Exam 1 part 2 Summer 2104

Question 1

Pubic Hair Stage 1

Answer 1

Prepubertal. The vellus over the pubis is similar to that on the abdomen. This hair has not yet developed the characteristics of pubic hair.

Question 2

Pubic Hair Stage 2

Answer 2

There is sparse growth of long, slightly pigmented downy hair, straight or only slightly curled, mainly at the base of the penis.

Question 3

Pubic Hair Stage 3

Answer 3

The hair is considerably darker, coarser, and more curled. It is spread sparsely over the pubis.

Question 4

Pubic Hair Stage 4

Answer 4

The hair is adult in type, but the area over which it is present is smaller than in most adults. It has not yet spread to the medial thighs or along the linea alba (in males).

Question 5

Pubic Hair Stage 5

Answer 5

The hair is adult in quality and quantity and has the classical triangular distribution in females. It may spread to the medial surface of the thighs.

Question 6

Breast Stage 1

Answer 6

There is no development. Only the nipple is elevated.

Question 7

Breast Stage 2

Answer 7

The “breast bud” stage, the areola widens, slightly darkens, and elevates from the rest of the breast. A bud of glandular tissue is palpable below the nipple.

Question 8

Breast Stage 3

Answer 8

The breast and areola further enlarge, presenting a rounded contour. There is no change of contour between the nipple and areola and the rest of the breast. The diameter of breast tissue is still smaller than in a mature breast.

Question 9

Breast Stage 4

Answer 9

The breast continues to grow. The papilla and areola project to form a secondary mound above the rest of the breast.

Question 10

Breast Stage 5

Answer 10

The mature adult stage. The secondary mound disappears. Some females never progress to Stage 5.

Question 11

Genital Stage 1 Male

Answer 11

Prepubertal. Penis, testes, and scrotum are about the same size and proportions as in early childhood. It is important to take into account whether the penis is uncircumsized when assessing penile growth, as the uncircumsized penis may appear larger than it really is.

Question 12

Genital Stage 2 Male

Answer 12

Only the testes and scrotum have begun to enlarge from the early childhood size. The penis is still prepubertal in appearance. The texture of the scrotal skin is beginning to become thinner and the skin appears redder due to increased vascularization.

Question 13

Genital Stage 3 Male

Answer 13

There is further growth of the testes and scrotum. The penis is also beginning to grow, mainly in length with some increase in breadth. It can be difficult to distinguish between Stages 2 and 3.

Question 14

Genital Stage 4 Male

Answer 14

The penis enlarges further in length and breadth and the glans becomes more prominent. The testes and scrotum are larger. There is further darkening of the scrotal skin

Question 15

Genital Stage 5 Male

Answer 15

The penis, testes, and scrotum are adult in size and shape

Question 16

Gynocomastias

Answer 16

a common condition characterized by the benign enlargement of breast tissue in males.

Question 17

Height velocity

Answer 17

The pubertal growth characteristics evaluated in various studies include age at takeoff, height at takeoff, age at peak height velocity, peak height velocity, duration of puberty, and the contribution of the pubertal height gain to final height.

Question 18

.Discuss the need for growth charts and their use in clinical practice?

Answer 18

The physical growth of infants and children has long been recognized as an important indicator of health and wellness (1,2). Growth charts have been used for at least a century to assess whether a child is receiving adequate nutrition and to screen for potentially inadequate growth that might be indicative of adverse health conditions. Traditionally, attention has focused on undernutrition. However, in the past few decades, concerns about excessive weight gain have increased, and growth charts have been used to screen for overweight, including obesity.

Question 19

SpeechDevelopement Red flags for a speech or language delay include:

Answer 19

• No babbling by 9 months.
• No first words by 15 months.
• No consistent words by 18 months.
• No word combinations by 24 months.

Question 20

SpeechDevelopement Red flags for a speech or language delay include:

Answer 20

• Slowed or stagnant speech development.
• Problems understanding your child’s speech at 24 months of age; strangers having problems understanding your child’s speech by 36 months of age.
Not showing an interest in communicating.
• Excessive drooling.
• Problems sucking, chewing, or swallowing.
• Problems with control and coordination of lips, tongue, and jaw.
• Stuttering that causes a child embarrassment, frustration, or difficulty with peers.
• Poor memory skills by the time your child reaches kindergarten age (5 to 6 years). He or she may have difficulty learning colors, numbers, shapes, or the alphabet.

Question 21

SpeechDevelopement Red flags for a speech or language delay include:

Answer 21

• Failure to respond normally, such as not responding when spoken to. This may include signs that the child does not hear well, such as not reacting to loud noises.
• A sudden loss of speech and language skills. Loss of abilities at any age should be addressed immediately.
Not speaking clearly or well by age 3.
ICP
Head Lag Autism Autism screening to be performed at 18 m/o and 24 m/o;

Question 22

Identify tricks of the trade used to facilitate the well child visit. Toddler

Answer 22

Examine on parent lap if uncooperative
	Use play therapy
	Distract with stories
	Let toddler play with equipment / BP
	Call by name
	Praise frequently
	Quickly do exam

Question 23

Identify tricks of the trade used to facilitate the well child visit. Preschool

Answer 23

 Allow parent to be within eye contact
 Explain what you are doing
 Let them feel the equipment

Question 24

Identify tricks of the trade used to facilitate the well child visit. School Age

Answer 24

 Allow the older child the choice of whether to have a parent present
 Teaching about nutrition and safety
 Ask if the child has any concerns or questions
 How are they doing in school?
 Do they have a group of friends they hand out with?
 What do they like to do in their free time?

Question 25

Describe two separate techniques for assessing joint joint stability

Answer 25

The Barlow method is an examinaiton method that identifies a loose hip that can be pushed out of the socket with gentle pressure. Approximately 80% of “Barlow Positive” hips will resolve spontaneously in the first few weeks of life. Early treatment may be recommended when the hip is “dislocatable” but minor degrees of instability can be treated with multiple diapers followed by an Ultrasound Study at approximately six weeks of age.

Question 26

Describe two separate techniques for assessing joint joint stability

Answer 26

The Ortolani method is an examination method that identifies a dislocated hip that can be reduced into the socket (acetabulum). Ortolani described the feeling of reduction as a “Hip Click” - a sound instead of a sensation of the hip moving over the edge of the socket when it re-located. After the age of six weeks, this sensation is rarely detectable and should not be confused with snapping that is common and can occur in stable hips when ligaments in and around the hip create clicking noises. When the Ortolani test is positive because the hip is dislocated, treatment is recommended to keep the hip in the socket until stability has been established

Question 27

.Know the elements of physical examination including different parts of the body

Answer 27

Tessticles- decended Ear- exam last in kids down and back, up and back adolecents Cover /Uncover check for strabismus (normal til 6 months) Cerebellar function finger to nose heel to shin Romberg Lymph nodes Palpate Submaxillary, Cervical,Axillary,inguinal

Question 28

Know the safety and injury prevention recommendations for: Adolescence

Answer 28

Adolescence: 11 to 21 Years • Driving • Sports • Violence • Gangs

Question 29

Know the safety and injury prevention recommendations for: middle childhood

Answer 29

Middle Childhood: 5 to 10 Years • School and community safety • Bullying • Play, sports, and physical activity

Question 30

Know the safety and injury prevention recommendations for: Early childhood

Answer 30

Early Childhood: 1 to 4 Years | • General safety concerns

Question 31

Know the safety and injury prevention recommendations for: Infancy

Answer 31

Infancy: Birth to 11 Months • General safety concerns • Sudden Infant Death Syndrome

Question 32

Know the safety and injury prevention recommendations for: prenatal period

Answer 32

The Prenatal Period | • Car safety seats

Question 33

Know the priorities for each well child visit. Newborn

Answer 33

Family Resources, Parental Well being, Breast feeding decisions, Safety, newborn care.

Question 34

Know the priorities for each well child visit. First Week

Answer 34

Parental well being, newborn transition, nutritional adequacy, safety, newborn care.

Question 35

Know the priorities for each well child visit. 2 month

Answer 35

Parental well , being, infant behavior, infant-family synchrony, nutritional adequacy, safety

Question 36

Know the priorities for each well child visit 4 months

Answer 36

Family functioning, infant development, nutritional adequacy and growth, oral health, safety

Question 37

Know the priorities for each well child visit 6 month

Answer 37

Family functioning, infant development, nutrition and feeding: adequacy/growth, oral health, safety

Question 38

Know the priorities for each well child visit 9 month

Answer 38

Family adaptation, infant independence, feeding routine, safety

Question 39

know the priorities for each well child visit 12 month

Answer 39

family support, establishing routines, establishing dental home, feeding and appetite changes, safety.

Question 40

Know the priorities for each well child visit 15 month

Answer 40

communication and social development, sleep routines and issues, healthy teeth, safety, temper tantrums and discipline

Question 41

Know the priorities for each well child visit 18 month

Answer 41

support, child development and behavior, language promotion/ hearing, toilet training readiness, safety

Question 42

know the priorities for each well child visit 2 years

Answer 42

Assessment of language development, temperament and behavior, toilet training, television viewing, safety

Question 43

Know the priorities for each well child visit 2.5 yr

Answer 43

family support, encouraging literacy activities, playing with peers, promoting physical activity, safety

Question 44

Know the priorities for each well child visit 3 yr

Answer 44

Family support, encouraging literacy activities, playing with peers, promoting physical activity, safety

Question 45

Know the priorities for each well child visit 4 yr

Answer 45

school readiness, developing healthy personal habits, TV/media, safety

Question 46

know the priorities for each well child visit 5&6 yr

Answer 46

School readiness, mental health, nutrition and physical activity, Oral health, safety

Question 47

know the priorities for each well child visit 7&8 yr

Answer 47

school, development & mental health, nutrition & physical activity, oral health, safety

Question 48

know the priorities for each well child visit 9&10 yr

Answer 48

School, development & mental health, nutrition & physical activity, oral health, safety

Question 49

know the priorities for each well child visit 11-14 yr

Answer 49

physical growth & development, social & academic competence, emotional well-being, risk reduction, violence & injury prevention

Question 50

know the priorities for each well child visit 15-17 yr

Answer 50

physical growth & development, social & academic competence, emotional well-being, risk reduction, violence & injury prevention

Question 51

know the priorities for each well child visit 18-21 yr

Answer 51

Physical growth & development, social & academic competence, emotional well-being, risk reduction, violence & injury prevention

Question 52

TSH and Free Thyroxine levels for Cogenital Hypothyroidism

Answer 52

TSH level < 5.5 or Free Thyroxine 0.7-1.7

Question 53

Speech development patterns.

Answer 53

Age Speech Production Articulation(Amount of Speech Following Commands Understood by a Stranger 1 1-3 words One-step commands 2 2 to 3 word phrases 50% Two – step commands 3 Routine use of sentences 75% 4 Routine use of sentences sequences; almost all Conversational give-and-take 5 Complex sentences, extensive use of almost all Modifiers, pronouns, and prepositions

Question 54

Common Skin Variation in Newborns & Infants

Answer 54

Thin, transparent skin, espically premature Color variations Vascular markings Pigmentations Lanugo (downy hair) more prominent in premature Original hair may shed at 4-8 weeks, and be replaced

Question 55

Skin color Variation Jaundice

Answer 55

pathologic in 1st 24 hrs; physiological after 24hrs

Question 56

Skin Color Variation: Acrocyanosis

Answer 56

cyanotic, cool extremities, warm, pink trunk

Question 57

Skin Color Variation: Cutis Marmorata

Answer 57

bluish mottling due to chilling or stress

Question 58

Skin Color Variation: Erythema toxicum

Answer 58

papules, vesicles on erythematous base at 24-48 hrs

Question 59

Skin Color Variation: Harlequin

Answer 59

color change lower side of body red, upper side pale- change reverses

Question 60

Skin Color Variation: Milia

Answer 60

white popular epidermal cysts with sebaceous retention

Question 61

Skin Color Variation: Miliaria

Answer 61

Miliaria (4 types)- obstruction of sweat ducts from head and humidity Neonatal acne, prickly head- miliaria- crystalline, rubra, pustulosa, profunda

Question 62

Skin Color Variation: Pallor

Answer 62

anemia or anoxia

Question 63

Skin Color Variation: Plethora

Answer 63

erythematous flush, due to polycythemia

Question 64

Skin Vascular Markings Capillariy heangioma

Answer 64

(telangiectasia or telangiectataic nevus or nevus simplex- “stork bites”, “angel kisses” usually fades

Question 65

Skin Vascular Markings: Nevus Flammeus

Answer 65

“port wine statins” nevus vasculosis—not likely to fade, can be associated with Sturge-Weber Syndrome.

Question 66

Skin Vascular Markings: Strawberry hemangioma

Answer 66

bright red, lobulated tumor

Question 67

Skin Vascular Markings: Cavernous hemangioma

Answer 67

bluish red, more vascular than strawberry.

Question 68

Skin Pigmentation

Answer 68

Mongolian spots in darker pigmented infants Pigmented nevi Café au Lait (> 3cm and < 6cm in # are WNL- larger size or more spots associated with Neurofibromatosis, or Von Recklinghausen Disease- an autosomal-dominant disorder, with tumors on peripheral or cranial nerves.

Question 69

Yellow Skin Color

Answer 69

Jaundice- observed in sclera, skin, fingernails, soles, palms & oral mucosa. Does not blanche with pressure over chest or nose areas. Is associated with live disease, hepatitis red cell hemolysis, biliary obstruction & sever infection during infancy. Carotenemia- observed in palms, soles, face, skin (not in sclera or mucuous membranes). Blanches easily to pressure over chest or nose. Occurs in older infants, with eating yellow vegetables. Renal Disease- Yellowing of exposed skin areas (not sclera or mucous membranes) may be associated with chronic renal disease.

Question 70

Supplemental Iron & Fluoride ( dosage & dosage schedule).

Answer 70

Iron deficiency is more common among Africian American & Mexican American children. Screening AAP recommends about 12 months, CCD recommends between 9-12 months and again at 15-18 months. Infants at risk factors are Infants born preterm or with low birth weight, infants fed non-iron fortified infant formula for more than 2 months, infants fed cow’s milk before age 1yr, infants who are breastfed and do not received adequate iron from supplemental foods after the age of 6 months.

Question 71

Supplemental Iron & Fluoride ( dosage & dosage schedule).

Answer 71

If the primary water source is deficient in fluoride < 0.3 then supplement with fluoride 0.25mg/day. At 6 months of age central incisors erupt 1st. there are 20 primary teeth in children. Dental screening can start at 6 months of age to 3 years, but should be established by 3-6 yr old.

Question 72

Tachyarrhythmias including SVTl, WPW, AF, VT.

Answer 72

Obtain History: Description of pain with associated symptoms, quality of pain ( slip rib syndrome- popping sensation with bending or clicking, pericarditis- sharp & retrosternal with radiation to left shoulder more severe in supine position or deep breathing, ischemic cardiac pain- squeezing, tightness in chest- aortic root dissection is extremely severe pain. Location: localized to chest wall, ischemic pain is diffuse. Radiation- left shoulder- pericarditis, neck or jaw- myocardial ischemia, epigastric and right shoulder- cholecystitis, between scapulae- aortic dissection. Child point to pain with one finger.

Question 73

Presentation of CHF in infants

Answer 73

generally include tachypnea, respiratory distress (retractions), grunting, and difficulty with feeding

Question 74

Still’s Murmur (location and sound)-

Answer 74

grade 1-3/6 early systolic ejection, musical or vibratory, short, often buzzing heard best midway between apex and LLSB. Softens or disappears when sitting, standing or with Valsalva maneuver. Louder when supine or with fever or tachycardia. Usual onset age 2-6yo may persist through adolescence. Benign condition.

Question 75

Venous Hum(location and sound)-

Answer 75

grade 1-2/6 continuous musical hum heard best at URSB and ULS and lower neck. Disappears in supine position, or with turning head when jugular vein is compressed. Common after 3 yo. Produced by turbulence in subclavian and jugular veins. Benign condition.

Question 76

Innocent murmur-

Answer 76

Most murmurs in infants and children originate through normal flow patterns with no structural or anatomic abnormalities of the heart or vessels. Most are heard in 3-4 year olds, change in sound with changes in position.

Question 77

SBE prophylaxis(sub-acute bacterial endocarditis)-

Answer 77

The new guidelines emphasize the need of optimal dental hygiene with regular dental brushing, at least 2-3 times a day, and flossing along with regular dental appointments. Antibiotic for Prosthetic cardiac valve or prosthetic material used for cardiac valve repair,Previous IE,Congenital heart disease (CHD),Unrepaired cyanotic CHD, including palliative shunts and conduits,Completely repaired congenital heart defect with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure,Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (which inhibit othelialization), Cardiac transplantation recipients who develop cardiac valvulopathy;Except for the conditions listed above, antibiotic prophylaxis is no longer recommended for any other form of CHD. †Prophylaxis is reasonable because endothelialization of prosthetic material occurs within 6 months after the procedure.

Question 78

Diagnosis of hypertension in children:

Answer 78

Blood pressure falls into several categories. ••Prehypertension is systolic BP and/or diastolic BP ≥90th percentile but 5 mm Hg above the 99th percentile (>99th percentile + 5 mm Hg). Left ventricular hypertrophy, the most prominent finding, is present in up to 36% of hypertensive children.

Question 79

SVT clinical presentation

Answer 79

; infants with irritability, poor feeding, sweating, poor coloration of skin, and who exhibit a pulse rate of 200-250 beats per minute. •Palpitations (the sensation of the heart pounding in the chest)•Dizziness, light-headedness (near-faint), or fainting•Shortness of breath• Anxiety•Chest pain or tightness.

Question 80

Hypercholesterolemia criteria;

Answer 80

Screening factors• Consume excessive saturated fats • Elevated blood pressure • Diabetes • Physical inactivity • Renal disease • Body mass index at or above the 85th percentile • Unobtainable family history or any factors for coronary artery disease Borderline- total cholesterol 170-199, LDL 110-129 High- total cholesterol > 200, LDL ≥130, triglycerides > 150

Question 81

Syncopal episodes in children presentation;

Answer 81

brief sudden LOC resulting in decreased postural tone, collapse and spontaneous recovery. May be preceded by diaphoresis, pallor, dizziness, blurred/tunnel vision, nausea, feeling hot, buzzing in the ears or muffled sounds.

Question 82

Syncopal episodes in children presentation;

Answer 82

Most in children are benign alteration in vasomotor tone (neurocardiogenic). Vasovagal(Vasodepressor) syncope- Hypotension without immediate compensatory heart rate increase. Cardioinhibitory syncope- BP drops as heart rate drops. Mechanism is excessive vagal tone. Reflex bradycardia often associated with cough, swallowing, hair combing, carotid pressure or micturition.

Question 83

POTS (Postural Orthostatic Tachycardia Syndrome)

Answer 83

mild form of a primary dyautonomia, exaggerated sinus tachycardia within 10 min of up right posture, > 30 bpm above resting heart rate. Orthostatic intolerance. c/o fatigue, exercise intolerance, lightedness, heat intolerance, chronic anxiety, mood swings and panic attacks. 10% progress to Pure Autonomic Failure. Usually self resolve by adulthood.

Question 84

Causes of Noncardiac Syncope

Answer 84

Seizures, atypical migraines, drugs, metabolic, hypoglycemia, hyperventilation syndrome, pregnancy, vertigo

Question 85

Arrhythmias & Conduction disorders-

Answer 85

Vtach (Arrhythmogenic right ventricular cardiomyopathy), SVT (pre-excitation WPW), Heart block- cogential (SLE), Acquired (post-op, infections, lyme disease,

Question 86

Child maltreatment-

Answer 86

does the presentation fit the clinical finding- if not need to be reported. Factors associated with child maltreatment include A child who is perceived by parents to be demanding or difficult to satisfy An infant who is diagnosed with a chronic illness or disability A family who is socially isolated, without community support Mental health issues with one or both parents that have not been diagnosed & treated A parent with career difficulties, who may see the newborn as an impediment or burden

Question 87

Child maltreatment-

Answer 87

If abuse is suspected, the health care professional should ask direct questions in a respectful way to determine whether any kind of abuse might be occurring. Any unexplained bruises or other signs of abuse should be thoroughly investigated. Abuse and neglect at this early stage have long-term effects on brain and development and increase the likelihood of behavior disorders in the child. Infant and toddlers are at higher risk for abuse and neglect than older children. Children who are younger than 3 years account for more than 1/3 maltreated children and 41% of fatally abused children are younger than 1 year.

Question 88

Causative factors of myocarditis;

Answer 88

Myocarditis is rare in young children. It is slightly more common in older children and adults. It tends to be more severe in newborns and young infants than in children over age 2. In children it is usually caused by viruses that reach the heart, such as the influenza (flu) virus, Coxsackie virus, parovirus, and adenovirus. However, it may also be caused by bacterial infections, including Lyme disease. Other causes of pediatric myocarditis include:•Allergic reactions to certain medications•Exposure to certain chemicals in the environment•Infections due to fungus or parasites•Radiation•Some diseases (autoimmune disorders) that cause inflammation throughout the body•Some drugs

Question 89

Terminology: Neonate/Newborn:

Answer 89

birth to 28 days

Question 90

Terminology: Perterm

Answer 90

gestational age <37 weeks

Question 91

Terminology: Term

Answer 91

gestational age 37-42 weeks

Question 92

Terminology: Post- term:

Answer 92

gestational age > 42 weeks

Question 93

Terminology Young child

Answer 93

1-5 years

Question 94

Terminology: Toddler

Answer 94

1-3 years

Question 95

Terminology: Pre-School:

Answer 95

3-6 years

Question 96

Terminology: School Age or Older Child

Answer 96

6-12 years

Question 97

Terminology: Infant

Answer 97

birth to 1 year

Question 98

Terminology: Young, immobile

Answer 98

birth to 6 months

Question 99

Terminology: Older mobile

Answer 99

6-12 months

Question 100

Terminology: Adolescent:

Answer 100

13 to 18/21 years

Question 101

Terminology: Pre-Adolescent

Answer 101

10-12 years

Question 102

Jaundice of Newborns: Bilirubin < 5ml/dl

Answer 102

Pathologic: occurs 1st 24 hrs of life, bilirubin increases faster than 5ml/dl/day Physiologic: Onset after 1st 24hrs, with peak from 72-90 hrs. declines at 4-7 days Breast feeding early onset: onset at 2-4 days. Peak at 3to 5 days. Late onset: onset 5-7 days. Peak at 10-15 days. May remain jaundice for 3-12 weeks.

Question 103

Complication of Jaundice

Answer 103

visual estimation of degree of jaundice is not reliable. Closely monitor the < 38 week, breast feeding. Treatment when indicated with phototherapy or exchange transfusion. (at window undressed tid for 10 minutes). Bilirubin is toxic to cells of the brain. If a baby has severe jaundice, there's a risk of bilirubin passing into the brain, a condition called acute bilirubin encephalopathy. Clinical indications Listlessness or difficulty waking,High-pitched crying,Poor sucking or feeding, Backward arching of the neck and body,Fever &Vomiting.

Question 104

Kernicterus

Answer 104

is the syndrome that occurs if acute bilirubin encephalopathy causes permanent damage to the brain with clinical symptoms such as Involuntary and uncontrolled movements (athetoid cerebral palsy), Permanent upward gaze, Hearing loss, improper development of tooth enamel.

Question 105

Eyes

Answer 105

Check for red reflex, Strabismus- alignment of eye important correlation with brain development. Eyes assessment for pupillary size, equality, reaction to light, accommodation, visual acuity. Vision screen 3-4yrs, Visual acuity 3-5yr is 20/40, age 8 years 20/20. E chart & strabismus check for preschool children. Snellen charts for older children.

Question 106

Amblyopia (lazy eye).

Answer 106

EOM’s- tracking 6 fields of vision.

Question 107

Strabismus (esotopia, exotropia)-

Answer 107

muscle imbalance test for corneal light reflex- cover/uncover.

Question 108

Conjunctivitis-

Answer 108

a red flag in the newborn may be STD from birth, preschool is # one reason they are sent home. Inflammation of eye – history of juvenile arthritis.

Question 109

Eye Variations: | Placement & symmetry

Answer 109

Wide set (hypertelorism) – Down Syndrome Close set (hypotelorism) Epicanthal folds or upward slants- ethnicity, Down Syndrome Character of eyebrows

Question 110

Eye Variations: Eyelids

Answer 110

Ptosis, lid lag, blepharitis (stye), swelling Dacryocystitis (blocked tear duct) may cause redness, swelling and discharge. Allergic shiner- dark circles may indicate allergy Perorbital edema may indicate renal problems Sunken eyes may indicate dehydration

Question 111

Eye Variations: Sclera

Answer 111

Jaundice (liver dz), injection (conjunctivitis), | Hemorrhage, blue color (osteogenesis imperfect)

Question 112

Eye Variations: Conjunctive

Answer 112

Inflammation, pallor (anemia) | Cobblestone appearance may indicate allergy

Question 113

Eye Variations: Cornea

Answer 113

Smooth, moist, clear (not injected with conjunctivitis red eye)

Question 114

Eye Variations: Pupil & Iris

Answer 114

Brushfield’s spot (light speckling of iris) seen in Down’s | Coloboma (notch at outer edge or iris) may indicate visual field defect

Question 115

Eye Variations: Othalmoscope

Answer 115

partial or dark red reflex, indicates pathology, various retinal anomalies or opacities of cornea, anterior chamber or lens (cataract). White retinal reflex indicates pathology (retinoblastoma, retinal detachment, chorioretinitis) Retinal hemorrhage is pathology, associated with a variety of causes: is a specific diagnostic criteria in shaken baby syndrome. Papilledema of increased ICP more likely in older children, with closed cranial sutures.