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PD III Test #3 - PED school-aged exam
Winter Semester 2011
97
Medical
Graduate
04/24/2011

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Cards

Term
If pt is lethargic, how should their temp be taken?
Definition
rectally
Term
If child < 3y/o has a fever and appears ill, what should you suspect?
Definition
sepsis,
UTI,
pneumonia,
other infx
Term
What may a child's temp be up to?
Definition
104 deg F/ 40 deg C
Term
What is sinus bradycardia in a child < 3y/o considered?
Definition
<100 bpm
Term
What is sinus bradycardia in a child 3 - 9 y/o considered?
Definition
< 60 bpm
Term
What is the average pulse rate for a child 1 - 2 y/o?
Definition
110bpm
Term
What is the average pulse rate for a child 2 - 6 y/o?
Definition
103 bpm
Term
What is the average pulse rate for a child 6 - 10 y/o?
Definition
95 bpm
Term
What is the normal respiratory rate in early childhood?
Definition
20 - 40 bpm
Term
What is the normal respiratory rate in late childhood?
Definition
15-25 breaths/min
Term
What is the appropriate way to fit the BP cuff?
Definition
Cuff should be able to cover 2/3rd of the upper arm or leg
Term
Where should the BP in an infant or toddler < 3y/o be taken? Why?
Definition
Both arms and 1 leg; to r/o coarctation of the aorta
Term
What is most transient HTN due to?
Definition
Due to meds (Prednisone or Ritalin)
Term
What is the most frequent cause of elevated BP in children?
Definition
improperly taken BP
Term
If sustained HTN is found in an infant or child, what conditions may be the underlying cause?
Definition
Renal Parenchymal
artery disease,
Primary HTN,
Coarctation of the aorta
Term
What is the rule of thumb for growth in height after 2 y/o?
Definition
at least 5 cm per year
Term
What is considered 'at-risk' for overweight?
Definition
> 85th %tile
Term
What is considered overweight?
Definition
>95th percentile
Term
What % of children are considered obese?
Definition
36% are >85th % and 16% have a BMI >95th %
Term
How can you differentiate an endocrine abnormality cause of obesity from an exogenous cause of obesity?
Definition
Endocrine causes tend to be short
Exogenous obesity are also tall for their age
Term
What is an Optotypes?
Definition
Symbols used to help determine visual acuity
Term
What is the best way to determine eye fixation preference?
Definition
covering one eye and seeing if child objects
Term
What are the normal visual acuities for:
Age 3?
Age 4?
Age 5?
Definition
Age 3 = 20/40
Age 4 = 20/30
Age 5 = 20/20
Term
At what age should a child's vision reach 20/20?
Definition
Age 5
Term
What can Anisometropia reult in?
Definition
amblyopia (lazy eye)
Term
Why is it important to treat amblyopia?
Definition
must be corrected early (by age 6 y.o.) or may result in permanent reduced visual acuity
Term
What can cause the TM to appear red?
Definition
Crying
Term
What % of school-aged children has a hearing impairment?
Definition
15%
Term
What is 0 - 20db considered?
Definition
Normal hearing
Term
What is 20 - 40 dB considered?
Definition
Mild hearing loss
Term
What is 40 - 60dB considered?
Definition
Moderate hearing loss
Term
What is 61 - 90dB conisidered?
Definition
Severe hearing loss
Term
What is > 90dB considered?
Definition
Profound hearing loss
Term
What type of hearing screening does AAP recommend for children > 4 y/o?
Definition
full scale acoustic screening in asymptomatic children
Term
If pt presents with unilateral drainage with foul smelling discharge what is the most likely cause?
Definition
foreign body
Term
What condition is characterized by Pale, boggy nasal mmbs?
Definition
perenniel allergic rhinitis
Term
When are Maxillary sinuses visible on xray?
Definition
4 y/o
Term
When are Sphenoid sinuses visible on xray?
Definition
by 6 y/o
Term
When are Frontal sinuses visible by on xray?
Definition
age 6-7 y.o
Term
What is hypernasal speech a characteristic of?
Definition
Submucosal cleft palate
Term
What is a Nasal voice plus snoring a characteristic of?
Definition
Adenoidal hypertrophy
Term
What is a Hoarse voice plus cough characteristic of?
Definition
Viral infection (croup)
Term
What is a voice described as "rocks in mouth" a characteristic of?
Definition
Tonsillitis
Term
What can posterior lymphadenopathy be indicative of?
Definition
lice or scalp fungus
Term
Should the thyroid gland be palpable or non-palpable in children?
Definition
non-palpable
Term
What lung condition has findings on auscultation described as Prolonged expiratory phase & Expiratory breathing?
Definition
Asthma
Term
What lung condition has findings on auscultation described as inspiration is prolonged?
Definition
Croup
Term
What muscles are most involved in retraction?
Definition
scalene,
sternocleidomastoid,
trapezius muscles
Term
What are Lower costal, subcostal (epigastric) and lower intercostal retractions often indicative of ?
Definition
flattening of the diaphragm due to air trapping and pulmonary hyperinflation
Term
Where is the PMI visible in a child < 7 y/o?
Definition
Visible at L.4th interspace
Term
Where is the PMI visible in a child >7 y/o?
Definition
Visible at L 5th Intercostal space
Term
Where is S1 louder in a child, where is S2 louder?
Definition
S1 is louder than S2 at apex
S2 is louder than S1 at the pulmonic area
Term
How is the heart heard best?
Definition
When pt is supine
Term
What are most innocent murmurs of childhood associated with?
Definition
tachycardia
Term
Which murmur is described as being caused by turbulence of blood in the jugulars?
Definition
Venous Hum
Term
Is venous hum continuous or incontinuous? Where is it heard loudest? How can it be stopped?
Definition
Continuous; Heard above the medial third of the clavicles, especially on right. 1st and 2nd interspaces; obliterate by pressure on jugular
Term
What age is a Still's murmur heard?
Definition
Preschool or early school age
Term
What age is a venous hum heard?
Definition
Preschool or early school age
Term
What age is the carotid bruit heard?
Definition
any age
Term
Which murmur is described as Soft, hollow, continuous, Louder in diastole, under the clavicle?
Definition
Venous hum
Term
Which murmur is described as Grade I-II, musical, vibratory, early and midsystolic, Mid/lower left sternal border?
Definition
Still's Murmur
Term
Which murmur is described as Early and midsystolic, usually louder on left. Eliminated by carotid compression?
Definition
Carotid bruit
Term
What are murmurs acquired after age 3 usually caused by? What valve is MC affected?
Definition
rheumatic dz, Mitral Valve
Term
When do umbilical hernias present from birth usually resolve?
Definition
By age three
Term
What test should you use to determine the liver span in PEDs pts?
Definition
Scratch Test
Term
Where can the spleen in children be felt?
Definition
Projects downward like a tongue (1-2 cm below the costal margin)
Term
How can you check for heel tap or rebound tenderness in PEDs pts?
Definition
Heel Tap = Ask child to hop on one foot
Rebound Tenderness = Jump off table
Term
When using Tanner stages of breast development, which stage is described as elevation of nipple only?
Definition
Stage 1
Term
When using Tanner stages of breast development, which stage is described as elevation of breast and nipple as a small mound and enlargement of areolar region?
Definition
Stage 2
Term
When using Tanner stages of breast development, which stage is described as further enlargement of breast and areola with no separation of their contours?
Definition
Stage 3
Term
When using Tanner stages of breast development, which stage is described as projection of areola and nipple to form a secondary mound above the level of the breast?
Definition
Stage 4
Term
When using Tanner stages of breast development, which stage is described as projection of nipple only, areola has receded to general contour of the breast (although in some individuals it is normal for areola to be a second mound)?
Definition
Stage 5
Term
Based on the Tanner stages of public hair for females, what stage is described as preadolescent or vellus hair only?
Definition
Stage 1
Term
Based on the Tanner stages of public hair for females, what stage is described as Sparse growth of long, slightly pigmented, downy hair or only slightly curled hair, appearing along labia?
Definition
Stage 2
Term
Based on the Tanner stages of public hair for females, what stage is described as Hair is darker, coarser, more curled, and spreads to the pubic junction?
Definition
Stage 3
Term
Based on the Tanner stages of public hair for females, what stage is described as Adult-type hair; there is no spread to the medial surface of thighs?
Definition
Stage 4
Term
Based on the Tanner stages of public hair for females, what stage is described as Adult-type hair with increased spread to medial surface of thighs; distribution is as an inverse triangle?
Definition
Stage 5
Term
Based on the Tanner stages of public hair for males, what stage is described as same as in childhood?
Definition
Stage 1
Term
Based on the Tanner stages of public hair for males, what stage is described as enlargement of testes and scrotum?
Definition
Stage 2
Term
Based on the Tanner stages of public hair for males, what stage is described as penis is lengthened?
Definition
Stage 3
Term
Based on the Tanner stages of public hair for males, what stage is described as scrotum darkened, penis width increases and glans develops?
Definition
Stage 4
Term
Based on the Tanner stages of public hair for males, what stage is described as pubic hair spreads to medial aspect of thighs?
Definition
Stage 5
Term
What is considered precocious puberty?
Definition
Breast enlargement and pubic hair <8yr
Term
Is rectal exam routine in children?
Definition
NO
Term
In what years would the vaginal exam show a flattened labia majora, thin minora, thick, avascular hymen covering vaginal opening?
Definition
Preschool years
Term
What can a common cause of erythema of the vagina be caused by?
Definition
bubble bath
Term
When is a vaginal exam indicated for in kids?
Definition
for abuse or pre-puberty bleeding and discharge
Term
What do Undescended testicles increase chances for developing?
Definition
for testicular cancer and infertility
Term
In what ages is genu varum common?
Definition
common from 2-9 y/o
Term
What percent of all childhood fractures are inflicted?
Definition
Approximately 30%
Term
What does gower's sign indicate?
Definition
muscle weakness (Muscular Dystrophy)
Term
What remains the best predictor of future intellect?
Definition
Language
Term
What does Goodenough-Harris or Gesell Figure’s test evaluate?
Definition
Visual Motor skills
Term
What are some of the non-specific symptoms consistent with head injury in a child?
Definition
Lethargy
Irritability
Persistent unexplained vomiting
Apnea
Coma
Convulsions
Term
What are some symptoms of abdominal trauma in a child?
Definition
Vomiting
Pain
Tenderness
Shock
Sepsis
Term
Where does accidental bruising typically occur in an ambulatory child?
Definition
Knee and shin
Forearm
Forehead and chin
Bony prominence, such as elbows, hips, and spine
Term
What is indicative of nonaccidental hot water burns, setting them apart from accidental burns?
Definition
Nonaccidental hot water immersion burns are typically bilateral and symmetrical with well-demarcated lines and without splash marks
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