Week 1

Question 1

History taking in pediatrics

Answer 1

Chief complaint, past history including birth history - prenatal, natal, postnatal. Allergies. Accidents, broken bones. Illnesses. Operations/Hospitalizations. Immunizations. Lab tests. Family hx of siblings, family health, family social hx

Question 2

ROS

Answer 2

Question each system, measure growth chart, weight, head circumference, BMI. Nutrition: breast fed, formula, eating habits. Patterns of elimination. Sleep patterns, naps. G&D.

Question 3

Not urinated in >6 hours worry about

Answer 3

dehydration

Question 4

Well child exam times

Answer 4

Newborn after discharge or 2 weeks later.. Then 1, 2, 4, 6 months then every 3 months until 2 years then 2.5y, 3y, 4y and annual

Question 5

Nutrition

Answer 5

What do they eat, how much formula, how often are they being breast fed. Solid food; 4-6 months. 1 year – how much whole milk versus solid foods. 2 year – type of milk? 2%. Variety of foods? Veggies, fruits.

Question 6

Elimination

Answer 6

Normal bowel pattern, how often wet diapers, toilet trained? Accidents day or night – may indicate Type 1 DM, Issues w constipation? When sick get hypermetabolic and can get loose stools leading to dehydration

Question 7

Sleep

Answer 7

Normal sleep pattern? Naps? Where do they sleep? Where do they wake up? Problem falling asleep or staying asleep

Question 8

When to assess respirations

Answer 8

When child is asleep count breaths for 1 minute

Question 9

Height

Answer 9

Record on growth chart, gain 1 inch per month, deviation may be endocrine problem

Question 10

Red flags

Answer 10

Weight parameters w change of 2% or greater, height below or above average, head circumference off the established curve, abnormal vital signs

Question 11

Measure height

Answer 11

Standing in socks or bare feet with heels back and shoulders touching wall

Question 12

Weight

Answer 12

Record on growth chart, newborn lose 10 percent of BW in 3-4 days, gains 1 ounce per day after that. Goal is to gain the 10 percent lost by dc in 2 weeks

Question 13

Weight norms

Answer 13

double birth weight by 6 months, triple by 1 year

Question 14

Head circumference

Answer 14

Done every visit up to 2 years, post font take 4 weeks to close triangle shape, anterior take 12-18 months diamond shape. Wrap tape over eyebrows and occipital prominence

Question 15

breast and genitalia scale

Answer 15

tanner

Question 16

this can fx during birth

Answer 16

clavicle

Question 17

musculoskeletal exam hips

Answer 17

ortaloni and barlows

Question 18

Neurological exam

Answer 18

Glasgow coma scale, observe natural state play games with them, CN 2-12

Question 19

Screening tests

Answer 19

NJ: PKU, Sickle cell, thyroid, galacftosemia. Billirubin, h&h at 1 year visit, lead 6-12 mos,

Question 20

Mantoux test

Answer 20

9-12mo, 4years, adolescence. 0 - negative, 3-5 + w close contact w TB patient, abnormal CXR, HIV, or

Question 21

Infant exam

Answer 21

Diaper on, wrap in blanket for warmth, pacifier to comfort, talk softly

Question 22

Head exam

Answer 22

until age 2, plot on growth curve, check fonatelles 12-18 mo anterior, post 2-5 months. Flat head babies need to do back to back sleep position.

Question 23

Toddler

Answer 23

examine on parents lap, talk w parent first, play therapy, distract w stories, let toddler play w equipment, call by name, praise, do exam quickly

Question 24

Preschool

Answer 24

have parent within eye contact, explain what you are doing

Question 25

School age child

Answer 25

Allow child to have choice of having parent present

Question 26

School age exam

Answer 26

privacy, explain procedure, explain equipment, interact during exam, matter of fact about genital exam

Question 27

Adolescent

Answer 27

ask about parent in room, private interview time for difficult questions, privacy

Question 28

headss exam

Answer 28

Home environment, Education, Activities, Drugs/Drinking, Safety, Sexuality

Question 29

Early autism screening tools

Answer 29

Infant/toddler checklist behavior scale, Modified checklist for autism in Toddlers (M-CHAT)