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Pediatrics Stepup Flashcards

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1
Q

when is birth weight regained

A

by 2 weeks

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2
Q

when is birth weight regained

A

by 2 weeks

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3
Q

what weight is considered fialure to thrive

A
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4
Q

hoes does height increase in first year of life

A

50%
doubles 4 years
triples 13

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5
Q

greater than normal height assoc with what

A

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

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6
Q

lesser than normal height assoc with what

A 
familial
neglect
turners
constitutional growth delay
chronic renal failure
asthma
CF
IBD
immunologic disease
growth hormone deficiency
hypothyroidism
glucocorticoid excess
kskeleteal dysplasias
neoplasm
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7
Q

when do you meausre head circumgerence

A

first -3 years

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8
Q

growth that declines after birth

A

post natal onset

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9
Q

growth that is anormal from time of birth

A

prenatal

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10
Q

growth that is consistently low

A

genetic

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11
Q

doctor visits in 1st month

A

one at 2 weeks

one at 1 month

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12
Q

doctor visit schedule 2 mo to 2 years

A

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

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13
Q

when is the H flu b vaccine not necessary

A

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

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14
Q

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

A

asplenic

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15
Q

when do children socially smile

A

2 months

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16
Q

when do children coo

A

2 months

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17
Q

when do children laugh

A

4 months

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18
Q

when do children have stranger anxiety

A

6 months

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19
Q

motor skills at 6 months

A

roll over and holds up with hands

sits without support

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20
Q

when do children babble

A

6 months

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21
Q

milestones of 9 month olf

A

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

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22
Q

milestones for 1 year

A

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

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23
Q

milestones for 18 months

A 
parallel play
walks forward and backward
makes tower 4 blocks and uses cup or spoon
10-50 words
2 word sentence
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24
Q

milestones for 2 year old

A

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

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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 ```

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