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Clinical Disciplines II > Well Child Exam > Flashcards

Well Child Exam Flashcards

1
Q

AAP recommended well visit schedule

A 
Birth
1 mo
2 mo
4 mo
6 mo
9 mo
12 mo
15 mo
18 mo
2 yr
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2
Q

What is measured in a newborn and pediatric growth curve?

A
  • height
  • weight
  • head circumference (Tracked until 2-3 years)
  • BMI (at 2 years)
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3
Q

Growth curve

A

Overweight =85-95%
Obese = >95%
Underweight =<5%

Microcephaly= <3%
Macrocephaly = >97%
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4
Q

When is a baby technically preterm?

A

<37 weeks

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5
Q

What is normal birth weight?

A

> 2500 grams is normal

Low is <25000gm
Very low is <15000gm

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6
Q

What range is appropriate for gestational age?

A

10-90%ile

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7
Q

Neonatal period

A

1-28 days

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8
Q

Post neonatal period

A

29th day - 1 year

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9
Q

Apgar Score

A

Key assessment off the newborn immediately after birth (minute 1 and minute 5)

—SCORE OUT OF 10—

HR: 0-absent, 1- slow, 2 >100

Respiratory effort: 0- absent, 1-slow, 2-good, crying

Muscle tone: 0-limp, 1-some flexion, 2-active motion

Response to catheter in nostril: 0-none, 1 - grimace, 2 - cough or sneeze

color: 0-blue or pale, 1 - body pink, extremities blue, 2- fully pink

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10
Q

When is the genetic newborn screen done?

A

heel stick before discharge and again at 7-14 days of life

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11
Q

Color of baby

A

Cyanosis- mild is normal at birth but should turn pink soon

Peripheral cyanosis (finger tips) - can be normal for 1-2 days

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12
Q

Vernix Caseosa

A
  • cheesy white covering
  • made from fetal corneocytes/sebaceous gland activity
  • rich lipid matrix
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13
Q

Milia

A
  • pinpoint white papules without erythema
  • blocked sebaceous glands
  • located on nose, chin, forehead & cheeks
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14
Q

Mongolian Spot

A
  • aka congenital dermal melanocytosis
  • blue patches of pigment
  • location: lumbar area, buttocks, or extremities
  • fade with time
  • seen in asian, native american, hispanic, african
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15
Q

Erythema Toxicum

A
  • yellow eosinophillic papules on a red base
  • Appear on day 2-4
  • Location: trunk
  • etiology thought to be due to immaturity of the pilosebaceous follicles
  • Timing: usually disappear in the 2nd week of life
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16
Q

Craniosynostosis

A

raised, bony ridge at a suture line (premature ossification of the suture line)

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17
Q

What endocrine disorder can be associated with large fontanelles?

A

hypothyroidism

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18
Q

Fontanelle closure

A

anterior fontanelle: closes by 9-18 months

Posterior fontanelle: closes by 1-2 months

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19
Q

Cephalohematoma

A

swelling/collection of blood over one or both parietal bones
-DOESN’T cross the suture lines

-resolves in weeks to months

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20
Q

Caput Succedaneum

A
  • edema of the scalp
  • Can cross suture lines
  • resolves in days
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21
Q

Hypetelorism

A

abnormally wide eyes

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22
Q

During what age are babies nose breathers so you need to be careful about keeping their nose open

A

<1 month

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23
Q

What do you do to the auricle to examin a babies ear?

A

pull auricle down

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24
Q

Epstein’s pearls

A

small white inclusion cysts

  • benign
  • on palate
  • seen between 2-4 months
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25
Q

Ankyloglossia (tongue tie)

A
  • limits movement of tongue
  • can interfere with nursing
  • puckering of midline of tongue**

Tx: cut it

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26
Q

Congenital torticollis “wry neck”

A
  • from bleeding into the sternocleidomastoid during birth
  • firm fibrous mass within the muscle 2-3 wks after birth
  • will disappear on its own
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27
Q

Upper airway sounds

A
  • harsh and loud
  • symmetric
  • louder as stethoscope moves up chest
  • inspiratory
28
Q

Lower airway sounds

A
  • asymmetric
  • louder going toward abdomen
  • expiratory
29
Q

If you find a diminished femoral pulse what might that be from?

A

coarctation of the aorta

30
Q

MC dysrhythmia in infants

A

paroxysmal supra ventricular tachycardia (PSVT)

31
Q

How many arteries and veins are in the umbilical cord?

A

2 - umbilical arteries

1 - umbilical vein

32
Q

Which side are hydroceles and inguinal hernias more likely to occur on?

A

Right

33
Q

Hernia vs. Hydrocele

A

Hernias are reducible, do not transillumiate

Hydroceles don’t reduce, can be transilluminated, resolve on their own

34
Q

If you can’t see the bottom of a sacral dimple, what test needs to be done?

A

Ultrasound

35
Q

During physical exam what would raise suspicion of a developmental displasia of the hips?

A

Audible click with Barlow or Ortolani (posterior hip dislocation)
-asymmetry of the hips

36
Q

Treatment for developmental hip dysplasia?

A
  • pavlik harness

- ortho eval

37
Q

Palmar grasp

A
  • baby will grasp your thumb

- birth - 3-4 months

38
Q

Plantar grasp (babinski)

A
  • toes will curl when you touch sole of baby’s foot

- Birth to 6-8 months

39
Q

Moro Reflex (Startle Reflex)

A
  • Abruptly lower baby while supine
  • arms should abduct and extend, hands open, legs flex
  • Birth to 4 months

**If they continue to do this beyond this time frame suggests neurologic disease

*asymmetric response indicated fracture of clavicle or brachial plexus injury

40
Q

Asymmetric Tonic Neck Reflex

A
  • when you turn the head to one side, the baby will flex the arm and leg on the opposite side
  • Birth to 2 months
41
Q

Positive Support Reflex

A
  • hold baby upright on its feet
  • should partially bear weight for 20-30 seconds
  • 2-6 months
42
Q

Rooting reflex

A

stroking perioral skin will cause baby to turn head to stimulated side and open mouth.

-birth to 3-4 months

43
Q

Trunk incurvation (Galant’s Reflex)

A
  • hold baby prone
  • stroke alongside the spine from the shoulder to buttock
  • spine will curve to stimulated side

-birth to 2 month

44
Q

Placing and Stepping Reflexes

A
  • like the positive support reflex but only one foot touches tabletop
  • look for other foot to step forward
45
Q

What is the most common cause of childhood blindness?

A

amblyopia

46
Q

When should you start checking BP?

A

start at age 3

47
Q

When do you screen for iron deficiency?

A

9 months or 12 months

48
Q

Rear facing car seat until what age?

A

2 years

49
Q

Booster seat until how tall?

A

4’9”

-No front seat until 13 years old

50
Q

1 month old

A
  • follows face
  • some head control
  • responds to sounds
  • spontaneous smile
51
Q

2 month old

A
  • Responsive smile
  • coos/vocalizes
  • lifts head when prone
  • follows to midline
52
Q

4 month

A
  • rolls from tummy to back
  • good head control
  • laughs, squeals
  • follows past midline
  • grasps toys
53
Q

6 month

A
  • sits with support
  • bears weight on legs
  • vocalizes “ba da”
  • reaches out for toys
  • follows 180 degrees
  • stranger danger/separation anxiety
54
Q

9 month

A
  • crawls
  • pulls up to stand
  • “mama” “dada”
  • pincer grasp**
55
Q

12 months

A
  • walks
  • waves bye-bye
  • points with index finger
  • self feeding
56
Q

15 months

A
  • 3 to 6 words
  • walks well
  • climbs stairs
  • imitates actions
57
Q

18 months

A
  • 5-15 words
  • some 2 word phrases
  • uses spoon/fork
  • scribbles
  • runs, walks backwards
58
Q

24 months

A
  • 20-50 words or more
  • 2 word phrases
  • kicks ball
  • builds 3-4 block tower
59
Q

What is a contraindication to the Hep B vaccine?

A

severe allergy to yeast

60
Q

What are some contraindications to the rotavirus vaccine?

A
  • Hx of intussusception

- Severe Combined Immunodeficiency

61
Q

DTaP vaccine

A
  • 5 total vaccines

- Diphtheria, Tetanus, Pertussis

62
Q

HIB (Haemophilus influenzae type B)

A

-4 total vaccines

contraindications:
- infant under 6 weeks

63
Q

IPV (Poliomyelitis)

A

NO longer a live vaccine**

contraindicated in pregnancy

64
Q

MMR vaccine

A
  • Measles, Mumps, Rubella
  • 2 total shots
  • live vaccine (so pregnant ladies cannot get this)
65
Q

Varicella

A
  • live vaccine

- 2 doses

66
Q

Hepatitis A

A

-2 doses

Clinical Disciplines II (15 decks)

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