Well Child Visit -Yang

Question 1

What are the fastest and second fastest periods of growth for children?

Answer 1

fastest=newborn (birth –> 1 year)

2nd=adolescent

Question 2

How long should a baby’s head circumference be measured during well child exams?

Answer 2

up to 3 years (head stops growing by then)

Question 3

What is the average head circumference of a newborn?

Answer 3

35 cm

Question 4

When will most infants regain their brithweight? Double their brith weight? Triple?

Answer 4

regain=2 weeks

double -6 months

triple =1 year

Question 5

What is the recommended way to divide food money in order to improve overall nutrition?

Answer 5

1/5 for fruits and veggies 
1/5 for meat and eggs 
1/5 for milk and cheese 
1/5 for bread and cereal
1/5 for sugar and other adjuncts

Question 6

What needs to be supplemented in exclusively breast fed infants?

Answer 6

Vitamin D

Question 7

What is human breast milk rich in that may allow for less viral diarrheal disease in breast fed infants?

Answer 7

Secretory IgA

Question 8

True or false: Mastitis is a contraindication for breast feeding

Answer 8

false.

continue to breast feed but make sure mom is on an antibiotic that is ok for baby

Question 9

What nutrients is goat’s milk low in? What can this cause in exclusively goat milk fed infants?

Answer 9

• low in vitamin D, iron, folic acid

- can cause megaloblastic anemia due to the folate deficiencyy

Question 10

What nutrients is goat’s milk low in? What can this cause in exclusively goat milk fed infants?

Answer 10

• low in vitamin D, iron, folic acid

- can cause megaloblastic anemia due to the folate deficiency

Question 11

What can cow’s milk given before 1 yo cause?

Answer 11

iron deficiency anemia secondary to GI irritation and hematochezia

Question 12

What can cow’s milk given before 1 yo cause?

Answer 12

iron deficiency anemia secondary to GI irritation and hematochezia

Question 13

*What is head lag? When should a baby no longer do this?

Answer 13

head lag is when you lift a baby from supine by the arms and they cannot straighten their head

should be gone by 6 months

Question 14

What is the MCHAT?

Answer 14

Modified checklist for Autism in Toddlers

-85% sensitive and 93% specific for Autism in 16-48 months

Question 15

What is the mnemonic for assessing development in adolescents?

Answer 15

BiHEADSSS

Body image, home, education, Activities, Drugs, sex, suicide and depression and safety

Question 16

Can you change a child’s temperament?

Answer 16

No. we can only modify behaviors

Question 17

What is the difference between primary and secondary enuresis? Which is more common?

Answer 17

Primary=persistent=have never been dry. Due to inadequate toilet training

Secondary=regressive=continent for 1 year and then begin to bed wet. can be due to a stressful event

Question 18

What scary thing can a temper tantrum lead to? Why does this happen?

Answer 18

Breath holding spells and seizures.

children can hold their breath until they become cyanotic and then lose consciousness and have a seizure

Question 19

What age group is iron deficiency anemia common in? What are some signs/symptoms of this?

Answer 19

• 9 months-24 months (especially if only breast feeding or drinking cows milk too early)
• pallor, pica (eating dirt) ,

Question 20

How is iron deficiency in children treated? For how long?

Answer 20

• modify diet to contain iron rich foods.
• supplement with iron ferrous salts (oral is preferred)
• treat for 3 months. 1 to correct the anemia and 2 to replace the iron stores

Question 21

What should iron supplements be taken with?

Answer 21

Vitamin C source –> help absorption

NOT MILK –> blocks Fe absorption

Question 22

When should a pediatric patient with iron deficiency anemia receive a blood transfusion?

Answer 22

ONLY if symptomatic:

• tachycardic
• hypoxic
• hypovolemic

Question 23

What is the treatment for a blood lead level 70? When is chelation necessary?

Answer 23

-70=immediate evaluation and treatment

Question 24

What are some PE findings in lead poisoning?

Answer 24

-x-ray: bright lead deposits in epiphyseal plates or bright spots in the bowel

Question 25

When should hearing be checked

Answer 25

language or speech delay

Question 26

When should kids undergo cholesterol screenings?

Answer 26

All children should undergo cholesterol screening once between ages 9-11 years and once between ages 17-21 years.

Question 27

What are the 3 leading causes of death in adolescents?

Answer 27

• Motor vehicle accidents
• homicide
• suicide

Question 28

What are the 3 leading causes of death in teens?

Answer 28

• accidents
• suicides
• homicide

Question 29

What vaccines should be given to a child

Answer 29

Polio, diphtheria, pertussis, tetanus, Hep B pneumococcal 13, HiB, rotavirus,

Influenza starting at age 6 months

Question 30

What vaccines should be given to a child >1 yo? When do you stop giving rotavirus? HiB and pneumococcal 13?

Answer 30

Varicella, MMR, Hep A

• No longer give rotavirus
• Over age 2 no longer give HiB or pneumococcal 13

Question 31

What vaccines should be given to a child >1 yo? When do you stop giving rotavirus vaccines? HiB and pneumococcal 13 vaccines?

Answer 31

Varicella, MMR, Hep A

• No longer give rotavirus
• Over age 2 no longer give HiB or pneumococcal 13

Question 32

What vaccines should be given to a child > 10 yo?

Answer 32

Tdap, HPV, Menactra

Question 33

What vaccines should be given to a child

Answer 33

Hep B, Polio, DTaP, Hib, Prevnar, MMR Varicella, Rotavirus

-influenza yearly after 6 months

Question 34

What vaccines should be given to a child > 10 yo?

Answer 34

Booster Tdap, HPV, Menactra

Question 35

What vaccine should be given to an 18 yo?

Answer 35

Booster TdaP