Well-Child Exam Flashcards
When do you start using BMI in kids?
@ 2 yrs
Prior to this=%
How long do you track head circumference for? why?
2-3 yrs of age
Assess for brain growth
Define underweight
<5%
Define overweight
85-95%
Define Obesity
> 95%
Define microcephaly
<3%
define macrocephaly
> 97%
What is considered Low BW?
<2500 grames=5.5 lbs
Define Preterm
<37 weeks
Define Term
37-42 weeks
Define Postterm
> 42 weeks
Define neonatal period
Day 1-28
Define Postnatal period
Day 29-1 yr
Define Vernix Caseosa
Cheesy white covering
Made from fetal corneocytes/sebaceos gland activity
Define Milia
Pinpoint white papule with surrounding erythema: Nose, chin, forehead, cheeks
Caused by blocked sebaceous glands
Define Mongolian Spot
“Congenital Dermal Melangocytosis”:
Blue patches of pigments
Lumbar, buttocks, extremities
Common in darker skin
Define Erythema Toxicum
Yellow Eosinophilic papule on red base
2nd-4th day of life, disappear w/in 1 wk
Trunk
What does widely split sutures suggest?
Increased ICP:
- Meningitis
- Hydrocephalus
What does raised, bony ridge @ suture line suggest?
Craniosynostosis
Referral to neurosurgery asap!
What does a bulging fontanelle suggest?
Increased ICP:
Bleed vs. Meningitis
What does a sunken fontanelle suggest?
Dehydration
What does a large posterior fontanelle suggest?
1st sign of congenital hypothyroidism
When does the anterior fontanelle close?
9-18 mos
Size of anterior fontanelle
1-4 cm
When does the posterior fontanelle close?
1-2 mos
Size of posterior fontanelle
<1 cm
Define Cepahlohematoma
Swelling/collection of blood over one or both of parietal bones
does NOT cross suture lines
resolves in weeks to months
Define Caput Succedeaneum
Edema of scalp
DOES cross the Suture lines
Resolves in days
Define Hypetelorism
Abnormally wide spacing of eyes
Define Epstein’s Pearls
Small, white benign inclusion cysts (palate)
Resolve spontaneously
Define Ankyloglossia. Tx?
“Tongue Tie”: Congenital short lingual frenulum
Tx: Frenulectomy in neonatal period
What causes Congenital Torticollis (wry neck)?
Bleeding into SCM during stretching process of birth
Define Pectus Excaviatum
Sternum Depression
Define Pectus Carinatum
Sternum Protrussion
What does decreased breath sounds on OJE side of the chest in an infant suggest?
Unilateral lesions: Congenital Diaphragmatic Hernia
What does diminished femoral pulses indicate?
Coarctation of aorta
What is the MC Dysrhythmia in infants?
PSVT
Define Hypospadias
Abnormal VENTRAL placement of urethral opening
Define epispadias
Abnormal DORSAL placement of urethral opening
If you can’t see the bottom of a Sacral Dimple, what do you need to order?
US
What are RF’s for Developmental Dysplasia of Hips (DDH)
- Breech
- Caucasian
- 1st born female
- FHX, prior child born w/ DDH
- Premature
Describe the Barlow test in evaluating DDH
Test for ability to sublet/dislocate an intact, but unstable hip
Describe Ortolani test in evaluating DDH
Test for posteriorly dislocated hip
DDH treatment
Ortho Eval + Pavlik Harness
What is a potential complication of DDH if left untreated?
Degenerative hip dz
What age should the Palmar Grasp Reflex be present?
Birth to 3-4 mos
What age should the Plantar Grasp reflex be present?
Birth to 6-8 mos
What age should the Moro Reflex (startle reflex) be present?
Birth to 4 mos.
Moro Reflex persistence BEYOND the 4 mos. suggests what?
Neurological Dz: Cerebral Palsy (esp. beyond 6 mos)
Assymetric More Reflex suggest what?
Clavicle Fx or Brachial Plexus injury
What age should the Asymmetric Tonic Reflex be present?
Birth to 2 mos.
Asymmetric Tonic Reflex persistence BEYOND the 2 mos. indicates what?
Asymmetric CNS development
What age should the Positive Support Reflex be present?
Birth OR 2 mos. to 6 mos
Lack of Positive Support Reflex suggests what?
Hypotonia or Flaccidity
What age should the rooting reflex be present?
Birth to 3-4 mos.
What age should the Trunk Incurvation (Galant’s Relflex) be present?
Birth to 2 mos.
Absence of Trunk Incurvation (Galant’s Relflex) indicates what?
SCI or lesion
VA for ages 3-5
20/40
VA for ages 6+
20/30
MCC for childhood blindness?
Amblyopia
What age do we start checking BP?
3 years
What age do we start screening for iron deficiency (hemoglobin)
9 or 12 mos.
What age do we start screening for Lead per CDC recommendation?
Ages 1-2
Target high risk homes=homes built before 1950
What age do we start autism screening?
18 & 24 mos.
@ what age and who do we screen for lipid panels?
Ages 2-10 IF risk factors:
- FHx hyperlipidemia
- FHx CV dz
- Obesity/overwt.
- HTN
- DM
1st dental visit
12 mos-2 yrs OR
3 yrs
How long in a rear facing car seat?
2 years
How long in a booster seat?
4’9”
How long until front seat?
13 y.o.
Hep B vaccine CI
Severe allergy to yeast
Rotavirus Vaccine CI’s
- Hx Intussusception
- Infants w/ SCID
- Defer in those w/ acute mod/severe gastro
Before this vaccine, what was the leading cause of invasive bacterial dz in children <5 yrs in the US?
HiB
HiB complications
- Meningitis
- Pneumonia
- Epiglottis
- Death
CI to HiB vaccine
- Children <6 wks
2. Allergic Rxn to previous HiB vaccine
What is a common cause for AOM and Sinusitis?
Pnuemococal
PCV 13 Vaccine CI
- Severe previous allergy to vaccine
2. Severe acute illness
Rubella disease complications
Very serious in pregnant women!
- Miscarriage
- Stillbirth
- Birth defects
Measles complications
- Encephalitis
2. Pneumonia
Mumps complications
- Encephalitis
- Meningitis
- Deafness
- Orchitis
MMR CI’s
- Anaphylactic Egg or Neomycin allergy
- Immunocompromised
- Pregnant or intending to get pregnant in 28 days
Hepatitis A tranmission
Contaminated food or water