Final Exam - General and Head Exam pt 1

what are some typical skin findings in an infant

milia, hemangiomas, port wine stains, atopic dermatitis, psoriasis

what are some typical skin findings in a toddler

cafe-au-lait spots, urticaria, impetigo, varicella, hand foot and mouth

what are some typical skin findings in a school age

scabies, scarlet fever, psoriasis, tinea corporis, acne

when do vascular lesions/hemangiomas typically resolve

by adolescence

what is a port wine stain

form of hemangioma, capillary malformation

flat

does NOT resolve with time

where is an area of concern for Port Wine Stains

lateralized and localized to forehead and upper eyelid

does cradle cap resolve on its own

yes

urticaria lasting

allergic, disorder

honey colored crusts is associated with what highly contagious condition

impetigo

what is a bullous

honey colored crust with clear fluid border from staph aureus

how long does varicella last

14-16 days

hand foot and mouth affectes children udner ___ years old. Where can sores be found?

10

all over but mostly hands, mouth, and feet

ruritic papules, vesicles, pustules, and linear burrows. Appears in finger webs, axillae, wrists, waist, nipples, genitals. Infants may have lesions on palms, soles, head, neck. Contagious, appears 4 to 6 weeks after contact. Intense itching, especially at night, is common.

scabies

diffuse erythema after pharyngitis onset

strawberry tongue

sandpaper like

scarlet fever

dull red, ring-shaped lesions with raised border

tinea corporis (ringworm)

what is the largest fontanelle? when does it close?

anterior (4-6 cm)

4-26 months

when does the posterior fontanelle close?

by 2 months (1-2 cm)

when examining the fontanelles, what is considered a red flag

bulging or depression

where should you measure head circumference to monitor brain growth? How often should this be done?

over occipital, parietal, and frontal prominence

every well child visit until sutures close

premature fusion of one or more cranial sutures likely associated with skull deformity and delayed milestones

craniosynostosis

what are the different types of craniosynostosis

simple - 1 suture

complex - multiple

syndromic - genetic

non-syndromic - idiopathic

what are risk factors for plagiocephaly

neck problems (torticollis)

assisted delivery

first-born

male

significant time spent supine

what are allergic shiners

dark shadows under eyes from allergies

what are dennie lines

horizontal skin creases under lower lids

what is a nasal pleat

horizontal crease above nose tip

what is ptosis

drooping of eyelid(s)

if pstosis is congenital, what is the cause

extraocular muscle or CNS abnormalities

what is blepharitis

inflammation of eyelids often due to staph or seborrhea

what is hordeolum

painful, tender mass on edge of eyelid

staph infection

what is a chalazion

painless, beady nodule

what are the MC eyelid tumors

hemangiomas

what are bright red patches on the eye caused by various factors such as infection, trauma, or bleeding disorders

subconjunctival hemorrhages

when should fixation on objected begin

2-4 weeks

when should visual tracking begin

5-6 weeks

when should convergence of eyes and reaching for objects begin

3 months

when should visual acuity increase rapidly

first 6 months

if strabismus persists after 6 months, what should occur

referral to opthlamologist

when using a visual acuity test for toddlers, a two-line visual difference between eyes warrants referral to who

ophthalmalogist

when should visual acuity be 20/20

by age 7

what are the four Ds of the ears

discharge

discoloration - Battler sign associated with head trauma (ecchymosis over mastoid area)

deformity

displacement

when should an otoscopic evauation happen during an exam

at the end

how do you pull the auricle on infants during an otoscopic exam? what about in older children?

inferior and posterior

superior and posterior

green foul-smelling purulent discharge coming from one side of the nose may indicate what

foreign object

what is ankyloglossia

tongue tie

acute pharyngitis and tonsilitis are caused by __ infections 90% of the time. Are antibiotics indicated or contraindicated? How is the cuase determined?

viral, contraindicated

throat culture or rapid identification test

when someone has Acute Stomatitis - Recurrent Aphthous Stomatitis (Canker Sore) what foods should be avoided

salty or acidic

gingiva Lasts 7-10 days.

Associated with: ◦ Fever, ◦ Tender cervical nodes ◦ Difficulty swallowing

Acute Stomatitis - Herpes Simplex

White, curdlike plaques mainly on buccal mucosa Caused by Candida albicans. Symptoms: ◦ Soreness ◦ Refusal to eat ◦ Diaper rash may be associated.

does not wipe away

thrush

for management of non-emergency illnesses, when should chiropractic begin

ASAP

upper cervical and sacrum

how often should parents monitor temp when a non-emergency illness is occurring

every 2 hours

severe headache, stiff neck, fever, rapid onset, life-threatening

meningitis

what type of breathing is normal in infants

abdominal (diaphragmatic)

periodic breathing

how can you examine lungs and thorax in infants

while they are crying

t/f pediatric patients have louder respiratory sounds

true due to thin chest walls

Viral upper airway obstruction, hoarse voice, stridor, barking cough.

croup

normal lung sound on percussion

resonant

what is the MC chronic lung disorder in children

asthma

Excessive mucous production; presents with wet sounds during respiration.

wet asthma

Dry, hoarse cough; associated with sympathetic nervous system.

dry asthma

Diagnosed based on presentation: cough, sputum production, rales/rhonchi, and clinical history of lower airway disease. Descending Infection

Symptoms and Examination ◦ Preceded by mild upper respiratory tract infection. ◦ Gradual onset of dry, unproductive cough followed by purulent sputum. ◦ Malaise, substernal pain, whistling sounds, chest soreness, shortness of breath common. ◦ Signs of naso-pharyngitis, rhinitis, and conjunctivitis on examination. ◦ Crackles and rhonchi are audible. ◦ Fever variable and usually low grade.

acute bronchitis

resolution of acute bronchitis begins ___ days after onset

5-10 days

do antiobiotics, antihistamine, or expectorants help with acute bronchitis

not usually