Pediatrics Quiz Flashcards
(126 cards)
1
Q
What is the term for birth to one month?
A
Neonate
2
Q
What is the term for one month to one year?
A
Infancy
3
Q
What is the term for one to three years?
A
Toddler
4
Q
What is the term for three to five years?
A
Preschool Age
5
Q
What is the term for five to ten years?
A
Middle childhood, school age
6
Q
What is the term for eleven to twenty one years?
A
Late childhood, adolescent
7
Q
Infants should lose weight in the first several days of life, but they should regain back to birth weight by _____________. Weight loss greater than ______ is abnormal.
A
10-14 days
10%
8
Q
Average weight gain for first 3 months:
Average weight gain for 3-6 months:
A
1 ounce per day
2-3 ounces per day
9
Q
Infants should double weight by _____, triple weight by ______, and quadruple weight by ___________
A
6 mo
1 year
2 years
10
Q
Head circumference increases by ______ in the first year of life
A
30%
11
Q
Head circumference should be measured from birth to _______
A
3 years
12
Q
Age range that a child should be measured by length (lying down)
A
Birth to 2 years
13
Q
The anterior fontanel is ________ in shape. It is formed from the junction of ______, _______, and ______ sutures. Closes around __________.
A
Diamond
Sagittal, frontal, coronal sutures
12-18 mo of age
14
Q
The posterior fontanel is ____ in shape. It is located between the _________ and ________ bones. Closes by the __________.
A
Triangular
Occipital and 2 parietal
End of the 2nd month of life
15
Q
Weight-for-length should be measured from:
BMI should be measured from:
A
Birth to 24 months
2 to 21 years
16
Q
Increased weight percentile, normal height percentile
A
Dietary management
17
Q
Increased weight percentile, decreased height percentile
A
Think about organic causes Hypothyroidism Excess production of cortisol (Cushing) Thalamic or pituitary disorders Down syndrome Prader-Willi syndrome Laurence-Moon syndrome
18
Q
Decreased weight percentile, normal height percentile
A
Dietary management
19
Q
Decreased weight percentile, decreased head or height percentile
A
Organic causes Lead intoxication HIV infection Failure of major organ system Iron deficiency
20
Q
Increased Height pathologies
A
Hyperthyroidism
Marfan syndrome
Klinefelter syndrome
Excess HGH
21
Q
Decreased Height pathologies
A
HGH deficiency Hypothyroidism Chronic anemia Turner Syndrome Failure of major organ system Skeletal dysplasia
22
Q
Increased head size pathologies
A
Hydrocephalus
Megaencephaly
23
Q
Decreased head size pathologies
A
Craniosynostosis Prenatal insult (maternal drugs/alcohol/infection) Chromosome defect
24
Q
Major Categories of Development in Children
A
Motor (Gross, Fine)
Cognitive
Emotional/Social
Language
25
Cognitive Development of a Newborn Infant
Recognizes facial expressions as similar even on different people
26
Cognitive Development of a 2-6 month old
Actively looking around
| Exploring environment and self (looking at hands, etc.)
27
Cognitive Development of a 6-12 month old
Has discovered hands, learns how to manipulate objects.
Puts everything in mouth
Object permanence
28
Emotional Development of a 2-6 month old
Become attached to parents and will mimic facial expressions --> first step in developing communications
29
Progression of expressive language
```
Cooing
Babbling
Single words
Putting 2-3 words together
Telling a story
```
30
Hearing test done at birth
```
BAER (Brainstem Auditory Evoked Response)
also EOAE (ABR more often)
```
31
By 1 year of age, what are expected growth goals?
Triple body weight
Increase length by 2
Significant increase in brain size and complexity
32
Special Concerns for the First Year:;
```
Feeding
Sleep patterns
Temperament
Developmental delays
Parent-Infant Interaction
Failure to thrive
```
33
Developmental Milestones for 1 month
Responds to sounds by blinking, crying, quieting, showing startle response.
Fixates on human face and follows with eyes.
Moves all extremities
34
Developmental Milestones for 2 months
Coos and vocalizes reciprocally
Smiles responsively
In prone position, lifts head, neck, and upper chest with support on forearms
35
Developmental Milestones for 4 months
Babbles and coos
Rolls over from front to back
Controls head well
Spontaneous social smile
36
Developmental Milestones for 6 months
```
Vocalizes single consonants (baba, dada)
Sits with support
Starts to self-feed
Transfers small objects from hand to hand
Rakes in small objects
```
37
Developmental Milestones for 9 months
```
Responds to own name
Can scoot on bottom
May pull to stand
Uses inferior pincer (thumb and finger)
Stranger anxiety
```
38
During the first 3 months of age, child increases about ______ per month. Then just under ________ per month from 4-6 months. At 7-12 months, _______ per month.
1 and 1/4 inches
1 inch
1/2 inch
39
Eruption of teeth starts by ________ of age - these are the ________ teeth
5-6 months
| Deciduous teeth
40
Special concerns for 1-5 y/o
```
Eye-hand coordination
Vocabulary
Reading Comprehension
Cognitive Delays
Excessive Tantrums
Toileting Problems
Aggression, isolation
```
41
Weight gain in early childhood (1 to 5 years) is ____________
4-6 pounds/year
42
By age 2, the toddler has _____ temporary teeth. By 2.5 years, the toddler has _____.
16
| 20
43
Developmental milestones for 12 months:
Pulls to stand, cruises, may take a few steps alone
Vocal of 1-3 words in addition to mama and dada
Drinks from a cup
44
Developmental milestones for 15 months:
```
Has vocabulary of 3-10 words
Can point to one or more body parts
Understands simple commands
Feeds self with fingers
Follows simple directions
```
45
Developmental milestones for 2 years:
Has vocabulary of at least 20 words
Uses 2 word phrases
Can follow 2-step commands
46
Developmental milestones for 3 years
Rides a tricycle
Copies a circle and a cross
Has self-care skills (feeding and dressing)
Shows earl imaginative behavior
47
Developmental milestones for 4 years
Talks about his daily activities and experiences
Builds a tower of 10 blocks
Hops, jumps on one foot
48
Weight and height gain for middle childhood (5-10 years)
8 pounds/year
| 2 inches/year
49
Permanent teeth erupt during ___________
School-age period, starting at 5 years old
50
Special concerns for middle childhood
Visual and auditory memory skills
Grades, absenteeism
Social isolation, bullying, peer pressures
Early onset of puberty (risky behaviors)
51
Developmental milestones for 5 years
Dresses self without help
Can count on fingers
May be able to skip
52
Developmental milestones for 6-8 years
Rides a bike
| Prints words and learns cursive writing
53
Developmental milestones for 8-10 years
Throws ball skillfully
Participates in organized sports
Handles eating utensils skillfully
54
In middle childhood, a child will have short bursts of anger by age ____ but should be able to control anger by _____
10 years
| 12 years
55
Early adolescence is defined as
11-14 years
56
Middle adolescence is defined as
15-17 years
57
Late adolescence is defined as
18-21 years
58
Growth spurt begins earlier in girls (_______ years) than boys (_______ years)
10-14 years girls
| 12-16 years boys
59
Males will gain up to ______ pounds during adolescence, and females will gain up to ________ pounds
65
| 55
60
Growth in height ceases at age ______ in females and _______ in males
16-17 females
| 18-20 males
61
Fats must constitute at least ______ of caloric intake to meet growth and development demands
30%
62
American Academy recommends exclusive breastfeeding in the first ______ of life
6 months
63
Breast Feeding Advantages: Lowered incidence/risk of:
```
Respiratory Infections
Otitis Media
GI Infections
SIDS
Asthma
Atopic Dermatitis
Inflammatory Bowel Disease
Obesity
T1DM
Childhood leukemia and lymphoma
Intelligence scores and teacher ratings significantly higher
Lower rates of sepsis and NEC
Fewer hospital readmissions
Lower incidence of retinopathy of prematurity
Significantly greater scores for mental, motor, and behavior ratings
```
64
Breast Feeding Advantages (For mom)
Delays return of ovulation (spacing of children)
Loss of pregnancy associated adipose tissue
Suppression of postpartum bleeding
Decreased breast and ovarian cancers rate
If lactated > 12 months, less HTN, HLD, CVD, and DM
65
Contraindications to Breastfeeding
```
Galactosemia
Certain Inborn Errors of Metabolism
HIV + mothers
Herpes on breast
Active TB (until treatment initiated)
Using illicit drugs
Taking antimetabolite chemotherapy
```
66
Types of Infant Formula
```
Cow-Milk Protein
Soy Protein
Hydrolyzed Protein
Free Amino Acid
Special Diagnosis (Preterm, Low mineral, Low fat)
```
67
Cow's Milk Formula has ____ kCal/oz, protein source is _______ and _______. Carbohydrate is ________.
20
Casein and Whey
Lactose
68
Contraindications to Cow's Milk Formula
Milk protein allergy
| Galactosemia
69
Preterm Infant Formulas have ______ kCal/oz. These infants need to be able to regulate their temperature, metabolic rate is higher. These concentrations have more Vitamin A and D.
24
70
Preterm transitional formulas bridge the gap between preterm and term formulas. Contains ______ kCal/oz
22
71
Human milk fortifiers are used in preterm infants (particularly VLBW), less than _______ grams. Matches growth and metabolic effects of preterm formulas.
1500 grams
72
Thickened Cow's Milk Protein are effective formulas for children with:
GERD
| Have added rice starch to thicken
73
Partially hydrolyzed cow's milk protein are effective formulas for:
Gassiness, fussiness, and constipation
| Protein is partially broken down into small peptides
74
Indications and Contraindications for Soy Protein Formula
Indications: Galactosemia, vegan diet preference
CI: cow milk protein enterocolitis/enteropathy, premature infants < 1800 grams
75
Which soy formula is marketed to help manage diarrhea/loose watery stools?
Isomil DF
76
Indications for Hydrolyzed Protein Formulas
Cow milk protein allergy
Soy protein allergy
Galactosemia
Colic
77
Exclusively breastfed infants should receive:
Vitamin D supplementation (400 IV/day) at birth
Fluoride at 6 months
Iron rich foods should be the first solids introduced
78
If parents have severe eczema, egg allergy, or both:
Consider IgE or skin prick test. If negative, introduce peanut containing foods (4-6 months)
79
If parents have mild to moderate eczema:
Introduce peanut containing foods around 6 months
80
If parents have no eczema or any food allergy:
Introduce peanut contains foods (age appropriate)
81
Gluten should be avoided before _______ and after ________. Introduction of gluten while breastfeeding may decrease the risk of ________, __________ and __________
Before 4 months
After 7 months
Celiac Disease, T1DM, Wheat allergy
82
Juice should be limited to < ______ in 1-3 y/o, < ______ in 4-6 y/o, and < ______ in 7-18 y/o
< 4 oz/day
< 6 oz/day
< 8 oz/day
83
Transition from formula to whole milk should be around ________. To avoid iron deficiency anemia, whole milk should be limited to ________
1 year
| 16 oz/day
84
May start to see food jags around ________
15 months
85
Most adolescents do not take in the RDAs for:
Calcium
Vitamin A
Vitamin C
Iron
86
_____ of children in the US ages 2-20 are obese. Maternal obesity during pregnancy increases risk by ________
17%
| 3-5 times
87
Complications of childhood obesity
Discrimination, teasing
Advanced bone age, increased height, early menarche
Pseudotumor cerebri
Obstructive sleep apnea
Slipped capital femoral epiphysis
Insulin resistance, T2DM, hypercholesterolemia, cholelithiasis
88
Pediatric undernutrition is at greatest risk from:
Utero to 2
89
Spectrum of conditions caused by varying levels of protein and calorie deficiencies
Protein-Energy Malnutrition (PEM)
90
Inadequate calories and nutrients. Loss of muscle mass and subcutaneous fat stores.
Marasmus
91
Clinical features of marasmus:
Dry skin
Thin, sparse hair
Apathetic, weak, irritable when touched
Bones hurt from being reabsorbed
92
Inadequate protein intake in the presence of fair to good caloric intake
Kwashiorkor
93
Clinical features of kwashiorkor:;
Hypoalbuminemia state resulting in pitting edema
Body weight is near normal (due to edema)
Normal subcutaneous adipose tissues and marked atrophy of muscle mass
94
Treatment of malnutrition: start calories at _____ higher than recent intake and then increase by _______ per day
20%
| 10-20%
95
Complications of malnutrition:
Susceptible to infection
Bradycardia and poor cardiac output (predispose to heart failure)
Permanent growth stunting
Delayed development
96
Common Problems in the Well-Infant Visits
```
Crying Infant
Infant feeding problems (formula, breastfeeding)
Temper tantrums
Sleeping problems
Eating problems in toddlers
Unwanted habits
Aggressive behavior
Fever
```
97
Components of the sports physical
Safety devices, pre-season training, dehydration
Full physical exam + joint/muscle examination
Family medical history
Medical conditions - CI to play
Weight
98
Anticipatory Guidance for the newborn/first week visits
Infant Care
Sudden Infant Death Syndrome Risk Reduction
Breastfeeding
Prevention of Shaken Baby Syndrome
99
Anticipatory Guidance for the 1-11 month old
Crib safety, safety seat
Childproofing the home
Introduction of solids
100
Anticipatory Guidance for the 1-4 year old
Toilet training
Bedtime routines
Reading aloud
Brushing teeth and flossing
101
Anticipatory Guidance for the 5-10 year old
```
School readiness
Physical activity
Sexuality education
Healthy meals and snacks
Explaining that certain body parts are private
```
102
Anticipatory Guidance for the 11-21 year old
```
Safe driving
Substance use and abuse
Sexual activity
Violence and suicide prevention
Depression
```
103
Strategy used in a population to identify unrecognized disease in individuals without signs or symptoms
Screening
104
Identifies individuals with increased risk for a disease or unfavorable outcome based on answers to questions or population they are in
Risk Assessment
105
Vision Screening Components
```
Examination
Red reflex
Fixation
Corneal Light Reflex
Cover/Uncover
Visual acuity starting at 3
```
106
One of the most common conditions present at birth
Hearing loss
107
Infants that do not pass hearing screening should be referred for a formal eval no later than _______. Intervention services should start no later than ______
3 months
| 6 months
108
Recommended screening of hearing:
Infancy
4 years
5, 6, 8, 10 years
109
Risk Assessment Factors for Hearing Loss
```
Fam history of permanent hearing loss
NICU care of more than 5 days
Recurrent infections
Craniofacial abnormalities
Chronic or recurrent OME for at least 3 months
Head trauma
Chemotherapy
```
110
Blood pressure screening should begin at ________, and should afterward be measured at each health visit
3 years of age
111
Autism is recommended at:
Per AAP:
18 and 24 months
Any time parent raises concern
112
Newborn screening heel sticks are performed between:
24 hours and 7 days of age
113
______ of children in the US live in housing with deteriorating lead paint
25%
114
Blood lead levels as low as _____ micrograms/dL have been associated with adverse effects on cognitive development, growth, and behavior in children 5 years and younger
10
115
Medicaid enrollees should have lead screening at:
Blood lead test by 12 months age
24 months
36-72 months if not tested earlier
116
Refugees and Internationally adopted children should have lead screening at:
Upon arrival in US
| Repeat in children under 6 in 3 to 6 months after permanent placement
117
For non-medicaid, non-refugee children, lead screening should be done at:
12 and 24 months unless lead exposure can be confidently excluded
118
Screening for iron-deficiency anemia should be done for:
All infants at 12 months
All non-pregnant females (up to 21) every 5-10 years
Anyone at risk
119
Screening for TB should be done for:
All HIV-infected children/teens annually
| All incarcerated teens annually
120
Screening for dyslipidemia should be done for:
All teens once between 18 and 21 years old
| Screen children and teens at high risk
121
Teenage brain: don't blame it on the hormones, blame it on:
Synaptic pruning
Gray matter thinning
Will see observable behaviors during this time
122
NC Law permits minor consent for:
Contraceptives (inclu. emergency)
Testing/treatment of STDs/HIV
Preg testing and prenatal care
Tx for substance abuse or mental illness
123
Parental consent requirement may be waived for abortion if:
1. Minor is mature and well-informed enough
2. In minor's best interest that parents do not know/consent
3. Victim of rape or felonious incest
124
HEEADDSSS
```
Home life
Education
Employment/Eating
Activities
Drugs (alcohol/cig)
Depression/Diet
Sexuality self image
Suicide
Safety
```
125
Way for the adolescent to grade how you did/made them feel during their visit
SCAG (Structured Communication Adolescent Guide)
126
Developmental Milestones for 18 mo old:
Walls quickly or runs stiffly
Throws a ball
Vocabulary of 15-20 words
