Week 4 - Peds lecture Flashcards
If a child is ticklish during palpation, use ___ instead.
percussion
For wt, infant to 12 months = ___. Older infant = ___ only. Preschooler and older = ___-___ scale. NO ___.
nude, diaper, stand-up, shoes
Use a length board and measure for head circumference in infants to ___ months.
24
For children over ___ yrs, track BMI.
2
In a well baby, fontanel should be soft and ___. Capillary refill should be ___. ___ skin turgor.
flat, brisk, normal
In a sick baby, fontanels are ___ or ___, capillary refill is > ___ seconds. Skin turgor is ___.
bulging, depressed, 2, tenting
For fontanels, normal posterior is ___. Anterior fontanel closes around age ___.
closed, 1
Pull pinna ___ and ___ in pediatrics over age 5.
up, out
Want to see ___ ___ when performing an opthalmic exam. May be ___ in dark-skinned children. Should NEVER be ___ - indicative of osteoblastoma.
red reflex, darker, white
When palpating the precordium, it should be ___.
quiet
W/posture during development, child should go from pot-bellied to ___, lordotic to ___, and bow-legged to ___.
normal, straighter, straight
___ is where the head tilts to one side d/t a knot in the sternocleidomastoid muscles of the ___. Work w/PT and usually resolved on own.
Torticollis, neck
Knees further than ___-___ inches apart needs a referral for possibility of ___ or other causes of bowing.
3-4, ricketts
A common skin finding in children is ___ (atopic dermatitis), and is usually worse on ___ surfaces.
eczema, flexor
The Tanner scale is a ___ maturity scale. Peds should be Tanner ___ stage, which is prepubertal.
puberty, 1
Cervical lymphadenopathy is ___ in preschoolers. Worry if it is ___ or non-___.
common, tender, mobile
An ___ HR is normal bc variations occur in conjunction w/___.
irregular, respirations
When auscultating the heart, ___ are ALWAYS abnormal.
clicks
Obtain b/p at age ___.
3
Vibratory murmurs in peds is ___.
common
Unusual findings when assessing musculoskeletal includes: ___ swelling, ___ extremities, bruises NOT on ___ or ___.
joint, limp, tibia, forehead
___ assessment should be done at every well child visit, along w/physical assessment.
Developmental
When assessing adolescents, offer for ___ to leave the room.
parents
ALWAYS have chaperone present when assessing ___ on adolescents.
genitalia
When seeing dental erosions in adolescents, think either ___ or ___.
reflux, bulimia
Lymphadenopathy in adolescents is ___ normal.
not
In adolescents, use ___ ___ to check for mitral valve prolapse.
valsalva maneuver
Turner’s syndrome occurs in ___ and is a lack of the usual pair of ___ chromosomes, so may lack ___ features.
females, X, female
Klinefelter’s syndrome occurs in ___ and is where they have an extra ___ chromosome, so may develop ___ features, such as ___.
males, X, female, gynecomastia
Routine pelvic exams does not occur until ___ yrs of vaginal intercourse, or age ___.
3, 21
T or F: A female does not have to have a pelvic exam before starting on BC.
True
Important to educate males to clean underneath ___ if not circumsized.
foreskin
On male genitalia exam, perform a ___ cancer screening, ___ exam, and check for ___.
testicular, hernia, varicoceles
Varicoceles is swelling of the veins inside the ___, found along the ___ cord.
scrotum, spermatic
Important to screen for ___ and ___ in the musculoskeletal exam in adolescents.
scoliosis, kyphosis
Need to perform a ___-step exam for a physical in adolescents.
13
Step 1 is: observations of ___ and ___. Instruct pt to stand w/arms at ___.
stance, symmetry, side
Step 2 is: ___-___ flexibility. Instruct pt to look at ___ (c-spine extension), look at ___ (c-spine flexion), touch both ears to ___ (lateral flexion), and turn head to both sides (rotation).
C-spine, ceiling, floor, shoulder
Step 3 is: ___ strength. Instruct pt to ___ shoulder while examiner applies pressure against them. Expect ___ bulk and strength.
shoulder, shrug, symmetrical
Step 4 is: ___/___ strength. Instruct pt to hold arms ___ and lift ___ while examiner applies pressure against them. Expect ___ bulk and strength.
arm/shoulder, out, up, symmetrical
The first part of step 5 is: ___ external rotation. Instruct pt to hold arms out from ___ w/elbows bent at ___ degrees and raise ___ back as far as they can go.
shoulder, side, 90, hands
The second part of step 5 is: shoulder ___ rotation. Instruct pt to hold arms to ___, elbows bent at ___ degrees, pull hands downward, palms facing ___.
internal, side, 90, backward
Step 6 is: ___ ROM. Instruct pt to hold arms out from ___, palms up, straighten ___ completely; ___ completely.
elbow, sides, elbows, bend
Step 7 is: ___/___/___ assessment. Instruct pt to hold arms ___ at sides w/elbows bent at ___ degrees, supinate ___; pronate ___.
elbow/forearm/wrist, down, 90, palms, palms
Step 8 is ___/___ assessment. Instruct pt to make a ___; open hand and ___ fingers.
hand/finger, fist, spread
Step 9 is: ___ screen and assessment of ___ extremity. Observe symmetry of ___, ___, ___, and ___.
Scoliosis, lower, shoulders, waist, thigh, calf
Step 10 is: forward ___. Instruct pt to bend forward w/head and arms dangling. Observe for ___ across back.
bend, symmetry
Step 11 is: ___ strength and ___ ___ assessment. Instruct pt to stand on ___ and walk forward, then stand on ___ and walk forward.
calf, achilles tendon, heels, toes
Step 12 is: ___ flexion/extension. Instruct pt to squat on ___ and duck-walk for ___ steps, then stand up. Expect ___ movement, equal heel to butt distance, equal knee flexion, and to rise straight up.
knee, heels, 4, painless
Step 13 is: ___ extension. Instruct pt to lean back as far as possible.
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