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Flashcards in Pedia 3B - Applied Pediatric Ward Deck (254):
1

Heterophoria

Latent tendency for the eyes to deviate

2

Amaurosis

Partial or complete blindness

3

Orthophoria

Ideal condition of exact ocular balance

4

Heterotropia

Constant misalignment of the eyes

5

Dyscoria

Abnormal shape of the pupil

6

Scaphocephaly

Head is elongated in the AP diameter

7

Turricephaly

Top of the head is pointed

8

Plagiocephaly

One side of the head is more rounded

9

Oxicephaly

Tower head

10

Absence of clavicle

Cleidocranial dyostosis

11

Presternal edema

Mumps

12

Supernumerary nipples

Renal anomaly

13

Pigeon breast

Rickets

14

Shield chest

Turner's Syndrome

15

Hyper-resonant on percussion

Emphysema

16

Dullness on percussion

Consolidation

17

Increase vocal resonance

Consolidation

18

Age Related: Infancy
Behavioral problem:

Child neglect

19

Age Related: Pre-school
Behavioral problem:

Breath holding

20

Age Related: School age
Behavioral problem:

Bed wetting

21

Age Related: Adolescence
Behavioral problem:

Acting out behavior

22

Lesions - 1' or 2'
Macule

Primary

23

Lesions - 1' or 2'
Papule

Primary

24

Lesions - 1' or 2'Excoriation

Secondary

25

Lesions - 1' or 2'
Crust

Secondary

26

Lesions - 1' or 2'
Wheal

Primary

27

Lesions - 1' or 2'
Ulceration

Secondary

28

Lesions - 1' or 2'
Scar

Secondary

29

Finding: Exaggerated reflexes
Disease Associated:

Dse of CNS

30

Finding: Dark Urine
Disease Associated:

Myoglobiuria

31

Finding: Sensory changes
Disease Associated:

Peripheral Nerve Dse

32

Finding: ??
Disease Associated:

Anterior Horn Disease

33

Type of Rash: Malar Rash
Disease Associated:

SLE

34

Type of Rash: Erythema marginatum
Disease Associated:

ARD Acute rheumatic disease

35

Type of Rash: Purpuric Spots over distal portion of extremities
Disease Associated:

HSP Henoch Schonlein Purpura

36

Type of Rash: Evanescent macular rash
Disease Associated:

JRA Juvenile rheumatoid arthritis

37

Sexual Maturity Rating:
Nipple and areola form a secondary mound

IV

38

Sexual Maturity Rating:
Scrotal skin is pink/reddened

II

39

Sexual Maturity Rating:
Lanugo-like straight lightly pigmented pubic hair

II

40

Sexual Maturity Rating:
Larger penis with glans and penile breath increased in size

III

41

Sexual Maturity Rating:
Abundant dark and curly pubic hair spreading to the medial thighs

V

42

Sexual Maturity Rating:
Breast bud stage

II

43

Sexual Maturity Rating:
Elevation of papillae only

I??

44

Lesion: Strawberry nevi
Diagnosis:

Capillary hemagiomata

45

Lesion: Light or dark brown lesion usually seen in sun-exposed parts of the body
Diagnosis:

Hyper-pigmentation lesions (FRECKLES)

46

Finding: Single umbilical cord + Imperforate anus
Diagnosis:

Muscle
Renal - Ans?
Cardio

47

Finding: Large tongue + umbilical hernia
Diagnosis:

Hypothyroidism - Ans ?
Down syndrome
Hernia

48

Finding: Incessant crying
Diagnosis:

Temp
Feeding
Bowel movement
AOTA??

49

Finding: Myoclonus knee jerk in 2 week neonate
Diagnosis:

Physiologic

50

Finding: Concave nails (koilonychia)
Diagnosis:

IDA
Plummer Vinson Syndrome

51

Finding: Generalized hypotrichosis
Diagnosis:

hypothyroidism??

52

Finding: Harrison's groove
Diagnosis:

Rickets or COPD

53

Finding: Abdominal pain made WORSE by squeezing is likely due to some ________ condition
Diagnosis:

Inflammatory

54

Information: Parity + Gravidity of the Mother
Parts of the History:
- Prenatal
- Natal
- Neonatal

Prenatal

55

Information: Severity of Jaundice
Parts of the History:
- Prenatal
- Natal
- Neonatal

Neonatal

56

Information: Spontaneous breathing at birth
Parts of the History:
- Prenatal
- Natal
- Neonatal

Natal

57

Information: History of Phototherapy
Parts of the History:
- Prenatal
- Natal
- Neonatal

Neonatal

58

Information: APGAR score of 8
Parts of the History:
- Prenatal
- Natal
- Neonatal

Natal

59

History and PE Finding: Child swallows dirt, crayon, chalk etc
Condition:

PICA

60

History and PE Finding: Generalized jaundice except the sclera
Condition:

Lycopenia

61

History and PE Finding: Excessive thirst and water intake
Condition:

Polydipsia

62

History and PE Finding: Child regurgitates food into the mouth and chews on it
Condition:

Rumination

63

History and PE Finding: Patient is blue w/o dyspnea
Condition:

Met-hemoglobinemia

64

Description: Unsteady gait
PE Findings:

Ataxia

65

Description: Pulse rate INC w/INSP and DEC w/EXP
PE Findings:

Sinus Arrhythmia

66

Description: Pulse Volume DEC (or disappears) at end of INSP
PE Findings:

Pulsus paradoxus

67

Description: Rapid, deep respiration in metabolic acidosis
PE Findings:

Kussmaul's breathing

68

Description: ALT periods of deep and shallow respiration w/recurring periods of apnea
PE Findings:

Cheyne stokes?
Compare w/Biot's

69

To visualize tympanic membrane of older child, the pinna of the ear is held by fingers of one hand and gently pulled:

Up and back
(Younger - DOWN)

70

Major Salivary gland(s) located below and in front of the external auditory meatus is/are the:

DON'T KNOW
Submaxillary
Sublingual
Parotid

71

Complete set of milk (primary) teeth at 24 months:

20

72

Accessory muscle of expiration

Abdominal
INSP
- SCM
- Scalenii
- Trapezii

73

DEC vocal fremitus over
A Collapsed lung
B Pleural Effusion
C Lung consolidation
D A&B

?? I think D

74

Primary lesion is flat and flushed w/surface of skin blanching w/pressure

Macule

75

Bronchial breathing is considered abnormal if heard over the

Lower aspect of the anterior chest
NORMAL
- Trachea
- Midline of upper anterior chest
- Either side of the 2nd thoracic spine, over the posterior chest in small infants

76

Last part of PE (esp in young children)

EARS

77

The ff information is included in the hx of the PERSONAL habits of the patient EXCEPT
- School performance
- Sleeping
- Toileting
- Games and play

Personal habits
- Feeding
- Sleeping
- Toilet
- Games/Play
- Living condition

78

The ff are immediate reflection of adequate nutrition of an infant EXCEPT:
- sleeps after feeding
- Plays
- quiet after feeding
- Gaines weight

Sleeps after feeding?

79

Description: Shrieking cry
Diagnosis:

CNS disease

80

Description: Peripheral cyanosis, compared to central,
Diagnosis:

Tongue is not blue
Cold extremities

81

Description: Green colored watery stools
Diagnosis:

Rapid intestinal peristalsis

82

Difference between diastolic pressure of upper and lower limbs

NONE
Systolic difference = 5-10 mmHg higher in lower limbs

83

Normal resp rate of a NB

?? 30-50 ??
Normal Tachypnea
0-2m 30-50 >60
2-12m 20-30 >50
1-5y 20-30 >40
6-12y 15-20 >30
12-18y 12-18 >24

84

Palpable or not, NB has __ fontanels

SIX

85

Clinical History: G2P3
Type of History:
- Prenatal
- Natal
- Neonatal

Prenatal

86

Clinical History: Mother's age
Type of History:
- Prenatal
- Natal
- Neonatal

Prenatal

87

Clinical History: Polyhydramnios
Type of History:
- Prenatal
- Natal
- Neonatal

Natal

88

Clinical History: Phototherapy
Type of History:
- Prenatal
- Natal
- Neonatal

Neonatal

89

Clinical History: APGAR
Type of History:
- Prenatal
- Natal
- Neonatal

Natal

90

Finding: Muscle weakness w/rashes
Diagnosis:

Collagen vascular disorders

91

Finding: Joint tenderness, as a sign of arthritis should be differentiated from
Diagnosis:

Proximal bone tenderness
Tenderness along tendon attachments
Bone pain of leukemia

92

Finding: Erythema marginatum
Diagnosis:

ARF Acute rheumatic fever

93

Finding: Tenderness of sacro-iliac joint elicited by
Diagnosis:

Pretzel test

94

Finding: Ortolani's maneuver
Tests for:

Hip displacement

95

Finding: Grower's test
Diagnosis: ?

DMD

96

Finding: Tenderness over tibial tubercle suggests
Diagnosis:

Sarcoma

97

Finding: TRUE migrating pain can be seen in
Diagnosis:

Rheumatic fever

98

Finding: Excessive tearing may be d/t
Diagnosis:

Allergy
Local irritation of eyes
Crying

99

Finding: Failure of the fontanels to close by 18 months
Diagnosis:

Hydrocephalus
Ricketts
Hypothyroidism

100

Finding: Unusually long eyelashes
Diagnosis:

Malnutrition
Some normal

101

Finding: Hx of Doctor-shopping
Diagnosis:

Possibility of pediatric Munchhausen
(What is Sandifier Syndrome)

102

Number of pregnancies reaching the age of viability =

Parity

103

Number of pregnancies, regardless of viability

Gravida

104

Snoring is a form of ______ observed during sleep

STRIDOR

105

Generalized Cyanosis (inc tongue) + warm extremities

CENTRAL

106

Height should be measured in the ______ position in infants and children less than ___ years old

Supine
<3 years old

107

Head circumference is measured

1" above the Glabella
Max point of the Occipital protuberance

108

Axillary temp is usually _____ lower/higher than oral

0.5' lower

109

Head Circumference > Chest Circumference until ____

6 months of age

110

Sinus arrhythmia is characterized by RAPID pulse during ______ and SLOWER during

RAPID - INSP
SLOWER - EXP

111

Narrow cuff gives a ____ reading
Wide cuff gives a ____ reading

Narrow - HIGHER
WIDE - LOWER

112

Lesions: Crust
Type: 1' or 2'

2'

113

Lesions: Petechiae
Type: 1' or 2'

1'

114

Lesions: Excoriation
Type: 1' or 2'

Secondary

115

Lesions: Atrophy
Type: 1' or 2'

Secondary

116

Lesions: Pustule
Type: 1' or 2'

Primary

117

Prenatal
Natal
Neonatal
Gravity & Parity

Prenatal

118

Prenatal
Natal
Neonatal
Severity of Jaundice

Neonatal

119

Prenatal
Natal
Neonatal
Spontaneous breathing at birth

Natal

120

Prenatal
Natal
Neonatal
History of phototherapy

Neonatl

121

Prenatal
Natal
Neonatal
APGAR

Neonatal

122

History and PE
Child swallows dirt, crayon, chalk

PICA

123

History and PE
Generalized jaundice except the sclera

Lycopenia

124

History and PE
Excessive thirst and water intake

Polydipsia

125

History and PE
Child regurgitates food into mouth and chews on it

Rumination

126

History and PE
Patient is blue w/o dyspnea

Met-hemoglobinemia

127

History and PE
Generalized cyanosis and warm extremities

Central cyanosis

128

History and PE
Cyanosis
(Excluding tongue and w/cold extremities)

Peripheral cyanosis

129

History and PE
Pacified swallowing

Dysphagia

130

History and PE
Failure of muscle coordination

Ataxia

131

History and PE
Unsteady gait

Ataxia

132

History and PE
Pulse rate INC w/INSP and DEC w/EXP

Sinus arrhythmia

133

History and PE
Pulse volume DEC (or disappears) at end of INSP

Pulsus paradoxus

134

History and PE
Rapid, deep respiration in metabolic ACIDOSIS

Kussmaul's breathing

135

History and PE
Alt period of deep and shallow respiration w/recurring periods of apnea

Biot's breathing

136

History and PE
Lying still in bed and don't want their abdomen touched

Peritoneal irritation

137

History and PE
Irritability and dyspnea worsening on lying flat

Congestive heart failure

138

History and PE
Shrill shrieking and high pitched cry

CNS disease

139

History and PE
Abdominal pain AGGRAVATED by palpation

Abdominal pain secondary to inflammation

140

History and PE
Abdominal pain relieved by palpation

Abdominal pain secondary to SPASM

141

4m w/head circumference larger than chest circumference

NORMAL
H > C 4-6m

142

History and PE
12m old w/head circumference larger than chest

Marasmus
Hydrocephalus
EV Syndrome (small thorax)

143

History and PE
Noisy musical sound on respiration heard even w/o stethoscope

Wheeze

144

Prenatal
Natal
Neonatal
Mother's age

Prenatal

145

Prenatal
Natal
Neonatal
Polyhydromnios

Prenatal

146

Prenatal
Natal
Neonatal
Meconium staining

Natal

147

Prenatal
Natal
Neonatal
Duration of nursery stay

Neonatal

148

Prenatal
Natal
Neonatal
Severity of Jaundice

Neonatal

149

Prenatal
Natal
Neonatal
Maternal intake of metformin

Prenatal

150

Prenatal
Natal
Neonatal
NSD

Natal

151

Neonatal
Nutritional
Natal
Past Medical
Social and Personal
Family
Health history of the yaya

Family

152

Neonatal
Nutritional
Natal
Past Medical
Social and Personal
Family
Are these the Natural parents?

Family

153

Neonatal
Nutritional
Natal
Past Medical
Social and Personal
Family
Usual eating pattern

Social and personal

154

Neonatal
Nutritional
Natal
Past Medical
Social and Personal
Family
Is there bed wetting

Social and personal

155

Neonatal
Nutritional
Natal
Past Medical
Social and Personal
Family
Was phototherapy done?

Neonatal

156

Neonatal
Nutritional
Natal
Past Medical
Social and Personal
Family
40th week of gestation

Neonatal

157

Neonatal
Nutritional
Natal
Past Medical
Social and Personal
Family
Exchange transfusion was done

Past medical

158

Neonatal
Nutritional
Natal
Past Medical
Social and Personal
Family
APGAR score

Natal

159

Neonatal
Nutritional
Natal
Past Medical
Social and Personal
Family
Two cord coils

Natal

160

Neonatal
Nutritional
Natal
Past Medical
Social and Personal
Family
Presence of cataract

Neonatal

161

History and PE
Blood in the sputum

Hemoptysis

162

History and PE
History of repeated accidents

Past medical

163

History and PE
Pattern of weight gain

Nutrition

164

History and PE
Age of weaning

Nutritional

165

History and PE
Purposeless, repetitive movement

Tics

166

History and PE
Double vision

Diplopia

167

History and PE
Involuntary discharge of urine occuring during sleep at night

Enuresis

168

History and PE
Sensation as if surrounding objects are going round and round

Vertigo

169

History and PE
Purposeless, non-repetitive involuntary movement

Chorea

170

History and PE
Slow writhing movements of the distal portion of the extremities

Athetosis

171

History and PE
Purposeless, non-repetitive movement

Chorea

172

History and PE
Rapid, oscillatory movements present AT REST

Tremor

173

History and PE
Slow, rhythmic movements of the extremities and the face

Athetosis

174

History and PE
Intermittent contractions of a single muscle (or group) resulting in quick, jerky motion of a limb

Myoclonus

175

Decerebrate or Decorticate
Ext of the neck

Decerebrate

176

Decerebrate or Decorticate
Flexion of the elbows and wrists

Decorticate

177

Decerebrate or Decorticate
Extension of the LOWER limbs

Decerebrate and Decorticate

178

Decerebrate or Decorticate
Pronation of the forearm

Decorticate

179

Decerebrate or Decorticate
Ext at the elbows

Decorticate

180

Skin lesions
Blanch w pressure

Macule

181

Skin lesions
Do NOT blanch w/pressure

Petichiae

182

Skin lesions
Confluent papules

Plaques

183

Skin lesions
Larger lesions are called bullae

Vesicles

184

Skin lesions
Central portion of the lesion paler than periphery

Wheals

185

Normal or Abnormal
Hydrocele at 3 months

Normal (up to 3 months)

186

Normal or Abnormal
L scrotum is at a lower level than the right

Norma

187

Normal or Abnormal
Active bowel sounds in late intestinal obstruction

ABnormal

188

Normal or Abnormal
Kidney best felt in deep INSP

Normal

189

Normal or Abnormal
Milky white breasts secretions in a 5d neonate

Normal

190

Normal or Abnormal
Systolic blood pressure in the lower limbs is higher than upper

NORMAL

191

Normal or Abnormal
Pulse is rapid during INSP and slower during EXP

Normal

192

Normal or Abnormal
Head circumference remains larger than chest until 1 year old

Abnormal

193

Normal or Abnormal
APGAR score of 6

Abnormal
What's normal?
7 or greater = Good
4-6 - Asphyxiated --> Observe
3 or less --> Resuscitation

194

Normal or Abnormal
Newborn infant w/ weight loss of 20% after birth

ABnormal
10% is normal

195

Social/Personal
Natal
Neonatal
Nutritional
Family
Yaya diagnosed with milk PTB

Family

196

Social/Personal
Natal
Neonatal
Nutritional
Family
Sources of support

Social/personal

197

Social/Personal
Natal
Neonatal
Nutritional
Family
Baby sleeps after feeding

Nutritional

198

Social/Personal
Natal
Neonatal
Nutritional
Family
Exchange transfusion

Neonatal

199

Social/Personal
Natal
Neonatal
Nutritional
Family
Oliohydromnios

Natal

200

Prenatal
Natal
Neonatal
None
Term of pregnancy

Prenatal

201

Prenatal
Natal
Neonatal
None
Phototherapy?

Neonatal

202

Prenatal
Natal
Neonatal
None
Polyhydramnios

Natal

203

Prenatal
Natal
Neonatal
None
Meconium staining

Natal

204

Prenatal
Natal
Neonatal
None
Adequacy of milk intake

None
Nutritional?

205

Prenatal
Natal
Neonatal
None
Teenage pregnancy

Prenatal

206

Prenatal
Natal
Neonatal
None
G1P1

Prenatal

207

Prenatal
Natal
Neonatal
None
Birth weight

Natal

208

Prenatal
Natal
Neonatal
None
Forceps delivery

Natal

209

Prenatal
Natal
Neonatal
None
Induced labor

Natal

210

Physiologic or Pathologic
Cephal-hematoma

Physiologic

211

Physiologic or Pathologic
Ebstein pearls

Physiologic

212

Physiologic or Pathologic
Erythema toxicum

Physiologic

Def: common rash in neonates. Appears in up to half of newborns carried to term usually 2-5 days after birth; it does not occur outside neonatal period.

Blotchy red spots on skin w/overlying white or yellow papules or pustules.

213

Physiologic or Pathologic
Positive ankle clonus at 1 week

Physiologic

214

Physiologic or Pathologic
Unequal Moro reflex

Pathologic

215

Physiologic or Pathologic
Caput succedanum

Abnormal

Def: Neonatal condition involving sero-sanguinous, subcutaneous and extra-periosteal fluid collection w poorly defined margins cause by pressure of the presenting part of the scalp against the dilating cervix during delivery

216

Physiologic or Pathologic
Scaphoid abdomen at birth

Physiologic

217

Physiologic or Pathologic
Bounding dorsalis pedis pulses

Physiologic

218

Physiologic or Pathologic
Millia over the tip of the nose at 3 days of life

Pathologic
Milia are small raised pearly white or yellowish bumps on the skin usually around cheeks nose eyes, forehead and chest
Common in newborns
Tiny skin cyst filled w/keratin

219

Physiologic or Pathologic
Peripheral cyanosis at 4 hours of life

Pathologic

220

Physiologic or Pathologic
36.7' C at 24h of life

Abnormal

221

Physiologic or Pathologic
Head circumference of 34cm

Abnormal

222

Physiologic or Pathologic
Globular abdomen at 48h of life

Abnormal

223

Physiologic or Pathologic
RR of 60/min at 1h of life

Abnormal

224

Physiologic or Pathologic
(-) Fencing reflex at 1w

Normal

225

Physiologic or Pathologic
Consumes 15cc of breastmilk at 12h of life

Abnormal

226

Physiologic or Pathologic
(+) GRasp reflex at 24h of life

ABnormal

227

Physiologic or Pathologic
Passage of urine at 30h of life in 34 week neonate

Abnormal

228

Physiologic or Pathologic
(+) Crepitations over the clavicular area

Normal

229

Physiologic or Pathologic
(+) Head lag at 2w of life

Abnormal

230

Physiologic or Pathologic
Hydrocoele at 3m

Normal

231

Physiologic or Pathologic
Umbilical cord stump falls off at 21 days

Abnormal?
Falls off 6-18d
Heals 12-21d

232

Physiologic or Pathologic
Urethral discharge in a 3d male

Normal

233

Physiologic or Pathologic
Highly pigmented genitalia in a female newborn

Normal

234

True/False
In taking the hx, remember to have a period of communication with the child even though the parents are speaking

True

235

True/False
Important to use both open-ended and leading question

True

236

True/False
During the process of questioning, if a parent does not look in your eyes directly it always means evasion

False

237

True/False
Following history of doctor-shopping by the family, one must be aware of the possibility of pediatric version of "Sandifier Syndrome"

False
Munchausen

Sandifer syndrome
- spasmodic torsional dystonia
+ arching of the back
+ rigid opisthotonic posturing, mainly involving the neck, back, and upper extremities,

- associated with symptomatic gastroesophageal reflux, esophagitis, or the presence of hiatal hernia

238

True/False
Gravida is defined as the unmber of pregnancies reaching the age of viability

False
Parity

239

True/False
Snoring is a form of grunt which occurs during sleep

False
Stridor

240

True/False
Height should be measured in the supire position in infants and children below 2yo

False
3yo

241

True/False
Head circumference is measured at the maximum point of the glabella and a point 1 inch above the occipital protuberance

False
1" above the glabella and the most prominent aspect of the occipital protuberance

242

True/False
Normally at birth, HC > CC ad remains so until 6m

True

243

True/False
Axillary temperature is lower than oral

True
Axillary temp is at least 0.5'C lower than oral

244

True/False
Sinus arrhythmia is characterized by rapid pulse during expiration and slower during inspiration

False
Rapid - INSP
Slower - EXP

245

True/False
A narrow blood pressure cuff will give spuriously high blood pressure reading and broader cuff will give a lower reading

True

246

True/False
Movement is lost in both pyramidal and and extra-pyramidal dse

True

247

True/False
Presence of Moro is normal up to 6m

False

248

True/False
Absence of balancing reflex for sitting after 8months is abnormal

True

249

True/False
Knee jerk is an example of a deep reflex

True

250

True/False
Social smile is observed at 3 months

False

251

True/False
Bloody vaginal discharge among newborns is pathologic

False

Males should NOT have any discharge Meningeal signs:

252

True/False
Pleural pain gets worse on coughing. Also true for INC ICP

True

253

True/False
In carotenemia and lycopenemia, the sclera is not icteric

True

254

True/False
In PICA, aside from mental retardation, there is a history of swallowing anything inedible

False

Mental retardation must be ruled out to consider PICA