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58 Cards in this Set
- Front
- Back
Turner vs. Klinefelter syndrome
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Turner - XO - female phenotype
Klinefelter - XXY or XXY - feminized male |
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Genetic testing reveals baby will be born with XO sex chromosomes. What is this called? What are clinical manifestations?
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Turner's syndrome - webbed neck, low posterior hairline, beefy hands and feet (edema), widely spaced nipples. Puberty - short stature, delayed sexual development, socially awk but normal intelligence.
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Genetic testing reveals baby will be born with XXY sex chromosomes. What is this called? What are clinical manifestations?
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Klinefelter's syndrome. Male phenotype with feminized features presented during puberty - gynecomastia, feminized pubic hair pattern, well developed genitalia but small testes, may have high voice. May have lower IQ
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What is aneuploidy? examples?
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any deviation from 46 chromosomes. ie klinefelters xxy, turner's xo, trisomy 21
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What is mosaicism?
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body is made up of cells with varying genetics - mixed cell populations. ie calico cats
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What is the pattern of acquiring motor skills?
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cephalocaudal (head to toe) proximodistal (trunk to extremities)
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What is the immunologic benefit in breastfeeding?
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infants are not able to produce IgA, which protects the mucosal lining against infection (GI and GU). Breastmilk transfers mother IgA to baby. It also confers immunity to which the mother was exposed
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What is the oily white substance coating neonatal body? What is function?
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vernix caseosa - has immunologic properties that protect from infection, thermal regulation, and prevents transipdermal water loss
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Milestones for 1 mo.
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-obligatory nose breathing
-head lag - hands closed - watches face |
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milestones for 2 mo.
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post fontanel closed
- lifts head 45 deg when prone - strong grasp reflex - coos, social smile |
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milestones for 3 mo.
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- holds rattle
- squeals to show pleasure - "talks" when spokein to - interested in surroundings - recognizes familiar objects, faces |
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milestones for 4 mo.
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- drooling begins
- rooting disappereas - plays with hands, grasps objects withboth hands - laughs aloud - demands attention (fussing) |
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milestones for 5 mo.
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- birth weight doubles
- begins teething - rolls belly to back - grasps objects voluntarily - object directly to mouth |
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milestones for 6 mo.
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-rolls back to belly
- sits with support -hold bottle - grasps feet and pulls to mouth - holds arms up to be picked up |
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milestones for 7 mo.
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- tripods (sit with hands in front for support)
- bears weight on feet - transfers and rakes objects - bababa dada kaka - "talks" when others talk |
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miletsones for 8 mo.
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regular elimination patterns
- sits without support - reaches for toys - stranger anxiety peaks |
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milestones for 9 mo.
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-crawls
- pulls up to stand - crude pincer grasp - comprehends no-no |
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milestones for 10 months
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- change from prone to sitting
- mama and dada meaning undetood -says hi & bye, waves bye bye - object permanence |
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milestones for 11 mo.
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cruises (walk while holding onto furniture), neat pincer grasp
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milestones for 12 mo.
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- birth weight triples
-walks with one hand held - 3-5 words besides dada nad mama - undestands simple commands (give it to me) - security blanket/toy |
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Explain thumb sucking and pacifier use effects.
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- For preterm babies, sucking increases weight gain, improves pain mangement -
- For infants, It is thought to cause dental maloccusion, but only when secondary teeth are coming in. - it also is proven to reduce SIDS if used while sleeping. - American academy of peds recommends limited pacifier use. |
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What are signs of teething?
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fussiness, drooling, LOW GRADE fever, biting hard objects, inflamed gums
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How might you suggest a parent treat signs of teething?
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-frozen teething ring
-ice wrapped in washcloth for inflmmation. - baby orajel is sometimes used, MUST USE AS DIRECTED. more is not better. benzocaine overdose is lethal. |
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How many teeth should an 8 month old have?
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for first 2 years of life, can calculate suggested teeth amount : Age (mo.) - 6 = # teeth. so 8 mo. - 6 = 2 teeth.
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how many teeth should a 15 mo. have?
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for first 2 years of life, can calculate suggested teeth amount : Age (mo.) - 6 = # teeth. so 15 mo. - 6 = 9 teeth.
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tooth eruption progresses in what manner?
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two lower incisors, two upper incisors, two upper lateral incisors, two lower lateral incisors
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What is recommended length of time for breast milk intake?
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first 6 mo.
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What should you tell pt. about feeding their baby?
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All infants should receive daily supplement of Vit D (200IU) in first 2 mo of life. Iron fortified cereals after 4-6 mo. no water juice. solids between 5-6 mo.
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When should solids be introduced?
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5-6 mo
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when should iron supplements be introduced in baby's diet? why?
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4-6 mo if breastfed exlusively. this offsets the lack of maternal iron stores. (fortified cereals).
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what is recommended sequence of types of solid foods introduced into infant's diet?
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1. iron fortified cereals
2. vegetables (b/c won't eat it if applesauce comes first) 3. fruits 4. meat |
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When can veggies, fruit, meats be introduced?
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8-10 mo
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when can eggs and cheeses be introduced?
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12 mo
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why should juice be avoided in infants?
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empty calories. infants need fatty whole milk and other high calorie foods til 2yo for proper brain growth
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What are kinds of active immunities?
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natural - diseases. artificial - immunizations. create your own antibodies.
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What are kinds of passive immunity?
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ready made antibodies. natural - maternal antib. artificial - from elsewhere.
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baby teeth aka
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deciduous teeth
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how can parents prevent nursing caries in infants and toddlers?
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don't allow them to take bottle of milk to a bed
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What is normally used to introduce baby to solid foods and why?
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Iron fortified cereals. The iron is used to supplement the depletion of fetal iron stores (4-6 mo) and because of weaning from milk.
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What is the benefit of mixing fruit juices with cereal?
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vit C enhances iron absorption
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How does one cultivate a widely-ranged palate for a child?
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introduce many kinds of foods for first year, when they are more likely to eat them. Toddlers are picky, and less foodventurous.
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What vaccines should not be given in an immunocompromised patient?
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live vaccines. ie MMR and varicella (chicken pox)
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What injections are given at birth
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VIt K and HepB
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What childhood immunizations should not be given to pregnant women?
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Rubella, Varicella
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When receiving the meningococcal vaccine, an important consideration is?
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hypersensitvity to diptheria toxoid
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What are contraindications for Rotavirus?
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HIV+ mothers, immunodeficiencies
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hypersensitivity vs allergy vs intolerance
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- hypersensitivities include both allergies and intolerances.
- allergies produce immune response (inflammation, runny nose, sneezing, wheezing). - intolerance is malabsorption/digestion, and has no immunologic response. |
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What immunoglobin is responsible for allergies
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IgE
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What is the statistrics for atopy?
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atopy = hereditary tendency for allergies. child with allergic parent = 50% or more. child with 2 allergic parents = 100%.
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Name two strategies to avoid atopy.
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breastfeeding and selective introduction of solid foods.
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What solid foods should parent avoid to prevent allergies?
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dairy products until 12 mo. eggs until 24 mo. nuts, fish, seafood until 36 mo.
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What is the method to preventing food allergies?
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- wait to introduce highly allergic foods until later (nuts, fish).
- breastfeeding exclusively for first six months. |
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When should whole milk be introduced into a child's diet?
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12 mo.
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lactose intolerance
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= lactase deficiency
- may be primary (late onset) or secondary (to diseases that effect GI) - best treatment is elimination, but Vit D and Ca need supplementation - probiotics proven to help - small amounts may be tolerated - milk may be taken better with a meal rather than alone - yogurt contains inactive form of lactase, activ by pH and temp of duodenum |
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How can regurgitation be prevented?
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- frequent burping
- placing on R side, head elevated |
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FTT
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= failure to thrive = inability to obtain or use calories
- organic = physical cause - inorganic = psychosocial cause - idiopathic |
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Positional plagiocephaly
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= misshapen skull, commonly due to sleeping supine
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SIDS risk factors
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- maternal smoking or near infant
- soft beddings, toys, blankets - co sleeping - overheating |