Review set 4 Flashcards
(237 cards)
1
Q
Does IBS increase the risk of colon cancer?
A
NO
2
Q
Hcg doubles every ____ ____ in the first trimester.
Urine pregnancy tests can detect pregnancy by the ___ week of conception
A
2nd
3
Q
Physiologic changes in pregnancy:
Extra heart sound - ____ is common
A
S3
4
Q
***Pregnancy results in a ________ state
A
hypercoagulable
5
Q
Pregnancy:
Compression on the vena cava by the uterus decreases blood return esp when supine at 20 weeks and later. Position in _____ ____ ____ position.
A
left lateral decubitus
6
Q
Premature rupture of membranes (placenta abruptio) is premature separation of a ***______ implanted placenta from the uterus. Risk factors are a hx of placenta abruption, HTN, smoking, African American, rheumatoid disease, cocaine use, trauma. Has tender & contracted uterus that is severely painful
A
normally
7
Q
Placenta previa: _______ implanted placenta in the uterus and on top of the cervix. Sudden painless bright red bleeding in the 2nd to 3rd trimester.
A
abnormally
8
Q
NSAIDs are contraindicated in the ____ trimester of pregnancy b/c they block prostaglandins
A
3rd
9
Q
Women with no risk factors:
Screen for gestational diabetes at ___ - ___ weeks with a ___ gram 2-hr OGTT.
A
24 - 48
75
10
Q
Gestational diabetes:
Continue to screen after baby is delivered at __ - ___ weeks, then every ___ ___.
A
6 - 12
3 years
11
Q
Hypothyroidism in pregnancy:
If TSH is > ____, start treatment.
Recheck TSH and _____ levels every few weeks.
A
6
free T4
12
Q
Cardiovascular changes in pregnancy include all of the following EXCEPT:
1 The enlarged uterus displaces the heart upward and to the center of the chest
2 Systolic ejection murmur
3 Mammary souffle
4 Blood volume and cardiac output increase in the third trimester
A
1 The enlarged uterus displaces the heart upward and to the center of the chest
13
Q
Increased levels of progesterone during pregnancy is associated with:
1 N/V especially early in pregnancy
2 Delayed peristalsis in the GI tract with a delay in gastric emptying
3 Diarrhea due to an increase in peristalsis in the GI tract
4 An increase in the deposition of melanin in the skin
A
2 Delayed peristalsis in the GI tract with a delay in gastric emptying
14
Q
Miscarriage (spontaneous abortion):
A loss of pregnancy before ____ weeks
Threatened abortion: Cervix is/ is not dilated?
Inevitable abortion: Cervix is / is not dilated?
A
20
is not
is
15
Q
*** Naegele’s rule:
Using the date of the LMP, what do you do?
A
Add 9 months to the month and add 7 days to the date
16
Q
A 28 year-old primigravida's LMP was on March 10, 2020. Using Naegele's rule, which of the following dates is correct for her expected date of delivery? 1 Nov 10, 2020 2 Nov 17, 2020 3 Dec 10, 2020 4 Dec 17, 2020
A
4 December 17, 2020
17
Q
Uterine involution is completed by: 1 Four weeks 2 Six weeks 3 Eight weeks 4 Twelve weeks
A
2 Six weeks
18
Q
Early term pregnancy: ___ to ___ weeks
Full term pregnancy: ___ to ___ weeks
Late term pregnancy: ___ weeks
Post-term pregnancy: ___ weeks
A
37 to 38
39 to 40
41
42
19
Q
1st trimester: conception until ___ weeks
2nd trimester: __ weeks until ____ weeks
3rd trimester: ___ weeks until ___ weeks
A
12
13; 27
28; 40
20
Q
Primary teeth (baby teeth): First tooth - lower \_\_\_\_ incisors come in at \_\_ to \_\_\_\_ months of age
A
central
6 to 10
21
Q
Peds:
permanent teeth:
The first is the ____ ____ at age ___ to ___ years
A
central incisor; 6 to 7
22
Q
Peds:
Permanent tooth avulsion transport:
Do NOT clean the tooth. Avoid touching the root.
Best way to transport is to use ______ ____.
A
cold milk
23
Q
Infant weight:
***Infants lose up to ___% of body weight but will regain birth weight in ___ ____.
Double birth weight by ___ ___ of age.
Triple birth weight by ___ ____ of age.
A
7
2 weeks
6 months
12 months
24
Q
Infant weight and length:
0 to 6 months: __ to ___ ounces per week and __ inch per month
6 to 12 months: __ to ___ ounces per week and __ inch per month
A
6 to 8; 1
3 to 4; 1/2
25
Peds:
If the child's weight and/or length decelerates across ___ or more major percentiles, rule out failure to thrive.
Any child who is on the ___ to ___ percentile is considered as FTT.
The most common cause in primary care is ______.
Evaluate the child, including maternal bonding and depression.
2
3rd; 5th
undernutrition
26
Peds:
In infants, length (linear growth) is measured from birth to ___ ___. Starting at age ___, height is measured with child standing up.
24 months; 2
27
Newborns' focus distance is __ to ___ inches. Eyes may appear crossed but this is normal up to 2 months of age
and is ____ strabismus.
Lacrimal ducts are developed by __ to __ months of age.
8; 10
pseudo
2 to 3
28
Visual acuity of kids:
Reaches 20/20 by the age of ___ years.
The ______ chart is for color blindness.
6
| Ishihara
29
Age 3 to 5 years:
| Distance vision - ______ / _____/ ____ chart
Tumbling-E; HOTV; LEA
30
Testing vision in Age 6 years or older:
| Use the _______ chart
Snellen
31
*** If vision is 20/40, what does it mean?
the test subject sees at 20 feet what a person with normal vision sees at 40 feet.
32
Vision testing in kids:
Refer when the following is present:
Frequent headaches
Squinting
Strabismus
___-____ difference between each eye (even if passing range)
Vision worse than ___/___ in age > ____ years
two-line
20/30; 6
33
Baby eye color:
____ babies are born with dark blue or gray eyes, which can change in color.
______, ____, and some Hispanic groups are born with brown eyes which usually do not change in color.
Caucasian
| African-American; Asians
34
```
_______ test (red reflex test):
Use direct ophthalmoscope. Shine light _________ in both eyes. Look for ______ and round red glow from both eyes.
```
Bruckner
simultaneously
symmetrical
35
The Bruckner test (red reflex test) assesses for ______, opacities, strabismus, etc
retinoblastoma
36
_______ reflex (light reflex test):
Shine _______ on the child's eyes. Look for light reflection on the center of each eye. Look for ______ light reflection (from cornea).
This is a screening test for ______.
Hirschburg
flashlight
symmetric
strabismus
37
Strabismus:
| Refer for intermittent esodeviation (cross-eyes) at age __ _____ or older.
2 months
38
The cover/uncover test is a screening test for ________-.
Place fixation target so that the child/infant is looking _____.
Cover one eye/remove cover - observe unpatched eye immediately for deviation.
strabismus
| forward
39
***A mother calls you and reports that her newborn female infant has a small amount of blood in her vagina. Which of the following is the appropriate response?
1 Advise the mother to bring her infant to the office as soon as possible
2 Tell the mother that this is a normal finding and is due to the maternal hormones in her system
3 Advise the mother to take the infant to the closest ER
4 Advise the mother that her infant needs hormonal treatment
2 Tell the mother that this is a normal finding and is due to the maternal hormones in her system
40
Fontanels:
Posterior fontanel: closes by _____ months
Anterior fontanel: closes by ____ - ___ months
3
| 12 - 18
41
Hearing screening:
Newborn, toddler, or pre-school and older?
1 Understands simple commands
2 Pure tone audiometry
3 Otoacoustic emissions (OMEs) or auditory brainstem evoked responses
1 Toddler
2 Pre-school and older
3 Newborn
42
The mother of a 5 week old infant is concerned that her infant's eyes are crossed occasionally. The NP would:
1 Recommend referral to a pediatric ophthalmologist
2 Advise the mother that this is a normal finding in some infants up to 2 months of age
3 Recommend multivitamin supplements should be given to the infant daily
4 Educate her on how to patch the infant's eye every 4 hours
2 Advise the mother that this is a normal finding in some infants up to 2 months of age
43
Newborn screening tests:
TSH - screen for hypothyroidism (can lead to ____/____ retardation).
PKU: Inability to metabolize phenylaline to tyrosine due to defective enzyme. Causes ____ ____ / severe ______ _______
mental / growth
brain damage
44
Test for PKU: After ___ to ___ hours feeding formula or breast milk. Can be a false negative if obtained under ___ hours of age.
24 to 48
| 48
45
Hemoglobin and hematocrit - Do or do not screen at birth?
Do not
46
Physiologic anemia of infancy:
| Lowest H&H is at __ to ___ weeks of life - Hgb 11. Due to temporary shutdown of erythropoietin production.
8 to 12
47
Physiologic jaundice of infancy:
A ______ _____ (____) hyperbilirubinemia
Bilirubin is the breakdown product from old _____.
Jaundice appears when levels are __ or higher.
Jaundice first appears on the ____ and progresses downward.
transient unconjugated (indirect)
RBCs
5
head
48
Physiologic jaundice starts after __ - ___ days of life and resolves in ___ to ___ weeks. If before this, it is _______.
EVALUATE jaundice at the ____ day of life and when serum bilirubin level rises > ___ mg/day.
```
2 - 3
1; 2
pathologic
1st
5
```
49
Jaundice in the newborn:
| ________ is very high level of bilirubin and results in severe brain damage or death
Kernicterus
50
Conjunctivitis in the newborn:
The conjunctiva is the superficial membrane that covers the surface of the eyes. Neonatal eye infections are serious and may cause _______ if not treated ASAP.
_______ _______: All newborns should receive prophylaxis within 24 hours of birth.
blindness
| ophthalmia neonatorum
51
Conjunctivitis in the newborn:
| prophylaxis is with 5% ______ ophthalmic ointment
erythromycin
52
Appearance of conjunctivitis symptoms:
In the first 24 hours of life: Usually due to eye irritation from silver nitrate drops
From 2 to 4 days after birth: May have ______ infection of the eye. Look for purulent eye discharge and swollen eyelids. can cause blindness by corneal perforation. Treated with _______ IV plus treat for _______ infection.
From 4 to 10 days after birth: May have _______. Treat with PO or topical __________.
gonococcal
ceftriaxone; chlamydia
chlamydia
erythromycin
53
***Viral keratoconjunctivitis (pink eye)
Bright pink eye that is very _______ with *** _________ ________. Very contagious. Occurs in epidemics. More common in school-aged children.
Frequent handwashing advised.
Keep child out of school for __ _____.
itchy; PERIAURICULAR LYMPHADENOPATHY
1 week
54
From 0 to ___ weeks of age:
Strong primitive reflexes: Moro, rooting, blink, stepping, etc.
Cries without tears until about __ to ___ months of age.
Head lag
jerky uncontrolled arm and leg movements
breastfed babies should breastfeed ___ to ____ times per day, they may breastfeed every ____ to __ hours.
Newborns should not go on for more than ___ hours without feeding at night. If asleep, wake baby up to feed.
Sleeps about ____ hours per day.
```
4
2 to 3
8 to 12
1.5 to 3
4
16
```
55
Colustrum secreted in the first few days is high in _______ _______.
maternal antibodies
56
Breastfed infants need vitamin ___ drops
Avoid cow's milk during the first year of life due to ___ ______.
Start with formula that is fortified with _____.
D
GI bleeding
iron
57
Neonate variants:
___________: Diffused edema of scalp due to intrauterine or vaginal pressure
CROSSES the midline
Due to prolonged labor - goes away in a few days
Caputsuccedaneum
| *** To remember the crossing the midline or not identifier, think "PUT the CROSS" - caPUTsuccedaneum CROSSes
58
Neonate variants:
***___________: Swelling that DOES NOT cross the midline or suture lines.
Is a traumatic subperiostal hemorrhage.
Higher risk for ________.
Cephalohematoma
hyperbilirubinemia
59
```
______ ______ (seen in 80% of neonates):
Benign white to yellow cysts found on the gums and/or hard palate of neonates. May be mistaken for teeth in newborns.
```
Epstein's pearls
60
_________:
Abnormal urethral opening. Urethral opening is located in the ventrum (lower aspect) of the glans or shaft of the penis. Refer to pediatric urologist for surgical repair
Hypospadias
61
______:
Abnormal urethral opening. Urethral opening is located in the dorsum (upper aspect) of the glans or shaft of the penis. Refer to pediatric urologist for surgical repair.
Epispadias
62
__________:
Undescended testicle. Infant testicle may be in the ______ area.
____ groin with infant ____ ____.
Increases the risk for testicular cancer.
Refer to pediatric urologist.
Cryptoorchidism
inguinal
Massage; sitting up
63
Asymmetry of thigh / gluteal folds:
| Rule out congenital hip dysplasia by performing the ____ and ______ maneuvers.
Barlow; Ortolani
64
____ reflex:
Sudden loud noise or sudden head movement will cause symmetric abduction and extension of the arms followed by adduction and flexion of the arms over the body.
Disappears by 4 - 6 months.
Moro (startle reflex)
65
Placing/stepping reflex:
Hold baby upright and allow the dorsal surface of the foot to touch the edge of a table.
The baby will flex the ___ and ____ and place the stimulated foot on the tabletop in a stepping motion.
Absent in ____ and _____ births.
hip; knee
paresis; breech
66
_____ reflex:
Eyelids will close in response to bright light.
Disappears after 12 months.
Blink
67
____ ____ reflex:
Turning head to one side with jaw over shoulder causes the arm and leg on side where the head is turned to extend.
The arm and leg on the opposite side will ____.
Tonic neck
flex
68
_______ reflex:
Stroking a finger at the corner of the mouth causes mouth to open and baby to turn to stimuli.
Disappears by 3-4 months.
Rooting
69
Name the condition (Peds):
The thin membrane at the end of the nasolacrimal duct causes blockage.
Presents in the first few weeks of life.
Chronic tearing from the baby's eyes.
Most cases resolve spontaneously within __ months.
Findings: Crusts in eyelashes, eyelids stuck together, mucopurulent discharge, persistent tearing, WORSE ON AWAKENING
Treatment is to massage the lacrimal sac by placing finger on it and massage downwards towards the mouth.
Repeat several times a day.
Congenital lacrimal duct obstruction
70
Breastfeeding - first 6 months of life:
Look for inadequate or delayed milk production. There should be no clicking sounds.
Look for wet diapers (__ to __) and loose seedy stools __ to __ times in 24 hours.
Look for _______ fontanelles and none to very few wet diapers.
Give iron at ___ months of age.
4 to 8
3 to 4
sunken
6
71
```
Lactational mastitis:
More common in the 1st 3 months of breastfeeding.
Occurs in 2-10% of breastfeeding women.
Cause is _____, ____, or _____ _____.
Labs include:
Non-pharm treatment includes:
```
Pharm treatment includes: ________ or ______
Pharm treatment for MRSA (non-severe) is: _____ if NOT a newborn, or _______
staph; MRSA; strep pyogenes
C&S of milk
Cold compresses, NSAIDs, complete emptying of breast
dicloxacillin; Keflex
Bactrim
clindamycin
72
A new mother is breastfeeding her full-term 4-week old male infant. She wants to know whether she should give the infant vitamin supplements. You would tell her:
1 Since she is breastfeeding, the infant does not need any vitamin supplements.
2 Breastmilk contains all the vitamins and minerals that the child needs for the first 12 months of life.
3 All breastfed infants require Vitamin D supplementation
4 Breasfted infants require iron and vitamin B12 supplementation
3 All breastfed infants require Vitamin D supplementation
73
During a well-child visit, a new father wants to know if he can give fresh whole milk to his 6-month old son. The NP would recommend that:
1 He can start giving whole milk but not skim milk by 6 months of age
2 He should not give whole milk to his son until he is at least 12 months of age.
3 He can give whole milk to his son at any time
4 He should not give whole milk to his son without diluting it in water
2 He should not give whole milk to his son until he is at least 12 months of age.
74
```
Growth & development:
What age is this?:
STARTS to smile at people (social smile).
Starts to coo.
Turns head toward sounds.
Can hold head up.
Begins to follow things with eyes.
Brings hands to mouth.
```
2 months
75
Growth & development:
| At age ___ months, refer for floppy, lack of response to sounds, doesn't smile at people
2
76
Growth & development:
What age is this?:
May roll from tummy to back
when lying on stomach, cab push up to elbows
Holds head steady
Smiles in response to others (social smile)
Starts to babble
4 months
77
Growth and development:
At age ____ months, refer for a baby that:
doesn't smile at people, does not watch things as they move, can't hold head steady, does not coo, does not push down with legs when feet are placed on a hard surface
4
78
Growth & development:
What age is this?:
Rolls in both directions
Begins to jabber (consonants such as "m", "d")
Imitates sounds such as "raspberries" (imitated fart sound or whatever)
Begins to sit without support
Passes objects from one hand to the other
*** Palmar grasp of objects
Reaches for toys (raking)
Starts to crawl
6 months
79
Growth and development:
At age ____ months, refer for a baby that:
Does not babble, does not respond to sounds, can't roll, doesn't laugh
6 months
80
Growth & development:
What age is this?:
Separation anxiety and stranger anxiety ("clingy")
Plays peek-a-boo
Understands "no"
***Pincer grasp starts. Can pick up cereal with index finger and thumb. (fine motor)
Can pass things from hand to hand (fine motor)
Pulls to stand and "cruises" (holds furniture to move around a room) (gross motor)
9 months
81
Growth and development:
At age ____ months, refer for a baby that:
Absence of babble
Unable to sit alone
Still has strong primitive reflexes (Moro)
9
82
Growth & development:
What age is this?:
Follows simple one-step directions such as "pick up a toy"
Gross motor:
Walks idependently or holding one hand while walking
Growth rate slows down
12 months
83
Growth and development:
At age ____ months, refer for a baby that:
Absence of weight-bearing
Unable to transfer objects from hand to hand
12 months
84
12 month-old labs include:
| ___ and ____ ______
anemia; lead poisoning
85
The following are acceptable methods of birth control for breast-feeding mothers EXCEPT:
1 Diaphragm with spermicidal gel
2 Progesterone-only pills (Micronor)
3 Condoms
4 Low-dose oral contraceptives with at least 20 mcg estradiol
4 Low-dose oral contraceptives with at least 20 mcg estradiol - (NOT OK!)
86
A new mother who is on her fourth day of breastfeeding complains to the nurse practitioner of very sore breasts. The NP should:
1 Recommend a decrease in the number of times she breastfeeds her infant per day
2 Recommend that she stop breastfeeding and use infant formula for the next 48 hours
3 Educate the mother that this is normal during the first week or two of breastfeeding and the soreness will eventually go away
4 Recommend that she purchase plastic nipple pads for her nursing bra and use it daily
3 Educate the mother that this is normal during the first week or two of breastfeeding and the soreness will eventually go away
87
Infant colic: Rule of 3s:
Crying and irritability lasting a total of ___ hours per day. Occurs more than ___ days in a week.
Starts at birth and usually resolves by the age of ___ months.
Goal: Rule out _______ causes such as diaper rash, thrush, hair/fiber wrapped around a finger, toe, or penis, lactose intolerance.
3
3
3
physiologic
88
Down's syndrome: Sports participation:
Must be screened for ________ (___-spine) instability.
Before participating in sports, must evaluate with _______ __-____ x-ray.
atlantoaxial (C-spine)
lateral C-spine
89
Down's Syndrome:
High incidence of _____ ___ disease, thyroid disease, hearing loss etc.
Needs _____ and ____ x-ray in the first month of life
early onset Alzheimer's disease
congenital heart
echo; chest
90
```
A newborn infant who is small for gestational age is noted to have microcephaly with short palpebral fissures, a smooth philtrum and a thin upper vermillion border. The infant is most likely to be diagnosed with the following:
1 Down syndrome
2 Fetal alcohol syndrome
3 Growth retardation
4 Osgood-Schlatter disease
```
2 Fetal alcohol syndrome
91
The safest place in the car for an infant/child is in the ______ of the ____ seat.
***Infants up to _____ pounds should be in ____-_____ seats
middle; back
20; rear-facing
92
AAP recommends that kids ride in the back seat until age ______.
13 years
93
***Leading cause of death:
0 - 12 months: ______/ ______ _______
age 1 year to 24 years: _______
developmental / genetic disorders
| accidents
94
Toddlers:
2 years old:
_______ behavior
Builds towers of ___ or more blocks (** stacks __ cubes)
Draws ________ lines
Combines ___ to ___ word sentences intelligible mostly to family
Begins to run.
Climbs stairs up and down holding on railing or wall for support
Has security blanket or other transitional objects
Defiant
4; 6
straight
2 to 3
95
```
Toddlers: 2 years old:
Report when:
Loses ____,
does not use __-word phrases
Doesn't _____ steadily
```
skills
2
walk
96
A concerned new mother reports to you that her son, who is 3 years old, is not toilet-trained yet. Which of the following statements is FALSE:
1 Daytime control of bowel movements is usually the first skill that is achieved
2 Nighttime urinary continence may not be achieved until preschool age
3 Children should be toilet trained by age 12 months
4 Girls get toilet trained earlier than boys
3 Children should be toilet trained by age 12 months
97
```
Growth & development:
What age is this?:
Can ***pedal a tricycle.
Can copy a ***circle.
Builds a tower of > 6 blocks
Speaks in 2 to 3-word sentences, which can be understood by strangers most of the time
Climbs well, runs easily
Walks up and down stairs, one foot at a time
Magical thinking
```
Age 3
| For Tricycle, think THREE - "TRI - THREE"
98
At what age would you report the following:
| Unclear speech, can't work simple toys, does not speak in sentences, avoids eye contact, loses skill the child once had
Age 3
99
```
Growth & development:
What age is this?:
Draws a person with 2-4 body parts
Can copy a cross.
Hops on one foot up to 2 seconds
Cooperates with other children, likes to be with friends
Plays "mom" and "dad"
More magical thinking
Understands 2-step commands
```
age 4
| For the copying cross part - REMEMBER - the number 4 has a cross
100
Growth & development:
What age is this?:
Draws a person with at least ***6 body parts
Can copy a triangle and other geometric shapes
Uses a fork and spoon, sometimes a table knife
Stands on one foot for 10 seconds or longer
May start to ride a 2-wheeled bicycle
Age 5
101
Name this condition/pathology:
Can arise from anywhere in the sympathetic nervous system. The adrenal glands is the most common primary site.
***Abdominal mass is fixed, firm, irregular, and FREQUENTLY CROSSES THE MIDLINE.
Symptoms include abdominal pain, localized back pain, weakness (spinal cord compression), bone pain, scoliosis, anemia, hypertension
Initial imaging is abdominal ultrasound
NEUROblastoma
To remember neuroblastoma crossing the midline versus Wilm's tumor (nephroblastoma), think of how:
NEUROlogists (that I worked with) frequently cross boundaries
102
***Name this condition/pathology:
Asymptomatic encapsulated abdominal mass (kidney) that ***DOES NOT CROSS THE MIDLINE of the abdomen.
Abdominal pain in some, hematuria, hypertension, fever.
Avoid vigorous palpation (may rupture)
Peak age is 2-3 years
Female black children have a higher incidence
Wilm's tumor (nephroblastoma)
103
The following statements are true about Wilm's tumor EXCEPT:
1 The most frequent clinical sign is a palpable abdominal mass
2 It is a congenital tumor of the kidney
3 Microscopic or gross hematuria is sometimes present
4 The tumor commonly crosses the midline of the abdomen when it is discovered
4 The tumor commonly crosses the midline of the abdomen when it is discovered
104
***Pyloric stenosis:
Hypertrophy of the pylorus causes near complete obstruction of the gastric outlet, resulting in forceful vomiting.
Classic presentation is a young infant (3 to 6 weeks of age) develops projectile vomiting (non-bilious) immediately after eating (post-prandial vomiting). The infant acts hungry and wants to be re-fed after each episode. Infant will lose weight, may become dehydrated (less than 4 wet diapers/24 hours).
Physical exam reveals a palpable ***______-_____ firm mass at the ____ _____ quadrant.
Refer to ED.
olive-shaped
| right upper
105
Name the following condition:
Invagination of a part of the intestine into itself. It can occur anywhere in the intestines, but the most common location is near the ileocecal junction. The most common cause of intestinal obstruction in infants and *** the most common abdominal emergency in early childhood.
Classic presentation is sudden onset of intermittent severe and crampy pain that may be accompanied by vomiting. May have pain-free periods. Vomiting is initially non-bilious, but it can become bilious as obstruction worsens.
A painful *** SAUSAGE-LIKE abdominal mass that is located on the right side of the abdomen. The stool contains a mixture of blood and mucousy *** CURRANT JELLY STOOLS
Intussusception
106
Intussusception is treated by _____ (non-operative reduction) when stable, or fluoroscopic reduction
enema
107
Pediatric dermatology:
Name this condition:
Found mainly on the forehead, cheeks, nose in up to half of newborns
Multiple white firm 1-2 mm papules
Due to retention of keratin and sebum in the pilosebaceous duct and sweat ducts
Milia or Miliaria "prickly heat"
108
Treatment for milia or milaria or "prickly heat" is:
none. Resolves spontaneously.
109
Pediatric dermatology:
Name this condition:
Erythematous small papules and pustules (looks like a small mosquito bite)
On face, chest, back, extremity
Lasts 1-2 weeks and resolves spontaneously
Erythema toxicum "infant acne"
110
***Pediatric dermatology:
Name this condition:
Seen in 80-90% of African Americans, Asians, Hispanics, and Native American infants.
Blue-black patches that usually fade by age.
Usually on the lumbosacral area (but can be anywhere).
Treatment is not required - Resolves spontaneously within 1 to 3 years.
Can be mistaken for bruises or abuse.
Mongolian spots
111
What pediatric dermatologic condition can be mistaken for abuse or bruises?
Mongolian spots
112
Pediatric dermatology:
Name this condition:
Tufts of hair overlying the spinal column
Usually at the lumbosacral area
May be associated with spina bifida occulta
Faun tail nevus
113
Diagnostics for faun tail nevus include:
ultrasound of the lesion
114
Pediatric dermatology:
Name this condition:
***Flat light brown to dark spots > 5 mm
If 6 or more spots larger than 1/2 cm in diameter, rule out neurofibromatosis
Cafe au lait spots
115
Pediatric dermatology:
***If cafe au lait spots are found (flat light brown to dark brown spots > 5 mm) - six or more spots larger than 1/2 cm in diameter, rule out __________
or ________ disease (seizures, learning disorders, deafness)
neurofibromatosis
| Von Recklinghausen's disease
116
Pediatric dermatology:
Vascular malformations of infancy:
Appears in the first few weeks. Grows in the first _ to _ months of life then stable period, and involutes afterwards. Most lesions are benign and spontaneously resolve.
6 to 12
117
Pediatric dermatology:
Name this condition:
Most common vascular malformation of infancy. Light pink to pink-colored patch. Most common location is in the neck (40%), upper eyelid, etc.
Treatment is watchful waiting. Resolves in a few months to up to 5 years. If desired, may treat with pulse dye laser.
Salmon patch ("stork bite")
118
Pediatric dermatology:
Name this condition:
Raised / elevated vascular lesions in variable sizes. Bright red color and palpable (usually in the head, around the eyes, neck, but can occur anywhere). Up to 90% involute spontaneously by age 9 to 10 years. Watchful waiting.
Infantile strawberry hemangioma
119
For infantile strawberry hemangioma, refer if located on _______, _____ ____, _______, or for a large lesion.
nose, ear canal, genitals
120
Pediatric dermatology:
Name this condition:
Flat large pink, reddish, or purple-color discolorations. If trigeminal nerve affected - ocular defects - rule out Sturge-Weber syndrome.
Treatment is with ____-____ laser
Nevus flammeus or "port wine stain"
121
Pediatric dermatology:
Name this condition:
White to yellow greasy scales on the scalp. Causes erythema and pruritis. Other sites are forehead, eyebrows, ears, eyelashes.
Seborrheic dermatitis (cradle cap)
122
Treatment for cradle cap (seborrheic dermatitis) is _________, ________, or ______ oil, or
_____ ____ or ________ shampoo.
vegetable, mineral, baby
| Selsun Blue; ketoconazole
123
Pediatric dermatology:
Name this condition:
Starts as clusters of red papules which later coalesce into a BEEFY BRIGHT RED RASH with sharp borders. SATELLITE LESIONS found outside the borders.
Candida
124
If diaper candidiasis is found, you should also inspect the _______ for ____ candida.
pharynx; oral
125
Treatment for diaper candidiasis includes:
topical ________, ______ creams BID.
____-based ointments after each diaper change.
nystatin; azole
| zinc
126
How can you tell if candida diaper rash is from candida or from an allergic reaction to the diaper?
If it is an allergic reaction, there will be no rash in the _______ ______.
Intragluteal fold
127
Pediatric dermatology:
Name this condition:
***Red macules that develop into superficial vesicles and become pustular (pea-sized to large ringworm-like).
Honey-colored crusts (dried serous exudate).
Very itchy.
On face, arms, and legs
Impetigo: Staph aureus or beta strep
128
Treatment for impetigo is with _______ or _______-. For a mild case, use __________.
Keflex; dicloxacillin
| Bactroban
129
Complications of impetigo include possible ______ ______ if the bacteria is strep pyogenes.
rheumatic fever
130
Pediatric dermatology:
Name this condition:
A complication of strep tonsillopharyngitis. Infection by strep pyogenes/Group A strep.
diffused erythematous rash with many small papules that feels rough like ***sandpaper (SANDPAPER RASH). Thre rash blanches with pressure.
Can have peeling skin or desquamination or strawberry tongue, which are also present in Kawasaki disease. Look for acute onset, fever, red sore throat, potential tonsillar exudates.
Scarlet fever (Scarlatina)
131
Labs for scarlet fever include:
rapid strep test or throat culture for C&S
132
Treat scarlet fever with _____________ or ________
Penivillin V; Amoxicillin
133
Pediatric dermatology:
Name this condition:
***Starts with fever up to 104 or higher lasting > 5 days. Then ***rash appears mostly on trunk / perianal area. Oral mucous membrane changes (***Dry cracked red lips and a strawberry tongue). Erythema of palms and soles that desquaminate.
At least one large cervical node > 1.5 cm in diameter.
Bilateral nonexudative conjunctivitis with bright red eyes (90%).
Is due to systemic inflammation of medium-sized arteries (vasculitis).
Kawasaki Disease
134
*** Complications of Kawasaki disease include affected ______ _____ (20%),
_________,
______,
MI, CHF, and CAD
coronary arteries
aneurysms
arrhythmias
135
Treatment for Kawasaki disease includes first line ___ _________. If treated within the first 10 days of illness, reduces risk for coronary aneurysms.
Also, high-dosed _____ given QID.
```
IV immunoglobulin (IVIG)
ASA
```
136
***Pediatric dermatology:
Name this condition:
Highly pruritic especially at night.
superficial linear burrows, papules, and excoriations.
*** In finger webs, axillae, breast, buttocks, scrotum, penis, beltline.
Scabies
137
Treatment for scabies includes topical ______ cream. Apply on skin from ____ to ____ including fingernails and toenails. Remove by showering/bathing after __ to ___ hours.
______ cream is contraindicated in pregnancy, toddlers, infants, and hx of seizures.
Permethrin
neck; soles
8 to 14
Lindane
138
Scabies:
Wash clothing, bedding, and underwear used for ___ hours before treatment.
For larger outbreaks in nursing homes: ____ _____
is 1st-line treatment for residents and staff.
48
| oral invermectin
139
Pediculosis capitis (lice)
transmission is via close contact, combs, hats, fomites. Scalp itches and has excoriations.
Diagnosis is by visualization of ____ ____ ____ on hair shafts by a ____ ____, that cannot be dislodged.
ovoid white nits
| Woods Light
140
Lice treatment: After using permethrin cream, if no dead lice seen in __ to __ hours afterward, then the medication is not effective.
Nit removal: Use a ____ comb. Comb head every
__ to __ days for 2-3 weeks.
Vinegar soak in the hair makes it easier to remove the nits. Soak brushes/combs in Nix or hot water
Wash sheets, head gear, etc that were used 2 days prior to treatment.
OR stuff in sealed garbage bag for ___ _______.
8 to 12
lice
2 to 3
2 weeks
141
Pediatric dermatology:
Name this condition:
Dog or cat hookworm larva from fecal matter in beaches and soil that burrows under the skin. Very itchy.
Erythematous serpiginous lesions that advance 1 cm per day.
Location is on soles of feet, buttocks, hands, upper thighs.
Treatment (preferred) is with ________.
Cutaneous larva migrans
Ivermectin
142
```
***Pediatric dermatology:
Name this condition:
White to tan colored, smooth, waxy, dome-shaped papules with umbilication
No pruritis or inflammation
Self-limiting and clears in 3 months.
Watchful waiting especially in children.
```
Molluscum contagiosum: Poxvirus
143
Molluscum contagiosum:
| If found in genital area, R/O ____ / ____ ____
STDs / sexual abuse
144
Molluscum contagiosum:
Treatment:
There is insufficient evidence to conclude that treatment is effective for __-_____ molluscum.
Options include destruction of lesions with cryo, curettage, podofilix, etc.
non-genital
145
What is the first vaccine ever given (given at birth)?
Hep B
146
If the birth mother is discovered to be Hep B positive (HBsAg), what is done?
The Hep B vaccine and the HBIG (Hep B immune globulin) are both given as soon as possible after birth (within the first 48 hours of life).
147
Peds:
| How many doses are needed for Hep B vaccine?
3
148
Peds:
| What is the youngest age that the injectable flu vaccine can be given?
6 months
149
Which vaccines should not be given before 12 months of age?
| Why?
MMR and varicella.
| They may not be effective since the baby may not develop enough antibodies.
150
MMR vaccine:
Advise women not to get pregnant within ___ ____ of receiving.
Varicella vaccine:
After receiving, advise women not to get pregnant within the next ___ ______.
4 weeks
3 months
151
```
Which vaccines are given during the preschool years (age 4-6)?
_____
_____
_____
_____
```
DTaP (Do not give after age 7. Use Td or Tdap instead.)
IPV
MMR (needs 2 doses)
Varicella
152
Is severe egg allergy a contraindication for the flu vaccine?
no -
If the person has previously had a severe reaction, including anaphylaxis, give the shot in na clinical setting where resuscitation equipment is available.
153
Gardasil:
Give to all adolescents age __ - __ years. Needs 2nd dose in __ to __ months.
Before age ___, only need 2 doses.
At ages __ to ____, need 3 doses.
11 - 12
6 to 12
15
15 to 26
154
Babies with hx of intusussception should not be immunized with the _______ vaccine.
rotavirus
155
The minimum age that HPV vaccine can be given is ____.
9
156
Give DTaP or DT only to infants and children less than ___ years old.
Td and Tdap: Use at age ___ or older.
Replace one Td dose with Tdap (___ Tdap dose in a lifetime)
7
7
one
157
Age 11 - 12:
| Give ____ booster
Tdap
158
Tdap:
| Common side effect is ____ and _____ at the injection site.
pain; induration
159
When do you give the Td booster for a "dirty" wound?
Follow the 5 year rule. If the last booster was > 5 years ago, give the Td or Tdap booster.
160
When do you give the tetanus immunoglobulin (HyperTet)?
Indicated only for patients who have never been vaccinated for tetanus or for those who did not complete their primary series in infancy.
161
Do NOT give ____ or ____ again if:
Persistent inconsolable crying lasting > 3 hours within 48 hours of dose
Fever = or > 105 within 48 hours of dose
Seizures within 3 days of dose
Hypotonic and hyporesponsive shock-like state within 48 hours
Encephalopathy within 7 days
Anaphylaxis
DTaP or DT
162
```
What are NOT contraindications for giving DTaP?
Family histories of
S
A
S
```
Seizures
Adverse reactions
SIDs
163
Regarding SIDS, which of the following statements is false:?
1 Position infant on back when sleeping
2 Do not use soft pillows, mattresses, bumpers
3 Infants who are using pacifiers are at higher risk for
developing SIDs
4 Do not over-dress infants to prevent overheating
3 Infants who are using pacifiers are at higher risk for
| developing SIDs
164
A mother reports to you that her 6 month old infant has a mild cold. She tells you that his temp is 99.0 F. He is not irritable and is feeding well without problems. she wants to know whether it is OK for him to be immunized at this time. Which of the following statements is true?
1 The infant should not be immunized until he is afebrile
2 An infant can be immunized at any time
3 A healthy infant with a mild cold and temp of 99.0 can be immunized
4 Because immunizations are so important, it should be given to infants as scheduled
3 A healthy infant with a mild cold and temp of 99.0 can be immunized
165
What is the most common virus responsible for bronchiolitis?
RSV
166
_______ occurs in children < 2 years old with URI symptoms (Rhinorrhea) followed by small airway inflammation. Outbreaks occur in the fall and winter. Presents with minor symptoms to severe resp distress/failure.
Bronchiolitis
167
*** High risk for resp failure with bronchiolitis in infants who are premature, age < ___ weeks,
congenital _____ _____,
_______ disease, immunodeficiency.
12
heart disease
pulmonary
168
Name the following pediatric condition:
Onset of fever, cough with coryza, nasal congestion, wheeze, tachypnea, profuse rhinitis, clear mucus to white. Infant may be fussy and difficulty feeding due to nasal congestion. Gradually resolves in 2 to 3 weeks.
Bronchiolitis
169
```
Bronchiolitis:
PE reveals _______,
________,
________ _____ phase.
Diagnostics:
Usually no labs or chest x-rays needed.
Can do rapid RSV antigen test.
```
wheezing
rales
prolonged expiratory
170
Treatment for bronchiolitis is ________.
Nasal suctioning.
_________.
_____ _____.
AVOID _______ and _____ meds.
Aerosolized beta-agonists, ipratropium bromide, and epi has NOT been shown to benefit outpatients.
Treat fever with Tylenol.
symptomatic
hydration
pulse oximetry
decongestants; cough
171
```
Bronchiolitis:
Impending resp failure - refer to ER:
Appears exhausted
Change in LOC, lethargy, agitation
Nasal flaring, retractions, grunting
RR > 70 breaths/min
***Room air pulse ox < ___%
```
95
172
Name the pediatric condition:
A viral infection of the upper airways.
Presents with a *** barky "seal-like" cough which may be accompanied by inspiratory stridor. In older children and adults, hoarseness is the predominant symptom.
Fever, rhinorrhea, coryza, hoareseness.
Resolves in 3 days. More common in 6 months to 3 years.
croup (laryngotracheobronchitis)
173
Treatment for mild croup includes:
H
O
T
humidity
Oral fluids
treat fever
174
Treat croup with ____ air.
| Steam from hot shower, or _____ night air.
humid
| cold
175
Mild croup: Treat with one dose of __ ________
PO dexamethasone
176
```
A 3 year-old child is breathing rapidly and is sitting on the edge of the chair with his neck extended. He is drooling. He has a muffled voice and has difficulty swallowing his saliva. This would describe:
1 Croup
2 Bronchiolitis
3 Epiglottitis
4 Acute tonsillitis
```
3 epiglottitis
177
Epiglottitis:
***Caused by ______ _____ ___.
Watch for ________ _____ obstruction.
Hemophilus influenzae B
| sudden airway
178
Name the following commonly pediatric condition (ages 1 - 7):
Abrupt and rapid onset of high fever with severe sore throat, drooling, and distress with muffled voice or hot potato voice, inspiratory stridor. Feels like choking, anxious, restless.
Characteristic ***tripod sitting position with neck hyperexended with mouth open. Child will refuse to lay down.
Epiglottitis
179
Epiglottitis:
Do not place child in ______ position.
Do not examine pharynx with ___ ____ (can precipitate laryngospasms)
supine
| tongue blade
180
Name the commonly pediatric condition based on this:
| Lateral C-spine x-ray shows thumbprint sign.
Epiglottitis
181
Close contacts/daycare children and staff of those exposed to a child with epiglottitis should be treated with PO ________.
rifampin
182
Pediatrics:
What is the most common genetic disease in the caucasian population in which each parent must have a copy of the autosomal recessive defective gene?
Cystic fibrosis
183
Cystic fibrosis is a dysfunction of _______ glands.
Abnormal ____ transport of epithelial cells produces thick and tenacious mucus.
Mainly affects ______, ___ ___ , and _____.
exocrine
chloride
lungs; GI tract; pancreas
184
Most cystic fibrosis are colonized with _________ in the lungs and when they get pneumonia, they must also be treated for this with __________.
pseudomonas
| ciprofloxacin
185
Cystic fibrosis:
Diagnostic test is the _______ _______.
Median age to survival in the US is about _____ years to early ______.
sweat test
| 37.5; 40s
186
***Cystic fibrosis:
| To diagnose, must have a positive _____ _____test of > _____ on ____ separate tests on _______ days
sweat chloride
| 60; two; consecutive
187
Cystic fibrosis:
Genetic screening for family recommended. ____% chance the child will have CF disease if both parents are carriers of the defective CF gene.
25
188
Acute otitis media:
| Tympanogram will have a ___ ___, no ____.
flat line; peak
189
Preferred 1st-line tx for AOM is _______.
| If recent beta-lactam therapy or hx of recurrent AOM unresponsive to the 1st-line tx, treat with _________.
amoxicillin
| Augmentin
190
```
Not recommended for AOM:
O
S
A
D
```
OTC cold meds
Steroids
Antihistamines
Decongestants
191
AOM:
| Infants 6 months of age or younger: Treat _____ with _______.
immediately
| antibiotic
192
```
Decreases risk of AOM:
Breastfeeding
avoid passive ______ exposure
Limit exposure to multiple kids
Limit exposure to viral URI
Ensure that immunizations are up to date.
```
smoke
193
Name this pediatric condition:
Acute onset of fever, sore throat, rhinorrhea, malaise, some have N/V.
PE reveals purulent tonsillar exudate & anterior cervical lymphadenopathy.
Strep throat (GAS pharyngitis)
194
scarlet fever is strep throat accompanied by a ________ _____.
maculopapular rash
195
Peds:
1st-line tx for Strep throat is ___________.
Afer ___ ______ of antibiotic, the child is considered not infectious.
Penicillin VK
| 24 hours
196
Complications of strep throat include rheumatic fever, peritonsillar abscess, sepsis, and ____-_____ _____.
post-glomerular nephritis
197
Name this pediatric condition:
Abrupt onset of high fever (103-106)
Fever lasts 1-5 days, during which the child appears well. ***After high fever disappears, RASH APPEARS.
By day 3 to 4, profuse maculopapular rash appears mainly on the chest and abdomen.
Lasts about 7 days.
So basically, "fever....fever...RASH".
Roseola
198
***A mild rash illness that will spontaneously resolve. If a pregnant woman is exposed, it is usually not a problem for the woman or the baby. About half of pregnant women are immune. If not, illness will be mild.
Features a RASH THAT HAS 3 STAGES.
1st stage: "_____ _____" appearance
2nd stage: A ____-____ _____ rash on the arms and legs
3rd stage: Rash may recur for 2-3 weeks if aggravated by sunlight or heat
Duration: 5 - 10 days
```
slapped cheek (or an erythematous rash with circumoral pallor)
lace-like maculopapular
```
199
Name the childhood condition - viral rash:
Starts out as a red macule that becomes vesicular - crusted. Lesions are very itchy.
***NEW RASHES ERUPT DAILY FOR ABOUT 5 DAYS (has rashes at different stages)
Varicella
200
Varicella (chicken pox) is infectious for ___ hours before onset of rash untiL:
24
| all lesions have crusted
201
Treat chicken pox with ________ in children older than 12, or other high-risk patients
acyclovir
202
Name this pediatric viral rash:
Enterovirus, cocksackie virus
Acute onset of fever with sore throat, multiple small ulcers and vesicles posterior pharynx.
Palms and soles of feet with round red rashes.
Duration 7 to 10 days.
Treatment is symptomatic.
Hand-Foot-Mouth disease
203
Name this pediatric viral rash:
***Has Koplik's spots - ***small white papules on a reddened base inside the cheek (buccal mucosa by the posterior molars)
Rubeola
204
Name this pediatric viral rash:
Generalized red to pink rash. Look for red spots on the posterior pharynx.
Birth defects to fetus (check rubella titer pregnant women)
Rubella (German measles)
205
```
Peds:
Genu varum:
Is ________ in newborns.
Improves starting at age 18 months.
Can result in "intoeing" gait.
```
normal
206
Rickets is caused by inadequate _____ _____ or low levels of _____, phosphorus
vitamin D
| calcium
207
*** What is the MOST COMMON CAUSE of "intoeing" in children younger than 2?
Is this benign or not?
Internal tibial torsion
| It is benign.
208
What is this condition in pediatrics:
| Flexible flat feet, common in infants and young children. Special shoes and inserts are not necessary in this age group.
Pes planus
209
Name this ortho condition in peds:
forefoot is turned toward the middle of the body (inward)
Most cases resolve between age 1 to 2.
Another most common cause of intoeing.
Metatarsus adductus
210
```
Name this orthopedic variant in peds:
Affected foot (or both feet) are turned inward toward the middle of the body so that the outer edge of the foot faces sideways. If fixed/rigid deformity, refer.
```
Club foot (congenital talipes equinovarus)
211
Developmental dysplasia of the hip (DDH) is more common in ______. the left hip is 3x more likely to be affected.
Signs: Uneven skin folds or creases on the thighs and groin. One leg (knee) appears shorter than the other - this is called _________ sign.
Galeazzi's
212
Developmental dysplasia of the hip (DDH):
What is this sign called?
Bend hips with knees together. Compare height of knees. The knee on the leg with the abnormal hip will be shorter than the other "normal" leg.
Galeazzi sign
213
Developmental dysplasia of the hip:
____ will normalize with no treatment after 1 month
____ will normalize without treatment after 2 months
60%
| 88%
214
Lead poisoning in children:
| Chelate with IV _______ or _____
dimercaprol; EDTA
215
Iron poisoning in kids:
Will have Vomiting, diarrhea, GI bleed, seizures, coma
Antidote is chelation with ______
deferoxamine
216
```
A mother of a 7 year old boy tells the FNP that his teacher has complained to her of her son's daydreaming. These episodes are becoming more frequent. Sometimes, she notices that the child is staring into space and does not seem to hear when she speaks to him. These episodes last a few seconds. He does not seem to be aware of them. You would suspect:
1 A partial seizure
2 An absence seizure
3 A grand mal seizure
4 A Jacksonian seizure
```
2 An absence seizure
217
What type of seizures are more common in children?
Absence seizures or petit mal seizures
218
Primary nocturnal enuresis:
1st test is a ________.
Treat with _________ or ______ _______.
urinalysis
| imipramine; intranasal desmopressin
219
Encopresis:
Occurs most commonly in children aged __ and older.
Usually has a hx of ______ _______.
Labs: Usually none needed.
________ ______ will show how much stool is inside the colon.
4
chronic constipation
Abdominal x-ray
220
```
Peds:
Encopresis:
Give an ______. May need these daily.
Give suppositories and strong laxatives.
Defecation regimen:
Sit on toilet ____ daily at the _____ _____ for ___ minutes each time.
```
enema
twice; same time; 10
221
Peds:
Still's murmur:
All of the following are true about Still's murmur EXCEPT:
1 It is a benign systolic ejection murmur that has a vibratory quality and does not radiate
2 It is best heard between left lower sternal border and the apex using the bell of the stethoscope
3 It increases in intensity with the supine position
4 It is associated with a thrill and is usually rated at
Grade 4 to 5
4 It is associated with a thrill and is usually rated at
| Grade 4 to 5
222
```
Adolescence:
Gynecomastia:
Majority of cases are _______ and ______ in up to 50% of pubertal boys (peaks at age 13).
Most cases _______ _________.
Common in neonatal period and puberty.
```
physiologic; normal
resolve spontaneously
223
PE with gynecomastia in adolescence reveals ______, ___-shaped tissue ____ cm or larger under each areola/nipple. One breast may be larger than the other. Tenderness on breast palpation is very common.
rubbery; disc; 0.5
224
Adolescence:
Gynecomastia:
Obese males: "pseudo gynecomastia" is ________ tissue and not true gynecomastia.
Do ____ _____ on physical exam. Check testicular size, pubic hair, etc.
adipose
| Tanner staging
225
```
Adolescence:
Pathologic gynecomastia:
Causes are:
P
A
S
T
A
```
M
K
```
Pituitary tumors
Adrenal tumors
Steroids
Testicular tumors
Amphetamines
```
Marijuana
Klinefelters
226
```
Tanner Staging for males:
I Prepuberty
II _____ ______
III _____ ______
IV _____ _______
V Adult pattern
```
II Testis enlarges
III Penis elongates
IV penis thickens
227
Tanner Staging for girls:
Stage I: Prepuberty
II: _____ ______
III: breast tissue and areola are ___ _____ ____
IV: Areola/nipples form a _______ ______.
II: Breast bud
III: in one mound
IV: secondary mound
228
Tanner staging of pubic hair:
II: _____ growth that is easily ______
III: starts to ____
IV: Hair curly but not on ____ ____ yet
II: Sparse; counted
III: curl
IV: medial thigh
229
The mother of a 16 year-old boy is concerned that her son is not developing normally. On an exam, you note that he has small testes and no pubic hair (Tanner stage I). You would advise her:
1 That her son is developing normally
2 That her son is delayed and needs to be evaluated by a ped. endocrinologist
3 That her son should be re-checked in 3 months
4 Her son is developing slowly but is within normal limits
2 That her son is delayed and needs to be evaluated by a ped. endocrinologist
230
Autism:
A normal 3 year old clings to mom. An autistic 3 year old stands in the corner of a room and is Ok with mom leaving.
Asperger's: Spectrum disorder. Speech is preserved, but may be ______ tone. May speak in a loud voice. Restricted interests. May have a high _____.
monotonous
IQ
231
Name this pediatric genetic abnormality:
Child or adult has a long face with large ears. Joints are hyperextensible (especially the fingers). May have emotional or behavioral disturbance. Boys are more severely affected than girls. Most boys with this have mental retardation. About 20% of boys with this meet full criteria for autism.
Fragile X Syndrome
232
Name this pediatric genetic abnormality:
Only affects males.
Has an extra X chromosome.
Lack of secondary sexual characteristics, small testicles/penis, tall stature, wider hips, osteoporosis.
Klinefelter Syndrome
233
Name this pediatric genetic abnormality:
Only affects females. Has only one X chromosome. Associated with cardiac, musculoskeletal, thyroid disorder.
Short stature (heights below 50th percentile)
Webbed or wide neck with low hairline.
Absent breast development during puberty.
Amenorrhea due to premature ovarian failure (infertility).
Cardiovascular and kidney abnormalities.
Turner's syndrome
234
Psychosocial development theorists:
| Erickson: Made the states that have _____ ___ ____
something versus something
235
```
Psychosocial development theorists:
Erickson:
Trust vs mistrust (infants)
Autonomy vs shame and doubt (toddlers)
Initiative vs guilt (pre-school)
Industry vs inferiority (school-age)
Identity vs role confusion (Adolescent)
Intimacy vs isolation (adult)
Generativity vs stagnation (middle age)
______ vs _____ (elderly)
```
Integrity vs despair
236
Psychosocial development theorists:
Erickson:
Grandma is quilting for her grandkids. What stage of Erickson's theory of psychosocial development is she displaying?
Integrity vs despair
237
Freud:
Oral stage- infancy (birth to 18 months)
Anal stage - Toddlers (18 months to 3 years)
______ stage (_____ stage) - ______ age __ to __ yeras - child falls in love with the parent of the opposite sex
Latency stage - school age (6 years to puberty)
Genital stage - adolescence to adulthood
Phallic (Oedipal) - preschool; 3 to 6
