Term
| what is the baby called for the first 29 days? |
|
Definition
|
|
Term
| what is considered the post-neonatal period? |
|
Definition
|
|
Term
what do these APGAR scores mean at 1 min?
0-4
5-7
8-10 |
|
Definition
0-4 = resuscitation
5-7 = some depression
8-10 = normal |
|
|
Term
what do these APGAR scores mean at 5 minutes?
0-7
8-10 |
|
Definition
0-7 = high risk
8-10 = normal |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what is ELBW? VLBW? LBW? NBW? |
|
Definition
ELBW < 1000g
VLBW < 1500g
LBW < 2500g
NBW > 2500g |
|
|
Term
| what is preterm? term? post term? |
|
Definition
preterm < 37 weeks
term = 37 - 42 weeks
post term > 42 weeks |
|
|
Term
| ability of a newborn to selectively and progressively shut out negative stimuli such as repetitive sound |
|
Definition
|
|
Term
| when are tremors abnormal at rest? |
|
Definition
|
|
Term
| when is the Denver Developmental Screening Test used? |
|
Definition
birth - 6 years of age.
false negatives are common especially with language delay |
|
|
Term
| what are the ages for the different somatic growth charts? |
|
Definition
|
|
Term
| what is considered macrocephaly? microcephaly? |
|
Definition
maco > 97% or 2 SD above mean
mico > 2 SD smaller than average |
|
|
Term
| complications of macocephaly |
|
Definition
| hydrocephalus or subdural hematoma |
|
|
Term
|
Definition
| premature closure of the sutures |
|
|
Term
| normal SBP at birth, 1m, and 6m |
|
Definition
|
|
Term
|
Definition
| take for a full minute, 140-160 |
|
|
Term
| what is the criteria for tachypnea? |
|
Definition
0-2m > 60
2-12m > 50
> 12m > 40 |
|
|
Term
| what kind of temperature is preferred before 2m of age? |
|
Definition
|
|
Term
| what can pallor indicate? |
|
Definition
|
|
Term
| what can cyanosis indicate? |
|
Definition
|
|
Term
| what can plethora indicate? |
|
Definition
|
|
Term
| what can jaundice indicate? |
|
Definition
|
|
Term
| what can slate gray skin indicate? |
|
Definition
|
|
Term
| vasomotor response to cooling or chronic exposure to radiant heat, lattice like bluish mottling especially on extremities |
|
Definition
|
|
Term
| blue cast to hands and feet in response to cold. If not cleared in 8 hrs or with warming consider cyanotic CHD |
|
Definition
|
|
Term
| transient cyanosis of 1/2 the body or one extremity. Due to temporary vascular instability. |
|
Definition
|
|
Term
| multiple cafe au lait spots with smooth borders can indicate what disease? |
|
Definition
|
|
Term
| sebum and desquamated epithelial cells, a white cheesy material. Can cover the whole body at birth |
|
Definition
|
|
Term
| white papules without erythema, found on nose, chin, and forehead |
|
Definition
|
|
Term
| scattered vesicles on an erythematous base, usually on face and trunk from sweat gland duc obstruction |
|
Definition
|
|
Term
| erythema mcaules with central pin-point vesicles. appear like flea bites on 2nd-3rd day, disappear after 1 week. |
|
Definition
|
|
Term
| small vesiculopustules over a brown mascular base can last several months. MC in black infants. |
|
Definition
|
|
Term
| flat, irregular, light pink patches, common on the nape of the neck, upper lip, forehead, and upper eyelid. |
|
Definition
Nevus Simplex, Salmon Patch.
neck = stork bite
upper eyelid = Angel kisses |
|
|
Term
| what do black dots in the red reflex indiate? white reflex? |
|
Definition
black dots = cataract
white reflex = retinoblastoma |
|
|
Term
| what diseases are microstomia common in? |
|
Definition
|
|
Term
| what is macrostomia associated with? |
|
Definition
|
|
Term
| what type of mouth is associated with fetal alcohol syndrome? |
|
Definition
|
|
Term
white bumps found in the mouth?
blue/white bumps found in the mouth? |
|
Definition
white = Epstein Pearls
blue/white = Ranulas |
|
|
Term
| what diseases is macroglossia associated with? |
|
Definition
| hypothyroid, mucopolysaccharidosis |
|
|
Term
| when do the anterior and posterior fontanelles close? |
|
Definition
anterior = 4-6cm, closes @ 4-26m
posterior = 1-2cm, closes @ 2m |
|
|
Term
| localized subcutaneous edema over occipitoparietal region, cause by the vacuum effects of teh rupture of the amniotic sac |
|
Definition
|
|
Term
| localized swelling due to subperiosteal hemorrhage, doesn't cross the suture lines, heals in 3 weeks |
|
Definition
|
|
Term
| assymmetry of the skull caused by a child lying on one side, resolves when the child becomes more active |
|
Definition
|
|
Term
| percussion of the skull produces a "cracked pot" sound, normal in infants prior to sutures closing |
|
Definition
|
|
Term
| what is normal cephalic transillumination? |
|
Definition
frontoparietal = 2cm
occipital = 1cm |
|
|
Term
| what syndromes are associated with micrognathia? |
|
Definition
| Pierre-Robin syndrome, Treacher-Collins syndrome, Hallerman Strieff syndrome |
|
|
Term
| what is the most common neck mass? |
|
Definition
|
|
Term
| what should you suspect with polyhydramnios? |
|
Definition
| tracheo-esophageal fistula (TEF) |
|
|
Term
| when might strabismus indicate ocular weakness? |
|
Definition
|
|
Term
| what is the progression of the blink reflex? |
|
Definition
birth = blinks
1m = fixes on object
1 1/2 - 2 m = coordinated eye movement
3m = eyes converge and baby reaches
12m = acuity of 20/50 |
|
|
Term
| small, deformed or low set ears may be associated with what? |
|
Definition
|
|
Term
| how do you assess newborn hearing? |
|
Definition
|
|
Term
| white coating in the mouth that doesn't scrape away? |
|
Definition
|
|
Term
| cessation of breathing > 20 sec |
|
Definition
|
|
Term
| paradoxical breathing in which the abdomen moves outward while chest moves inward |
|
Definition
|
|
Term
| where do inspiratory sounds come from? expiratory? |
|
Definition
inspiratory = intrathroacic
expiratory = extrathoracic (trachea) |
|
|
Term
| common arrhythmias in infants |
|
Definition
|
|
Term
| which is normal S3 or S4? |
|
Definition
S3 is common and normal.
S4 is uncommon and abnormal. |
|
|
Term
| which abdominal mass has a covering, omphalocele or gastroschisis? |
|
Definition
| omphalocele has a covering |
|
|
Term
| where is the liver palpable in a newborn? |
|
Definition
| 2cm below R costal margin |
|
|
Term
| why is the newborn abdomen normally protuberant? |
|
Definition
|
|
Term
| how many arteries and veins in the umbilical cord? |
|
Definition
| 2 thick walled arteries, 1 larger vein. |
|
|
Term
| when does the newborn umbilicus fall over? |
|
Definition
| the amniotic portion dries and falls off within 2 weeks. |
|
|
Term
| granulation tissue formed at the base of the umbilicus during healing |
|
Definition
|
|
Term
| normal size of newborn kidney |
|
Definition
|
|
Term
| normal teste size in a newborn |
|
Definition
|
|
Term
|
Definition
| cryptorchidism, 2/3 descend by 1 year. |
|
|
Term
| children less than how old should have a parent in the room during the exam? |
|
Definition
|
|
Term
| what are brushfield spots associated with? |
|
Definition
|
|
Term
| what should you r/o in a child < 3 yo with a fever and appearing ill |
|
Definition
|
|
Term
| Normal HR: 1-2yo, 2-6yo, 6-10yo |
|
Definition
1-2 = 70-150
2-6 = 68-138
6-10 = 65-125 |
|
|
Term
| definition of bradycardia < 3 yo, 3-9 yo |
|
Definition
<3 = < 100bpm
3-9 = < 60 bpm |
|
|
Term
| respiratory rate in childhood |
|
Definition
early = 20-40. tachypnea > 40
late = 15-25.
Adult rate by 15 yo |
|
|
Term
| what is the BP difference when taken on the thigh vs arm? |
|
Definition
| thigh = 10mm higher than arm |
|
|
Term
| probable cause of transient HTN? sustanted HTN? |
|
Definition
transient = meds
sustained = renal parenchyma or artery disease, primary HTN, coarctation of the aorta |
|
|
Term
|
Definition
underweight < 5%
at risk over weight > 85%
overweight > 95% |
|
|
Term
| when does it become possible to measure the visual acuity of a child? What is it's progression? |
|
Definition
3 yo = 20/40
4 yo = 20/30
5 yo = 20/20 |
|
|
Term
| by what age is it best to correct amblyopia? |
|
Definition
|
|
Term
| AAP recommends full scale acoustic screening for kids what age? |
|
Definition
|
|
Term
| what is the speaking decibel range? |
|
Definition
|
|
Term
|
Definition
normal 0-20dB
mild loss 21-40dB
moderate loss 41-60dB
severe loss 61-90dM
profound loss > 90dB |
|
|
Term
| pale, boggy nasal membranes are associated with |
|
Definition
| perenniel allergic rhinitis |
|
|
Term
| unilateral nasal discharge associated with a foul smell |
|
Definition
|
|
Term
| when are the sinuses visible by xray? |
|
Definition
maxillary = 4yo
sphenoid = 6 yo
frontal = 7yo |
|
|
Term
| hypernasal speech is associated with what? |
|
Definition
|
|
Term
| nasal voice plus snoring is associated with what? |
|
Definition
|
|
Term
| hoarse voice plus cough is associated with? |
|
Definition
|
|
Term
| pt sounds like they have rocks in their mouth, what is this associated with? |
|
Definition
|
|
Term
| what are posterior cervical nodes associated with? |
|
Definition
|
|
Term
| prolonged expiratory phase and expiratory breathing is associated with? |
|
Definition
|
|
Term
| prologed inspiration is associated with? |
|
Definition
|
|
Term
| where is the heart located in early childhood? |
|
Definition
|
|
Term
| where is the PMI less than 7yo? greater than 7yo? |
|
Definition
< 7yo = L 4th interspace
> 7 yo = L 5th interspace
< 4yo = L of MCL
4-6 yo = at MCL
> 7 yo = R of MCL |
|
|
Term
|
Definition
S1>S2 @ apex
S2>S1 @ pulmonic area |
|
|
Term
| where are innocent murmurs loudest? |
|
Definition
|
|
Term
| continuous murmur, loudest wtih diastole, low pitch, heard at 1st and 2nd interspace |
|
Definition
|
|
Term
| what types of murmurs are associated with pallor, cyanosis, poor growth, SOB, and squatting? |
|
Definition
|
|
Term
| prior to age 3 organic murmurs are though to be? after age 3? |
|
Definition
before age 3 = congenital
after age 3 = rheumatic valvulitis |
|
|
Term
| when do umbilical hernias usually resolve? |
|
Definition
|
|
Term
| what is considered precocious puberty? |
|
Definition
|
|
Term
| vulvular erythema may be from? |
|
Definition
|
|
Term
| fusion of the minora should occur when? |
|
Definition
|
|
Term
| how can you reduce the cremasteric reflex in order to do a testicular exam? |
|
Definition
| have to pt cross their legs |
|
|
Term
| cryptorchidism causes an increased risk of what? |
|
Definition
| testicular cancer and infertility |
|
|
Term
| when is genu varum common? |
|
Definition
|
|
Term
| what is the best predictor of future intellect? |
|
Definition
|
|
Term
| what are the symptoms of head injury? |
|
Definition
| lethargy, irritability, persistent unexplained vomiting, apnea, coma, convulsion |
|
|
Term
| children do bruise accidentally but rarely before when? |
|
Definition
|
|
Term
| superficial yellow crusted lesion with satelitte lesions |
|
Definition
|
|
Term
| what is the healthiest period of life? |
|
Definition
|
|
Term
| what is the leading causes of death for adolescents? |
|
Definition
| MVA, suicide, and homicide |
|
|
Term
| normal adolescent vital signs |
|
Definition
HR 10-14yo = 85
HR > 15yo = 60-85
RR varies from 12-18 breaths/min
skin - pubertal changes like acne, areolar pigmentation, apocrine sweat glands, axillary/genital hair. |
|
|
Term
| what is considered "normal" pubertal timing? |
|
Definition
|
|
Term
| when does puberty normally begin in girls? boys? what about end? |
|
Definition
girls, begins at 10yo, ends at 14yo
boys, begins at 11yo, ends at 16yo |
|
|
Term
| how long does puberty normally last? |
|
Definition
|
|
Term
| at what Tanner stage does menarche normally begin? |
|
Definition
|
|
Term
| when does acne begin? what's the difference between white and black heads? |
|
Definition
| begins at 10yo. white = close, black = open |
|
|
Term
| what happens to the eyes during puberty? |
|
Definition
| the eyeball lengthens (myopia) |
|
|
Term
|
Definition
|
|
Term
| what are the indications for a pelvic exam in an adolescent? |
|
Definition
| sexual activity, abnormal discharge, menstrual/anatomic abnormalities, pelvic pain |
|
|
Term
|
Definition
|
|
Term
| what is the MCC of delayed puberty? |
|
Definition
| anorexia nervosa, chronic disease |
|
|
Term
| what can delay the onset of menarche specifically? |
|
Definition
|
|
Term
| difference between phimosis and paraphimosis? |
|
Definition
phimosis - unable to retract the foreskin.
paraphimosis - foreskin stuck retracted, unable to replace over the glans. |
|
|
Term
| enlarged femoral lymph nodes that are non-tender are often associated with? |
|
Definition
|
|
Term
| unilaterally enlarged and tender femoral lymph nodes are often associated with? |
|
Definition
|
|
Term
| how do you differientiate a femoral vs inguinal hernia? |
|
Definition
above the inguinal ligament - inguinal
below inguinal ligament - femoral |
|
|
Term
what preiod of adolescence?
rapid growth of sex characteristics, body/self image fluctuance, preoccupied with physical changes, short stature in boys, breast development in girls, alligience shifts to peers, think concretely. |
|
Definition
| early adolescence (10-13yo) |
|
|
Term
what stage of adolescence?
more comfy with body, intense emotional and mood swings, starts thinking abstractly (self centered, "it won't happen to me"), peers determine standards for behavior/fashion |
|
Definition
| middle adolescence (14-16yo) |
|
|
Term
what stage of adolescence?
less self centered, shift from peer group to individuals, dating becomes more intimate, think more realistically, period of idealism with rigid concepts of right and wrong |
|
Definition
| late adolescence (17yo +) |
|
|
Term
|
Definition
|
|
Term
| this drug temporarily inhibits the release of dopamine in the brain --> remarkable hypotonia. Cant be detected in urine 4-5 hrs after IV injection. decreases heart and respiratory rate. |
|
Definition
|
|
Term
| this drug works like heroin and is an analogue of methamphetamine |
|
Definition
|
|
Term
| know the million causes of fatigue listed |
|
Definition
| categories = physiologic, CV, pulm, hematologic, infectious, neuro, endo + metabolic, psychiatric, neoplastic, inflammatory, trauma, miscellaneous |
|
|
Term
| tired feeling and sense of weariness that may or may not be related to or worsened by task performance. |
|
Definition
|
|
Term
| feeling that consists of listlessness and langour, a desire to sit and dream, perhaps even laziness or mental inertia. |
|
Definition
|
|
Term
| feeling of not being well, out of sorts |
|
Definition
|
|
Term
| lack of motor strength and a decreased ability to perform certain physical tasks - can be generalized or localized |
|
Definition
|
|
Term
| acute fatigue is categorized as how long? and may follow what? |
|
Definition
| < 1 m and may follow an infection |
|
|
Term
| how can you differentiate organic and psych fatigue? |
|
Definition
organic = less severe on awakening, worsens during the day, is continuous and progressive.
psych - equally present, not relieved by rest, intermittent/remitent over time, may improve on weekends/vacation. |
|
|
Term
| how long is chronic fatigue present, what is it associated with? |
|
Definition
| >1m, associated with medical, psych, CFS, and fibromyalgia |
|
|
Term
| what meds can be associated with fatigue? |
|
Definition
| antihistamines, sedatives, hypnotics, psychotropics, some antihypertensives (BB), methyldopa |
|
|
Term
| know diagnostic criteria for CFS |
|
Definition
|
|
Term
| clinically apparent increase in the interstitial fluid volume which may expand by several liters before the abnormality is evident. can be generalized or localized. |
|
Definition
|
|
Term
| accumulation of excess fluid in the peritoneal cavity |
|
Definition
|
|
Term
| accumulation of excess fluid in the pleural cavity |
|
Definition
|
|
Term
|
Definition
|
|
Term
| proteinuria > 3.5g/dL, hypoalbuminemia < 2g/dL, +/- hypercholesterolemia |
|
Definition
|
|
Term
| hematuria, proteinuria, HTN |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| salt restriction, avoid prolonged sitting, avoid restrictive leg garmets, treat with propranalol/captopril |
|
|
Term
| what should you consider with chronic leg edema that is unilateral and painful? |
|
Definition
|
|
Term
| how should you treat low risk unexplained weight loss? |
|
Definition
| observe for 1m, give nutritional advice, have pt keep food diary to follow up. |
|
|
Term
| lab studies for decreased food intake |
|
Definition
| CBC with diff, CMP, serum drug levels (digitalis specifically), EGD, GI series, HIV test |
|
|
Term
| labs to test for impaited nutritional absorption |
|
Definition
| stool = mircoscopic and guiac, qualitative 72 hr stool sample, fecal fat, serum caratolene, D-xylose test, secretin stimulation test, small bowel biopsy, stool O&P |
|
|
Term
| labs for incraesed nutritional demand |
|
Definition
| TSH, AFB, CMV, occult malignancy |
|
|
Term
| preferred time from injury to definitive care |
|
Definition
| 1 hr - termed the "golden hour" |
|
|
Term
| what is the platinum half hour? |
|
Definition
| the time remaining of the "golden hour" once the pt arrives at the ED |
|
|
Term
| what is the purpose of the primary survey? secondary survey? |
|
Definition
primary = completed in less than 30 secs, ABCDE, find immediately life threating injuries.
secondary survey = find injuries that could BECOME life threatening |
|
|
Term
| what is the order to control bleeding? |
|
Definition
| direct pressure, pressure point, elevation, tourniquet |
|
|
Term
| what is the best predictor of trauma outcome? |
|
Definition
|
|
Term
| implications of different GCS scores |
|
Definition
13-15 = mild disability
9-12 = moderate disability
3-8 = severe disability
< 8 = intubate |
|
|
Term
| all pts with head or maxillofacial trauma should be assumed to have what? |
|
Definition
| c-spine injury until positively excluded. Absence of neuro defecit doesn't preclude a c-spine injury. |
|
|
Term
| what are the parts of a secondary survey? |
|
Definition
| rapid interveiw (AMPLE), recheck vitals, focused physical exam, radiographs, determination of the mechanism of injury = critical! |
|
|
Term
| fracture of the atlas from axial loading |
|
Definition
|
|
Term
| fracture from anterior displacement of C2 over C3, cause = severe hyperextension |
|
Definition
Hangman's fx (traumatic spondylolisthesis).
MOI = judicial hanging or MVA |
|
|
Term
| MOI in a clay shoveler's or tear drop fx |
|
Definition
|
|
Term
| what does dull chest percussion signify? hyperresonant? |
|
Definition
dull = hemothorax
hyperresonant = tension pneumo |
|
|
Term
| MC injured organ from blunt trauma |
|
Definition
|
|
Term
|
Definition
| 2 breaths first. ratio = 30:2, 1 finger compressions for infants, 2 fingers for children |
|
|
Term
| modified GCS <4 yo for verbal |
|
Definition
5 = appropriate words, social smile, fixes and follows.
4 = cries but consolable.
3 = persistently irritable.
2 = restless, agitated.
1 = none |
|
|
Term
| hallmarks of respiratory distress |
|
Definition
| tachypnea, nasal flaring, retraction, stridor, cyanosis, head bobbing, prolonged expiration, grunting |
|
|
Term
|
Definition
| croup, epiglottitis, foreign body, bacterial tracheitis |
|
|
Term
|
Definition
| asthma, pneumonia, bronchiolitis, foreign body |
|
|
Term
| peak age for foreign body airway obstruction |
|
Definition
|
|
Term
| treatment for foreign body airway obstruction in children (young) |
|
Definition
| 5 back blows alternated with 5 chest compressions repeated 5 times |
|
|
Term
|
Definition
|
|
Term
|
Definition
| orthostasis = SBP < 80, tachycardia > 130bpm |
|
|
Term
| when are febrile seizures common? |
|
Definition
|
|
Term
| know the Lund and Brower chart for pediatric burns |
|
Definition
|
|
Term
| when should you hospitalize burns? |
|
Definition
adults with 2nd degree or greater > 15%
children with 2nd degree or graeter > 10% |
|
|
Term
| classic symptoms = myalgia, weakness, darkened urine |
|
Definition
|
|
Term
| defintiive testing for rhabdo |
|
Definition
Creatine kinase (CK) testing is definitive.
Elevated or 2-3x above normal pt may have rhabdo.
If elevated 100x above normal rhabdo is very likely.
Urinalysis shows hemoglobin or myoglobin |
|
|
Term
|
Definition
| hydration, diuretics (help flush the kidneys), bicarb (prevent myoglobin breakdown in kidneys), renal dialysis |
|
|
Term
| MS exam of infants focuses on |
|
Definition
| detection of any congenital abnormalities particularly of the hands, spine, hips, legs, and feet. |
|
|
Term
| what does an audible click during ortalani and barlow mean? what does hip dysplasia sound like? |
|
Definition
audible click doesn't necessarily mean dislocation.
Hip dysplasia = audible clunk |
|
|
Term
| when does genu varum resolve? |
|
Definition
|
|
Term
| adduction of the forefoot without inversion |
|
Definition
| metatarsus adductus = normal. |
|
|
Term
| what should you do if you suspect abnormalities of the nervous system? |
|
Definition
| inspect CN function, sensory function, and less common primitive reflexes |
|
|
Term
| when doing the neuro exam persistent irritability suggests |
|
Definition
| neuro insult, metabolic, infectious, or constitutional abnormalities, or drug withdrawal |
|
|
Term
| what reflex is important to assess why? |
|
Definition
| anal reflex, loss of reflex = spinal cord abnormalities |
|
|
Term
| ankle clonus up to 10 beats may be normal, what does sustained clonus mean? |
|
Definition
| could indicate CNS disease |
|
|
Term
| babinski reflex is normal up to what age? |
|
Definition
|
|
Term
| stranger anxiety is normal at what age? |
|
Definition
|
|
Term
| muchal rigidity is a reliable indicator of what? |
|
Definition
|
|
Term
| what indicates a + Trendelenberg sign? |
|
Definition
| when standing on the affected side, the hip will displace toward the unaffected side, indicating gluteus medius weakness on the opposite side from the hip tilt. |
|
|
