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Peds Newborn- Adolescents > week 3 content > Flashcards

week 3 content Flashcards

1
Q

AAP periocity table of timing of well child visits

A
  • 3-5 days of age (when home from hospital)
  • 1 month
  • 2,4,6,9,12,15,18,24, and 30 months
  • annually beginning age 3
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2
Q

start the visit: 3 things

A
  • review VS and anthropometrics before you enter the room
  • greet the family and patient
  • ask about concerns
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3
Q

first step of the data collection

A

history

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4
Q

when does the head to toe PE start?

A

preschool

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5
Q

interval history

A

allergies, ER visits, illnesses, injuries, hospitlaizations

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6
Q

other components of the history

A
  • medications
  • nutritional history
  • physical activity hisotry
  • elimination
  • safety
  • sleep
  • social history
  • developmental history
  • mental health assessment
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7
Q

temp taking regulations

A
  • no axillary temps (except for newborn)
  • no typmanic temps less than 6 mo
  • oral temp at age 4-5 years
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8
Q

apicle pulse should be taken when

A

ages 6 years and younger

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9
Q

bp should be taken when

A

ages 3 years and older

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10
Q

length measured until when

A

2 years, then the height is started

when switching over, there can be a change in length becuase when they are laying down they can be “stretched” a bit

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11
Q

head circ is measured when

A

3 years and younger

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12
Q

BMI calculated at age

A

2 and older

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13
Q

notes about wt measuring

A
  • infant weighed naked, no diaper
  • toddlers weighed in diaper only
  • preschool and older weight with no shoes or jacket
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14
Q

absent red reflex

A

indicative of a retinoblastoma

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15
Q

weak or absent femoral pulses

A

coarc of the aorta

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16
Q

undecended testes

A

need to have happened and if not, should be refered to urology by 6 mo of age

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17
Q

hip click

A

look for it in every exam for the first whole YOL (ortolani and barlow)

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18
Q

strabismus

A
  • intermittment si normal for first 4 mo
  • finding can be cover uncover test OR unequal light reflexes
  • if not fixed, what can happen: amblyopia
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19
Q

umbilical hernia

A

can resolve on own

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20
Q

scoliosis

A

assessed via forward bending beginning at age 9-10 for girls and 11-12 for boys. refer if >25 degrees

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21
Q

aap recommendations for PPD screening

A

1,2,4,6 mo visits
use Edinburg of PHQ9
if depression is found, sent to therapy, provider or ER if self harm is evident

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22
Q

CCHD screening

A

pulse ox on R arm, and R or L lower extremity
pass : difference between them is less than 3% and both are between 95-100%

23
Q

school hearing tests ages

A

4,5,6,8,10 and then 1 time between ages 11-14, and another time between 15 and 17

24
Q

iron deficincy

A
  • risk assessment: 4 mo
  • preemie: higher risk for iron deficiency
  • risk assessment measure H and H at 12,15,18,24, and 30 mo
25
Q

dental screening and oral health

A
  • 6 months: screening starts
  • 1 year: refer to dental home
  • first semi-annual cleaning starts at 3 years
26
Q

latent TB

A

1,6,12 and 24 mo risk assessment

27
Q

reasons to check blood pressure before age 3

A
  • SGA
  • birth weight <1500g
  • born at < 32 weeks
  • neonatal complications that require intensive care or umbilical artery catheterization
    -CHD
28
Q

screening for dyslipidemia

A

kids with risk factors: begins after the age of two
kids without risk factors: screen 2x during childhood, once between age 9-11, one between 17-21

29
Q

screening for alcohol, nicotine and substance abuse starts when

A

age 11. start the conversation of dangers at age 9

30
Q

depression screen

A

annual 12-21

31
Q

girls reach full height when?

A

1-2 years after menarche

32
Q

first female sign of puberty, then what follows?

A

breast development or thelarchy, 6 months later then there is pubic hair

33
Q

average age of menarche

A

12.5 years (usually 1.5-2.5 years after breast bud development, takes 18-24 mo to establish reg. cycles

34
Q

primary amenorrhea

A
  • no menarche by 16 years
  • no breast buds by 14 years
35
Q

earlist puberty change for males is? what happens 6 months later?

A

growth of the testes, grow pubic hair (adrenarche), then elongation/widening of the penis.

36
Q

which teste hangs lower

A

L

37
Q

3 causes of death in adolecents

A

1) unintentional injuries (MVA)
2) suicide (last 15 years)
3) homicide

38
Q

situations to breech confidentiality

A

danger to self
danger to others
child abuse
resportable STI’s
gunshot/knife wound
billing 3rd party payers

39
Q

sensitive questions to ask with parents out of the room

A

BI-HEADSS
Bi- body image
do you ever feel bad about your weight? does anyone else make you feel bad about your weight?

H-home situation
Do you feel safe at home?

E-education/employment
do you have a job? how are things going at school?

A- activities
are you in sports?

D- dating/drugs
have you ever tried any frugs? marijuana? pills? have you tried alcohol?

S-sexuality
do you have a girlfriend/boyfriend or both? are you sexually active? what types of sexual acitvity are you engaed in? do you use protection? have you ever been made to do seomthing you are uncomfortable with doing?

S- suicide

40
Q

testing/screening for STI’s

A

sexually active: screen annually for chlamidia and gonorrea
HIV: once between ages 15-18 per periocidity table

41
Q

difference between PE and WCC

A
  • does not replace a WCC
42
Q

stats on sports physical

A

65-75% detection rate of conditions

43
Q

history that is connected to CHD

A
  • alcohol exposure in utero
  • fam h/o
  • maternal diabetes
  • h/o rhumatic fever or Kawasaki
    -genetic
43
Q

timing of sports physical

A

4-6 weeks before the season starts

44
Q
A
45
Q

s1 sound

A

closure of the mitral and tricuspud valve

inaudible: VSD< atrioventricular valve regurgitation, PDA, and occasionally Pulm valve stensosis

46
Q

pathological murmurs

A

higher than a grade 3- when a thrill is present

47
Q

venous hum

A

not pathalogical- no referral

48
Q

functional murmur identifier

A

stills murmur decreases in intensity when the child stands up

49
Q

what are we worried about when the murmur increases when the patient stands up?

A

hypertrophic cardiomyopathy- associated with sudden death in athletes

50
Q

thrills are felt with what

A

blood flow from high to low pressure

51
Q

innocent murmur VS ASD

A
  • precordial activity is increased in ASD
  • S2 splits and moves with respiration in an innocent murmur wharas it is “fixed” and non effected by inspiration in an ASD
  • patient stands up- innocent increases in intensity, ASD does not
52
Q
A

Peds Newborn- Adolescents (12 decks)

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