Block 1 Flashcards
(111 cards)
1
Q
Deals with the health of infants, children, and adolescents; their growth and development; and their opportunity to achieve full potential as adults
A
Pediatrics
2
Q
The specialty of pediatrics is concerned with __________ rather than on the disease
A
human growth and development – on health
3
Q
Age =
A
≤18 years old and 364 days
4
Q
Content variations:
A
→ Prenatal and birth history → Developmental history → Social history and family o Type of family (nuclear, extended, etc.) o Environmental risks o Immunization history o Feeding history
5
Q
Involves the use of silence plus non-verbal indications of interest
A
Active listening
6
Q
Used to encourage the patient to continue talking
A
Facilitation
7
Q
Statements that invite the patient to describe the symptoms or feelings more fully
A
Door openers
8
Q
Words to indicate to the patient that the interviewer is listening and encourages to go on narrating relevant historical data
A
Rocking
9
Q
Question, word, or phrase that the patient has just stated that will aid the patient in further elaborating his thoughts
A
Repeating
10
Q
May require open-ended or specific questions
A
Questioning
11
Q
Request for more information in a specific area already mentioned
A
Probing questions
12
Q
Request an explanation of what has been said
A
Clarifying questions
13
Q
Response that repeats something the patient just said
A
Reflection
14
Q
Focuses the patient’s attention on a component of his experience such as feelings, behaviors, statements
A
Confrontation
15
Q
GENERAL DATA
Patient
A
→ Name → Age / Date of Birth → Sex → Address → Nationality / Origin
16
Q
GENERAL DATA:
Informant
A
→ Relationship to the patient → Number of hours informant stays with the patient → Educational attainment → Involvement in the care of patient → Reliability (%)
17
Q
Why was the patient brought to the hospital?
It is the primary but not necessarily the reason why parents bring the patient to the doctor
Should be stated briefly in the informant’s own words
Most important complaint with their duration
Single symptom or group of related symptoms
Should not include diagnostic terms
OPD = for follow up
CP Clearance
Well baby care or immunization
A
Chief complaint
18
Q
Most important
This is a story of the condition or disease of the patient, prompting him to see a physician
Should be well organized, in a chronological order
→ use hours, days, weeks, and months
Begin with:
→ Date of onset (time) (acute or chronic)
→ Nature of the onset of symptoms
o Specify the time by period prior to admission or the age of the patient
A
History of present illness
19
Q
Include maternal and birth history
A
For newborns or if present problems are related to the prenatal or perinatal period
20
Q
Previous admission not related to the current case must be included in the ?
A
past medical history
21
Q
If the previous admission is related to the present illness, these should be written on the ?
A
first paragraph of HPI
22
Q
Questions for Children with Injuries
A
What events preceded the injury?
When and how did they notice the child was injured?
Who had access to the child prior to the injury?
Who was in the home?
Who took care of the child?
Was there any precipitating event prior to injury?
→ Feeding
→ Toileting
→ Diaper changing
→ Fighting
What is the child’s nature?
→ Colicky
Relationship between caretaker and child?
Response of caretaker to the injuries?
23
Q
Checklist to make sure that major items have not been omitted from the history
A
REVIEW OF SYSTEMS (ROS)
24
Q
If these information are directly related to the current history, it should be integrated into?
A
HPI
25
ROS:
| General
Recent weight
Appetite
Fatigue
Fever
26
ROS:
| Head
Headache
| Dizziness
27
ROS:
| Eyes
Vision
Glasses
Photophobia
Blind spots
28
ROS:
| Ears
Hearing loss
Tenderness
Pain
Tinnitus
29
ROS:
| Nose
Obstruction
Discharge
Epistaxis
30
ROS:
| Mouth and Throat
Thrush
Mouth sores
Bleeding or sore gums
Dental care
31
ROS:
| Breasts
Pain
Swelling
Masses
32
ROS:
| Respiratory
Wheezing
Cough
Difficulty in breathing
Hemoptysis
33
ROS:
| Cardiovascular
Chest pain
Cyanosis
Palpitations
34
ROS:
| Gastrointestinal
```
Abdominal pain
Vomiting
Diarrhea
Constipation
Jaundice
```
35
ROS:
| Genitourinary
```
Dysuria
Polyuria
Oliguria
Flank
Pain
```
36
ROS:
| Menstruation
Dysmenorrhea
| Menorrhagia
37
ROS:
| Extremities
Muscular weakness
Stiffness
Pain
38
ROS:
| Skin
Abnormal sweating
Rashes
Pigmentations
39
ROS:
| Hematological
Easy bruising
| Bleeding
40
ROS:
| Nervous System
Irritability
Convulsion
Headache
41
Chronological statement of normal and abnormal physical and personality development from conception to the present (as appropriate to the age of the child)
PERSONAL HISTORY
42
Mother’s general health
Prenatal / Maternal / Gestational
43
Questions for Prenatal / Maternal / Gestational History
→ When the prenatal medical supervision began? Difficult Pregnancy?
→ OB Score, Parity and Gravida of the mother
→ Maternal illnesses during pregnancy
o Measles, Gestational DM, Viral illnesses, TORCH, Hypertension
→ Smoking / drinking habits / substance abuse
→ Exposure to radiation / drugs
→ Maternal diet / multivitamins
44
Questions for birth history:
```
Where?
→ Hospital
→ Lying-in
→ At home
Duration and circumstances of labor
Type of delivery
→ Analgesia used
→ Difficult delivery
→ Presentation
Birth weight
Age of Gestation
APGAR score
Immediate complications
→ Cyanosis
→ Apnea
```
45
Maternal birth and neonatal histories should be included only in patients that are ?
<2yo and if related to the illness for >2yo.
46
Questions for Neonatal History
Feeble or vigorous, convulsions, hemorrhage, infections, jaundice (day of onset, duration, severity)
Congenital anomalies
→ Was the child ill during the neonatal period?
47
Feeding / Nutrition:
| Infancy (≤2 years old)
```
→ Breastfeeding
o Exclusive / mixed
o Frequency
o Amount
→ If breastfeeding, indicate if it is exclusive or mixed
→ Complementary foods
o Age introduced
o Frequency
→ Usual food intake for breakfast, lunch, dinner, snacks, food preference
→ Food intolerance
→ Multivitamins, Iron supplements
```
48
Feeding/Nutrition
| Children and Adolescents (2-20 yo)
```
→ Appetite = good or bad
→ Usual food intake
→ Assess 5 basic food groups are eaten daily
→ Actual caloric intake
→ Food preferences
```
49
Growth and Development:
| Up to 1 year old
```
→ Smiled
→ Crawled
→ Held head
→ Stood w/ support
→ Rolled over
→ Single words
→ Sat w/ support
```
50
Growth and Development:
| From 1 to 5 years old
```
→ Walked w/ support
→ Walked alone
→ Handedness
→ Used sentences
→ Toilet training – began and completed
→ Daily routine – sleep and play
→ Dental eruption
→ School adjustments
```
51
Growth and Development:
| From 6 to 12 years old
→ School placement and adjustments
→ Specific aptitudes
→ Specific disabilities
→ Daily routine – play and sleep
52
Behavior
```
Sleeping habits
Toilet training
→ Enuresis
→ Started and completed
→ Night time and day time bladder control
Thumb sucking
Nail biting
Breath-holding
Masturbation
Destructive, aggressive
Shy, submissive, happy, difficult
Relationship with peers / siblings
Hobbies, interests, performance in school
```
53
HEADSSS is used for?
Adolescents
54
HEADSSS stands for?
```
H - Home environment
E - Employment and Education
A - Activities
D - Drugs
S - Sexual activity / sexuality
S - Suicide / Depression
S - Safety
```
55
FRST stands for?
F - Family / Friends
R - Recreation
S - Spirituality
T - Threats and Violence
56
Home environment
→ With whom does the adolescent live?
→ Have there been any recent changes in the living situation
→ How are things between parents at home?
→ Are the parents employed?
57
Employment and Education
→ Is the adolescent currently in school?
→ What are his/her favorite subjects?
→ How is his performance in school?
→ Has he ever been truant or expelled from school?
→ What are his future education / employment goals?
→ Currently employed, working student?
58
Activities
```
→ What does he do in his spare time?
→ What does he do for fun?
→ To whom does he spend time with?
→ Hobbies, interests?
→ Physical, sexual, emotional, verbal, parental discipline
```
59
Drugs
→ Has the adolescent ever used tobacco, alcohol, or illicit drugs?
→ Is the adolescent still using these drugs?
→ Are friends using or selling any drugs?
60
Sexual activity / sexuality
→ Sexual orientation
→ Is he sexually active?
→ Does he use contraception or protection?
→ History of sexual or physical abuse
61
What is the basic concepts in HPI?
-If the patient is newborn or if related to the
present illness, maternal and birth history
must be included in the HPI
UST Pedia (3rd Ed) Page 3
62
Which of the ff statements is correct in weight
measurement of pediatric patients?
A. Taken preferably with minimal clothing on
B. Infant weight scale should be you used for
children <1 year old
C. Should be taken in every child visit in patients
12 years old and below only
D. All of the above
A. Taken preferably with minimal clothing on
Weight is preferably taken with minimal clothing
on, using the same scale which has been
calibrated before use. An infant weighing scale
should be used for children <2y.o. (UST Pedia
3rd Ed, Page 15)
63
```
rectal temp should not be taken
A. NB
B. 3mos
C.6mos
D.1yo
```
D.1yo
64
Which of the following is false regarding BP
measurement of pediatric px?
A. BP cuff should be completely encircled
around the arm
B. Inflatable bladder should be over the
antecubital fossa
C. Inflatable bladder should be inflated 2/3 of the
upper arm length
D. Too large cuff can lead to falsely low blood
pressure
B. Inflatable bladder should be over the
antecubital fossa
Center the inflatable bladder over brachial artery
(UST Pedia-3rd Ed Page 13)
65
```
At what age is the head circumference usually
taken?
A. 2 years old
B. 3 years old
C. 4 years old
D. A and B
```
B. 3 years old
UST Pedia-3rd Ed Page 14
66
```
U:L ratio at birth
A. 1.7
B. 1.3
C. 1
D. 0.5
```
A. 1.7
UST Pedia-3rd Ed Page 16
67
2-week-old NB infant was rushed to the ER
due to diarrhea. Upon PE, depression of anterior
fontanel was noted. This indicates:
A. Craniosynostosis
B. Dehydration
C. Hypothyroidism
D. Increased intracranial pressure
B. Dehydration
UST Pedia-3rd Ed Page 18
68
```
Which of the following signs will prove to the
physician that a 1 yr old baby is in
cardiopulmonary distress
a. bp90/60.
b. chest retraction and inwarding
c. conscious
d. RR 35/min
```
b. chest retraction and inwarding
69
Vocal fremitus is increased in?
-Consolidation
| UST Pedia-3rd Ed Page 27
70
```
Continuous musical sound that can be High
pitched with a whistling quality:
A. Stupor
B. Rhonchi
C. Crackes
D. Wheezing
```
D. Wheezing
UST Pedia-3rd Ed Page 29
71
```
Crackles heard during the auscultation of the
chest is associated with?
a. Pneumonia
b. Consolidation
c. Asthma
d. A and C
```
d. A and C
UST Pedia-3rd Ed Page 29
72
```
which of the ff is acceptable CR for 3 y.o with
temp of 39oC
a.60-100
b.70-110
c.85-130
d. 100-160
```
b.70-110
UST Pedia-3rd Ed Page 13
73
```
Normal RR value for 1 month old infant
A. 25-40/min
B. 30-45/min
C. 35-55/min
D. 40-70/min
```
C. 35-55/min
UST Pedia-3rd Ed Page 13
74
```
The following are included in the EPI of the
DOH, except:
A. BCG
B. DPT
C. Measles
D. Varicella
```
D. Varicella
75
BMI of a 5 y/o patient, 18 Kg and 110cm.
Ans. 14.9
76
johann 10 months old 12kg 3100-birthweight.
| what is the Average weight ?
answer:8700g
77
px: 33cm birth HC PX DETAILS : 3100 birth
weight 10 month old 12 kg present wt Expected
HC
A. 40
B. 41
C. 42
D. 43
C. 42
```
First 4 months:
½ in * 4 = 2 in
Next 6 months:
¼ in * 6 = 1.5 in
2 in + 1.5 in = 3.5 in Æ 8.89 cm
33+ 8.89 = 41.89 or 42
```
78
when is the perfect time to get the chest
| circumference-
mid inspiration
79
the urethral orifice is on the posterior
| surface of the penis.
Hyposphadia
80
Cyanosis, rapid breathing, scaphoid
| abdomen
Congenital diaphragmatic hernia
81
These are dark blue or purple bruise-like
macular spots usually located over the sacrum
A. Macular hemangioma
B. Transient pustular melanosis
C. Erythema toxicum
D. Mongolian spots
D. Mongolian spots
82
```
These are numerous areas of red skin with a
yellow white papule in the center
A.Macular hemangioma
B. Transient papular melanosis
C. Erythema toxicum
D. Mongolian spots
```
C. Erythema toxicum
83
```
This is also known as nevus flammeus,
usually seen in birth and does not blanch in
pressure.
a. millia
b. transient melanosis
c. mongolian spot
d. port wine nevus
```
d. port wine nevus
84
```
This is a vacular nevus usually seen in
occipital area, eyelid and glabella also called as
"storks bites" that usally diappears on the first
year of life
a. Macular hemangioma
b. Transient Pustular Melanosis
c. Erythema toxicum
d. Mongolian spots
```
a. Macular hemangioma
85
```
Pallor may be secondary to the following,
EXCEPT?
A. Anemia
B. Birth asphyxia
C. Tetralogy of Fallot
D. Patent Ductus Arteriosus
```
B. Birth asphyxia
* Skin turns blue or gray in asphyxia
86
```
Term given for persistent mottling in patients
with Down Syndrome.
A. Acrocyanosi
B.Plethora
C. Cutis Marmorata
D. Miliaria Crystalline
```
C. Cutis Marmorata
87
```
The following statements are correct about
anterior fontanelle EXCEPT:
A. Diamond shape
B. Found in coronal and sagittal suture
C. Non palpable in 8mo
D. NOTA
```
C. Non palpable in 8mo
88
A NB was delivered full term via NSVD after
prolonged labor. PE was normal except for the
head with soft tissue swelling. Which of the ff will
confirm that this is a case of caput succedaneum
and not cephalohematoma?
A. Does not cross the suture line
B. Presence of erythema
C. Well demarcated
D. AOTA
B. Presence of erythema
89
```
abdominal defect wherein the intestines are
covered by a peritoneum and umbilicus is
centrally located.
A. Diaphragmatic Hernia
B. Umbillical Hernia
C. Omphalocoele
```
C. Omphalocoele
90
Abnormal fusion of the 3rd and 4th, or the
2nd and 3rd fingers, with strong relation to family
history
A. Polydactyly
B. Syndactyly
B. Syndactyly
91
Previous admission should be written in the
past medical/illness even if it is related in the
HPI.
-False
92
Review of system is an important checklist to
make sure that major items have not been
omitted from the history and should be included
in all pediatric history
-False
93
T/F. Prenatal and birth history is important
and must be included in every pediatric history
report.
- False
94
Blood pressure is routinely taken in 3 years
| old and above?
- True
95
Parental behaviors and emotions are not
important in pediatric history since the patient is
the infant/child.
- False
96
Physical examination must be done
systematically from head to foot at the
examination table for infants and young children.
-True
97
As physicians it is important to know the
| normal values in every age group
- True
98
Ideally, fullterm baby, are measured once,
| anytime after birth and before discharge.
- False
99
T/F when measuring the length, it is best and
most accurate to let the px inhale deeply staying
fully erect
- False
100
```
Prior to discharge, a neborns ees are
observed to be swelling and draining pus. What
is to be considered?
A.Viral conjunctivitis
B.Treponemal eye infection
C.Gonnococal eye infection
D.NOTA
```
C.Gonnococal eye infection
101
```
Advice to parents to bring her newborn back
to the hospital.
a. Jaundice after 48 hours
b. Temperature of 37c
c. Eating every 6 hours
d. all of the above
```
a. Jaundice after 48 hours
102
The following should be done 30sec after
| birth except:
A. Suction of mouth first then nose
103
Immunization visit schedule
a. 4 weeks of life
b. 6 weeks
c. 7 days of life
d. 3 weeks
b. 6 weeks
104
```
After 30 seconds of thorough drying, the
newborn was noted to be gasping. Which of the
ff should be done:
A. Reposition, suction, ventilate
B. Dry the baby and keep warm
C. Do skin to skin contact
D. Do not clamp the cord
```
A. Reposition, suction, ventilate
105
The following should be done 30sec after
| birth except
- Suction of mouth first then nose
106
```
Early skin to skin contact and delayed
washing for 6 hours is for prevention of:
a. Hypothermia, infection, hypoglycemia
b. Anemia, infection, hyperglycemia
c. Hypothermia, infection, hypoglycemia
d. Anemia, infection, hypothermia
```
a. Hypothermia, infection, hypoglycemia
107
```
After cord clamping, apply:
A. 70% alcohol
B. povidonne Iodine
C. Mupirocin ointment
D. None of the above
```
D. None of the above
108
```
Do not suction to if baby is breathing
normally to prevent the following except:
A. Aspiration
B. Infection
C. Trauma
D. All of the above
```
D. All of the above
109
Good attachment and suckling:
- Mouth wide open
110
Enumeration
A. What are the time bound interventions in
the Essential Intrapartum and Newborn Care
1. TIME BAND: Within the 1st 30 secs.
2. Call out the time of birth
INTERVENTION: Dry and provide
warmth.
3. TIME BAND: If after 30 secs of thorough
drying, newborn is breathing or crying
INTERVENTION: Do skin-to-skin
contact
4. TIME BAND: 1 - 3 minutes
INTERVENTION: Do delayed or nonimmediate
cord clamping
5. TIME BAND: WITHIN 90 min of age
INTERVENTION: Provide support for
initiation of breastfeeding
111
B. Two assessment tools used for
| determining gestational age.
Ballard's scoring and Lubchenco chart
