th percentile)

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15
Q

how do you calculate mean parental height for boys and girls to determine if child’s height is normal

A
  • girls: (paternal height (in.) + maternal height (in) - 2.5) / 2
  • boys: (paternal height (in.) + maternal height (in) + 2.5) / 2
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16
Q

What is a patient’s weight concerning

A

drop more than one large percentile or extreme underweight

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17
Q

What is the rule of thumb for growth for the first 2 years of life

A
  1. weight loss in first few days (5-10%)
  2. return to birth weight by 7-10 days
  3. double birth weight 4-5 months
  4. triple birth weight 1 yr
  5. quadruple birth weight 2 yr
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18
Q

average weight at birth, 1 yr, 5 yr and 10 yr

A
  • birth: 3.5 kg
  • 1 yr: 10 kg
  • 5 yr: 20 kg
  • 10 yr: 30 kg
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19
Q

average daily weight gain for the first 3-4 months? For the rest of the first year?

A
  • 20-30 g for first 3-4 months
  • 15-20 g for rest of 1st year
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20
Q

average length at birth

A

20 in

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21
Q

average HC at birth

A

35 cm

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22
Q

what parameters show failure to thrive

A
  • height or weight drops below 3rd percentile on standarized growth chart
  • drop of 2 or more major percentile lines on standarized growth chart
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23
Q

caloric intake required for infants

A

100 to 110 kcal/kg/day

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24
Q

When can a child be diagnosed with HTN

A

systolic BP and or diastolic BP > or = to 95% for age, sex, and height on 3 or more occasions

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25
Q

stages for HTN

A
  • stage 1: BP > or = 95% but < (99th percentile + 5 mm Hg)
  • stage 2: BP > (99th percentil + 5 mm Hg)
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26
Q

when does annual screening for BP begin

A

3 yrs old

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27
Q

Children younger than 3 y.o should have his/her BP measured under the following circumstances

A
  • premature
  • congenital heart disease
  • renal disease
  • transplant (organ or bone marrow)
  • CA
  • elevated intracranial pressure
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28
Q

what are the 3 most common disorders among children and adults

A
  1. language impairment
  2. learning disabilities
  3. intellectual disabilities
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29
Q

at what visits does the AAP encourage developmental-behavioral surveillance

A
  • 9 mo
  • 18 mo
  • 2 yr or 2.5 yr
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30
Q

Parent report tests

A
  • Parents’ evaluations of developmental status (PEDS)
  • PEDS: developmental milestones (PEDS:DM)
  • Ages and stages questionnaire
  • infant-toddler checklist for language and communication
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31
Q

direct observation/elicitation tests

A
  • Battelle developmental inventory screening test (BDIST)
  • PEDS:DM
  • Bayley infant neurodevelopmental screen (BINS
  • brigance screens II
  • safety word inventory and literacy screener (SWILS)
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32
Q

Broad-band tests (involve parent report)

A
  • ages and stages questionnaire: social emotional (ASQ: SE)
  • Brief infant-toddler social emotional assesment (BITSEA)
  • conners 3rd edition (conners 3)
  • Eyberg child behavior inventory/sutter-Eyberg student behavior inventory
33
Q

narrow band tests

A
  • conners 3 attention deficit hyperactivity disorder (ADHD) index (Conners 3AI)
  • modified checklist for autism in toddlers (M-CHAT)
  • vanderbilt ADHD diagnostic parent and teacher rating scale
34
Q

rule of thumb to calculate average weight in kg

A

10 + 2(age) or 4 + (mo/2)

35
Q

rule of thumb to calculate max normal HR

A

170-10 (age)

36
Q

rule of thumb to calculate min normal HR

A

70 + 2 (age)

37
Q

rule of thumb to calculate max normal RR

A

50-10 (age)

38
Q

when should you consider a pediatric cardiology referral

A
  • h/o heart disease or murmur
  • h/o dyspnea or chest pain on exertion
  • irregular HR or palpitations
  • syncope
  • fam h/o MI, CVA before age 50 yr
39
Q

what 3 things are you concerned with when examing an adolescent

A
  1. progress through puberty
  2. obesity
  3. orthopedic problems
40
Q

what is common when assessing the neck of people ages 6-20 yrs. What are RED flags

A
  • lymph nodes, tonsils, adenoids are greater in size during this time than adulthood
  • asymptomatic cervical lymphadenopathy is common
  • RED fLAGS: painful, unilateral solitary adenopathy > 2 cm diameter, weight loss
41
Q

when should you refer a child who commonly gets pharyngitis to ENT

A

after 3-4 documented strep infections in one year

42
Q

How do you get a child to take a deep breath

A

“blow out” a light

43
Q

Where should you auscultate the heart until age 7

A
  • 4th intercostal space until age 7 (then drops to 5th)
  • left of mid-clavicular line at 4 years; at MCL at 5-6 years; to right of MCL at 7 years
44
Q

If you detect a systolic, short duration, low intensity murmur in a child, what should you tell parents

A

50% of children may have an innocent murmur during childhood

45
Q

what is a contraindication to play sports

A

presence of 1 kidney

46
Q

what should you check for once males start participating in sports or weight lifting

A

inguinal hernia

47
Q

when should you start doing a pelvic exam on females

A

sexually active

48
Q

what rating system is used to note development of secondary sexual characteristics

A

Tanner Sexual Maturity Rating (SMR)

49
Q

what would give a tanner score of 1 in a girl

A
  • nipple elevation only
  • no pubic hair
50
Q

what would get a tanner score of 1 in a male

A
  • testicles 1-2 cm
  • no pubic hair
51
Q

when does visual acuity check start

A

3 yo

52
Q

what eye exam scores for preschoolers and children > 6 warrant referral

A
  • preschoolers less than 20/40
  • children > 6 yo less than 20/30
53
Q

when does infant hearing screening begin

A

1 month

54
Q

if infant has not passed otoacoustic emissions (OAE), when should comprehensive eval take place

A

by age 3 mo

55
Q

automated auditory response (AABR)

A

measures how hearing nerve responds to sound: clicks or tones are played through earphones into baby’s ears. 3 electrodes are placed on head that measure nerve response

56
Q

otoacoustic emissions (OAE)

A

measures sound waves produced in inner ear

57
Q

AAP recommends that children ages (XX) get formal hearing screening

A
  • (2 yr if risk factors for hearing lose) otherwise ..
  • 4 yr
  • 5 yr
  • 6 yr
  • 8 yr
  • 10 yr
58
Q

AAP recommendation for screening of cholesterol and lipids for peds

A

do not support universal screening!

  • screening is recommended for BMI > 85th percentile or if children are at high risk for hyperlipidemia
59
Q

congential heart disease puts a child at what risk group category?

A

Tier III: high setting for accelerated atherosclerosis therefore needs cholesterol and lipid screening

60
Q

medicaid eligibilty to screen for lead

A
  • 9 mo
  • 12 mo
  • 24 mo

* lead levels usually peak at 18-24 mo

61
Q

With increased risk of exposure to lead, how long should you do blood tests

A

up to 6 yrs

62
Q

iron deficiency anemia is how prevalent in 1-3 yr old children

A

8%

63
Q

when should you iniate hemoglobin and hematocrit testing

A

between 9-12 mo

  • prematurity, low-iron formulas are risk factors
64
Q

poor, or special needs children should get iron deficiency anemia assessments ..

A
  • 18 mon
  • 2 yr
  • 3 yr
  • 4 yr
  • 5 yr
65
Q

when shoud you not assess iron deficiency anemia

A

acute illness or within several weeks of fever/infection

66
Q

when should a UA be performed

A

routine surveillance not performed

67
Q

AAP recommendation for TB testing

A
  • annual TB testing is not recommended for all children
  • selective screening based on risk : homeless shelter; clinical findings suggestive of TB; immunosuppressive therapy; HIV +; incarcerated
68
Q

when should dental screening begin

A

1 yr

69
Q

median age of SIDS? peak incidence?

A
  • median age: 11 weeks
  • peak incidence: 2-4 mo
70
Q

breast feeding has what impact on SIDS

A

reduces risk

71
Q

AAP recommendation for breast feeding

A

first 6 months of life

72
Q

if breastfeeding is adequate, how many wet diapers and meconium stool will occur in first 24 hours

A
  • 1 wet diaper
  • 1 stool
73
Q

when does urine become light yellow

A

day 4 of life; 4-6 times in 24 hours

74
Q

when does stool color change from meconium stool

A

by day 3

75
Q

when does urine become colorless

A

day 5 +; expect 6-8 times in 24 hours

76
Q

is vit D supplementation recommended after birth

A

400 IU/day soon after birth with babies that are solely breastfed

77
Q

is fluoride supplementation recommended in infants

A

after 6 months with children that are solely breastfed

78
Q

standard substitute for breastmilk

A

enfamil; similac; carnation good start

* (cows milk with lactose )

Pediatrics I, exam 1 (4 decks)

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