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PCM II - Exam II > Pediatric Examination - SRS > Flashcards

Pediatric Examination - SRS Flashcards

1
Q

What 3 specific areas should be addressed at each well child exam?

A
  1. physical development
  2. cognitive development
  3. social and emotional development
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2
Q

When are kids called the following?

  • Newborn
  • Infancy
  • Toddler/Early Childhood
  • School-aged/Middle Childhood
  • Adolescence (11-20 years)
A

•Newborn

0-28 days

•Infancy

0-12 months

•Toddler/Early Childhood

1-4 years

•School-aged/Middle Childhood

5-10 years

•Adolescence (11-20 years)

Early, middle, & late

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3
Q

What are the components of the APGAR scoring?

A
  • A: Appearance (color)
  • P: Pulse
  • G: Grimace (reflex irritability)
  • A: Activity (muscle tone)
  • R: Respiratory effort
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4
Q

Most babies start out at what apgar score?

A

9 - due to aprocynosis (spelling?)

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5
Q

In APGAR, what does activitys stand for?

A

Muscle tone

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6
Q

What are three things given shortly after delivery?

A
  1. –Erythromycin ointment in eyes to prevent infection (prevent STD infection)
  2. –Vitamin K injection to prevent bleeding
  3. –Full bath
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7
Q

What is the ballard scoring system for?

What are the subranges?

A

To determine gestational age in weeks.

Neuromuscular maturity

-1 to 5

Physical maturity

-1 to 5

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8
Q

what defines a pre-term baby?

A

less than 37 weeks

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9
Q

What is post term baby time fram?

A

more than 42 weeks

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10
Q

How often should neonates feed?

A

Every three hours

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11
Q

In first week of life, what should happen to a childs weight?

A

Normal to lose up to 10% of birth weight over first week.

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12
Q

Elevated bilirubin prior to first 24 hours of life indicate it is more than physiological jaundice.

What are common causes of pathological jaundice of the newborn?

A

•ABO incompatibility/Rh
•Cephalohematoma
•Infection
•Hemoglobinopathies
–ex: thalassemia
•Enzyme deficiencies
–ex: G-6-PD

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13
Q

What is a cephalohematoma?

A

Large bruise that doesn’t cross suture lines

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14
Q

What is done prior to discrharge from the hospital?

A

–Hepatitis B immunization
–Hearing screen
–Newborn Screening blood test

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15
Q

When should there be PCP follow up after discharge?

A

24-48 hours

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16
Q

What components are used for assessment of developmental milestone?

A

•Physical
–Gross Motor
–Fine Motor
•Language/Cognitive
•Personal/Social

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17
Q

How does neurologic development progress?

A

Centrally to peripherally

  1. –Head control
  2. –Trunk control
  3. –Use of arms
  4. –Use of legs
  5. –Use of hands then fingers
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18
Q

What are the normal language milestones up to 1 yr?

A

–2 months-cooing
–6 months-babbling
–1 year-1-3 words

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19
Q

At 9 months and older, how should you examine the child?

A

On parent’s lap

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20
Q

Until when should you measure head circumference?

A

At each visit until 36 months

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21
Q

At what age would you begin checking BP at a well child exam?

A

3 years

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22
Q

What are the primitive reflexes to test?

A
  1. Palmar grasp
  2. Plantar grasp
  3. Moro (startle reflex)
  4. Asymmetric Tonic Neck
  5. Positive support
  6. Rooting
23
Q

How do you test the palmar grasp

A

finger in hand and press against palmar surface –> grasps finger

24
Q

How do you check plantar grasp?

A

Touch sole at base toes –> toes curl

25
Q

How do you test the Moro reflex?

A

Hold supine support head, back, legs; abruptly lower 2 feet –> arms abduct& extend, hands open, & legs flex, +/-cry

26
Q

What do you use Barlow and Ortolani maneuvers to test for?

A

Signs of hip dislocation

Can indicated developmental hip dysplasia (DHD)

If positive, imaging

27
Q

What does ortolani test look for?

A

presence of posteriorly dislocated hip

28
Q

What does the barlow test reveal?

A

ability to sublux or dislocate intact but unstable hip

29
Q

When does the anterior fontanelle close?

A

4-26 months

30
Q

When does posterior fontanelle close?

A

2 months

31
Q

At what age should a toddler be understandable to all?

A

By 4 years of age

32
Q

Where should you examine a toddler?

A

On parents lap

33
Q

Where should you examine a school age child?

A

On table

34
Q

What are new topics to discuss for school age children?

A

•School issues
–Performance, bullying, special ed, behavioral issues?
–Does your child have a place to do homework?
•Start talking about body changes of puberty/age appropriate
•Remember that health and development is heavily influenced by physical, social, environmental factors and disease (child abuse, chronic illness, socioeconomic status)

35
Q

When does puberty begin for females?

A

8-13 years

36
Q

When does puberty begin for males?

A

9-13.5

37
Q

What is adrenarche?

A

–Activation of adrenal medulla for production of adrenal androgens
–Occurs before the onset of puberty

38
Q

What is gonadarche?

What are the hormonal changes for boys and girls respectively?

A

–Earliest gonadal changes of puberty-GnRH released
•Boys-LH stimulates testosterone production and FSH stimulates sperm maturation
•Girls-FSH stimulates estrogen & follicle formation and LH stimulates corpus luteum after ovulation

39
Q

What is Thelarche?

A

Beginning of breast development at puberty

40
Q

What is pubarche?

A

beginning of pubic hair

41
Q

What is Tanner 1 for breasts?

A

elevation of nipple only, preadolescent

42
Q

What is tanner 2 for breasts?

A

2-elevation breast/nipple as small mound (breast buds)

43
Q

What is tanner 3 for breasts?

A

further enlargement breast/areola, no separation of contour

44
Q

What is tanner 4 for breast development?

A

Projection areola/nipple to form secondary mound

45
Q

What is tanner 5 for breasts?

A

mature stage, projection of nipple only

46
Q

What is tanner 1 for boys?

A

preadolescent-no pubic hair (fine body hair only); penis/testes same size as childhood

47
Q

What is tanner 2 for boys?

A

Pubic hair-sparse slightly pigmented, straight. Penis-slight or no enlargement. Testes/scrotum-larger, slightly reddened

48
Q

What is tanner 3 for male?

A

Pubic hair-darker, coarser, curlier, sparsely over pubic sym; Penis-larger in length. Testes/scrotum-further enlargement

49
Q

Tanner 4 for boys?

A

Coarse/curly greater than stg 3 but not as great as adult; not on thighs. Penis-further enlargement length/breadth w/ dev. of glans. Testes/scrotum-further enlarged, scrotal skin darkened

50
Q

What is tanner 5 for males?

A

Pubic hair-adult quantity & quality, spread to medial thighs. Penis-adult size &shape. Testes/scrotum-adult size & shape.

51
Q

What is the acronym for how to approach topics with teens?

A

HEADS

H- Home how are things?

E - Education, how is school?

A - Alcohol, are your friends drinking?

D - Drugs - do your friends try drugs?

S - Sex: Do you have a boyfriend/girlfriend? Sexually active?

52
Q

When do you kick parents out of the room?

A

When a child ilooks mature enough that someone might mistake them for an adult.

53
Q

What is the typical order of changes in males during puberty?

A
  • Testicular growth
  • Pubic hair
  • Penile enlargement
  • Growth spurt peaks (age 14)
54
Q

What is the typical order of changes in females during puberty?

A
  • Breast buds
  • Pubic hair
  • Growth spurt peaks (age 12)
  • Menarche (T4)

PCM II - Exam II (4 decks)

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