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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

1st and 2nd most common cause of death in adolescents

MVA, homocide