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PCM 2 final > Peds Physical Exam > Flashcards

Peds Physical Exam Flashcards

(52 cards)

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1
Q

principles of development?

A
  1. predictable path
  2. range of normal development is wide
  3. various factors affect child development & health
  4. development levels determines how you conduct the HPI/PE
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2
Q

when to perform physical exams?

A

every few months until 4 yo, then annually through middle childhood & adolescence until adulthood

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3
Q

newborn

A

0-28 days

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4
Q

infant

A

0-12 months

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5
Q

toddler/early childhood

A

1-4 yrs

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6
Q

school-aged / middle childhood

A

5-10 years

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7
Q

adolescence (11-20)

A

early, middle, late

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8
Q

what is neonatal resuscitation?

A

warm, dry, suction

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9
Q

APGAR

A

appearance (color)
pulse
grimace (reflex irritability)
activity (muscle tone)
respiratory (effort)
*you want 2s in all categories / assign at 1 min & 5 min

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10
Q

what is given immediately after birth?

A

-erythromycin ointment in eyes
-Vit K to prevent bleeding
-full bath

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11
Q

ballard scoring system

A

neuromuscular activity (square window, scarf sign) + physical maturity (skin, lanugo, plantar surface, ear recoil)

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12
Q

neonatal intake

A
  • q2-3 hours
  • breastfeeding w/ some colostrum
  • formula 15-30 ml
    *normal to lose 7-10% weight first few days of life
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13
Q

neonatal output

A

-6-8 voids per day by day 4-5
-initial stools = meconium (should stool within first 24 hrs of life)
-breast fed = yellow, seedy
- formula = green-yellow

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14
Q

physiologic jaundice

A

“normal”
-in 1/2 all newborns
-appears on 2nd & peaks on 5th day
-disappears within a week

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15
Q

pathologic jaundice

A

*risk of kernicterus
any jaundice within first 24 hrs = pathologic
-breastfeeding jaundice
-ABO incompatibility/Rh
-cephalohematoma
-infection
-enzyme deficiencies

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16
Q

hospital discharge after birth?

A
  • 2 days after vaginal delivery
    -3 days after C section
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17
Q

what needs to be done prior to discharge?

A
  • Hep B immunization
    -hearing screen
    -1st newborn screening blood test
    -circumcision
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18
Q

what is the expected weight gain?

A

1 ounce per day
-should be back to birthweight by 10-14 days

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19
Q

common issues in early infancy?

A

-congestion
-constipation
-colic (fussy, crying, usually in evenings - use white noise, car rides / resolves by 3-4 months)

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20
Q

infant developmental milestones?

A
  • babbling @ 6 months, 1-3 words @ 1 yr
    -6 mos recognize strangers
    -9 mos stranger anxiety, object permanance
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21
Q

infant developmental milestones?

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A
  • babbling @ 6 months, 1-3 words @ 1 yr
    -6 mos recognize strangers
    -9 mos stranger anxiety, object permanancet
22
Q

toddler milestones

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A

-after 2 yrs gain 2-3 kg & 5 cm per year
-2 yr old = 2 word sentence
-3 yr old = 3 words sentences
-by 4 yrs speech is 100% understandable to all
-temper tantrums are common

23
Q

head injury in neonate

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A
  • caput succedaneum crosses suture lines
    -cephalohematoma does not
24
Q

plagiocephaly

Study These Flashcards
A

positional deformity of skull

25
craniosynostosis
early fusion of sutures
26
fontanelle closure?
-anterior: larger and 18m-2 yr -posterior: smaller & 1-2 mos
27
infant seborrheic dermatitis
"cradle cap" -scaling of scalp or eyebrows
28
eyes exam
-cover/uncover test 9 mo-3 yo -formally assess visual acuity starting at 3 yrs
29
ear exam
-otitis externa -otitis media (kids have wider, shorts tubes compared to adults which predisposes them to infection)
30
mouth/throat exam
observe philtrum, vermillion border, tongue, cleft pallate -usually 1 tooth for each month b/n 6-26 mos
31
neck exam
thyromegaly, lymph nodes, torticollis
32
CV exam
-brachial & femoral pulses b/l, PMI, murmurs -BP not measured in kid under 3 yo
33
neonate HR & RR
40-60 breaths 120-160 beats
34
lung exam
-periodic breathing in infants -apneic = <15-20 sec pause -skin color, retractions, grunting, nasal flaring, ascultation
35
abdominal exam
auscultate, percuss, palpate -spleen should not be palpable
36
GU exam
labial adhesions or discharge descended testicles, hydroceles, urethra position *do not forcible retract foreskin in uncircumcised infants -rectal exam using pinky
37
MSK exam
-obvious deformities, edema, muscle wasting, calluses, ROM, scoliosis -* normal to have increased lumbar concavity & decreased thoracic convexity, protuberant abdomen, bowlegged/knock kneed
38
hip exam
-ortolani test: for post dislocated hip that you attempt to reduce -barlow test: ability to sublux or dislocate intact but unstable hip
39
neuro exam
gross assessment unless concerned otherwise -primitive reflexes -gross CNs -strength & muscle tone
40
primitive reflexes
-palmar grasp: place finger in hand and they grasp finger (B-4 mo) -moro (startle): hold supine support head, quickl lower feet & move arms (cry or not) (B-4 mo) -rooting: stroke perioral skin, mouth opens & turns head toward side stimulated (B-4 mo) -parachute: suspend prone & lower head to surface, extrems then extend (4 mo, doesn't disappear)
41
skin exam
-rashes = atopic dermatitis -color = pink vs cyanotic -lesions = mongolian spots, nevi, hemangiomas
42
impetigo
honey crusted lesions, commonly from staph -tx with abx cream
43
ringworm
tinea infection -elevated red rings with central depression
44
school aged children
-consider bullies, school performance, special ed, behavioral issues -puberty / body changes
45
adolescent
-pt gowned & on table -give pt option of asking parent to leave room during HPI & most PE -need chaperone for breast & GU exam
46
early adolescent
10-14 yo -puberty begins -concrete operational cognition -social identity is important
47
middle adolescence
15-16 yo -females more comfortable than males -insight developed -independence-limit testing, experimentation, dating
48
late adolescence
17-20 yo -adult appearance -formal operational cognition future oriented
49
HEADSS approach for teens
H - how are things going at home? E - how is school going? A - do you or your friends drink etoh? D - do you or your friend do drugs? S - sexual activity S - suicidal thoughts (depression screening)
50
tanner stages of sexual maturity ratings (SMR)
-description of development of secondary sex characteristics
51
Tanner Female
1. preadolescent, nipple elevation only, no pubic hair 2. elevation breast/nipple as small mound, sparse pubic hair growth 3. further enlargement, darker, coarse pubic hair 4. projection areola/nipple, coarse & curly pubic hair as in adults 5. projection of nipple only, hair adult in quantity & quality
52
Tanner Male
1. preadolescent 2. sparse pubic hair, no penis enlargement, larger testes 3. darker pubic hair, longer penis, enlarged tests/scrotum 4. coarse & curly pubic hair, enlarged penis, further enlarged testes/scrotum 5. adult quant/quality of hair, adult penis & testes

PCM 2 final (7 decks)

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