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GK Clinical Disciplines II Exam 1 > Well Child 2 > Flashcards

Well Child 2 Flashcards

1
Q

Abdomen

  • What are the vessels of the umbilical cord?
  • Definition: develops at base of navel, pink granulation tissue formed during the healing process
A
  • Cord: 2 umbilical arteries, 1 umb vein
  • Umbilical granuloma
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2
Q

What is this?

A

Umbilical Granuloma

  • develops at base of navel
  • pink granulation tissue formed during healing process
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3
Q

Male GU

  • Presence of testes, size of penis, appearance of scrotum
  • 30% of pre term male infants are born w/ what?
  • Definition: abnormal ventral placement (check before what?)
  • Definition: abnormal dorsal placement (uncommon)
A
  • 30%: undescended testicle
  • Hypospadias (Hypo-below)
  • Epispadias (Epi-eye)
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4
Q

Male GU

  • What are 2 common scrotal masses in newborns?
  • What side are they most common on?
A
  • hydroceles & inguinal hernias
  • RIGHT
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5
Q

Which mass?

  • Overlie the testes & spermatic cord
  • Not reducible
  • Can be transilluminated
  • Usually resolves by __ months
  • Refer to urology to r/o what?
A

Hydrocele

  • 18
  • hernia
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6
Q

Which mass?

  • Separate from the testes
  • Usually reducible
  • Often DO NOT transilluminate
  • Do not resolve
A

Hernias

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7
Q

Female GU

  • Often a milky white discharge present, but what may be present?
  • Labial adhesions
  • What may be noted at birth?
A
  • Blood tinged
  • imperforate hymen
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8
Q

Anus / Spine

  • Imperforate anus is not always obvious. Cannot assume until baby passes what? Usually passes within how many hours?
  • If there is a sacral dimple, must get what test?
A
  • Meconium / 48 hours
  • US (to check for spina bifida)
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9
Q

Extremities

  • Count fingers/toes
  • Check for what 2 things?
A
  • Syndactyly (webbed or conjoined fingers or toes)
  • Palmar crease (single palmar crease - simian crease associated w/ trisomy 21)
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10
Q

Hip

  • Evaluation for what condition?
A

Developmental dysplasia of the hips (DDH)

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11
Q

5 risk factors for Developmental Dysplasia of the Hips (DDH)

A
  • breech
  • caucasian
  • 1st born female
  • family hx
  • prematurity
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12
Q

Hip

  • What would prompt a further work up of DDH?
  • Which tests for ability to sublux or dislocate an intact, but unstable hip? (IN)
  • Which tests for posteriorly discolated hip? (OUT)
  • What other finding is suggestive of DDH?
A
  • Audible “click” heard w/ maneuvers
  • In: Barlow
  • Out: Ortolani
  • Asymmetry of leg creases
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13
Q

Tx for DDH?

A
  • Ortho eval & pavlik harness
  • If untreated can lead to degenerative hip disease
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14
Q

Palmar Grasp

  • Primitive Reflex
  • Place your finger into baby’s hand and press (baby will flex all fingers to grasp your finger)
  • What age?
A
  • Birth - 3/4 months
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15
Q

Plantar Grasp Reflex

  • Primitive Reflex
  • Touch sole at base of toes
  • Toes will curl
  • Age?
A
  • Birth - 6/8 months
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16
Q

What reflex?

  • Hold baby supine while supporting head, back, legs
  • Abruptly lower entire body about 2 feet
  • –> arms should abduct & extend
  • –> hands open & legs flex (baby may cry)
  • Age?
  • Persistence beyond what age suggests what?
  • Asymmetric response indicates what?
A

Moro Reflex (Startle Reflex)

  • birth - 4 months
  • 6 months –> neurological dz: CP
  • Fx of clavicle or brachial plexus injury
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17
Q

Which primitive reflex?

  • with baby supine, turn head to one side, holding jaw over shoulder
  • the arms/legs on side to which head is turned extend (think bow & arrow)
  • the opposite arm/leg flex
  • What age?
  • Persistence beyond this age suggests what?
A

Asymmetric Tonic Neck Reflex

  • Birth - 2 months
  • asymmetric central nervous system development
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18
Q

Which reflex?

  • Hold the baby around the trunk & lower until the feet touch a flat surface
  • the hips, knees & ankles extend & baby stands up, partially bearing weight, sags after 20-30sec
  • What age?
  • Lack of reflex = hypotonia or flaccidity
A

Positive Support Reflex

  • Birth - 2/6 months
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19
Q

Which reflex?

  • stroke the perioral skin at the corners of the mouth
  • the mouth will open & baby will turn the head toward the stimulated side
  • Age?
A

Rooting Reflex

  • Birth - 3/4 months
20
Q

Which reflex?

  • Support the baby prone w/ one hand
  • stroke one side of the back 1cm from midline, from shoulder to buttocks
  • the spine will curve TOWARD the stimulated side
  • Age?
  • Absence suggests what?
A

Trunk Incurvation (Galant’s Reflex)

  • Birth - 2 months
  • Transverse spinal cord lesion or injury
21
Q

Which reflexes?

  • hold baby upright from behind (as in positive support reflex)
  • have one sole touch the tabletop
  • the hip & knee of that foot will flex & the other foot will step forward
  • alternate stepping will occur
  • What age?
A

Placing & Stepping

  • Birth (best after 4 days) - variable age to disappear
22
Q

Vision

  • Always check for what?
  • Ages 3-5: 20/40
  • Ages 6+: 20/30
  • The AAP recommends annual photo screening between what ages?
  • What is the MC cause of childhood blindness?
A
  • Red reflex
  • 1 - 3 yrs
  • Amblyopia
23
Q

Hearing Screening

  • AAP recommends universal hearing screening before when?
A

Before leaving the hospital

24
Q

Blood Pressure

  • Start checking at what age?
  • Check before this age if pt has risk factors:
    • Kidney disease, prematurity, congenital heart disease, recurrent UTIs, hematuria, proteinuria
    • Other conditions associated w/ HTN: neurofibromatosis, tuberous sclerosis)
A
  • 3 yrs
25
Q

Additional Screening

  • Check what level to screen for iron deficiency at 9 months or 12 months?
  • CDC recommends universal screening of what for children age 1-2 yrs old?
  • Autism screening at what ages?
  • STI testing for high risk adolescents
A
  • Iron def: Hemoglobin
  • 1-2 yrs: Lead (targeted screening for those in communities w/ high risk = homes before 1950)
  • Autism: 18mo & 24mo
26
Q

Lipid Panel

  • Fasting lipid screening is recommended for children between what ages?
  • (if what 6 certain RF are present?)
  • Controversial if need to screen if pt/adolescent has no RF or Fam hx
A
  • 2 - 10 yrs
  1. Fam hx of HLD
  2. Fam hx of early CV disease
  3. Obesity
  4. Overweight
  5. HTN
  6. DM
27
Q

Dental

  • Wash gums/teeth prior to 1st dental visit
  • 1st dental visit between what ages?
  • Brush 2x/day
  • Floss 1x/day
  • Dental visit how often?
A
  • 1st: 12mo - 3yrs
  • Every 6 months
28
Q

Dental: Baby Teeth eruption ages: UPPER

  • Central incisor
  • Lateral incisor
  • Canine
A
  • Central: 8-12 months
  • Lateral: 9-13 months
  • Canine: 16-22 months
29
Q

Dental: Baby Teeth eruption ages: UPPER

  • 1st molar:
  • Second molar:
A
  • 1st: 13-19 months
  • 2nd: 25-33 months
30
Q

Dental: Baby Teeth eruption ages: LOWER

  • 1st molar:
  • 2nd molar:
  • Canine:
  • Lateral incisor:
  • Central incisor:
A
  • 1st molar: 14 - 18 mo
  • 2nd molar: 23 - 31 mo
  • Canine: 17-23 mo
  • Lateral incisor: 10 - 16 mo
  • Central incisor: 6 - 10 mo
31
Q

Permanent Teeth Eruption - UPPER

  • Central incisor
  • Lateral incisor
  • Canine
  • 1st premolar
  • 2nd premolar
A
  • Central incisor: 7-8 yrs
  • Lateral incisor: 8-9 yrs
  • Canine: 11-12 yrs
  • 1st premolar: 10-11 yrs
  • 2nd premolar: 10-12 yrs
32
Q

Permanent Teeth Eruption - UPPER

  • 1st molar:
  • 2nd molar:
  • 3rd molar:
A
  • 1st molar: 6-7 yrs
  • 2nd molar: 12-13 yrs
  • 3rd molar: 17-21 yrs
33
Q

Permanent Teeth Eruption - LOWER

  • Central incisor
  • Lateral incisor
  • Canine
  • 1st premolar
  • 2nd premolar
A
  • Central incisor: 6-7 yrs
  • Lateral incisor: 7-8 yrs
  • Canine: 9-10 yrs
  • 1st premolar: 10-12 yrs
  • 2nd premolar: 11-12 yrs
34
Q

Permanent Teeth Eruption - LOWER

  • 1st molar:
  • 2nd molar:
  • 3rd molar:
A
  • 1st molar: 6-7 yrs
  • 2nd molar: 11-13 yrs
  • 3rd molar: 17-21 yrs
35
Q

Car Safety

  • Rear facing car seat until how old?
  • Booster seat until how tall?
  • No front seat until what age?
A
  • Rear facing: 2 yrs
  • Booster: 4’9”
  • Front seat: 13 yrs
36
Q

Safety at Home

  • Keep what 3 things away from kids in the house?
  • What number should you have on hand?
A
  • Button batteries
  • Laundry pods
  • cleaning products
  • Poison control
37
Q

Milestones of what age?

  • fixes/follows on face
  • some head control
  • responds to sounds/noises
  • spontaneous smile
A

1 month

38
Q

Milestones of what age?

  • Responsive smile
  • coos/vocalizes
  • lifts head when prone
  • follows to midline
A

2 months

39
Q

Milestones of what age?

  • rolls from tummy to back
  • good head control
  • laughs, squeals
  • follows past midline
  • grasps toys/objects
A

4 months

40
Q

Milestones of what age?

  • sits w/ support
  • bears weight on legs
  • vocalizes “ba, da-da”
  • reaches out for toys
  • follows 180 degrees
  • stranger danger/separation anxiety
A

6 months

41
Q

Milestones of what age?

  • crawls
  • pulls up to stand & cruises on furniture
  • says mama/dada
  • immature pincer grasp
  • responds to name
A

9 months

42
Q

Milestones of what age?

  • walks (however, may be delayed up until __ months)
  • waves bye-bye
  • says mama/dad
  • points w/ index finger
  • self feeds w/ fingers
A

12 months

  • 18 mo
43
Q

Milestones of what age?

  • 3-6 words
  • walks well
  • climbs stairs
  • imitates actions
A

15 months

44
Q

Milestones of what age?

  • 5-15 words
  • some 2 word phrases
  • uses spoon/fork
  • scribbes
  • follows simple commands
  • runs, walks backward
A

18 months

45
Q

Milestones of what age?

  • 20-50 words or more
  • 2 word phrases
  • kicks ball
  • builds 3-4 block tower
  • 50% speech understandable
A

24 months

46
Q
A

GK Clinical Disciplines II Exam 1 (13 decks)

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