Pediatrics Stepup Flashcards Preview

Step2CK > Pediatrics Stepup > Flashcards

Flashcards in Pediatrics Stepup Deck (133):
1

when is birth weight regained

by 2 weeks

2

when is birth weight regained

by 2 weeks

3

what weight is considered fialure to thrive

4

hoes does height increase in first year of life

50%
doubles 4 years
triples 13

5

greater than normal height assoc with what

familial, precocious puberty, gigantism, hyperthyroidism, klinefelter, marfan or obesity

6

lesser than normal height assoc with what

familial
neglect
turners
constitutional growth delay
chronic renal failure
asthma
CF
IBD
immunologic disease
growth hormone deficiency
hypothyroidism
glucocorticoid excess
kskeleteal dysplasias
neoplasm

7

when do you meausre head circumgerence

first -3 years

8

growth that declines after birth

post natal onset

9

growth that is anormal from time of birth

prenatal

10

growth that is consistently low

genetic

11

doctor visits in 1st month

one at 2 weeks
one at 1 month

12

doctor visit schedule 2 mo to 2 years

2,4 and 6 months
then 9,12,15,18
then after age 2 annual visits

13

when is the H flu b vaccine not necessary

children >5 that were never vaccinated because low risk of infection at this age

14

which children should always always receive Hflu-b and pneumococcal vaccines

asplenic

15

when do children socially smile

2 months

16

when do children coo

2 months

17

when do children laugh

4 months

18

when do children have stranger anxiety

6 months

19

motor skills at 6 months

roll over and holds up with hands
sits without support

20

when do children babble

6 months

21

milestones of 9 month olf

interactive games, separation anxiety
crawls, and pulls to stand
grasp with thumb
first words begin

22

milestones for 1 year

separation anxiety
walks with help, pincer grasp, makes twoer of 2 blocks
5-10 vocab

23

milestones for 18 months

parallel play
walks forward and backward
makes tower 4 blocks and uses cup or spoon
10-50 words
2 word sentence

24

milestones for 2 year old

dresses with help
runs, climbs stairs
tower 6 blocks
50-75 words and 3 word sentences

25

milestones 3 year old

magical thinking
gender identity
climbs and descends stairs
makes tower 9 blcoks
draws circle

26

milestones for 6 year old

skips, draws a person
fluent speech

27

milestones for 6 year old

skips, draws a person
fluent speech

28

what weight is considered failure to thrive

less then 5th percentile

29

hoes does height increase in first year of life

50%
doubles 4 years
triples 13

30

greater than normal height assoc with what

familial, precocious puberty, gigantism, hyperthyroidism, klinefelter, marfan or obesity

31

lesser than normal height assoc with what

familial
neglect
turners
constitutional growth delay
chronic renal failure
asthma
CF
IBD
immunologic disease
growth hormone deficiency
hypothyroidism
glucocorticoid excess
kskeleteal dysplasias
neoplasm

32

when do you meausre head circumgerence

first -3 years

33

growth that declines after birth

post natal onset

34

growth that is anormal from time of birth

prenatal

35

growth that is consistently low

genetic

36

doctor visits in 1st month

one at 2 weeks
one at 1 month

37

doctor visit schedule 2 mo to 2 years

2,4 and 6 months
then 9,12,15,18
then after age 2 annual visits

38

when is the H flu b vaccine not necessary

children >5 that were never vaccinated because low risk of infection at this age

39

which children should always always receive Hflu-b and pneumococcal vaccines

asplenic

40

when do children socially smile

2 months

41

when do children coo

2 months

42

when do children laugh

4 months

43

when do children have stranger anxiety

6 months

44

motor skills at 6 months

roll over and holds up with hands
sits without support

45

when do children babble

6 months

46

milestones of 9 month olf

interactive games, separation anxiety
crawls, and pulls to stand
grasp with thumb
first words begin

47

milestones for 1 year

separation anxiety
walks with help, pincer grasp, makes twoer of 2 blocks
5-10 vocab

48

milestones for 18 months

parallel play
walks forward and backward
makes tower 4 blocks and uses cup or spoon
10-50 words
2 word sentence

49

milestones for 2 year old

dresses with help
runs, climbs stairs
tower 6 blocks
50-75 words and 3 word sentences

50

milestones 3 year old

magical thinking
gender identity
climbs and descends stairs
makes tower 9 blcoks
draws circle

51

milestones 4 year old

plays with others
hops on 1 foot
draws a cross and triangle
4 word sentences

52

milestones for 6 year old

skips, draws a person
fluent speech

53

moro reflex

extension head causes extension and flexion of limbs
startle reflex
up until 3 months old

54

grasp reflex

placing finger in palm causes grasping
up until 3 months old

55

rooting

rubbing cheek turns mouth
up until 3months old

56

placing reflex

rubbing foot dorsum causes foot to step up
up until 2months

57

screening in newborn/1 week old

PKU
hypothyroid
maple syrup urine disease
CF
hearinb, visual mobility and red reflex

58

when do teens have increased confidence and more open relationship with parents

17-21

59

when do you introduce solid foods like pureed and vegetables

4-6 months

60

when do kids start teething

4 months

61

when do check for anemia in kids

9 months

62

when to check lead exposure and PPD in kids if in high risk area

1 year

63

when do kids transition from crib to bed

around 2 years old

64

screening in 3 year old

visual acuity, cholesterol
routine dental checkups

65

when to start checking hearing in children

4 years old

66

Hep B series

birth
1-2 mo
6-18 mo

67

Rota virus series

2,4,6

68

DTaP series

2,4,6,15-18
4-6yr
Tdap at 11-12 yr

69

Hib series

2,4,6 and 12-15

70

PCV series pneumococcal

2,4,6,12-15

71

IPV series

2,4,6-18 4-6yr

72

MMR series

12-15
4-6 yr

73

VZV series

12-15
4-6 yr

74

Hep A series

1st at 12 mo
2 given at least 6 mo apart

75

MCV meningococcal series

11-12 yr and 16-18 yrs

76

HPV series

can start around 11/12
do 3 doses over 6 month period

77

Tanner 1 in men

small genitals

78

Presentation Wiskott Aldrich

susceptible to encapsulated bacteria and opportunistic infections
eczema and thrombotyopenia
easy bleeding, decreased IgM
WASP gene

79

Tanner 3 in men

penile enlargement and further testicular growth
more hair growth

80

Tanner 4 men

penile glans enlargement and darkening scrotal skin
hair becomes coarser

81

Tanner 5 men

adult

82

adolescence

10-19 years

83

when do teens desire independence and start having sexuality

14-16 years

84

when can doctor break confidentiality with teen patient

life threatening concerns like suicidal ideation, homicidal ideation, life threatening disease

85

main cause of death for teens

accidents

86

why do immune disorders not present early after birth

still have maternal Ab for around 3 months

87

What are the congenital T cell disorders

DiGeorge and Chronic mucocutaneous candidiasis

88

DiGeorge characteristics

tetany
facial abnormalities
decreased Ca
congenital heart disease
no thymid shadow
22q11

89

Tx DiGeorge

Ca
Vit D
thymic transplant
bone marrow transplant
surgery for heart
IVIG or prophylactic antibiotics

90

Dx chronic mucocutaneous candidiasis

poor reaction to C albicans anergy test
decreased IgG

91

What are the congenital B cell disorders

X linked agammaglobulinemia
IgA deficiency
Hyper IgM disease
Common variable Immunodeficiency

92

presentation X linked agammaglobulinemia

low B cell and Ab levels
X linked so more common in boys
recurrent bacterial infections after 6 months old
no B cells in peripheral smear
total Ig levels are low

93

presentation IgA deficiency

increased respiratory and GI infections
normal level other Ig

94

Presentation IgM disease

defect in CD40 L on T cell causing bad interaction with M cells
low IgG and high IgM
possible anemia and thrombocytopenia and lymphopenia

95

infections in IgM disease

encapsulated bacteria (pulmonary and GI)

96

risk of trisomy increases significantly after what age of woman

35

97

presentation common variable immunodeficiency

low Ig lvels
increased resp and GI illnesses in second decade of life
increased risk neoplasm and autoimmune disorders

98

poor response to vaccines

common variable immunodeficiency

99

T cells in common variable immunodeficiency

decreased CD4:CD8 T cell ratio

100

Combined T and B cell congenital disorders

SCID
Wiskott Aldrich
Ataxia-Telangiectasia

101

Presentation SCID

abset T cells
significant recurrent infections
fatal at any age
decreased WBCs and Ig

102

Tx for SCID

IVIG
antibiotics
BM transplant
no live or attenuated vaccines

103

Presentation Wiskott Aldrich

susceptible to encapsulated bacteria and opportunistic infections
eczema and thrombotyopenia

104

Tx for wiskott aldrich

splenectomy
antibiotics
IVIG
BM transplant

105

Presentation ataxia-telangiectasia

auto recessive
cerebellar dysfunction, cutaneous telangiectasias after 3 years old
increased risk CA
impaired WBC and IgA development

106

Congenital phagocytic disorders

chronic granulomatous disease
Hyper IgE disease
Chediak Higashi syndrome
Leukocyte adhesion deficiency

107

Presentation and problem in chronic granulmoatous disease

Neutrophils cannot digest bacteria
recurrent bacterial and fungal infections
cutaneous, pulmonary and perirectal abscess
chronic lymphadenopathy

108

Tx chronic granulomatous disease

prophylactic antibitoics
gamma IFN
corticosteroids
BM transplant

109

Hyper IgE syndrome "Jobs"

defect in netrophil chemotaxis
T cell signaling and overproduction IgE
chronic dermatitis, recurrent skin abscesses and pulmonary infections
!! retained first teeth and coarse faicalfeatures
increase esosinophils

110

Tx hyper IgE syndrome

prophylactic antibiotics, skin hydration and emollient use

111

Chediak Higashi syndrome

auto recessive
dysfunction neutrophils
recurrent staph, strep and gram - and fungal infections
abnormal platelets. Albinism!!!!
neurologic dysfunction

112

Dx Chediak Higashi

large granules in granulocytes on peripheral smear

113

Tx chediak higashi syndrome

prophylactic antibiotics
BM transplant

114

Leukocyte Adhesion deficiency

inability neutrophils to leave circulation from integrin malfunciton (type 1) or E selectin malfucntuin (type2)
recurrent infections URI and skin
delayed separation umbilical cord
short stature
abnomral facies
cognitive impairment

115

diagnosis leukocyte adhesion deficiency

increased serum neutrophils
defective chemotactic response upon stiulation

116

Tx leukocyte adhesion deficiency

prophylactic antibiotics
BM transplant
type 2 Tx with fructose

117

complement deficiencies are predisposed to what

SLE

118

Turners

45XO
usually end in abortion
female has short stature, infertility, abnormal genital formation, coarctation, craniofacial abnormalities (neck webbing)

119

47 XXY

klinefelter
male with testicular atrophy
tall and thind body
gynecomastia
infertility
mild mental retardation

120

when do most trisomies occur

nondisjunction during meiosis of maternal germ cells

121

characteristics of down

mental retardation
craniofacial abnormalities
vision and hearing loss
simian crease on hanfs
cervical spine instability
increased space in 1st and 2nd toes
increased risk duodenal atresia
alzheimers disease
ALL
cardiac defects

122

Characteristics edwards
trisomy 18

mental retardation, small mouth, rocker bottom feet
overlapping fingers
cardiacdefects
GI abnormalities
fatal in first year usually

123

characteristics trisomy 13

cleft lip and palate
cardiac defects
CNS defects
severe mental retardation
polydactyly
fatal in first year usually

124

What is used to Dx deletion syndromes

FISH and karyotyping

125

Fragile X syndrome genetics

X linked mental retardation
males > females
high terminal cGG codon repeats

126

characteristics fragile X

large face with prominent jaw and large ears
mild hand and foot abnormlaites
large testicles
mental retardation
hyperactiivty with possible seizures

127

Most common cause familial mental retardation in men

fragile X syndrome

128

cri du chat

entire 5p deletion
high pitched cat like cry
small head
small birth weight
early mortality from failure to thrive

129

wolf hirschhorn

4p16 deletion
metnal retardation and cranial abnormalities

130

prader willi

15q11 and 15q13 deletion paternal allele
overeating obesity and decreased muscular tone in infancy

131

angelman

15q11-q13 deltion on maternal allele
get puppet like movement
happy mood and unprovoked laugher
mental retardation and seizures

132

velocardiofacial

22q11 deletion
cleft palate, cardiac, speech disorders, significant overbite
T cell deficiency
Di George like Sx

133

Williams deletion in kids

7q11.23
look like an elft with short upturned nose and long philtrum wide mouth
mental retardation
cheerful personality
cardiac defects