Hep B vaccine schedule - ANSWER - 3 doses (0, 1-2, 6-18 months)
Rotateq vaccine schedule - ANSWER - 3 doses (2, 4, 6 months)
- administer first dose at 6-14 weeks
- MUST be completed by 32 weeks of age
DTaP vaccine schedule - ANSWER - 3 primary (2,4,6 months)
- 2 boosters (15-18 months & 4-6 years)
- not indicated for children older than 7 years
HiB vaccine schedule - ANSWER - 2 primary (2 and 4 months)
- 1 booster (12-15 months)
- first can be given at 6 weeks
- not indicated for 5 years and older
Pneumococcal vaccine schedule - ANSWER - PCV13 (2,4,6 months)
- PPSV23 (2-5 years if had the PCV13)
- Cochlear implant
- Native Americans
Influenza vaccine - ANSWER - 1 dose for all people 9 years and older
- Children 6 months - 8 years should get two doses
MMR vaccine - ANSWER - 2 doses (12-15 months & 4-6 years)
Hep A vaccine - ANSWER 2 doses (12 months and then 6 months after)
Trisomy 21 - ANSWER - Down syndrome
Symptoms
- Brushfield spots (dark spot on iris)
- Upward slanting eyes
- Flattened nose
- Atlanto-axial instability
XXY Syndrome - ANSWER Klinefelter Syndrome
- most common cause of infertility in men
XO Karyotype - ANSWER Turner Syndrome
- most common sex-chromosome anomaly in females
- webbed neck
- coarctation of aorta
"shield" shaped chest
,Tay-Sachs Disease - ANSWER - Jewish population
- Normal at birth
- Symptoms start at 3-6 months
- Cherry red macula
DiGeorge Syndrome - ANSWER - Affects parathyroid gland and thymus
- Get a lot of infections
Low birth wight - ANSWER <2,500 g
Appropriate for gestational age - ANSWER head circumference, weight, and length
are all > 10th percentile but < 90th
Signs of central cyanosis - ANSWER warm skin
deep blue nail beds
may improve with oxygen
Erythema toxicum - ANSWER - most common newborn rash
- appears day 2-5 after birth
- resolve by day 14
Port wine stain - ANSWER - vascular birthmark
- superficial and deep dilated capillaries
- need to rule out Sturge-Webber syndrome
Anterior fontanel closure - ANSWER by 18 months
posterior fontanel closure - ANSWER by 1-2 months
Osteogenesis Imperfecta - ANSWER - deep blue sclera
DDH Assessment - ANSWER - Ortolani: click is heard or felt
- Barlow: feeling of a slip as the femoral head slips away from the acetabulum
- Allis sign: unequal leg length
- Galeazzi sign: unequal knee height
Mandatory Newborn Screening - ANSWER - PKU
- Galactodemia
- Hemoglobinopathies
- Hypothyroidism
When to start getting BMI - ANSWER 2 years
,when should testes be fully descended - ANSWER 3 months
Stills Murmur - ANSWER - most common innocent murmur
- hear best at LLSB and apex
- Louder when supine
- Musical systolic
What is considered hearing loss - ANSWER loss of > 20 decibles
when does separation anxiety being - ANSWER 9 months
Cows milk - ANSWER avoid until 12 months
Screen time in infants - ANSWER none until 18 months
Infant Developmental Warning Signs - ANSWER - visual delay
- does not raise head when on stomach by 3 months
- does not try yo pick up a toy by 6 months
- does not laugh
Tibial torsion - ANSWER - typically resolves by 4 months
M-CHAT-R - ANSWER Modified Autism Screening
- done at 16-30 months
- score >2 indicates need for follow-up
PHQ-9 - ANSWER Depression Screening
- begins annually at age 12
Cholesterol Screening - ANSWER - for all children between 9-11 years
- again at 17-21 years
School age - ANSWER 6-12 years
- Industry vs. Inferiority
- Develop self-esteem
- Talk to kids alone around 11-12 years
- Breast development begins
ADHD - ANSWER - inattention
- hyperactive
- impulsive
- must be going on for 6 months
, Boys Secondary Sex Characteristics - ANSWER stage 3: penis elongates
stage 4: penis enlarges, rugae appear
Girls Breast development - ANSWER stage 2: breast budding
stage 3: breast enlargement without separate nipple contour
stage 4: areola and nipple project as secondary mound
Pubic Hair Development - ANSWER stage 2: sparse, pale, fine
stage 3: darker, increased amount, curlier
Female menses - ANSWER menarche starts 2-3 years after starting breast stage 2
precocious puberty - ANSWER Girls: onset before 8 years
Boys: onset before 9 years
S1 - ANSWER mitral and tricuspid valves close
S2 - ANSWER aortic and pulmonic valve close
Murmur Grades - ANSWER I- saft, barely audible
II- clearly audible, but faint
III- moderatley loud
IV- loud with a thrill (don't need stethoscope to hear)
V- loud, thrill palpable
VI- very loud, heard w/o stethoscope, thrill palpable and visible
Atrial Septal Defect - ANSWER - Grade II/III systolic ejection murmur
- Left upper sternal boarder
- EKG: RVH
- most close on their own
Ventricular Septal Defect - ANSWER - Grade II-IV, systolic ejection murmur
- holosystolic thrill, might be felt at LLSB
- most common congenital heart defect
- EKG: LVH
- found in Down syndrome
Patent Ductus Arteriosus - ANSWER - II-IV holosystolic
- Machinery sound, LUSB
- very common in prematures
- cardiomegaly
- prostaglanins (motrin) can cause it to close
Rotateq vaccine schedule - ANSWER - 3 doses (2, 4, 6 months)
- administer first dose at 6-14 weeks
- MUST be completed by 32 weeks of age
DTaP vaccine schedule - ANSWER - 3 primary (2,4,6 months)
- 2 boosters (15-18 months & 4-6 years)
- not indicated for children older than 7 years
HiB vaccine schedule - ANSWER - 2 primary (2 and 4 months)
- 1 booster (12-15 months)
- first can be given at 6 weeks
- not indicated for 5 years and older
Pneumococcal vaccine schedule - ANSWER - PCV13 (2,4,6 months)
- PPSV23 (2-5 years if had the PCV13)
- Cochlear implant
- Native Americans
Influenza vaccine - ANSWER - 1 dose for all people 9 years and older
- Children 6 months - 8 years should get two doses
MMR vaccine - ANSWER - 2 doses (12-15 months & 4-6 years)
Hep A vaccine - ANSWER 2 doses (12 months and then 6 months after)
Trisomy 21 - ANSWER - Down syndrome
Symptoms
- Brushfield spots (dark spot on iris)
- Upward slanting eyes
- Flattened nose
- Atlanto-axial instability
XXY Syndrome - ANSWER Klinefelter Syndrome
- most common cause of infertility in men
XO Karyotype - ANSWER Turner Syndrome
- most common sex-chromosome anomaly in females
- webbed neck
- coarctation of aorta
"shield" shaped chest
,Tay-Sachs Disease - ANSWER - Jewish population
- Normal at birth
- Symptoms start at 3-6 months
- Cherry red macula
DiGeorge Syndrome - ANSWER - Affects parathyroid gland and thymus
- Get a lot of infections
Low birth wight - ANSWER <2,500 g
Appropriate for gestational age - ANSWER head circumference, weight, and length
are all > 10th percentile but < 90th
Signs of central cyanosis - ANSWER warm skin
deep blue nail beds
may improve with oxygen
Erythema toxicum - ANSWER - most common newborn rash
- appears day 2-5 after birth
- resolve by day 14
Port wine stain - ANSWER - vascular birthmark
- superficial and deep dilated capillaries
- need to rule out Sturge-Webber syndrome
Anterior fontanel closure - ANSWER by 18 months
posterior fontanel closure - ANSWER by 1-2 months
Osteogenesis Imperfecta - ANSWER - deep blue sclera
DDH Assessment - ANSWER - Ortolani: click is heard or felt
- Barlow: feeling of a slip as the femoral head slips away from the acetabulum
- Allis sign: unequal leg length
- Galeazzi sign: unequal knee height
Mandatory Newborn Screening - ANSWER - PKU
- Galactodemia
- Hemoglobinopathies
- Hypothyroidism
When to start getting BMI - ANSWER 2 years
,when should testes be fully descended - ANSWER 3 months
Stills Murmur - ANSWER - most common innocent murmur
- hear best at LLSB and apex
- Louder when supine
- Musical systolic
What is considered hearing loss - ANSWER loss of > 20 decibles
when does separation anxiety being - ANSWER 9 months
Cows milk - ANSWER avoid until 12 months
Screen time in infants - ANSWER none until 18 months
Infant Developmental Warning Signs - ANSWER - visual delay
- does not raise head when on stomach by 3 months
- does not try yo pick up a toy by 6 months
- does not laugh
Tibial torsion - ANSWER - typically resolves by 4 months
M-CHAT-R - ANSWER Modified Autism Screening
- done at 16-30 months
- score >2 indicates need for follow-up
PHQ-9 - ANSWER Depression Screening
- begins annually at age 12
Cholesterol Screening - ANSWER - for all children between 9-11 years
- again at 17-21 years
School age - ANSWER 6-12 years
- Industry vs. Inferiority
- Develop self-esteem
- Talk to kids alone around 11-12 years
- Breast development begins
ADHD - ANSWER - inattention
- hyperactive
- impulsive
- must be going on for 6 months
, Boys Secondary Sex Characteristics - ANSWER stage 3: penis elongates
stage 4: penis enlarges, rugae appear
Girls Breast development - ANSWER stage 2: breast budding
stage 3: breast enlargement without separate nipple contour
stage 4: areola and nipple project as secondary mound
Pubic Hair Development - ANSWER stage 2: sparse, pale, fine
stage 3: darker, increased amount, curlier
Female menses - ANSWER menarche starts 2-3 years after starting breast stage 2
precocious puberty - ANSWER Girls: onset before 8 years
Boys: onset before 9 years
S1 - ANSWER mitral and tricuspid valves close
S2 - ANSWER aortic and pulmonic valve close
Murmur Grades - ANSWER I- saft, barely audible
II- clearly audible, but faint
III- moderatley loud
IV- loud with a thrill (don't need stethoscope to hear)
V- loud, thrill palpable
VI- very loud, heard w/o stethoscope, thrill palpable and visible
Atrial Septal Defect - ANSWER - Grade II/III systolic ejection murmur
- Left upper sternal boarder
- EKG: RVH
- most close on their own
Ventricular Septal Defect - ANSWER - Grade II-IV, systolic ejection murmur
- holosystolic thrill, might be felt at LLSB
- most common congenital heart defect
- EKG: LVH
- found in Down syndrome
Patent Ductus Arteriosus - ANSWER - II-IV holosystolic
- Machinery sound, LUSB
- very common in prematures
- cardiomegaly
- prostaglanins (motrin) can cause it to close
