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DIT Level 3 > Well Child Visit > Flashcards

Well Child Visit Flashcards

1
Q

Developmental age: social smile and eyes follow to midline

A

2 months

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2
Q

Developmental age: babies aware of caregiver and eyes follow past midline

A

4 months

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3
Q

Developmental age: roll over, sits upright, grasps/rakes, babbles

A

6 months (dog)

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4
Q

Developmental age: crawling, grasps with thumb, maybe a word

A

9 months

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5
Q

Developmental age: 2-5 words, pulls to stand (cruising), walks with help, pincer grasp, 2 block tower, stranger anxeity

A

12 months (rule of 2s)

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6
Q

Developmental age: runs/walks backwards, uses spoon and cup, 2-word sentence, copies parent, 4-block tower

A

18 months

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7
Q

Developmental age: walks up and down stairs with help, jumps, 6 block tower, 2-3 word sentences, 50-75 words, follows 2 step commands

A

2 yrs

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8
Q

Developmental age: rides tricycle, copies a circle

A

3 yrs

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9
Q

Developmental age: plays with others, draws a “+” and triangle, 250 words, 4 word sentence

A

4 yr

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10
Q

Developmental age: skipping, draws a stick figure

A

6yr

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11
Q

Baby should be back to birth weight

A

2 weeks

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12
Q

Child weighs double their birth weight

A

4 months

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13
Q

Child weighs triple their birth weight

A

12 months

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14
Q

Child weighs quadruple the birth weight

A

24 months

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15
Q

Anticipated weight gain from 2 yr to 13 yrs

A

5 lbs per year

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16
Q

Causes of inadequate weight gain

A 
poor food intake (including neglect/abuse)
chronic V/D
malabsorption
neoplasms
congenital disease - cardiac, endocrine
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17
Q

Childhood obesity risks

A 
rapid growth
sleep apnea
HTN
SCFE
Precocious puberty
increased skin infections
social dysfunction
early DM onset
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18
Q

newborn to 3 mo anticipated weight gain

A

26-31 g per day

19
Q

age that height increases by 50% from birth length

A

1 yr

20
Q

height double the birth length

A

4yrs

21
Q

height triple the birth length

A

13 yrs

22
Q

Anticipated growth rate from 2y to adolescence

A

2 inches per year

23
Q

Greater than normal height causes

A 
Familial tall stature
precocious puberty
gigantism - elevated growth hormone
hyperthyroidism
Kleinfelter Sn
Marfan Sn
Obesity
24
Q

Lower than normal heath causes

A 
familial short stature
neglect
Turner sn
constitutional growth delay
chronic renal failure
asthma
CF
IBD
immunologic disease
GH deficiency
hypothyroidism
glucocorticoid excess
skeletal dysplasias
neoplasm
25
Q

Failure to thrive definition

A

wt below 2-3rd percentile, corrected for gestational age
Wt less than 80% of ideal weight for age
Wt crosses 2 major percentile curves downward on the standard growth curve over time
Wt to length ratio less than 10th percentile
rate of daily wt gain less than expected for age

26
Q

Causes of macrocephaly

A 
TaySachs dz
Maple syrup urine disease
Neurofibromatosis
Tuberous sclerosis
Hydrocephalus
Increased ICP
skeletal dysplasia
acromegaly
ICH
27
Q

Causes of microcephaly

A 
fetal toxin exposure (alcohol)
Chromosomal trisomies
congenital infection (TORCH)
Cranial anatomic abnormalities
Metabolic disorders
Neural tube defects
28
Q

Normal growth rate that declines after birth

A

postnatal onset

29
Q

Growth abnormal from time of birth

A

prenatal onset

30
Q

Growth low to normal range but eventually closer to mean

A

constitutional growth delay

31
Q

Growth consistently abnormal

A

genetic short stature

32
Q

Amblyopia

A

decreased vision due to disuse/misuse of eye during critical visual development between 3-5 yrs

Treat underlying problem
Patch good eye to let bad eye develop

33
Q

Strabismus

A

abnormal eye alignment which impart vision and depth perception

-EOM issue

Risk amblyopia

34
Q

Esotropia

A

inward deviation of eye

35
Q

Exotropia

A

outward deviation of eye

36
Q

Retinoblastoma

A

MC intraocular malignancy in children
MC presentation: leukocoria (white reflex)
also can present with strabismus

Mets within months

Tx:
enucleation
radiaiton
brachytherapy
chemotherapy
37
Q

Lead poisoning

A

Early sxs: anorexia, decreased activity, irritability, insomnia
Screen children who live in areas where more than 27% of housing built before 1950

Tx for severe toxicity >70 mcg/dL:
Dimercaprol AND calcium disodium edatate

38
Q

Child abuse - presentation, evaluation

A 
Presentation:
FTT
multiple fractures of varying ages
bruises/burns
SDH
Retinal hemorrhage
Implausible injuries
Genital trauma or discharge - suggestive of sexual abuse
Evaluation:
PT/PTT
LFTs
STD testing
CBC
Skeletal survey
CT of head

Always reports suspected child abuse to CPS regardless of how mild the suspicion

39
Q

Pediatric Hep B vaccination recommendations

A

Hep B vaccine at birth

If maternal Hep B - give Hep B IG

40
Q

Immunizations and severely immunosuppressed

A

avoid live vaccines - varicella, MMR, Rotavirus

Rotavirus still recommended in HIV patients

41
Q

Risk associated with Rotavirus

A

risk intussusception

avoid in patient with hx of intussusception and older than 8 mo who are on catch up schedule

42
Q

Sudden infant death syndrome

A

Peaks 2-4 months
Risk: exposure to cigarette smoke, maternal age less than 20, prematurity, prone sleeping, soft bedding, overheating

Preventive measures: place on back to sleep, firm sleep surface, no pillows, soft objects or loose bedding, avoid smoking during pregnancy and after delivery

Less effective measures: breastfeeding and use of pacifier when sleeping

43
Q

Car seat safety - under 2, 2-5, over 5

A

under 2: rear facing car seat, middle back seat

2-5y: bigger forward facing car seat with chest harness

Over 5: booster seat in back seat until over 4’9”

All under 13 yo in rear seats

DIT Level 3 (32 decks)

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