Flashcards in Peds Deck (154):
1
things that can be done at 2 months old
coos vowels, lifts head when prone, smiles
2
things that can be done at 6 months old
can transfer things from one hand to another, able to sit up without support, rolls supine to prone, can say baba or dada,
3
things that can be done at 9 months
plays peek-a-boo, feeds self, pulls self up to stand
4
things that can be done at 12 months
takes steps, wave "bye bye", says "mama" and "dada", uses sippy cup, can say 2-4 words, knows first name
5
things that can be done at 15 months
feeds self with spoon, knows 4-6 words, follow commands
6
things that can be done at 18 months
able to walk backwards, knows 10-20 words
7
avoid giving hard candy in children less than
6 years old
8
infants up to this age should be in a rear-facing car seat
age 2
9
physiologic jaundice starts at ____ and will clear up in _____
24 hours; 2-3 weeks
10
breast milk jaundice shows at ___ and can take up to ____ to clear
after 7 days; 1 month
11
things that can be done at 2 years old
speech understood by family, stacks 6 cubes, runs/jumps/climbs, walk up and down stairs
12
things that can be done at 3 years old
speech understood by stranger, can copy a circle (3=circle), can throw a ball overhead, rides a tricycle
13
When dooes the Oedipal stage (Freud) occur?
3-5 years old, the child wants to marry the parent
14
things that can be done at 5 years old
copies a square, can dress self
15
signs of autism can appear by
18 months
16
s/s of autism
does not wave by 12 months; no babbling by 12 months
17
things that can be done at 4 years old
can copy a cross (4 points on cross), hops on one foot
18
precocious puberty is puberty starts
before age 8 in girls; before age 9 in boys
19
delayed puberty if
no breast development by age 12 in girls; if not testicular growth by age 14 in boys
20
first sign of puberty in boys
enlargement of testes
21
first sign of puberty in girls
breast bud (thelarche)
22
Tanner stage III in boys is
elongation of penis
23
A genetic defect caused by trisomy of chromosome 21
Down's syndrome
24
s/s of Down's syndrome
round, flat face; palpebral fissures, low set ears, enlarged tongue, short neck
25
Those with Down syndrome have a high risk of
congenital heart defects, hearing and vision problems, cataracts, early onset Alzheimer
26
s/s of Fetal Alcohol syndrome
microcephaly, narrow eyes, flat nasal bridge, thin upper lip
27
cryptorchidism has a high risk of
testicular cancer
28
Any neonates with acute conjunctivitis presenting within 30 days or less from birth should be tested for
chlamydia, gonorrhea, herpes simplex, and bacterial infection
29
s/s of gonococcal ophthalmia neonatorum
red conjunctiva, purulent discharge, swollen eyelids
30
difference between gonococcal and chlamydial eye infection in newborns
gonococcal show within 2-4 days after birth; chlamydia show within 4-10 days after birth
31
SIDS is common in those less than
1 years old
32
small pustules that are 1-3 mm in size with erythematous base; erupts during 2-3 day of life and last 1-2 weeks; resolve on own
erythema toxicum neonatorum
33
trx for seborrheic dermatitis in newborns (cradle cap)
soak in vegetable or mineral oil and scrub gently to remove scales; resolves within a few months
34
tufts of hair on lumbosacral area
Faun tail nevus
35
Faun tail nevus should warrant a
ultrasound to r/o spina bifida
36
flat, light brown to dark brown spots greater than 5 mm
cafe au lait spots
37
If there are multiple cafe au lait spots noted, then
refer to peds neurologist to r/o neurofibromatosis
38
pink to red flat stain-like skin stains on the upper and lower eyeslids or on face
"port wine" stain
39
trx for "port wine" stain (nevus flammeus)
refer to peds opthl to r/o glaucoma
40
raised vascular lesions that are bright red in color
hemangioma
41
newborn vision is
nearsighted (myopia)
42
amblyopia
lazy eye
43
misalignment of one or both eyes "cross eyed"
esotropia
44
vision of ____ or worse in a child more than ____ years of age should be referred
20/30; 6
45
the red reflex screening is to test for
retinoblastoma and cataracts
46
mnemonic for high-risk factors for hearing loss in newborns
HEARS:
Hyperbilirubinemia,
Ear infections,
Apgar scores low at birth,
Rubella, CMV, toxoplasmosis
Seizures
47
test for PKU in newborn
after protein feedings (milk or formula) for at least 48 hours
48
Supplement with this if mother is breasfeeding
vitamin D drops because breaskmilk alone does not provide adequate levels.
49
sticky and thick yellowish fluid that comes before breast milk; contains maternal antibodies and nutrients
colostrum
50
failure to pass meconium in ___ is a sign of intestinal obstruction
24 hours
51
introducing solid foods
can start at 4-6 months; start with rice cereal; introduce one food at a time for 4-5 days
52
"cone-shaped" head in newborn that is self-limited
caput succedaneum
53
Newborns ____ their birth weight by 6 months and _____ their birth weight by 12 months
double; triple
54
head circumference is measured until age
3 years old
55
In newborns chest is ____ than head circumference
less
56
teeth that erupt at 6-10 months of age
lower central incisors (lower front teeth)
57
Infant should have complete set of primary teeth by age
2.5
58
urethral meatus located on the ventral (posterior) aspect of the penis
hypospadias
59
urethral meatus located on the dorsal (anterior) aspect of the penis
epispadias
60
common in newborn males where there is presence of fluid inside the scrotum
hydrocele
61
first permanent tooth erupts at age
6 years
62
____ crosses cranial midline and ____ does not cross midline
caput succedaneum; cephalohematoma
63
Avoid cow's milk when?
first 12 months of life
64
moro (startle) reflex disappears by
3-4 months
65
step reflex disappears by
6 weeks
66
rooting reflex disappears by
3-4 months
67
white papules found on gum line that resemble erupting tooth
Epstein's pearls
68
Education to parents about DTaP vaccine
can cause fever, irritability, and swelling at injection site
69
contraindications to administering DTaP vaccine
severe allergic reaction, encephalopathy, seizures, fever greater than 105
70
persistent tearing and crusting of one or both eyes; mucoid discharge may be seen when eye is palpated
lacrimal duct obstruction
71
s/s of acute dacrocystitis
red, warm, tender, and swollen lacrimal ducts
72
trx for acute dacrocystitis
lacrimal sac massage
73
s/s of colic
occurs for more than 3-4 hours a day for more than 3 days a week in an infant less than 3 months
74
When the hips of a newborn are rotated to hear for a click
Ortolani manuever
75
When the knees of a newborn are pushed toward midline
Barlow maneuver
76
populations that need Tdap
all pregnant females in 1st trimester, elderly greater than 65, those caring with young children
77
dosing for IPV
2, 4, 6 months, 4-6 years
78
dosing for PCV13
2, 4, 6, 12-15 months
79
these signs after a live vaccine are normal and represent a normal reaction to viral replication
fever and rash
80
dosing for varicella vaccine
12-18 months, 4-6 years
81
MCV4 is given to those
age 11-12; booster at age 16
82
vaccine given ___ before scheduled time is considered valid; but if it's given ___ before schedule time then it's an invalid dose.
4 days; 5 days
83
why is Tdap administered to every pregnant women?
protects mother and infant from pertussis
84
Recommended length of time to monitor a child after rcving immunization
15 minutes
85
rash after MMR vaccine is most likely to occur
7 days after immunization
86
dosing with multiple live vaccines
either give all at same time or wait 4 weeks between
87
hyperactivity and impulsivity are observed by age ___ and decline after age ___
4; 8
88
These symptoms of ADHD not usually observable by adolescence
hyperactivity and impulsivity
89
inattention is usually observed around age
8 or 9
90
DSM-5 criteria for diagnosis of ADHD
for those less than 17 more than 6 symptoms;
for those older than 17, more than 5 symptoms
91
difference between management of childhood asthma and adult asthma
leukotriene blockers are more effective in children; oral pill is easier to give than inhaler
92
most common pathogen involved with PNA in those 6 months to 5 years
virus
93
s/s of PNA in children
fever, increased respirations
94
DOC for PNA in children
amoxicillin 90 mg/kg/day
95
for weight based dosing atbx, what weight is a child start to be dosed for an adult?
65 lbs
96
bronchiolitis is common those
less than 2 years old
97
common causes of bronchiolitis
RSV, adenovirus
98
s/s of bronchiolitis
URI for 1-3 days, then wheezing, increased RR, fever, thick nasal secretions
99
trx for bronchiolitis
symptomatic; NO bronchodilators or steroids
100
trx for croup
single dose of oral dexamethasone
101
s/s of cystic fibrosis
recurrent pulmonary infections, greasy stools, weight loss
102
when all blood counts are low in leukemia
pancytopenic
103
most common presenting s/s of leukemia
fever, bleeding, bone pain, painless lymphadenopathy
104
___ is considered enlarged nodes except in the epitrochlear (greater than 5 mm), inguinal (greater than 15 mm), and cervical (greater than 20 mm)
10 mm
105
diagnostic in leukemia
thrombocytopenia, blast cells
106
characteristics of febrile seizures
occur once and don't recur in 24 hours; occur during illness
107
febrile seizures occur before age
5
108
ibuprofen is not recommended in those less than
6 months
109
medications for fever
do not combine or alternate tylenol and ibuprofen
110
gastroesophageal reflux in infants
common d/t immature LES
111
how to differentiate GER from GERD in infant
GERD will have irritability during reflux episode
112
gastroesophageal reflux in infancy usually resolves by
1 year of age
113
intussusception has been associated with ____ and is considered a ____
rotavirus vaccine; medical emergency
114
s/s of intussusception
3-11 month child cries and pulls legs up to chest, currant jelly stools
115
management of encopresis
laxatives (Miralax) daily until normal stools, then taper gradually
116
trx for viral gastroenteritis
5-10 teaspoons of commercially prepared electrolyte solutions every 4 hours
117
undescended testicle increases risk of
testicular cancer, inguinal hernia, testicular torsion, subfertility
118
hydrocele should be resolved by ____; if not, then consider a ____
1 year of age; hernia
119
retrograde passage of urine from bladder to upper urinary tract
vesicoureteral reflux
120
long-term complications of UTI in infants are:
renal scarring, impaired renal growth, HTN
121
trx for UTI in infants
3rd gen cephalosporins
122
common injury in 1-4 year olds caused by annular ligament slipping over the head of the radius
nursemaid's elbow
123
Weight change in newborn
Normal to lose 10% of weight in 1st week of life
124
Fetal nutrition is best determined by assessing
SQ fat on anterior thighs and gluteal region.
125
Stork bite or pink/red capillary on face or neck is known as
nevus simplex
126
anterior fontanelles close by age
9-18 months
127
posterior fontanelles close by age
2 months
128
normal for _____ to be closed at birth, but abnormal for _____ to be closed early.
posterior; anterior
129
eye spacing is far apart
hypertelorism
130
low set ears may indicate
renal agenesis
131
shortening of sternomastoid muscle
torticollis
132
a webbed neck may be associated with
Turner Syndrome
133
normal for this in female newborn genitalia
milky white discharge
134
testing corneal light reflex should be started by
6-12 months
135
at what age should eye alignment occur?
2-4 months
136
most common cause of vision problems in children
amblyopia
137
The corneal light reflex and cover/uncover tests are used to assess for
strabismus
138
attempt vision screening at age
3
139
pediatric hearing loss is associated with
speech delay
140
normal heart rate of newborn
120-160
141
when should routine BP screening begin in children
3 years old
142
dyslipidemia screening in children
start at 2, 4, 6, 8, 10 then annually.
Get fasting lipid profile at age 18-21.
143
Normal bilirubin level is
below 5 mg/dL
144
Hand placement for Ortolani maneuver
on greater trochanter
145
Galeazzi test
unequal knee heights used to assess for hip dysplasia
146
Talipes equinovarus
club foot- urgent ortho referral
147
Refer to ortho for scoliosis if
Cobb angle greater than 20 degrees
148
Who would be of greater concern for scoliosis?
pre-adolescent who hasn't had growth spurt yet with Cobb's angle greater than 20 degrees
149
Correct order of hair maturation in boys
pubic, axillary, then facial (works down then up)
150
genu varum up to 20 degrees is considered normal up to what age
24 months
151
painful abdominal mass that crosses the midline
neuroblastoma
152
asymptomatic abdominal mass that rarely crosses the midline
Wilms's tumor
153
Wilms's tumor is common in
black, female 2-3 year olds.
154