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Pediatrics - Growth and Development
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Terms in this set (100)
Neonate age range
Infant age range
29 days - 1 year old
Toddler age range
Variable, usually 2-3 years old
Child age range
Generic, <12 years old
What biometric tool is the most well-known for measuring development in children?
Denver Developmental Screening Test II
Observable traits and actions that have been shown to develop consistently in our population
How much weight loss is acceptable in the 1st week of life?
Up to 10%
When should the neonate return to birth weight after the initial 1st weight loss?
at 2 weeks
How much should the infant weigh at 4-6 months?
double the birth weight
How much should the infant weight at 12 months?
triple the birth weight
At what age should you expect to see shifts on growth charts, often due to genetic predisposition?
at around 9 months
At what percentile of growth would cause alarm and action?
<5th percentile with no obvious cause
How many major lines or channels must be crossed in order for you to take action?
2 percentile lines or major channels consecutively without cause
T/F. Growth rate declines rapidly during ages 1-12 years.
What is the difference in growth charts?
Gender specific (one of male, one for female)
Formula to predict mature height in inches
(Father+Maternal height+2.5)/2 MALES
(Father+Maternal height-2.5)/2 FEMALES
How can mature weight be predicted?
Fat babies become fat adults.
Period of rapid weight gain during the 1st 4 months of life correlates with obesity at 7 yo
Does the Denver II assess IQ?
What is assessed by the Denver II?
Fine Motor-Adaptive skills
Gross motor skills
Purpose of Denver II
Provide an objective test for developmental delay
What age of child is the Denver II designed for?
0-6 years old
Gross Motor Skills at 2 weeks
Gross Motor Skills at 2 months
Lifts head in prone, grasps
Gross Motor Skills at 4 months
Head no longer lags when the body is pulled up
Able to roll over (front to back)
Gross Motor Skills at 6 months
Sit independently (tripod)
Gross Motor Skills at 9 months
Pulls to stand
Gross Motor Skills at 12 months
Gross Motor Skills at 18 months
Run, 1-2 stairs
At what age can a child recognize sound?
When should a child be able to say words (generally)?
by age 2 years old
When should a child be able to say sentences (generally)?
by age 3 years old
At what ages does the child exhibit stranger anxiety?
between 6 months and 36 months
If the child is experiencing a language delay, what is the first exam the child should have?
Ear and hearing exams
At what age should rolling be a red flag?
<3 months (Increased tone)
At what age should poor head control be a red flag?
>5 months (hypotonia)
At what age should lack of sitting be a red flag?
>7 months (hypotonia)
At what age should hand dominance be a red flag?
At what age is fallure to vary voice pitch a red flag?
At what age is lack of babbling/localizing sound a red flag?
What should DBP be in a child 3 years old or older?
At what age should the child be able to fix and follow with eyes?
by 6 weeks old
At what age should the child try the eye chart instead of just fixing and following?
At 2 years old
Which vaccine is the only one given at birth?
If there is a delay in the next shot in the vaccine series, should you start over?
How many shots are in the Hep B series and in the IPV series?
How many shots are in the MMR series and Hep A series?
How many shots are in H. Influenza Type B series and in the DTaP series?
Which vaccines require a booster at 4-6 years?
DTaP and IPV
A vaccine delayed is a vaccine _______.
Contraindications to vaccines
History of anaphylaxis
Live vaccines in immunocompromised or pregnant patients
What condition are some parents concerned about MMR vaccine causing in their children?
When examining the child, what should you exam first before they cry?
Heart and lungs
When examining the child, what should you exam last?
Ears and Oral
What is the weight and/or age requirement for being in an approved rear-facing car seat?
<20 lbs or <12 months
What is the weight and/or age requirement for being in an approved front-facing car seat?
20-40 lbs AND 1-4 years old
What is the weight and/or age requirement for using an approved booster seat?
40-80 lbs and 4-8 years old
What is the weight and/or age requirement should sit in the back seat and prohibited from sitting in the front seat?
<12 years old
In Texas, what is the requirement for child passenger safety seat program?
Under 8 years old, under 4'9"
In order to reduce the risk of SIDS, should the baby sleep with a parent?
In order to reduce the risk of SIDS, what position should the child sleep in?
Does heavy blankets, pillows, multiple blankets, and overly padded bumpers increase the risk of SIDS?
What hazards are children at increased risk of getting when a parent smokes?
Small for Gestational Age
Are hazards still present to child if the parent only smokes outside?
Which makes the baby gain weight more rapidly and increases obesity risk, breast milk or bottle formula?
Which increases chance of baby having jaundice, breast milk or bottle formula?
Exclusively breast-fed infants should receive what vitamin supplements?
Vit D (until able to eat Vit D enriched foods)
Iron (>6 months)
When can infant get cow's milk, honey or canned foods?
after 12 months old
What condition can the infant get if the infant younger than 12 months get honey or canned foods?
What can happen to infants younger than 12 months drinking cow's milk?
GI bleeding and anemia
When can an infant begin solid foods?
What order should an infant begin solid foods?
Should solid foods replace or supplement the bottle/breast?
What is the limit of juice that can be given to an infant?
4 oz per day
Why is it a bad idea to limit fat intake in a child 1-12 years old?
Nerve tissue develops
Children do not need to be on "diets" before the age of ___________.
3 years old
What type of carbs are encouraged in children 1-12 years, complex or simple?
Children under _____ should not watch television at all.
2 years old
Children watching television should do so no more than _______ per day.
At what age should toilet training occur?
2-3 years old
At what temp should the hot water heater be kept?
120 degrees F
How often should a new food be introduced?
every two weeks
What is the limit of juice that can be given to a child 1-12 years?
What is the limit of milk that be can be given to a child 1-12 years?
<24 oz per day
Is a Growth Hormone assay necessary in workup if weight and height are low but teeth are erupting at a normal rate?
If there is a delayed eruption of teeth, what labs should you check?
TSH and calcium (hypothyroid, hypopituitarism, rickets)
When and what teeth erupt first?
Lower central incisor followed by upper central incisor, starting at 6 months
When do permanent teeth erupt?
6-8 years old, ending at 12 years old
3rd molars erupt at 18 years old
How can you prevent dental caries (cavities)?
Avoid prolonged or nightime bottles
Avoid excessive soda and juice
Ensure adequate fluoride intake
At what age can the child use fluoride toothpaste?
2 years old
If a child cannot use flouride toothpaste before age 2 years, then can be used to brush the child's teeth?
Brush teeth with water
How does thrush present?
erythematous plaque under white lesion
Is a KOH necessary to confirm thrush?
Treatment for thrush
Side effect of Gentian Violet
Will stain skin for 1-2 weeks
If child has thrush and is breast-feeding, what should be done to the mother?
Ensure treatment of Candida on mother's nipples
Contact dermatitis from urine and feces exposure
Most children with diaper rash are also coinfected with ________.
Candida albicans (70%)
Treatment Diaper Rash
Change diaper more often
Switch to cloth diapers
Nystatin, Lotrimin, others
If the diaper rash spares the scrotum, do you suspect Tinea or Candida?
If the diaper rash has "satellite lesions", do you suspect Tinea or Candida?
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