CDM Final Exam Questions & Answers Correct 100%

PECARN Rule for age <2 years when is a CT recommended? - Answer AMS GCS < 15 palpable skull fx PECARN Rule for age >2 years when is a CT recommended? - Answer AMS GCS < 15 signs of basilar skull fx PECARN Rule for age <2 years when is observation vs CT recommended? - Answer LOC >5s non-frontal hematoma not acting normally severe mechanism PECARN Rule for age >2 years when is observation vs CT recommended? - Answer h/o LOC h/o vomitting severe HA severe mechanism what are "severe mechanisms" in the PECARN rule? - Answer -MVC w/ pt ejection, death of another passenger, or rollover -pedestrian or cyclist (w/o helmet) stuck by a motor vehicle -fall from >5ft of 3ft <2yo -head strike with high impact object what defines "AMS" in the PECARN rule? - Answer agitation, somnolence, repetitive questioning, slow response to verbal communication who do the PECARN rules not apply for? - Answer -child w/ ventricular shunt -bleeding disorders -children for whom theirs is clinical concern for abusive head trauma -children with evidence of increased intracranial pressure and/or focal neuro findings after minor blunt head trauma ***these scenarios need imaging What is the Parkland formula? - Answer 4 ml of LR x wt(kg) x % of body burned give half in first 8 hours and then the other half for the first 16 hours only _____ and ______ degree burns are applied in the Parkland Formula - Answer 2nd and 3rd degree how do you calculate mid-parental height? - Answer (mother's ht + father's ht)/2 +/- 2.5 inches what are some points for pt education in pediatric growth? - Answer -diet and stress management (avoid excess caffeine, sugar and processed foods) -sleep hygiene and adequate sleep -limit screen time and encourage activity -calculate mid-parental ht describe the changes to penis and pubic hair in males age 12.4-14.5yo - Answer STAGE 2: slight enlargement of scrotum and testes, textured scrotal skin appears pubic hair: small amount of long and slightly pigmented hair at base of penis and scrotum describe the changes to penis and pubic hair in males age 12.9-14.9yo - Answer STAGE 3: penile growth in length hair is darker and starts to curl but still in small amounts describe the changes to penis and pubic hair in males age 13.3-15.4yo - Answer STAGE 4: further penile growth in length and circumference, glans is larger and broader hair is adult in type, extends across pubis but spares the medial thighs describe the changes to penis and pubic hair in males age 14.1-16.3yo - Answer STAGE 5: testes and scrotum are adult in size pubic hair is adult in quantity and pattern (now onto medial thighs) what is the mean onset of acne for males and females? - Answer males- 14.3 females- 13.2 describe the changes to breasts and pubic hair in females age 10.5-12.9yo - Answer STAGE 2: breasts and papilla are elevated as small mound or breast bud hair is sparse, lightly pigmented located on medial border of labia majora (presexual hair) describe the changes to breasts and pubic hair in females age 11.3-13.5yo - Answer STAGE 3: breast and areola enlarged, no contour separation (breast elevation) hair is darker and more coarse, increase in amount and begins to extend laterally (sexual hair) describe the changes to breasts and pubic hair in females age 11.8-14.0yo - Answer STAGE 4: areola and papilla from secondary mound projecting from contour of surrounding breast (areolar mound) hair is dark and coarse, extends across pubis put spares medial thighs (mid-escutcheon) describe the changes to breasts and pubic hair in females age 13.3-15.5yo - Answer STAGE 5: adult size and contour, nipple projects (adult contour) adult hair now spreading onto medial thigh (female escutcheon) at what age range have 90% of females reached menarche? - Answer 11.8-14.0yo unique history Qs for pediatric falls - Answer -height from which child fell -witnessed vs unwitnessed -vomiting or behavior change after -vision changes -other signs of trauma/injury (bleeding, laceration, FB, puncture, abrasion) -UTD on tetanus -is hx consistent w/ mechanism of injury and PE -is it consistent w/ possible seizure or cardiac cause a lack of these characteristics can help r/o seizure etiology of pediatric fall - Answer lack of: -personal or family hx -birth trauma -pre-term birth -post-ictal period these characteristics can help r/o cardiac etiology of pediatric fall - Answer -single fall -no evidence of murmur -no cyanosis -no h/o fatigue w/ feedings -meeting all other gross motor milestones