Pediatric Clinical Skills and Growth Assessment: Key Concepts and Examinations

What age range does pediatrics typically span?

Pediatrics spans from birth through adolescence, often defined as up to 22 years of age.

During a pediatric history for an infant, who is the primary source of information?

For infants, the primary source of information is the caregiver.

Children aged 3-6 years can typically provide what details regarding pain?

They can provide localization and onset details regarding pain.

What topics are included in the crucial pediatric social history?

Housing situation, financial security, and environmental factors.

For a neonate, what two aspects of history are paramount?

The prenatal and birth history.

In the pediatric exam, what is the primary goal for a neonate?

Identify major malformations such as congenital heart defects or DDH.

The pediatric physical exam progresses from the least invasive to the most ____ or ____.

invasive; uncomfortable

What two assessments must precede the ear and throat exam?

Listening to the heart and lungs.

Three signs of respiratory distress in an infant with bronchiolitis?

Tachypnea, retractions, and nasal flaring.

Which pediatric age group exhibits prominent stranger anxiety?

Toddlers.

What is the Chaperone Rule for adolescent examinations?

A third party is recommended for chest or genital exams.

How do the vital signs of a neonate compare to an older child?

Higher HR and RR, lower BP.

What is anthropometry in pediatrics?

Evaluation of growth with standardized measurements.

Three measurements for children under 2 years?

Weight, Length, Head Circumference.

Measurements for children over 2 years and what is calculated?

Weight and Height; BMI is calculated.

Which growth charts are used for children under 2?

WHO growth charts.

Which growth charts are used for children over 2?

CDC growth charts.

A BMI >95th percentile indicates what?

Obesity.

Corrected age should be used for premature infants until what age?

Until age 2 (or 3 for VLBW infants).

What does an Apgar score of 3-4 at 1 minute indicate?

Severe cardiopulmonary depression.

An SGA infant has a weight below what percentile?

Below the 10th percentile.

LGA infants are common in mothers with what condition?

diabetes.

What does a bulging fontanelle suggest?

increased intracranial pressure.

What does a depressed fontanelle suggest?

Dehydration.

When does the anterior fontanelle close?

At 18 months.

When does the posterior fontanelle close?

By 2 months.

Which neonatal head swelling crosses suture lines?

Caput succedaneum.

Which head swelling does NOT cross suture lines?

Cephalohematoma.

Jaundice before day 3 of life suggests what?

Pathological jaundice.

High bilirubin can cause what neurological condition?

Kernicterus.

Dermal melanocytosis typically fades by what age?

Age 5-6.

An asymmetric Moro reflex suggests what?

Brachial plexus injury or fracture.

When does the Moro reflex disappear?

3-5 months.

A positive Babinski reflex is normal until what age?

Until 1 year.

What does a high-pitched shrill cry indicate?

Increased intracranial pressure.

The _____ maneuver attempts to dislocate the hip.

Barlow.

The _____ maneuver attempts to relocate the hip.

Ortolani.

DDH screening should occur how long?

During the first year.

What is talipes equinovarus?

Clubfoot, a fixed foot deformity.

Erb's palsy results in what posture?

Waiter's tip position.

Premature closure of cranial sutures is called what?

Craniosynostosis.

Why must strabismus be detected early?

To prevent amblyopia.

At what age does routine visual acuity testing start?

Age 3.

How to pull the pinna in an infant >4-6 months?

Upward and backward.

Cause of Early Childhood Caries?

Sleeping with milk/juice bottle.

Mnemonic for adolescent psychosocial interview?

HEAADSSS.

What does the A stand for in HEAADSSS?

Activities.

Tanner staging in females is based on what?

Breast and pubic hair development.

Tanner staging in males is based on what?

Genital and pubic hair development.

What test screens for scoliosis?

Forward bend test.

What is Osgood-Schlatter disease?

Pain/swelling of tibial tubercle in athletic adolescents.

What is the TEN 4 rule?

Bruising on Torso/Ears/Neck or any bruise in <4 years; any bruise <4 months.

Fundoscopic exam for retinal hemorrhage diagnoses what?

Shaken Baby Syndrome.

Why suspect pregnancy despite recent menstruation?

Up to 25% of women bleed in first trimester.

The zygote divides to form what?

The morula.

What is an ectopic pregnancy?

Implantation outside the uterus.

What hormone begins secretion on day 8?

hCG.

Primary function of hCG early in pregnancy?

Maintain the corpus luteum.

When do hCG titers peak?

Days 60-70.

What is fetal situation?

Relationship of fetal to maternal longitudinal axis.

Most common fetal presentation?

Cephalic/vertex.

Typical fetal attitude?

Flexion.

What does Station 0 indicate?

Head at ischial spines (engagement).

Second cardinal movement of labor?

Descent.

What is quickening?

First perception of fetal movement.

What causes heartburn in pregnancy?

Progesterone + uterine pressure.

Dark abdominal line in pregnancy?

Linea nigra.

Pigmentation of the face in pregnancy?

Cloasma.

Risk of chromosomal abnormality at age 35?

1 in 200.

Height associated with CPD risk?

152.5 cm.

Most common medical complication of pregnancy?

Diabetes.

GBS screening occurs during which trimester?

Third trimester.

Naegele Rule?

Subtract 3 months, add 1 year, add 7 days.

Why avoid prolonged supine position?

Supine hypotension.

Is dark blue cervix at 6-8 weeks normal?

True.

What is Hegar's sign?

Softening of cervical isthmus.

Fundus at the umbilicus occurs at what gestational age?

20 weeks.

Descent of fundal height near term is called what?

Lightening.

Normal fetal heart rate?

120-160 bpm.

Purpose of Leopold's maneuvers?

Assess fetal position and presentation.

Which maneuver locates the fetal back?

Second.

What is a threatened abortion?

Bleeding with closed cervix.

Key symptom of placenta previa?

Painless vaginal bleeding with soft uterus.

Most associated with placental abruption?

Hypertension.

What does a CGA include beyond physical health?

Function, cognition, mental health, socioeconomic factors.

Which ADL most often leads to home care referral?

Bathing.

Examples of IADLs?

Meal prep, finances, medications.

Principal predictor of disability/death in elderly?

Gait speed.

TUG >20 seconds indicates what?

High risk; needs evaluation.

Arm-Crossed Standing Test assesses what?

Hip/knee flexors and quadriceps.

Unintentional weight loss threshold for concern?

>5% in 6 months.

What does M stand for in Meals on Wheels?

Medications.

PHQ-2 score ≥3 requires what?

PHQ-9 evaluation.

What is the Brown Bag Review?

Medication reconciliation method.

Temperature <36°C in elderly suggests what?

Hypometabolism.

Most frequent cause of legal blindness in elderly?

Macular degeneration.

Common reversible cause of conductive hearing loss?

Cerumen impaction.

Most common sensory deficit in healthy elderly?

Loss of vibratory sensation.

Cogwheel rigidity suggests what disease?

Parkinson's disease.