Well Baby Care

Question 1

List 6 things to ask about for counselling parents on safety for children

Answer 1

No honey until 1 year 
Choking haxards 
VIT D for baby and Mom 
Fed is best 
Button battery ingestion-Give honey 
Guns
Carbon monozide 
Electric plugs 
Car seats 
Poison storage and phone number

Question 2

What should babies be able to do by 2 month

Answer 2

Coo

Question 3

What should babies be able to do by 4 months

Answer 3

Hold an object and hold their head study

Question 4

What should kids be able to do by 4 years

Answer 4

Stand on one foot

Question 5

What should kids be able to do at 6 months

Answer 5

Sit up

Question 6

What should kids be able to do at 8 months

Answer 6

Pincer grasp

Question 7

What should kids be able to do at one year

Answer 7

Walk

Say a few words

Question 8

What should kids be able to do at 2 years

Answer 8

Run

Say 2 word sentences

Question 9

What should kids be able to do at 3 years

Answer 9

Follow 3 step directions

Speak in sentences

Question 10

How long should you breast feed for

Answer 10

At least 2 years
With Vit D
BUT FED IS BEST

Question 11

List four types of formulas you can use for cows milk protein allergy

Answer 11

Hydrolyzed cows milk
Hydrolyze rice milk (not as easy to get)
Soy milk
Amino acid-based formula

Question 12

DDX for kid who is fussy after meals

Answer 12

GERD
Pyloric stenosis 
Cows milk allergy 
Gastroenteritis 
Hiatus hernia 
Hydrocephalus

Question 13

List 5 pros and 4 cons of circumcision

Answer 13

1. Reduced penile cancer
2. Reduced phimosis
3. Reduced UTI
4. Reduced HPV
5. Reduced HIV
6. Reduces HSV
7. Reduced cervial cancer and STI in partner
8. Risk of infection
9. Risk of bleeding
10. Meatal stenosis
11. Ethical concerns

NNT Jfor the pros are generally high

Question 14

What kind of milk should a baby be drinking

Answer 14

Formula or breast until 1 year
Homo milk at 1 year
Transition to 1-2% by 2-3 years
Discontinue bottle by 18 months

Question 15

When can you buy your kid an ipad

Answer 15

Not before 2 years

Question 16

What should you include in a physical exam

Answer 16

Height
Weight
Head circumfrence 
BMI (at 16)
Fontanelles 
Eyes
Hearing 
Heart
Lungs
Abdomen
Skin 
Hips until walking 
Genital (Testes)

Question 17

When and how to introduce real food

Answer 17

6 months
One food per 3 days to check for any reaction
Don’t avoid allergens
Choking safe foods

Question 18

Risks of undescended testes

Answer 18

Torsion 
Trauma 
Tumor
Hernia
Infertility

Question 19

Score to diagnose testicular torsion

Answer 19

TWIST
Absent cremateric refelx
N+V
High riding testicle
Testicular swelling 
Hard testicle 

ANY =Ultrasound
If they have all of them can skip the ultrasound and just refer to surgery

Question 20

List four basic concepts of NRP

Answer 20

PPV is the mainstay
Limit suctioning
Skin 2 skin
Use O2 judiciously

Question 21

What medication should you consider giving in a new born who is less responsive than you would like with a slow breathing rate

Answer 21

Naloxone if possible opioids

Question 22

How many breaths per minute if CPR on a new born

Answer 22

20-30 with a rescue airway

Question 23

List 5 risks for sepsis

Answer 23

Chorioamnionitis
Fever
<37 weeks
Rupture >18 hours 
GBS +

Question 24

What are the bugs that can cause sepsis in the new born

Answer 24

Listeria
E. Coli
GBS

Question 25

List 7 symptoms of hypoglycemia

Answer 25

``` Jittery Lethargic Homotonic Sweating Weak cry Tachypnea Seizures ```

Question 26

How to treat hypoglycemia in the new born

Answer 26

Feed | If can't feed give D10 W IV and recheck glucose q 30 minutes

Question 27

What drug may a mother be on that increases risk of hypoglycemia complications in a new born

Answer 27

Beta blocker, because it can mask symptoms

Question 28

What tests should you get to investigate hyperbilirubinemia

Answer 28

``` Hemoglobin Group and Screen Conjugated bilirubin Coombs (Direct looks for antibodies on the baby's red blood cells, indirect looks for antibodies in the serum) Peripheral smear ```

Question 29

List the 3 rules of 1 for downs syndrome

Answer 29

1 palmar crease 1% recurrence 1st toe web space

Question 30

List 5 risks for hip dysplasia

Answer 30

``` Female First born Feet first (breech) Fluid low (Oligo) Family history ```

Question 31

So you diagnose a baby with a simple URTI. In your discussion with a parent when are you going to tell them to come back

Answer 31

Fever >24 hours Fluid ins and outs inadequate Fatigued/Lethargic Fearful symptoms (LOC, Respiratory distress etc.) In this case specifically resp distress, indrawing, retractions, wheezing, unable to play

Question 32

List three vitals we can get to look for congenital hear disease

Answer 32

Pulse ox at 24-36 hours to check for congenital heart disease >95% in the right foot and <3% difference between hand and foot BP-If 6-9 mmHg less in the calf could be coarctation HR-ausculation more improtant to listen for murmurs

Question 33

List 5 features of down syndrome

Answer 33

``` Hypotonia Large tongue and small mouth Short neck Flattened nasal root Epicanthal folds Up slanted fissures Third fontanelle Rounded head Wide gab between 1st and 2nd toe ```

Question 34

List 5 features of fetal Alcohol syndrome

Answer 34

``` Smooth philtrum Thin vermilion border of the upper lip Short palperbral fissures Strabismus Ptosis Midface hypoplasia Cleft palate Irritability Hearing loss Post natal growth deficience ```

Question 35

Important questions to ask on new born history (List 7)

Answer 35

``` Screening during pregnancy Drugs and medication during pregnancy GBS status APGARS Meconium ROM Gestational diabetes Family history Need for resuscitation ```

Question 36

List three features of a pathalogical murmur

Answer 36

Grade 3+ Holosystolicc Diastolic