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81 Cards in this Set
- Front
- Back
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What physical findings should be taking?
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BP (UPPER AND LOWER EXT), weight, length, head/chest/abd circumference
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What should you always examine first?
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heart and lungs
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What skin findings are normal from birth trauma?
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petechiae (not diffuse), bruising, lacerations
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When is jaundice abnormal?
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during the 1st 24hrs of life
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What are cafe au lait spots assoc with?
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neurofibromatosis & ADHD
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What are port wine stains?
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made of dilated blood capillaries - permanent
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Strawberry hemangioma
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face, scalp, back, or chest
may develope at several weeks grows rapidly, remains fixed, then dissappears by age 9 |
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Cavernous hemangioma
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red-blue spongy mass of tissue
may disappear - usu around school age |
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Which is more deeply situated - strawberry or cavernous hemangioma?
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cavernous
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What should midline lesions make you think of?
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possible CNS connections
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When should you biopsy a midline lesion?
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only MAYBE after proper evaluation
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What are mongolian spots
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normal blue/brown spots on thighs, back, buttocks - mistaken for child abuse
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What is erythema toxicum?
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NORMAL papules on red base
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What is neonatal pustular melanosis?
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pustules that heal as brown pigmented macules
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What are common terms for nevus flammeus/simplex?
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stork bites, salmon patches, angel kisses (forehead)
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What when do glabella lesions?
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may take years - can often be seen into adulthood esp when flushed
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When is vernix seen?
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common after 35 wks - sheds into amnionic fluid after 40 wks
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When is lanugo present?
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in a preterm
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What is common regarding sutures in newborn?
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overlapping
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When are sutures not palpable?
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after 6 mo - final closure in adulthood
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Which sutures close in early neonatal period?
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metopic sutures
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What is craniosynostosis?
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premature closure of sutures = palpable ridge
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When will a head return to normal shape after modling?
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1 week
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What is scalp edema that CROSSES midline?
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caput sucedaneum
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what is bleeding beneath periosteum of parietal bone that NEVER crosses suture lines?
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cephalohematoma
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What causes facial nerve paraysis?
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damage to facial nerve from forceps delivery
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when is mandibular placement commonly seen?
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after breech/facial presentation deliveries
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How do you classifly macrocephaly? what is the most common cause?
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> 3 std above mean
hydrocephaly |
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How do you classify microcephaly?
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> 3 std below mean
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What is the name for a "ping pong ball" head? Is it normal?
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Craniotabes - normal up to 3 yo
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What do you call rounded, compressible, usually midline masses?
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Encephalocoeles (Brain)
Meningocoeles (Spine) |
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What is occipital/frontal/parietal bossing?
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big forehead frequently in preterm
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When does the anterior fontanel close?
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4-26 mos
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When does the posterior fontanelle close?
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remains palpable for 4-8 wks
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Is early close of fontanelles a concern?
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not as long as head grows normally
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What do unusually small fontanels indicate?
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slow brain growth or craniosynthostosis
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What do sunken fontanels indicate?
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dehydration >10%
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What do bulging fontanels indicate?
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hydrocephalus, meningitis/infxn, intravascular hemorrhage
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What is craniosynostosis?
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premature closing of a suture - alien baby
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What happens to fontanel when a baby cries?
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it bulges, but remains pulsatile
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What does the anterior fontanelle look like in hydrocephalus?
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rarely visibly pulsatile, almost always bulges
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What is the significance of red reflex?
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lens is clear
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What is the significance of white reflex?
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abnormal - think retinoblastoma
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Are a babies PERRLA?
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They are PPERRL - not accomodation
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What will a baby do if you shine a bright light in its eye?
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blink
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2 common findings in eyes?
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subconjunctival hemorrhage
disconjugate eye gaze |
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Describe the sun-setting sign
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irises appear to sink beneath lower eyelids when infant quickly lowered
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What are epstein pearls?
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normal, small, white cysts at midline junction of hard and soft palate
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What does a webbed neck indicate?
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turner syndrome
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What does a short neck indicate?
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Klippel Feil Syndrome
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Where do you find the PMI?
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4th interspace close to sternum - abex beat not usu apparent
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What does a continuous thrill indicate?
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Patent Ductus Arteriosis
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What does systolic thrill suggest?
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congential heart disease
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What do systolic murmurs on the 1st day of life indicate?
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closing of ducus arteriosis
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What do distant heart sounds suggest?
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pneumothorax or pneumopericardium
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What do right heart sounds suggest?
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dextrocardia
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What do weak/absent femoral pulses suggest?
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coarctation of the aorta
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How many veins/arteries does the umbilical cord normally have>
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2 arteries, 1 vein
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What is omphalitis?
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erythema and infection at the cord base
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What is omphalocoele?
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herniation of intestines at umbilicis
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What does a scaphiod abdomen suggest?
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diaphragmatic hernia
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What does distention suggest?
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infection or congential obstuction
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What is the difference between hypospadius and epispadius?
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urethral meatus on the vental side or the dorsal side
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Normal penile length
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>2cm
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Up to what gestational age may an infant still have undescended testicle?
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up to 34 wks
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How to differentiate between hernia and hydrocele?
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transilluminate!
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Is blood tinged vaginal discharge normal?
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yes- after day 3
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Define Developmental Dysplasia of the Hip (DDH)?
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any abnormality of childs proximal femur or acetabulum - most commonly referring to neonatal hip instability to stable hip w/shallow acetabulum
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When to perform hip exams?
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at birth an through subsequent well child visits
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When do ortolani and barlow tests become less sensitive?
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after 2-3 mo
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Signs of DDH at 3mo
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asymmetric shortening of led, decreased aBduction, asymmetric thigh or gluteal folds
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Signs of DDH in child
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limp/waddling gait
hyperlordiosis of lumbar spine |
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What is a positive ortolani sign?
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click or clunk when aBducting w/upward pressure
relocating dislocated hip |
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What is a positive barlow's sign?
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femora head clicks as it dislocated when hips are aDducted w/backwards pressure
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what should you notice about the anus?
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patency and position
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Name that reflex: turn to nipple
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Sucking/rooting reflex
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Name that reflex: extension of arms/grabbing toes
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Moro/Startle Reflex
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Name that reflex: toes curl when knees and hips bent
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plantar grasp
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Name that reflex: infant in prone position - lateral trun curvature toward stimulus
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Galant reflex
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Name that reflex: reub sacrum along spine - causes head and spine extension / knee flexion
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perez reflex
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When is placing and stepping response best seen?
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best at 4-5 days
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