Pediatrics Exam 2 (Lederman's)

Front 1

ACOG recommends ___ months of EXCLUSIVE breast feeding

Back 1

6 months of exclusive (but ongoing breast feeding for 2 years)

Front 2

How often should you breast feed during the neonatal period?

Back 2

every 2-3 hours

Front 3

How often should you breast feed at ~5-6 months?

Back 3

every 3-5 hours

Front 4

When are the growth spurts for a baby for the first year of life?

Back 4

3 weeks
6 weeks
3 months
6 months
9 months
12 months

Front 5

What is colostrum? When does the mother produce it?

Back 5

"first milk"
Produced by mom for the first 3-5 days after birth

Front 6

What is the significance of colostrum?

Back 6

Contains high levels of antibodies, leukocytes and anti-inflammatory factors. Also, it helps the baby prep to recieve breast milk

Front 7

What are the benefits of breast feeding to the mother?

Back 7

Causes a release of oxytocin (which aids in shrinking uterus back to normal size), decreased risk of cancer
PROMOTES AND AIDS WEIGHT LOSS TO PRE_PREGNANCY STATUS

Front 8

The risk of acute GI illness is ___ times higher in formula fed babies

Back 8

6 times higher

Front 9

What is foremilk and what is it's function?

Back 9

@ beginning. It contains sugar, proteins, minerals and fluid.
It's function is to quench thirst of baby

Front 10

What is hindmilk and what is it's function?

Back 10

@ end. It contains nutrients and is fat dense (thick and creamy).
It's function is to give the baby the feeling of being "full"

Front 11

It is important to put the baby to the breast within how long after birth?

Back 11

within the first hour

Front 12

Neonates nurse ___-___ times a day

Back 12

8-10

Front 13

Neonates should have ___-___ wet diapers/day and ___ BM a day

Back 13

4-6 wet diapers/day
3 BM a day

Front 14

Estrogen (increases/decreases) milk supply?

Back 14

decreases

Front 15

What are contraindications to breastfeeding?

Back 15

glactosemia, phenylketonuria, intestinal lactase deficiency

Front 16

What are some RELATIVE contraindications to breast feeding? (relative = can be changed)

Back 16

Vegan diet, low Vit D fortified food/sunlight, <1800 kcal/day

Front 17

If you are using goat's milk, what must be added?

Back 17

B vitamins

Front 18

What is the order of preference for options if you aren't able to breastfeed?

Back 18

1. Get some from friend
2. Goat's milk (raw)
3. Cow's milk (raw)
4. organic formula

Front 19

At ___ months, the baby should be ready for introduction of solid foods

Back 19

6 months

Front 20

A baby is ready for solid foods at 6 months, because the baby will start producing _____

Back 20

proper amylase

Front 21

When introducing solid foods to a baby, you introduce one food at a time and wait ___-___ days to make sure it's ok

Back 21

wait 4-7 days

Front 22

When introducing solid foods to a baby, what foods are recommended you start with?

Back 22

yellow veggies with a high water content (you want them to be slightly thicker than breastmilk

Front 23

What are some signs of food reaction when solid foods are first introduced to the babie's diet?

Back 23

fussiness
rash/hives (around moth, anus, arms/legs)
diarrhea
vomiting
swelling

Front 24

What are the most common allergens to a baby?

Back 24

cow's milk
eggs
peanuts
soy
wheat

Front 25

Normal temperature for a child is ___ for oral and ___ for rectal

Back 25

98.6 F oral
99.6 F rectal

Front 26

For a child, a temperature of ___ F oral and ___ F rectal is indicative of a fever

Back 26

99.5 F oral
100.4 F reectal

Front 27

_____ temperature is most accurate

Back 27

rectal

Front 28

Name 4 situations where temperature is raised in a child

Back 28

1. highly active child
2. stress or crying
3. amount of clothing
4. environment

Front 29

Temperature is 1 degree higher after ___ pm.

Back 29

5

Front 30

What is the average height of a newborn?

Back 30

19-21"

Front 31

What is the average weight of a newborn?

Back 31

7 lbs, 8 oz

Front 32

What is the average pulse rate of a newborn? Where should this be taken at?

Back 32

120-140 bpm
TAKE AT FEMORAL OR BRACHIAL ARTERY

Front 33

What method is used when taking the blood pressure of a newborn?

Back 33

Flush method

Front 34

When a baby is crying, their pulse rate should be ~___ bpm. When a baby is sleeping, it should be ~___ bpm

Back 34

crying = 190 bpm
sleeping = 90 bpm

Front 35

Where do you auscultate PMI for patients under 7 yoa? Older than 7 yoa?

Back 35

Under 7 = 4th intercostal space right of midclavicular line
Over 7 = 5th intercostal space right of midclavicular line

Front 36

How do you record the respiration rate of a baby?

Back 36

note the rise and fall of the abdomen for 1-2 minutes

Front 37

What is the average head circumference of a newborn? At 1 yoa?

Back 37

newborn is 13.5"
1 yoa is 18.5"

Front 38

An enlarged head circumference means what 2 things?

Back 38

hydrocephalus
increased ICP

Front 39

When does the anterior fontanelle close?

Back 39

7-19 months (avg - 12 months)

Front 40

When does the posterior fontanelle close?

Back 40

3 months

Front 41

All sutures are palpably closed by ___ months

Back 41

six

Front 42

When looking at a childs nose, what are some things you want to look for?

Back 42

integrity
clor
consistency of nasal mucosa
position of septum

Front 43

What will the nose look like if the child has allergic rhinitis?

Back 43

pale, boggy nasal mucosa
clear mucus
line on nose from allergic salute
allergy shiner

Front 44

What will the nose look like if the child has an infection?

Back 44

red nasal mucosa
yellow or green mucus

Front 45

What is the number one reason for nose bleeds in children?

Back 45

epistaxis/excoriation

Front 46

Excessive nose bleeds could be a sign of what 4 things?

Back 46

1. high BP
2. increased intracranial pressure
3. cranial tumor
4. leukemia

Front 47

Greyish, soft grape like out-growths are known as _____

Back 47

polyps

Front 48

In the infant, you want to make sure the tongue can come past the _____

Back 48

lips (so it's not painful to the mother when breastfeeding)

Front 49

Downward displacement and/or retraction of the tongue is known as _____.

Back 49

Glossoptosis (most commonly seen in Down's)

Front 50

What are koplik spots? What are they indicative of?

Back 50

found near 2nd molar on buccal mucosa; small greyish center, with a red rim

indicative of measles

Front 51

Thrush is indicative of what?

Back 51

candida albicans

Front 52

If the tongue is red/inflammed, it is indicative of what?

Back 52

upper respiratory tract problem (scarlet fever = strawberry tongue)

Front 53

To make sure the ears are in the correct position, draw a line from the _____ to the _____ and the top of the ear should be above this

Back 53

line from inner canthus to occiput

Front 54

What cranial nerves does the rooting reflex test?

Back 54

CN V and VII

Front 55

What cranial nerves does the sucking reflex test?

Back 55

CN V, VII, IX, X, XII

Front 56

What cranial nerves does the blinking reflex test?

Back 56

CN II and VII

Front 57

Describe the blinking reflex

Back 57

shine a penlight into the baby's eyes and they should blink. (CN VII closes eyes, because CN II sees the light)

Front 58

Describe the moro startle reflex

Back 58

take the baby seated and put it's arms to the chest, drop them (by laying them down) to see them extend to catch something

Front 59

in the moro startle reflex, what are you testing for?

Back 59

symmetry (both arms reaching out).

Front 60

If moro startle reflex is absent in a baby, what does this mean?

Back 60

UMNL, brachial plexus injury, fractured clavicle

Front 61

What cranial nerve does the tonic neck (fencer stance) reflex check?

Back 61

CN VIII

Front 62

Describe the tonic neck (fencer stance) reflex.

Back 62

put the baby down supine and the doctor passively turns the baby's head to one side. The ipsilateral arm and leg extend and the contralateral arm and leg should flex

Front 63

What all is tested with the palmar/plantar grasp reflex?

Back 63

C8/T1 for gripping, DCML. If retained past 6 months, suspect cerbral palsy

Front 64

What are you looking for with the vertical suspension/inversion reflex?

Back 64

You want the nose, episternal notch, and umbilicus in a straight line. MOST COMMON PROBLEM ASSOCIATED WITH THIS IS CONGENITAL HIP DYSPLASIA

Front 65

Describe the crossed-extensor reflex

Back 65

baby is lying down and doctor provides a scratch (mildly painful stimulus) and you should feel the baby try and kick the hand out of the way

Front 66

Describe the acoustic blink reflex

Back 66

clap by the babies ear (where they can't see your hands) and baby should blink

Front 67

What should you see with babinkski's sign?

Back 67

foot flare and extension of the big toe

Front 68

Describe the trunk incurvation reflex (aka galant's reflex)

Back 68

hang the baby over your arm on their belly. Stroke the paraspinals from occiput to sacrum and see if the baby laterally flexes to the ipsilateral side

Front 69

describe the reverse fencers reflex

Back 69

while holding the baby in vertical inversion, take the weight off of one leg. The baby should turn it's head to the side of flexion. If not, suspect UPPER CERVICAL SUBLUXATION