Pediatrics

Question 1

at what minute intervals is the APGAR score done in neonates?

Answer 1

1
3
10 min

Question 2

What does APGAR stand for

Answer 2

A - activity
P - pulse
G - grimace
A - appearance
R- respiration

Question 3

an APGAR score of ______ means they are in excellent condition

Answer 3

7-10

Question 4

what is released during breast feeding that gives mom the “high”

Answer 4

oxytocin

Question 5

T or F: your patient just gave birth via C-section, so the newborn does not need the erythromycin eye ointment

Answer 5

FALSE - bacterial conjunctivitis can travel up the uterus still - every baby gets it

Question 6

upon inspection of a newborn, you notice speckled iris and medial epicanthic folds - what are the eye speckles and what are you thinking is the cause?

Answer 6

Brushfield Spots

Down Syndrome

Question 7

hypoglycemia in neonates is serum glucose < ___ mg/dL

Answer 7

40

Question 8

T or F: after birth, you notice that the baby is grunting, cyanotic, and in respiratory distress. Quickly hand the baby to the mom for skin-to-skin, this will resolve the issue

Answer 8

FALSE - meconium aspiration; do NOT give to mom, go to warmer and suction

Question 9

you can predict the levels of bilirubin by the level of jaundice on skin. How much bilirubin if the jaundice reaches to the nipples (no abdomen/arms)

Answer 9

<12 mg/dL

Question 10

at what level of bilirubin do you need to do blood transfusion?

Answer 10

> 20-25 mg/dL

Question 11

T or F: pathologic jaundice should never happen within first 24 hours of life

Answer 11

True (if levels >5 mg/dL in first 24 hours = pathologic jaundice)

Question 12

what is kernicterus?

Answer 12

brain damage, coma, death from too much bilirubin

Question 13

what is breast milk jaundice?

Answer 13

around 1 week of age, infants become jaundiced due to dehydration from low milk volume

Question 14

Your infant patient is turning 1 in 3 days; but her mother can’t come back then for her MMR. Just give it to the baby now.

Answer 14

FALSE! only give MMR if 12 months of older - not a day before

Question 15

The Tanner stages have how many stages?

Answer 15

5

Question 16

at what stage of Tanner staging do physical changes begin (thicker pubic hair, longer/larger penis, breasts expand) - around age 12-13 years

Answer 16

Stage 3

Question 17

At what Tanner stage does the brain begin to send signals to prepare for physical changes

Answer 17

Stage 1

Question 18

At what tanner stage is puberty in full swing (scrotum darkens, deeper/cracking voice, girls get first period)

Answer 18

Stage 4

Question 19

what tanner stage is the beginning of physical development?

Answer 19

stage 2

Question 20

this is the final stage of Tanner staging, and the end of physical maturation

Answer 20

stage 5

Question 21

female puberty begins with thelarche - what is thelarche?

Answer 21

appearance of FIRST breast tissue

Question 22

how long after appearance of mature pubic hair does menses begin?

Answer 22

1 year after

Question 23

SIDS is death in infant under the age of ______

Answer 23

1 year

Question 24

SIDS incidence peaks at what age?

Answer 24

2-3 months

Question 25

What is the difference between contact and noncontact trauma that contributes to Shaken Baby Syndrome

Answer 25

Contact: direct impact to local area - scalp hematomas, skull fractures Noncontact: acceleration of head

Question 26

A mother brings her infant in, and you notice that he is having decreased muscle tone and appetite, is extremely irritable, and lethargic. The mother further complains of poor sucking and swallowing abilities. What is at the top of your DDX?

Answer 26

Shaken baby syndrome

Question 27

T or F: using an infant swing, tossing child in air, and bouncing child on knee are NOT violent enough to cause injuries associated with SBS

Answer 27

True

Question 28

Colic is defined as crying for ___ hours per day, ____ or more days per week, for ____ weeks

Answer 28

3+

Question 29

use the acronym PURPLE for Colic - what do the letters mean?

Answer 29

``` P - peaks at 2 months U - unpredictable R - resistant to soothing P - pain-like expression L - long bouts E - evening crying ```

Question 30

what is the leading cause of death for kids > 1 year?

Answer 30

unintentional injuries

Question 31

what should you set the water heater to, in order to prevent scalding?

Answer 31

120 F

Question 32

how long can you leave children <7 years alone for?

Answer 32

NEVER

Question 33

how long can you leave an 8 year old alone for?

Answer 33

no more than 2 hours

Question 34

how long can you leave a 9 year old alone for?

Answer 34

no more than 4 hours

Question 35

how much daily iron is recommended for breastfeeding infants at 4 months old?

Answer 35

1 mg/kg/day

Question 36

how much vitamin D is required for breastfed babies?

Answer 36

400 IU/day

Question 37

when starting to feed your baby (breastmilk), start small. How many ounces every 2 hours is ok?

Answer 37

2 ounces every 2 hours

Question 38

how many ounces daily should 4-6 month olds be fed?

Answer 38

6-7 ounces

Question 39

T or F: formula/breast milk is the infant's MAIN food intake until 1 year of age

Answer 39

True

Question 40

when is it necessary to supplement fluoride?

Answer 40

6 months, only for those without access to fluoride-filled water at home

Question 41

your distressed patient has a newborn baby who is not sleeping through the night. you inform her that her baby probably won't sleep 6 full hours until age ____

Answer 41

3-4 months

Question 42

T or F: keeping the colicky baby awake as late as possible will help her sleep through the night

Answer 42

FALSE - does more harm than good keeping them up.

Question 43

sleep disruption is common at _____ months

Answer 43

9 months

Question 44

what is the definition of enuresis

Answer 44

bed-wetting after 5 years old

Question 45

how do you treat an infant with hypoglycemia?

Answer 45

give infant formula or breast milk until glucose is stable (IV if needed)

Question 46

If nuchal rigidity is found in fetal US, and you suspect Down syndrome, what are your next steps?

Answer 46

Genetic testing for diagnosis and ECHO to assess ventricular function

Question 47

Newborns bilirubin levels at 4 hours of life is 7 mg/dL. Is this a concern?

Answer 47

Yes - greater Than 5 within first 24 hours is risk of kernicterus