Pediatrics/Growth and Development Flashcards
(113 cards)
1
Q
Hep B schedule
A
#1 - Birth #2 - 1-2 months - at least one month after first dose #3 - Age 6 months - but at least 2 months after 2nd dose
2
Q
Tdap for adolescents
A
Tdap booster Age 11-12
3
Q
Hib vaccine - when do you no longer give?
A
after 5 years of age
4
Q
When is it okay to give live vaccines?
A
after 1 year of age
5
Q
When do you give the MCV4 booster
A
Age 16
6
Q
What is appropriate spacing for vaccines?
A
4 days prior is okay, any earlier is invalid and must be repeated.
7
Q
ADHD characterized by
A
Hyperactivity
Impulsivity
Inattention
8
Q
What is a common assessment scale for ADHD
A
Connors’ - Long and short form
9
Q
Asthma tx in 0-4 year olds
A
Use Nebulizer!
Inhaled corticosteroids (only one approved for young children is budesonide)
SABA - albuterol
leukotrine receprot agonist - montelukast
10
Q
Asthma tx in 5-11 year olds
A
Can use inhaler as appropriate
Inhaled corticosteroids (fluticasone, budesonide)
SABA - albuterol
leukotrine receprot agonist - montelukast
11
Q
What type of pneumonia is common in children under 5?
A
viral, treat empirically
12
Q
What is the most sensitive sign of pneumonia in children?
A
Increased resp
13
Q
Sx RSV
A
URI 1-3 days which progresses to lower resp tract infection Paroxysmal wheezing Increased RR 40-60 Fever Cough Thick purulent nasal secretions
14
Q
What is the most common organism for croup?
A
Parainfluenza types 1,2,3
Adenovirus
Influenza virus
15
Q
Westley Croup score
A
Mild disease (can keep with PCP) - barking cough, hoarse cry, no stridor at rest Moderate (ER) - Stridor at rest, mild retractions, sx resp distress Severe (ER) - Significant stridor at rest, retractions are severe.
16
Q
Tx mild croup
A
Hydration, cool mist, antipyretics
Single dose of dexamethasone
17
Q
Organism with epiglottitis
A
Hib
18
Q
Cystic fibrosis
A
Mutation of chromosome 7
19
Q
Enlarged nodes “rules”
A
10mm is enlarged unless…
Epitrochlear - >5mm
Inguinal - > 15mm
Cervical - > 20mm
20
Q
Criteria for febrile seizures
A
Temp >38C Age < 6yo Absence of CNS infection No metabolic abnormality No hx of febrile seizures
21
Q
Pyloric stenosis sx
A
3-6 week old male with projectile vomiting
Olive like mass better palpated after vomiting
22
Q
GER
A
frequent regergitation in the absence of pathology
Resolves before 1 year of age
Place supine to sleep
23
Q
Red flags with reflux in infants
A
GI bleeding Refusal to feed Forceful vomiting Constipation/Diarrhea Abd tenderness Fever
24
Q
Intussusception
A
Vast majoity under 2 yo
Sausage like mass
Classing child crys and pulls legs up to chest
25
Dx Intussusception
KUB, Abd US
26
Intussusception classic triad
Intermittant colicky abd pain, vomit, bloody mucus stool (currant jelly)
27
Encopresis
Involuntary stooling over 4 yo. More common in males. Constipation often underlying problem.
28
Replacement mild dehydration
5 tsp per pound over 4 hours
29
Replacement moderate dehydration
10 tsp per pound over 4 hours
30
Cryptorchifism
testes not in scrotum and can't be manupulated there (usually found in infants)
31
Retractile testes
Move between scrotum and inguinal ring (5-6 yo)
32
When do you refer with undecended testes?
6 months
33
Most common cause of UTI in children
bowel and bladder dysfunction
34
What test for first fibrile UTI
renal and bladder ultrasound for all infants 2-24 months
35
Dx Kawasaki's disease
```
Fever for 5 days with (4 of 5):
Bilat cunjunctival injection without excudate
Polymorphus rash
Inflamm changes of lips or oral cavity
Changes in extremities
Cervical lymphadanopathy
```
36
Dx studies with Kawsaki disease
CBC, ESR, CRP, ALT/`AST, UA throat culture
37
Osgood schlatter disease
Osteochondritis on tibial tubercle
Common cause of adolesant knee pain
More common in athletes
38
Sx Osgood schlater disease
Swelling affected knee
Bilat symptoms
Prominent tibial tubercle
39
Trendelenberg sign
Standing on affected side causes pelvic tilt. POsitive in SCFE, Legg-Calve Pertes, ansd Dev Dysplasia
40
Roseola
Human Herpesvirus 6
41
Fifth Disease
Parvovirus B19
42
Rubella
Rubella virus
43
Rubeola (measles)
Rubeola virus
44
Chicken pox
Herpes virus
45
Hermangina
Coxsackie A virus
46
Hand Foot and mouth disease
Coxsackie virus A16
47
Measles
Maculopapular brick red rash. Starts on the head and neck and then spreads to trunk and extremities
48
Fifth disease (Erythema infectiosum)
Slapped cheek rash. Lacy macular rash
49
Rubella
Maculopapular rash. Looks like measles rask. Remarkable lymphadonopathy, macules on soft palate
50
Roseola (exanthem subitum)
High fever for 2-4 days then abrupt cessation of fever with appearance of maculopapular rash but not on the face
51
Chicken pox
vesicular lesions on erythematous case appearing in crops
52
What are the 3 C's in Rubeola?
conjunctivitis, coryza, cough
53
Koplik's spots
Resemble grains of sand on the oral mucosa and precede rash. Common with measles (rubeola)
54
When should you have post-partal visit?
2-3 days after birth
55
Milia
What papules on the nose and cheeks
56
Mongolian spots
Congenital with indefinite borders. Buttocks and base of spine. Pred. in AA and Asian infants.
57
Nevus simplex
Stork bite. pink red capillary on face or neck
58
Nevus flammeus
Port wine stain anywhere on malformation body
59
Anterior fontanelle closes?
9-12 months
60
Posterior fontanelle closes?
2 months
61
Hypertelorism
eyes spaced far apart
62
When should red reflex be present?
bilat at birth
63
Normal resp infant
40-60 breaths/min
64
Murmurs in infants
almost universal
65
Deep sacral dimples, hemangioma, discoloration of sacrococcygeal area, can indicate
neural tube defect
66
When finger foods?
8-10 months
67
Iron needs infant
1mg/kg/day
68
When start floride baby?
6 months
69
Who needs vit D
Exclusively breastfed babies
70
Eye eval newborn-3months
red reflex, inspection
71
Eye eval 0 3-6 mo
fix and follow, red reflex, inspection
72
Eye eval - 6-12 months
fix and follow each eye, corneal light reflex, red reflex, inspection
73
Eye eval > 3 years
visual acuity, corneal light reflex, cover/uncover, red reflex, inspection, attempt ophthalmology
74
What does the cover/uncover test check for?
Stabismus
75
Normal HR infant
120-160 with marked sinus arrhythmia
76
Normal HR 3 yo
80-120
77
Normal HR 6 yo
70-110
78
When BP screening children
3yo
79
Kernicterus
What happens to the infants brain with increased bilirubin. Deposits in brain leading to delay and damage.
80
POsitive galeizzi test indicates?
hip dysplasia
81
What is considered scoliosis
>10 degree curvature
82
Female Turner stage 1
Prepubertal. Papilla elevated above chest wall.
83
Female Tanner stage 2
Breast bud stage (8-13yo) Breast and papilla form small mound, areola increases in diameter.
84
Female Tanner stage 3
Breast and areola enlarge. No seperation of contours
85
Female Tanner stage 4
Secondary mound formed by areola and papella at level of breast
86
Female Tanner stage 5
Adult breasts
87
Male Tanner Stage 1
testes 1cm, scrotum and penis are size seen early childhood
88
Male Tanner Stage 2
Slight enlargement of testes 2-3cm, scrotum becomes reddened and textured
89
Male Tanner Stage 3
Further testicular growth (3-4cm) slight enlargement of penis
90
Male Tanner Stage 4
Penis enlarges in length and diameter. Testes enlarge 4-5cm
91
Male Tanner Stage 5
Adult genitalia
92
Adolescence 11-14
```
Egocentric, moody behavior
Eating disorders emerge
Focus is on concrete and present
Risk taking behaviors
Death secondary MVI - think seatbelt
```
93
Adolescence 15-17
Peer groups
Seek privacy
Transition from concrete to operational behavior
Risk taking escalates
94
Adolescence 18-21
Key developmental task focus is achieving
Emotional intimacy
Risky behaviors peak
Death secondary to MVI, suicide, homicide
95
Development - 2 months
Focuses on face
Grasps rattle if placed in hand
Smiles, coos
Able to lift head 45 degrees
96
Development - 4 months
```
Able to hold and control head when held upright
No head lag when pulled upright
Raises body on hands
Rolls prone to supine
Follows light 180 degrees
```
97
Development - 6 months
```
Able to place object in opposite hand and in mouth
Sits with support
Rolls supine to prone
Bears weight
Recognizes parents
Says dada or baba
Babbles
Smiles, squeals, laughs, imitates sounds
```
98
Development - 9 months
```
Pulls to stand
Bangs, shakes, and throws objects
Able to feed self with finger foods
Says 2-4 words
Looks for hidden objects
Responds to name and a few words
Feeds self and drinks from cup
Waves and says bye bye, dada, mama
Imitates vocalizations
```
99
Development 15 months
```
Walks well and is able to stoop
Can point to body part
Says 3-6 words
Stacks 2 blocks
Follows simple commands
POints, grunts, and pulls to show what they want
Listens to a story
```
100
Development - 18 months
```
Able to walk backwards
Can throw a ball
Says 15-20 words
Uses 2 word phrases
POints to multiple body parts
```
101
Development - 2 years
```
Able to walk up and down stairs one step at a time
Can kick a ball
Says at least 20 words
Imitates adults
Follows 2 step commands
Stacks 5 blocks
```
102
Development - 3 years
```
Able to jump
Can stand on one foot
Able to ride a tricycle
Says name, age, and gender
Knows gender of others
Able to copy a circle and cross
Able to recognize colors
```
103
Development - 4 years
```
Able to ding a song
Able to hop on one foot
Able to throw a ball overhand
Able to draw a person with 3 parts
Able to cut and paste
Albe to build a tower with 10 blocks
Counts to 5
Able to copy a square
Able to dress self with supervision
```
104
Development - 5 years
Able to draw a person with body, head, arms, legs
Able to recognize most letters and can print some
PLays make believe
Learns address and phone number
Can define at least one word
105
Anticipatory guidance - Birth
Feed every 2-3 hours, awaken if more than 4 hours
Does not need Vit D unless no sunlight
Back for sleeping
Do not use baby powder
106
Anticipatory guidance - One month
Do not place bottle in bed with baby
No solids until 4 months
Discus colic and comfort measures
107
Anticipatory guidance - 2 months
No solid foods or cereal in bottle
| Do not give honey or water in bottle
108
Anticipatory guidance - 4 months
Childproof home
Introduce solid foods
Have syrup of ipecac available
109
Anticipatory guidance - 6 months
Solids 2-3 times a day
Avoid choking hazards
Start using a cup
Floride supplements
110
Anticipatory guidance - 9 months
Mashed foods and finger foods
Wean from bottle
Brush teeth
111
Anticipatory guidance - 12 months
Start on whole milk
| Allow to feed self
112
Anticipatory guidance - 18 months
Allow to feed self with spoon or hands
| Toilet training can start
113
Anticipatory guidance - 3 years
Time out can start - 1 minute for each year
