Peds-H&P Flashcards
(85 cards)
1
Q
If a child’s blood pressure is consistently above the 95th%, what could this indicate?
A
- Kidney dz (including renal artery dz)
- Coarctation of the aorta
2
Q
Prehypertensive
A
90th-95th percentile
3
Q
Acrocyanosis
A
- Blue cast to hands and feet when presented to the cold
- IF persists > 8 hrs OR doesn’t disappear with warming–>congenital heart dz
4
Q
Central cyanosis
A
- tongue, oral mucosa
- Suspect congenital heart disease
5
Q
Jaundice <24 hrs
A
Hemolytic disease
6
Q
Jaundice >2-3 weeks
A
Liver disease
7
Q
Erythema Toxicum
A
- Appears 2-3 days after birth
- Disappears w/in 1 week
- Red macule with central pinpoint vesicles
8
Q
Pustular melanosis
A
- Small vesiculopustules over brown base
- More common in African Americans
9
Q
Milia
A
- Pinhead-sized smooth white raised area w/o erythema
- ->Nose, chin, forehead
- Due to retention of sebum in openings of sebaceous glands
10
Q
Sutures
A
-Membranous tissue spaces that separate the bones of the skull
11
Q
Fontanelles
A
Areas where major sutures intersect
12
Q
Fullness or bulging of fontanelles
A
Suspect increased intracranial pressure (e.g. due to CNS infection)
13
Q
Toddler
A
1-2 years
14
Q
Child
A
2+ years
15
Q
Hypertensive
A
> or equal to 95th percentile
Stage 1=95th percentile to 5 mm Hg above 99th percentile
Stage 2= > or equal to 99th percentile plus 5 mm Hg
16
Q
Tachypnea in a child >1 year
A
> 40 bpm
17
Q
What does the tympanic membrane temperature measure?
A
- Core body temperature: shares blood supply with hypothalamus
- Aprrox. 1 degree higher than oral
18
Q
What temperature is preferred for infants and young children?
A
Rectal temp
19
Q
Overweight
A
85th-95th percentile
20
Q
Obese
A
> or equal to 95th percentile
21
Q
What does a single line skin crease indicate?
A
- Down Syndrome
- Fetal alcohol syndrome
22
Q
Eczema
A
=Atopic dermatitis Younger Children -Face, elbow, knees (extensor surfaces) Older Children -Hands, neck, elbows, knees (flexor surfaces), ankles
23
Q
Impetigo
A
“Honey colored crusts”
- Highly contagious staph or strep infection
- Causes: pruritus, burning, regional lymphadenopathy
24
Q
“Ringworm”
A
Fungal infection
- Tinea capitis (head)
- Tinea corporis (arms, legs, body)
25
Where is the best place to check for skin turgor on a child?
-Abdominal skin
26
Fetal Alcohol Syndrome (FAS) presentation
- Smooth philtrum (vertical groove on the surface of the upper lip)
- Widespread eyes
- Inner epicentral folds
- Mild ptosis
- Hirsute forehead
- Short nose
- Thin upper lip
27
What does a goiter indicate ?
- Intrauterine deprivation of thyroid hormone
| - Look at the side to evaluate for a goiter
28
What lymph nodes is it never normal to be enlarged?
Supraclavicular lymph nodes
29
Amblyopia
"lazy eye"
=A 2-line difference (20/50 and 20/30)
-Reduced vision in an eye that appears structurally normal
30
Congenital cataracts
Opacity of the lens
31
Retinoblastoma (<2 y/o)
- White reflex
| - Ill-defined mass on fundoscopic exam
32
Esotropic
- Convergent
- Internal
* form of strabismus
33
Exotropic
- Divergent
- External
* form of strabismus
34
How do you test for strabismus?
- Corneal light reflex
| - Cover-Uncover test
35
What does low or poorly shaped auricles indicate?
- Renal disorders
| - Congenital abnormalities
36
Mastoiditis
- Infections that extends to the air cells of the skulls behind the ear
- Untreated otitis media
- Tenderness to palpation of the mastoid
37
Features of TM infection
- Red
| - NO mobility
38
Otitis externa
- Ear canal itching
- Musty, foul-smelling
- Conductive haring loss (exudate and swelling)
- Red canal, edematous; tympanic membrane obscure
39
20/20 vision
Age 6
40
What is the most common ear infection in childhood?
Otitis media=infection of middle ear
| -Often follows/accompanies URI
41
Why are children more susceptible to otitis media than adults?
- Eustachian tubes are shorter, more horizontal and straighter=easier for bacteria to enter
- Tube is floppier, with a tinier opening that's easy to block
42
Otitis media sx's
- Fever, tugging earlobe, anorexia, irritability, dizziness, v/d
- Deep-seated earache
- Discharge if tympanic membrane ruptures
- Conductive hearing loss
- Tympanic membrane: red, thickened, bulging, no mobility
43
What is otitis media with effusion associated with?
- Allergies
| - Obstructed or dysfunctional Eustachian tube
44
Signs and ex's of otitis media with effusion
- Sticking/crackling sound on yawning or swallowing
- Feeling of fullness
- Conductive hearing loss
- Tympanic membrane: retracted, yellowish, air fluid level/or bubbles, dull, impaired mobility
*Uncommon: Pain, discharge
45
What is a common reason for tympanostomy tubes
-Chronic otitis media with effusion as this can delay speech development
46
What indicates a congenital abnormality on a nose exam?
- Saddle-shaped nose with a low bridge and broad base (congenital syphilis)
- Short, small nose
47
"Allergic Salute"
Transverse crease @ the juncture between the cartilage and the bone of the nose
48
What does a strawberry tongue with a scarlet fever indicate?
- Childhood illness
| - Caused by group A strep
49
Tonsil grade 1+
Visible
50
Tonsil grade 2+
Halfway between tonsillar pillars and the uvula
51
Tonsil grade 3+
Nearly touching the uvula
52
Tonsil grade 4+
Tonsils touching each other
53
Tonsillitis presentation
- Caused by Streptococci
- Sore throat, referred pain to ears, dysphagia, fever
- Tonsils red, swollen, purulent exudate
- Anterior cervical lymph nodes enlarged
54
Infectious mononucleosis
- Caused by Epstein-Barr virus
- Most common in teens
- Enlarged anterior and posterior cervical chains
- Splenomegaly, hepatomegaly, rash
* Looks like strep: pharyngitis, fever, fatigue, malaise
55
Epiglottitis presentation
- Sudden high fever
- Drooling!
- Croupy cough
- Sore throat
- Apprehension & focus on breathing : tripod position, next extended
- ->impending airway obstruction
56
Pneumonia Inspection
- Tachypnea
- Shallow breathing
- Flaring of nostrils
- Occasional cyanosis
- Limited movement; splinting
57
Pneumonia palpation findings
Increased fremitus=consolidation
58
Pneumonia percussion findings
Dullness=consolidation
59
Pneumonia auscultation findings
- Crackles
- Rhonchi
- Bronchial breath sounds + ego phony, bronchophony, whispered pectoriloquy
60
Bronchitis Inspection findings
- Tachynpnea
| - Shallow breathing
61
Bronchitis palpation findings
Tactile fremits undiminished
62
Bronchitis percussion findings
Resonance
63
Bronchitis auscultation findings
- Prolonged breath sounds
- Crackles
- Expiratory wheezes
64
Asthma Inspection findings
- Tachypnea
| - Dyspnea
65
Asthma palpation findings
- Tachycadia
| - Diminished fremitus
66
Asthma percussion findings
-Hyper-resonance
67
Asthma auscultation findings
- Prolonged expiration
- Wheezes
- Diminished lung sounds (like pneumonia)
68
Apical impulse
4-th-5th left ICS
| Apex of heart is higher, heart lies more horizontal
69
Still's murmur
- Most common BENIGN murmur
- Early-mid systolic
- Best heard mid or lower LSB
70
Venous hum
- Caused by turbulence of blood flow in the internal jugular vein
- Louder during diastole
- Best heard in supraclavicular space
71
What does spider nevi on the abdomen indicate?
liver disease
72
Diastasis Recti
- Midline separation (1-4 cm) of the rectus abdominus between diploid and umbilicus
- Resolves by age 6
73
What is the most common intra-abdominal tumor of childhood? (2-3 yrs of age)
Nephroblastoma (film's tumor)
=Malignant
-Firm, non-tender mass deep w/in flank
-Low-grade fever, HTN
74
What is the most common abdominal emergency in children <2 y.o.
Intussusception
| -Telescoping of one segment of intestine into another resulting in INTESTINAL OBSTRUCTION
75
Dance Sign
- Movement of cecum from normal position
- ->RLQ feels empty
- Sign of Intussusception
76
Intussusception ABCDEF
```
A-Abdominal "sausage" in RUQ or LUG
A-Acute Abdominal pain
B-Blood from rectum: Red current jelly appearance (blood and mucus)
C-Colic: babies draw up their legs
D-Distention, Dehydration & shock
E-Emesis
F-Face pale
```
77
Osgood-Schlatter disease
- Osteochondritis of the tibial tubercle
- Subacute ex's or tendon inflammation from repetitive quadriceps contraction
- Ages 9-14, athletes, undergone rapid growth spurt
78
Most common cause of sudden cardiac death in athletes?
Hypertrophic cardiomyopathy
79
What positions do you perform the cardiac exam?
- Supine
- Standing
- Straining (during Valsalva)
80
What is the recommended amount of physical activity each day?
60 minutes
81
What age do you start monitoring BP?
Age 3
82
What age do you start monitoring BMI?
Age 2
83
How long do you measure head circumference?
Until age 2
84
Gross examination of eyes until what age?
Age 3
85
What age do we begin Audiometry?
Age 5
