Caq Pediatrics Flash Cards - Health Maintenance Section Caq Pediatrics For Physician Assistant

Front 1

This is when a child's birth weight and height are initially normal, but drop off proportionately during the first 2 years of life.

Back 1

Constitutional Growth Delay

Front 2

In regards to growth, this is relatively spared compared to height and weight.

Back 2

Head Circumference

Front 3

With this, weight, height, and head circumference are all significantly below the norms

Back 3

Intrauterine insult/genetic abnormality

Front 4

With this, head circumference frequently is spared, while height and weight are severely affected. This growth pattern may also be seen in genetic short stature and constitutional growth delay.

Back 4

Structural dystrophies/endocrine etiologies

Front 5

With this, head circumference and height are spared, but significant weight loss occurs. Over time, with persistent undernutrition, height, and eventually head circumference, also will fail to sustain expected growth.

Back 5

Caloric insufficiency

Front 6

Birth weight is regained by?

Back 6

day 10-14 of life

Front 7

Birth weight doubles by?

Back 7

4 months

Front 8

Birth weight triples by?

Back 8

12 months

Front 9

Birth weight quadruples by?

Back 9

24 months

Front 10

After age 2, normal weight gain is ?

Back 10

5lbs/year until adolescence

Front 11

Birth length increases by ? at 1 year.

Back 11

50%

Front 12

Birth length doubles by what age?

Back 12

4 years old

Front 13

Birth length triples by what age?

Back 13

13 years old

Front 14

After age 2, average height increases by how much until adolescence?

Back 14

2"/year

Front 15

When does the largest rate of growth occur for the head?

Back 15

Between 0 and 2 months, 0.5cm/week.

Front 16

This is a disruption of growth characterized by weight loss or failure to achieve expected body weight, or failure to grow in length/height and head circumference.

Back 16

Failure to thrive

Front 17

An identifiable organic (i.e., medically treatable) etiology is not found in the majority of children with?

Back 17

Failure to thrive

Front 18

If a pt has one point on the growth curve, what will it show if it represents failure to thrive?

Back 18

weight < 3rd percentile
weight for height < 5th percentile
weight 20% or more below ideal weight for height

Front 19

If a pt has a series of points on the growth curve, what will it show if it represents failure to thrive?

Back 19

Weight gain < 20 grams/day from 0 to 3 months of age
Weight gain < 15 grams/day from 3 to 6 months of age
Downward crossing of > 2 major percentiles

Front 20

Gastrointestinal causes of excessive caloric losses include? (5 things)

Back 20

1. Malabsorption associated with small or large intestinal disorders
2. Pancreatic disease
3. Infection
4. Anatomic defects (short gut syndrome, blind loop syndrome)
5. Severe liver disease with impaired bile metabolism

Front 21

Renal causes of excessive caloric losses? (4 things)

Back 21

1. Renal tubular acidosis
2. Renal dysplasia or other structural anomaly
3. Nephrogenic diabetes insipidus
4. Chronic renal failure

Front 22

What are the main causes of increased caloric requirements? (4 things)

Back 22

1. Cardiopulmonary disorders (e.g., CHF)
2. Malignancies
3. Hyperthyroidism
4. Chronic or recurrent infections (e.g., HIV, primary immunodeficiencies)

Front 23

Head circumference two standard deviations above the mean?

Back 23

Macrocephaly

Front 24

Head circumference two standard deviations below the mean?

Back 24

Microcephaly

Front 25

In preterm infants, ? should be used when plotting the head circumference.

Back 25

gestational age

Front 26

This group is at increased risk of hydrocephalus.

Back 26

premature infants

Front 27

What is the diagnostic test of choice for macrocephaly in a premature infant?

Back 27

Cranial ultrasound

Front 28

Normally, the head grows ? per month for the first year, with the most rapid growth occurring in the first ?

Back 28

1cm per month

6 months

Front 29

Brain weight doubles by ?

Back 29

6 months

Front 30

Brain weight triples by ?

Back 30

1 year of age

Front 31

The majority of head growth occurs by ?

Back 31

4 years of age

Front 32

Microcephaly is best evaluated by?

Back 32

CT or MRI

Front 33

This refers to the presence of a genetic or chromosomal condition in which mass and/or structural brain growth is reduced?

Back 33

Primary microcephaly

Front 34

This may result from prenatal or postnatal infections (e.g., CMV - characterized by peri-ventricular caclifications; toxoplasmosis - characterized by intracranial calcifications throughout the cortex), exposure to toxins, and CNS injury affecting normal brain development.

Back 34

Secondary microcephaly

Front 35

This determines skull growth?

Back 35

brain growth

Front 36

This presents with both an abnormally shaped skull and palpably thickened suture lines; neither finding is present in conditions in which lack of brain growth causes premature fusion of the cranial bones.

Back 36

Primary craniosynostosis

Front 37

This is most often due to excess CSF (hydrocephalus), excess brain tissue, thickening of the skull, or subdural or epidural bleed?

Back 37

Macrocephaly

Front 38

This is characterized by excess brain tissue due to increased size or number of brain cells. It can be a normal anatomic variant, but is frequently associated with specific syndromes (neurofibromatosis Type 1, Beckwith Wiedemann syndrome, Noonan syndrome, fragile X syndrome), or metabolic disorders.

Back 38

Megalencephaly

Front 39

An infant with this generally presents at birth, whereas those with a metabolic disorder have a normal head size at birth that enlarges during infancy.

Back 39

Anatomic megalencephaly

Front 40

This is asymmetric growth of the head.

Back 40

Plagiocephaly

Front 41

A significant increase in the prevalence of deformational flattening of the skull has resulted from?

Back 41

The recommendation that sleeping infants be placed on their backs to reduce SIDS

Front 42

Most sutures are closed by ?, and ossify by ?, fusion is complete by ?

Back 42

1. 12-24 months
2. 8 years old
3. Early adulthood

Front 43

When is the MORO reflex absent?

Back 43

3-4 months

Front 44

When is the palmar grasp absent?

Back 44

2-3 months

Front 45

When does the parachute reflex show?

Back 45

Present by 6-9 months

Front 46

At what age does a child life their head momentarily?

Back 46

1 month

Front 47

At what age does a child lift their head up to 45 degrees, can lift head off table?

Back 47

2 months

Front 48

At what age does a child lift their head up to 90 degrees, and can lift their chest?

Back 48

4 months

Front 49

When does a child show head lag?

Back 49

As a newborn

Front 50

When does a child exhibit no head lag?

Back 50

At four months

Front 51

When does a child lift their head off a table in anticipation of being lifted?

Back 51

6 months

Front 52

At what age does a child roll front to back

Back 52

4-5 months

Front 53

At what age does a child roll back to front

Back 53

5-6 months

Front 54

At what age does a child sit with support

Back 54

6 months

Front 55

At what age does a child sit with no support

Back 55

7 months

Front 56

At what age does a child show involuntary grasp

Back 56

Newborn

Front 57

At what age does a child show grasp reflex disappearing, bringing hand to midline

Back 57

2 months

Front 58

At what age does a child show voluntary grasp (no release)

Back 58

4-5 months

Front 59

At what age does a child show ability of raking objects, transferring objects between hands?

Back 59

6 months

Front 60

At what age does a child use thumb to grasp cube

Back 60

6-8 months

Front 61

At what age does a child show a "mature" cube grasp (fingertip and distal thumb)

Back 61

10-12 months

Front 62

At what age does a child play "pat-a-cake"?

Back 62

9-10 months

Front 63

At what age does a child build a tower of 2 cubes

Back 63

13-15 months

Front 64

At what age does a child scribble

Back 64

15 months

Front 65

At what age does a child draw vertical lines

Back 65

18 months

Front 66

At what age does a child build a tower of four cubes

Back 66

18 months

Front 67

At what age does a child use a cup well

Back 67

15-18 months

Front 68

At what age does a child use a spoon well

Back 68

2 years

Front 69

At what age does a child manage large buttons

Back 69

3 years

Front 70

At what age does a child use a fork

Back 70

4 years

Front 71

At what age does a child tie shoes

Back 71

6 years

Front 72

At what age does a child stack six blocks?, 8 blocks?, 3 block bridge?, and a 5 block gate?

Back 72

1. 24 months
2. 30 months
3. 3 years
4. 4 years

Front 73

At what age does a child pull to stand

Back 73

9 months

Front 74

At what age does a child walk holding onto furniture

Back 74

11 months

Front 75

At what age does a child walk without help

Back 75

13 months

Front 76

At what age does a child walk well

Back 76

15 months

Front 77

At what age does a child run well

Back 77

2 years

Front 78

At what age does a child go up and down stairs two feet on each step

Back 78

2 years

Front 79

At what age does a child go up and down stairs one foot per step each way

Back 79

4 years

Front 80

At what age does a child jump off of the ground with 2 feet up?

Back 80

2.5 years

Front 81

At what age does a child hop on 1 foot?

Back 81

4 years

Front 82

At what age does a child skip?

Back 82

5-6 years

Front 83

At what age does a child balance on one foot for 2-3 seconds?

Back 83

3 years

Front 84

At what age does a child balance on one foot 6-10 seconds

Back 84

4 years

Front 85

At what age does a child show a social smile

Back 85

1-2 months

Front 86

At what age does a child smile at a mirror

Back 86

4 months

Front 87

At what age does a child show separation anxiety

Back 87

6-12 months

Front 88

At what age does a child wave bye bye

Back 88

10 months

Front 89

At what age does a child show or offer a toy to an adult

Back 89

11 months

Front 90

At what age does a child dress themselves

Back 90

3 years

Front 91

At what age does a child tie shoe laces

Back 91

5 years

Front 92

At what age does a child show symbolic play

Back 92

12 months

Front 93

At what age does a child show parallel play; empathy

Back 93

24 months

Front 94

At what age does a child show fantasy play

Back 94

36 months

Front 95

At what age does a child show cooperative play

Back 95

3-4 years

Front 96

At what age does a child show they can tell fantasy from reality?

Back 96

5 years

Front 97

At what age does a child show they can play a game with rules?

Back 97

6 years

Front 98

At what age does a child Coo

Back 98

2-4 months

Front 99

At what age does a child squeal?

Back 99

4 months

Front 100

At what age does a child babble?

Back 100

6 months

Front 101

At what age does a child say Mama/Dada: non-specifically, polysyllabic babbling

Back 101

9 months

Front 102

At what age does a child speak first words of mama/dada specifically

Back 102

9-12 months

Front 103

At what age does a child understand 1 step commands

Back 103

15 months

Front 104

At what age does a child use > 5 words; follows simple commands; can identify 4 body parts

Back 104

18 months

Front 105

At what age does a child have a vocabulary of 10-50 words

Back 105

13-18 months

Front 106

At what age does a child use two word sentences

Back 106

18-24 months

Front 107

At what age does a child have 100-200 words in vocabulary; speech 50% understood; uses personal pronouns; identifies six body parts

Back 107

24 months

Front 108

At what age does a child understand prepositions

Back 108

30 months

Front 109

At what age does a child Speak in 3-4 word sentences; knows hundreds of wors; speech is 75% understood; can use plurals; can identify 2 colors; what/who questions?

Back 109

36 months

Front 110

At what age does a child show speech 100% understood; speaks in paragraphs; uses past/present tense; identifies gender, identifies 5-6 colors; uses "why" questions?

Back 110

4 years old

Front 111

At what age does a child show operational thinking?

Back 111

6 years old

Front 112

For screening purposes, obtain a blood sample from newborns ? and never after ?

Back 112

1. before hospital discharge
2. Never after seven days of age

Front 113

Obtain blood for screening for PKU when?

Back 113

In the first 24-48 hours of life

Front 114

When should the red reflex be documented and why?

Back 114

It should be documented at birth, absence of a red reflex may be caused by a congenital cataract.

Front 115

By what time should an infant be able to track across midline and smile to a smiling face?

Back 115

Two months

Front 116

By what time should a child be able to track an object to 180 degrees and have a conjugate gaze?

Back 116

Four months

Front 117

A toddler/preschooler should be evaluated for what, in regards to their vision/occulomotor function?

Back 117

They should have a cover/uncover test with each eye while looking ahead at an object 10 feet away. This is to see if pt has ocular misalignment (strabismus),

Front 118

At what age should you do a Random Dot E Test, which will show up to 20% of children having a refractive error, usually myopia (nearsightedness)

Back 118

3-5 years of age

Front 119

At all ages, you should refer a child with a difference of what acuity (on eye chart) between left and right eyes.

Back 119

> 1 line in acuity between left and right eyes.

Front 120

The American Academy of Pediatrics recommends universal hearing screening of infants when?

Back 120

Before leaving a birthing hospital with the goal of 100% screening of all infants by age 3 months.

Front 121

What are the two tests used for hearing screening?

Back 121

The auditory brainstem response, or the otoacoustic emissions analysis.

Front 122

The goal of the hearing tests is designed to identify hearing loss of ? in the 500Hz to 4,000 Hz range (the range of most human speech).

Back 122

Hearing loss of 35dB or greater

Front 123

Hearing screening should be done in what other instances (apart from regularly

Back 123

1. If a pt is on ototoxic medications (gentamicin), or chemotherapy.

2. Confirmed history of infectious diseases, such as congenital CMV, HSV, rubella, toxoplasmosis, syphilis, or neonatal mumps/measles.

Front 124

Overweight is defined as having a body mass index between?

Back 124

Between the 85th and 95th percentiles.

Front 125

Obesity is defined as?

Back 125

A BMI > 95th percentile caused by excess body fat.

Front 126

What two ethnicities/genders, have the highest rates of obesity?

Back 126

African-American adolescent girls, and Mexican-American boys between the ages of 6 and 12 years have the highest rate of obesity compared to other ethnic groups

Front 127

What are the three prenatal factors associated with an increased risk of obesity?

Back 127

1. Weight grain during pregnancy

2. High birth weight

3. Gestational Diabetes

Front 128

At what age, should yearly blood pressure screening begin for children?

Back 128

Three years of age

Front 129

Hypertension is defined as?

Back 129

Blood pressure > 95th percentile for sex, age, and height on at least three occasions over a period of days to weeks.

Front 130

Cholesterol screening (non-fasting) is now recommended at least once between what ages, and then again between what ages?

Back 130

1. 9 and 11 years old

2. 17 and 21 years old

Front 131

When should you check cholesterol of a pt between 2-8 years, and 12-16 years?

Back 131

If pt has a family hx of myocardial infarction, angina, stroke, or cardiovascular surgery (<55 years in males; <65 years in females), or a parent with a total cholesterol > 240mg/dL or known dyslipidemia.

Front 132

The AAP/Bright Futures guidelines recommend hematocrit/hemoglobin testing in children at what age for iron deficiency screening?

Back 132

9-12 months

Front 133

Which is more accurate when screening for lead poisoning and iron deficiency, capillary or venous sampling?

Back 133

Venous sampling

Front 134

All asymptomatic, sexually active females and males should be screened annually using nucleic acid amplification tests (NAATs) on urine specimens to screen for what two things?

Back 134

Gonorrhea and Chlamydia

Front 135

The AAP recommends universal screening for autism with an autism specific tool (e.g., M-CHAT) at the ? visit, and a repeat specific screening at the ? visit, or whenever parental concerns are raised.

Back 135

1. 18 month visit

2. 24 month visit

Front 136

Key features of this include impairment in reciprocal social interactions, qualitative impairment in communication, and restrictive, repetitive stereotypical behaviors, interests, and other activities.

Back 136

Autism

Front 137

The following are early signs of what?
1. Absence of social smile at 6 months, limited eye contact
2. Absence of babbling, pointing or using other gestures by 12 months
3. Not using single words by 16 months or 2 word phrases by 24 months or stereotypic language
4. Lack of make believe or symbolic play
5. Failure to develop age-appropriate peer relationships
6. Lack of social emotional reciprocity
7. Restrictive interests, inflexible routines, preoccupation with parts or objects

Back 137

Early signs of autism

Front 138

When should a child be seen by a dentist?

Back 138

Children with risk factors for caries should be seen by a dentist as early as 6 months of age and no later than 6 months after the 1st tooth erupts or 12 months of age (whichever comes first).

Front 139

What is the latest a child should see a dentist?

Back 139

36 months

Front 140

According to AAP when should you start to discuss sex/drugs with pt's at well child visits?

Back 140

Age 10

Front 141

The AAP strongly supports this as the preferred method of feeding for all infants, including those born prematurely, for a minimum of 4, but preferably 6 months.

Back 141

Breast Feeding

Front 142

These formulas are nutritionally equivalent to cow's milk formulas, and are recommended for infants with clinically significant lactose intolerance.

Back 142

Soy-protein formulas.

Front 143

This is recommended by the AAP, for exclusively and partially breastfed infants beginning in the first few days of life.

Back 143

Vitamin D supplementation

Front 144

Vitamin B12 deficiency is common in what patients?

Back 144

Breastfed infants, whose mothers are strict vegetarians, and those infants that are fed goat's milk

Front 145

Iron fortified formulas are recommended when?

Back 145

When infant is not breastfeeding

Front 146

Full term, healthy breastfed babies should receive daily supplementation of what? at 4-6 months of age.

Back 146

Iron supplementation

Front 147

What can happen if you introduce cow's milk prior to 12 months of age?

Back 147

It can result in occult GI blood loss and worsening of iron deficiency.

Front 148

TRUE or FALSE?

No child less than six months of age should receive fluoride supplementation.

Back 148

True

Front 149

If fluoride is not sufficient in the water supply, begin supplements at what age?

Back 149

six months

Front 150

Children should avoid taking too much fluoride in their diets, or when using toothpaste due to what?

Back 150

Fluorosis, a cosmetically disfiguring condition

Front 151

At what age are most infants ready to proceed to solid foods?

Back 151

4-6 months

Front 152

By what age are most infants using a spoon and a cup?

Back 152

6-9 months

Front 153

Babies are usually competent with spoon and cup by what age?

Back 153

15-18 months

Front 154

Finger foods become popular at what age?

Back 154

7-9 months

Front 155

What food should avoided due to risk of aspiration?

Back 155

Raw carrots
large pieces of raw apple
whole or coin shaped pieces of hot dog
whole grapes
large cookies
peanuts
popcorn
hard candy

Front 156

When do primary teeth start to form?

Back 156

in utero

Front 157

When do permanent teeth start to form?

Back 157

shortly after birth

Front 158

Newborns sleep how long a day?

Back 158

12-16 hours/day

Front 159

6-15 month old sleep schedule?

Back 159

Usually 10-12 hours at night with 2 nap periods during the day

Front 160

After fifteen months of age, what is the sleep schedule like?

Back 160

Naps decrease to 1/day; by four years of age, the naps completely disappear

Front 161

How do experts recommend infants be put to bed?

Back 161

Allow infants to fall asleep on their own and in their own cribs.

Front 162

This is defined as excessive, unexplained paroxysms of crying in an otherwise well-nourished, normal infant lasting > 3 hours a day and occurring > 3 days a week for at least 3 weeks; 30-50% of infants have this.

Back 162

Colic

Front 163

The only vaccine currently recommended at birth?

Back 163

Hepatitis B

Front 164

When is the second dose of Hepatitis B vaccine recommended?

Back 164

1-2 months of age

Front 165

When is the third dose of Hepatitis B vaccine recommended?

Back 165

At least four months after the first dose, and two months after the second dose.

Front 166

When can hepatitis B immunization be delayed?

Back 166

When the infant is preterm and the mother is HBsAg negative.

Front 167

What vaccines are recommended at two and four months of age?

Back 167

DTap
Hib
IPV
Rotavirus vaccine
PCV13

Front 168

What does DTap stand for?

Back 168

D-diphtheria
T-tetanus
aP-acellular Pertusis

Front 169

What does Hib stand for?

Back 169

Haemophilus influenzae type b conjugate vaccine

Front 170

What does IPV stand for?

Back 170

Inactivated polio virus

Front 171

What does PCV13 stand for?

Back 171

Pneumococcal conjugate - pneumococcal polysaccharies are "conjugated" to nontoxic diphtheria toxin.

Front 172

What vaccinations are recommended at six months?

Back 172

A third dose of DTaP and PCV13, a third dose of IPV can be given anytime between 6-18 months

Front 173

A third dose of IPV can be given anytime between?

Back 173

6-18 months

Front 174

What is Pentacel?

Back 174

A combination vaccine that contains DTaP/Hib/IPV

Front 175

Influenza vaccine is recommended universally for what age pediatric patients?

Back 175

All children 6 months to 18 years of age.

Front 176

What are the two types of influenza vaccine?

Back 176

IIV (inactivated influenza)
LAIV (the live vaccine)

Front 177

LAIV (live influenza vaccine) should not be given to?

Back 177

Children < 2 years of age or to older children who have wheezed in the last 12 months or who are known to have asthma.

Front 178

What is the only vaccine, given before 12 months, that is a living vaccine?

Back 178

Rotovirus

Front 179

By six months of age, a patient should have received what vaccines, and how many doses?

Back 179

Three doses of hepatitis B, 3 doses of DTaP, 3 doses of PCV13, 2 doses of IPV, 2 doses of Hib, and 2 doses of Rotavirus vaccine.

Front 180

What vaccinations are due at 12 months of age?

Back 180

A final Hib, and PCV13 (between 12-15 months), and the initial MMR and Varicella vaccines. Hepatitis A vaccine.

Front 181

What vaccines are due at 15 months of age?

Back 181

A fourth DTaP

Front 182

What vaccines are due at 4-6 years of age?

Back 182

Fifth dose of DTaP, fourth dose of IPV, second dose of MMR, and the first varicella.

Front 183

What vaccine is due at 11-12 years of age?

Back 183

In an effort to boost pertussis immunity, TDaP is recommended at this age. Also, conjugated meningococcal vaccine (MCV4).

Front 184

How is HPV (Human papillomavirus vaccine) given?

Back 184

It is given in a 3 dose series (initial dose, 2 months after the first dose, then six months after the first dose.

Front 185

When is HPV vaccine recommended

Back 185

11-12 years

Front 186

What is the earliest, and the latest you can give HPV vaccine?

Back 186

Can be given as early as nine years old, and as late as 26 years of age.

Front 187

After the administration of TDaP at the age of 11 or 12 years old, when is a Td booster recommended?

Back 187

Every 10 years, unless a dirty wound has occurred.

Front 188

What are the subcutaneous vaccines?

Back 188

MMR, varicella, MMRV, and IPV

Front 189

What vaccines can be given as a nasal spray?

Back 189

LAIV (live attenuated influenzae vaccine)

Front 190

What vaccination is given orally?

Back 190

Rotavirus

Front 191

What four live vaccines are routinely given?

Back 191

MMR, Varicella, Rotavirus, and LAIV

Front 192

Which vaccine is contraindicated when a severely immunocompromised person lives in the household, or the pt is a pregnant woman?

Back 192

LAIV

Front 193

Influenza vaccine, and yellow fever vaccine, can cause an anaphylactic reaction in patients with an allergy to what?

Back 193

eggs

Front 194

The following symptoms are consistent with what?

1. Paroxysmal crying
2. Qualitatively different crying from the baby's normal cry (loud, continuous, high pitched)
3. Hypertonic positioning
4. Inconsolable

Back 194

Colic

Front 195

These are disturbing dreams that occur during REM sleep?

Back 195

Nightmares

Front 196

When do nightmares typically occur?

Back 196

The last third of the night

Front 197

What is the term for the following?

A distinct non-REM parasomnia, an abrupt arousal from stage 3 or 4 slow wave sleep to near arousal. Most occur during midnight to 2:00 AM. The child appears to be awake but is unresponsive, difficult to arouse, unaware of the parent's presence, cries intensely, is often diaphoretic, and appears disoriented.

Back 197

Night terrors

Front 198

What stage of life typically has the following sleep pattern?
Longer sleep duration 16-18 hours per 24 hours
REM sleep occurring at sleep onset
Increases proportion of REM sleep

Back 198

Infants

Front 199

What stage of life typically has the following sleep pattern?
Onset of sleep occurs via non-REM sleep
Non-REM sleep occupies approximately 75% of total sleep time
REM and non-REM sleep alternates throughout the night with a period of 90 to 100 minutes, and a progressive lengthening of the duration of REM sleep periods in the final 1/3 of the night.

Back 199

Children

Front 200

What stage of life typically has the following sleep pattern?
Sleep requirement of about 9 hours
Decrease in slow-wave sleep beginning in puberty and continuing into adulthood
Physiological shift in sleep onset to a later time

Back 200

Adolescents

Front 201

Middle of the night feedings should stop when?

Back 201

By age 4-6 months

Front 202

When should infants be placed in their crib?

Back 202

While drowsy, but not yet asleep

Front 203

This is defined as a lack of airflow through the nose and mouth without accompanying respiratory effort.

Back 203

Central sleep apnea

Front 204

This is defined as a cessation of airflow despite respiratory effort.

Back 204

Obstructive sleep apnea

Front 205

This significantly correlates with an increased incidence of obstructive sleep apnea?

Back 205

Increased weight

Front 206

Signs and symptoms of sleep apnea often overlap with diagnostic criteria for what?

Back 206

ADD ADHD

Front 207

What is the gold standard for sleep apnea diagnosis?

Back 207

Polysomnogram

Front 208

What is included in the recommended treatment plan of sleep apnea?

Back 208

Adenotonsillectomy, obesity prevention/weight loss, CPAP, or BiPAP use, topical nasal steroids, short-term use of topical decongestants, antihistamines, and when indicated, repair of craniofacial anomalies.

Front 209

Deafness is defined as hearing loss > than ?

Back 209

> than 90 dB.

Front 210

What is the most common cause of hearing loss in children?

Back 210

Conductive

Front 211

What are some of the major causes of conductive hearing loss in children?

Back 211

Cerumen impaction and fluid in the middle ear, due either to acute suppurative otitis media or otitis media with effusion.

Front 212

This type of hearing loss is severe, and usually caused by dysfunction of the sensory epithelium, cochlea, or neural pathways, leading to the auditory cortex via the 8th cranial nerve and other connections.

Back 212

Sensorineural hearing loss

Front 213

Sensorineural hearing loss most often affects what frequencies of hearing?

Back 213

Higher frequencies.

Front 214

Deafness is associated with what syndromes? (6 syndromes)

Back 214

Treacher-Collins
Alport
Crouzon
Waardenburg
Usher
Trisomy 21

Front 215

One form of prolonged Q-T syndrome is associated with sensorineural hearing loss, an important clue in a patient with syncope and a history of hearing loss. What is this syndrome called?

Back 215

Jervell and Lange-Nielsen syndrome

Front 216

In what percentage of cases is hearing inherited?

Back 216

50%

Front 217

80% of inherited cases of deafness are genetically transferred how?

Back 217

80% are autosomal recessive

Front 218

What is the most common infectious cause of deafness?

Back 218

CMV

Front 219

Apart from CMV, what is another infectious cause of deafness?

Back 219

Toxoplasmosis

Front 220

In regards to vision, most term newborns are what?

Back 220

Myopic (nearsightedness) at birth with a visual acuity of approximately 20/400.

Front 221

In regards to vision, this occurs by two weeks of age, and improves over the next three months.

Back 221

Color discrimination

Front 222

In regards to vision, this occurs at approximately three months of age, and is near adult functionality by 6 months.

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Fine-depth perception

Front 223

In regards to vision, this may indicate a number of abnormalities (cataracts, glaucoma, retinoblastoma, strabismus, high refractory error) and should be referred immediately.

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Abnormal red reflex

Front 224

This is the continuous or intermittent misalignment of one or both eyes (anomaly of ocular alignment), in which one or both eyes are turned in (esotropia), out (exotropia), up (hypertropia), or down (hypotropia).

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Strabismus

Front 225

This is the most common cause of visual loss in individuals < 45 years old. It is not due to ocular pathology and is not correctable with glasses or contact lenses. This may result from early childhood refractive disorders, strabismus, anisometropia (an unequal refractive error between the eyes), cataracts, or corneal opacities.

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Amblyopia

Front 226

The ability to match colors is present by what age?

Back 226

2 years

Front 227

Abnormal color vision occurs in approximately 8-10% of boys and <0.5% of girls and is due to what?

Back 227

X-linked inheritance protan and deutan deficits (red-green)

Front 228

This is a developmental proliferative retinal vascular disorder; the incidence and severity of the disorder increases with decreasing gestational age.

Back 228

Retinopathy of prematurity

Front 229

What are the primary risk factors for retinopathy of prematurity?

Back 229

Prematurity
Elevated arterial oxgygen tension
Assisted ventilation for > 7 days
Surfactant therapy
Cumulative illness severity

Front 230

This is the leading malignant ocular tumor of childhood, and it occurs at a rate of 3.7 cases per million.

Back 230

Retinoblastoma

Front 231

This is associated with inactivation of a gene on chromosome 13q14; there is a significant risk of secondary malignancies, especially osteosarcoma, soft tissue sarcomas, and malignant melanoma. The tumor arises from the primitive retinal cells-most present prior to the age of 4.

Back 231

Retinoblastoma

Front 232

This classically presents with a white pupillary reflex. - leukocoria; strabismus may also be the initial presenting complaint.

Back 232

Retinoblastoma

Front 233

What is onychophagia, and at what age does it primarily occur?

Back 233

A common habit of children and adults. It includes biting the nail, cuticles, and/or soft tissue and frequently leads to irritation, bleeding, and infection. Nail biting is most common between the ages of 10 and 18 years old. About 50% of children have the habit at some time during childhood.

Front 234

What is bruxism?

Back 234

Grinding or clinching of the teeth produces a high pitched, annoying sound, typically nocturnal. More common in boys, and appears to be familial.

Front 235

This is defined as an inability to resist repetitively pulling out one's own hair from the scalp, often causing patches of partial or complete alopecia. In some cases, the eyelashes, eyebrows, or pubic hair is repetitively pulled. Girls are most often affected.

Back 235

Trichotillomania

Front 236

A deficiency in this can be associated with trichotillomania.

Back 236

Iron

Front 237

These are classified as sudden, rapid, involuntary, purposeless stereotyped repetitive movements, gestures, or utterances that are usually briefly supproessible.

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Tic

Front 238

This is the most severe of the tic disorders. It generally starts in early childhood with simple motor tics. From there, the character of the tic can vary from touching, squatting, and twirling to development of vocal tics after a year or two.

Back 238

Tourette

Front 239

This is the most common recurrent pain syndrome in children.

Back 239

Headaches

Front 240

What are the three types of headaches in children?

Back 240

1. Migraine
2. Tension (stress)
3. Organic

Front 241

What is the most common type of headache in children?

Back 241

Tension

Front 242

What is the average age of onset for headaches in a child?

Back 242

7

Front 243

These are characterized by periodic episodes of paroxysmal headache accompanied by nausea, vomiting, and/or abdominal pain, which are typically relieved with sleep.

Back 243

Migraines

Front 244

What is the most common type of migraine?

Back 244

Migraine with aura

Front 245

These headaches are due to muscle contraction, are infrequent in the morning hours, and typically become more severe as the day goes on?

Back 245

Tension Headaches

Front 246

These headaches are usually diffuse and generalized, and may result from structural abnormalities, metabolic diseases, or infectious etiologies.

Back 246

Organic Headaches

Front 247

These headaches can occur several times a day, for a few weeks, before remitting. Daily attacks may occur at the same hour each day. The pain is strictly unilateral, severe, and is supra-orbital, retro-orbital, or temporal in location. The pain has been described as an "ice-pick" or a "hot poker".

Back 247

Cluster Headaches

Front 248

What are six things, in association with headache, that would make you concerned for a space occupying lesion?

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1. Sleep related headache
2. Absence of family hx of migraine
3. Vomiting - especially early in the AM upon arising
4. Absence of visual symptoms
5. Confusion
6. Abnormal neurologic examination.

Front 249

This is the most common musculoskeletal problem for children, occuring in up to 20% of school age children. It peaks between 7 and 12 years of age. Girls are more often affected than boys.

Back 249

Limb pain = "growing pains"

Front 250

These are recurrent, self-limited benign limb pains of unknown etiology that are not due to growing; i.e., there is no evidence that growth "hurts". Typically bilateral, they are often described as deep, sharp aching pain in the muscles of the legs.

Back 250

"Growing pains"

Front 251

This often presents with severe nighttime pain that responds to salicylates and nonsteroidal anti-inflammatory agents, but not to acetaminophen. The proximal femur is the most common location followed by the tibia.

Back 251

Osteoid osteoma

Front 252

Plain radiographs will reveal a sharp round or oval lesion < 2 cm in diameter with a homogeneous dense center and a 1-2 mm peripheral radiolucent zone.

Back 252

Osteoid osteoma

Front 253

This disease is due to a repetitive stress injury (often described in a volleyball or basketball player) to the patellar tendon at its insertion into the tibial tubercle. It is most common in children ages 10-15 years old.

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Osgood-Schlatter Disease

Front 254

This is characterized by pain, limp, and limited range of motion in the hip. It typically presents between 3 and 8 years of age; the mean age at presentation is six years. It is more common in males than females. The etiology is unclear but may be related to a posttraumatic response, infection, or allergy.

Back 254

Transient synovitis

Front 255

This is characterized by a partial or complete idiopathic avascular necrosis (osteonecrosis) of the femoral head, most often in boys between the ages of 3 and 12 years with a peak incidence at 5-7 years old. No weight bearing on the affected limb and a referral to an orthopedist is recommended.

Back 255

Legg-Calve-Perthes disease

Front 256

This is characterized by posterior slippage of the epiphysis off the metaphysis causing a limp and impaired internal rotation. It is more likely to occur in an obese child during early adolescence and near the time of peak linear growth. It is seen with increased frequency among African-Americans. Immediate referral and surgical repair are recommended.

Back 256

Slipped capital femoral epiphysis