Developmental / Neurology – Flashcards
136 test answers
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at the first birthday how much should a child weight?
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3x their birth weight
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in FFT, what is affected first? second? last?
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weight > height > head circumference
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what are signs of FFT in a child?
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SMALL KID S-subcutaneous fat loss M-muscle atrophy A-alopecia L-lagging behind norms L-lethargy K-kwashiorkor (protein malnutrition) or Marasmus (nutrition deficiency) I-infection D-dermatitis
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what is kwashiorkor ?
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protein deficiency in a growing child
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what is marasmus?
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nutritional deficiency in a growing child
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what are the 3 areas of developmental milestones in children?
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motor language social (and there is other, which is quite annoying and non-specific)
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at what months/ages are developmental milestones measured?
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1 mo 2 mo 4 mo 6 mo 9 mo 12 mo 2 yr 3 yr 4yr 5 yr 6 yr
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Development at 1 month Motor language social
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motor - reacts to pain language- responds to none social - regards human face, make eye contact
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so essentially, developmentally what can a 1 month old do?
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responds to pain if you hurt it make some noise if you do looks at you and can make eye contact
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Development at 2 months Motor language social
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motor - *head up prone* and eyes follow object to midline language - coos by 3 months social - *social smile* and recognizes parent
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so essentially, developmentally what can a 2 month old do?
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can hold *head prone*, coo by 3 months, and can recognize parent and *smile*
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Development at 4 months Motor language social
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motor - *rolls over* language - *laughs and squeals* social - *regards hands* (looks and sees hands)
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so essentially, developmentally what can a 4 month old do?
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can roll over, laugh and squeal, and looks at their hands
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Development at 6 months Motor language social
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motor - *sits weel unsupported*, moves objects from hand to hand, *rolls prone to supine* language - *babbles* social - recognizes strangers
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so essentially, developmentally what can a 6 month old do?
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6abbles (babbles) *s*ix = *s*trangers *s*itting at six months
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Development at 9 months Motor language social
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motor - *pincer grasp immature*, mature by 11-12 months, *crawls* and cruises (walks using furniture) language - mama/dada , bye-bye social - stranger anxiety
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so essentially, developmentally what can a 9 month old do?
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can crawl, therefore explore takes 9 months to become a "mama" (can say mama) pinches furniture to walk (pincer grasp and uses furniture to walk)
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Development at 1 yr Motor language social
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motor - *walks with 1 hand held*, throws objects language - *knows 1-3 words*, *can follow 1-step command with gesture* social - n/a
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so essentially, developmentally what can a 1 year old do?
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knows 1 word at 1 year walking away from mom causes anxiety, but they can't walk fully because they need a hand to help
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Development at 2 yr Motor language social
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motor - *walks up and down stairs*, copies a line, *runs, kicks ball* language - *2-3 word phrases*, 1/2 of speech is understood by strangers, *knows name* social - parallel play
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so essentially, developmentally what can a 2 year old do?
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knows 2 word sentences half of language can be understood by others
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Development at 3 yr Motor language social
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motor - *draws circle and pedals a cycle*, can repeat 3 numbers, can build blocks language - speaks sentences, 3/4 of speech is understandable to strangers, recognizes 3 colors social - plays in group, *plays simple games*, knows gender, first and last name
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so essentially, developmentally what can a 3 year old do?
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tricycle, 3 cubes, 3 numbers, 3 colors, 3 kids to make a group to play, and 3/4 of speech should be understood by strangers
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Development at 4 yr Motor language social
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motor - *hops on 1 foot*, identifies body parts, copies cross & square, *throws overhead* language - speech is completely understood, *can tell a story* social - plays with kids, social interaction
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so essentially, developmentally what can a 4 year old do?
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song "head, shoulders, knees, and toes" = 4 parts remind you that at age 4 body parts can be remembered all of speech is understood can copy square (4 edges) and cross (4 parts)
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Development at 5 yr Motor language social
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motor - copies triangle, catches ball, skips, dresses self language - writes name, counts 10 objects social - n/a
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so essentially, developmentally what can a 5 year old do?
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can draw, catch ball, skip, dress, and can write name
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Development at 6 yr Motor language social
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motor - draws a person with 6 parts, ties shoes language - identifies left and right social - n/a
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so essentially, developmentally what can a 6 year old do?
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skips, ties shoes, and can draw person with 6 parts
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what is the moro reflex? when do you see it? what happens?
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seen birth - 5/6 months while supine, allow head to fall back ~3cm and the baby should have symmetric extension and adduction, then flexion of limbs
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what is the timing of the moro reflex?
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birth - 5/6 moths
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what is the startle reflex? when do you see it? what happens?
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seen birth - 5/6 months startle the baby and arms and legs immediately flex
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what is the timing of the startle reflex?
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birth - 5/6 months
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what is the galant reflex? when do you see it? what happens?
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seen birth -2/6 months while prone, stoke the paravetebral region of back and pelvis will move in the direction of the stimulated side
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what is the timing of the galant reflex?
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birth to 2/6 months
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what is the sucking reflex? when do you see it? what happens?
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becomes voluntary at 3 months stimulate the babies' lips and the baby should suck
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what is the timing of the sucking reflex?
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becomes voluntary at 3 months
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what is the babinski reflex? when do you see it? what happens?
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seen birth - 4 months stroke from toes to heel and you see fanning of toes
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what is the timing of the babinski reflex?
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birth - 4 mos
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what is the tonic neck reflex? when do you see it? what happens?
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seen birth - 6/7 months while supine rotate head laterally and you will see extension of limbs on chin side and flexion of limbs on opposite side (fencing position)
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what is the timing of the tonic neck reflex?
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birth - 6/7 months
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what is the rooting reflex? when do you see it? what happens?
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seen <1 month stroke finger from mouth to earlobe and head turns towards stimulus mouth opens
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what is the timing of the rooting reflex?
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less prominent after 1 month
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what is the palmar/plantar grasp reflex? when do you see it? what happens?
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seen from birth - 2/3 months stimulation of palm or plantar surface of foot and there is palmar or plantar flexion
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what is the timing of the palmar/plantar grasp reflex?
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birth - 2/3 months
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what is the parachute reflex? when do you see it? what happens?
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papers at 9 months and lasts through life horizontal suspension and quick thrusting movement towards surface causes extension of extremities
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at what age should children have all of their teeth, including secondary molars?
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2 & 1/2 years
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what are the first teeth to erupt, and at what age?
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central incisors between 5-8 months
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when do permeant teeth begin to develop?
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age 6-7
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what are common causes of delayed eruption of teeth?
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genetic abnormalities (down syndrome) endocrine disorders (hypothyroidism)
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at what age should children see the dentist for the first time?
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12 mos
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what is the leading cause of death in children <1 year of age?
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perinatal condition, including: congenital malformation (#1 cause) low birth weight SIDS perinatal infection
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from age 1-24, the leading cause of death is?
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INJURY
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what are some important anticipatory guidance for 1 week - 1 month
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infant sleep on back with nothing in crib to prevent SIDS car seat smoke free home keep water <120F in house NO HONEY UNTIL AGE 1!
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what are some important anticipatory guidance for 1 moths - 1 year
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childproof home of tubs with water, plastic bags, electrical outlet coverings, guns, knives no use of ipecac syrup avid baby walkers do not put baby to bed with bottle, will causes caries breast feed or give iron fortified formal, but no whole milk until after 1
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at what age should solid foods begin to be introduced to children?
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4-6 months
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at what age can children start drinking while milk?
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1 yr
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at what age can kids have honey
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1 yr
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at what age can kids start using a cup?
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6-9 months
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at what age should a child be weaned from a bottle?
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9 months
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what are some important anticipatory guidance for 1 year - 5 years
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use toddler car seat (1-4 yrs) and booster seat (4-8 years) brush teeth allow kids to eat with utensils wear bike helmet keep away from pools without proper watching
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what are some important anticipatory guidance for 6 year - 10 years
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reinforce proper hygiene teach stranger safety provide healthy meals and snacks use booster until 4'9"
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at what height can you stop using a booster seat?
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4'9"
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at what age should you test lead level?
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12 moths
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at what age should you test for anemia?
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9-12 moths (WIC requires 9 months, remainder is 12)
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children <20 pounds should be using with type of car seat?
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rear facing
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children 20-40 pounds should be using with type of car seat?
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forward facing car seat
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vaccines given at: birth
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hep B
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vaccines given at: 2 months
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hep b rota virus (LIQUID) DTaP Hib Pneumococcal Inactivated Polio
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vaccines given at: 4 months
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rota virus (LIQUID) DTaP Hib Pneumococcal Inactivated Polio
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vaccines given at: 6 months
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hep b (*third dose can be given from 6-18 months*) rota virus (LIQUID) DTaP Pneumococcal Inactivated Polio (*third dose can be given from 6-18 months*) *INFLUENZA* (yearly, but starting at 6 months)
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vaccines given at: 12 months
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hep b (if not given at 6 mos, can go to 18 mos) Hib (12-15 mos) Pneumococcal (12-15 mos) Inactivated Polio (if not given at 6 mos, can go to 18 mos) influenza (yearly, but starting at 6 months) *first dose MMR* *first dose Varicella* *first dose Hep A*
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vaccines given at: 15 months
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hep b (if not given at 6 mos, can go to 18 mos) *4th dose DTaP* (thru 18 mos) Hib (12-15 mos) Pneumococcal (12-15 mos) Inactivated Polio (if not given at 6 mos, can go to 18 mos) influenza (yearly, but starting at 6 months) MMR (12-15 mos) Varicella (12-15 mos) Hep A (12-15 mos)
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vaccines given at: 18 months
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DTaP (if not given at 15 mos) 2nd Hep A dose (must be 6 months after 1st dose)
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vaccines given at: 2 years - 3 years
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Hib (if not given at 12-18 months)
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vaccines given at: 4 years - 6 years
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D Tap (5th) Inactivated polio (4th) MMR (2nd) Varicella (2nd)
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at what age do you get the *T*DaP?
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age 11
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vaccines given at: 11 years - 12 years
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Tdap HPV
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Hep B vaccine is given at what months?
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birth 2 mos 6 mos 12 mos
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at what ages is Dtap given?
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2, 4, 6 months and 12-18 dos
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at what ages is Hib given?
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2, 4, 6 months and between 12-15 months
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T or F, MMR is a live virus vaccine?
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TRUE
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how is MMR vaccine delivered?
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sub-q
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at what ages is MMR given?
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12-15 months and second dose 4-6 years
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at what ages is the inactivated polio vaccine given?
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2 mos, 4 mos, between 6-18 months, and 4-6 years
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at what age is varicella given?
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minimum 12 months between 12-18 months, and 4-6 years
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what is the minimum age to receive the flu vaccine (seasonal)
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6 months
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what infectious disease is commonly known to cause febrile seizures?
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roseola
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the diagnosis of epilepsy requires ___ of more unprovoked seizures
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2
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what is an absence seizure?
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sudden brief disconnection of activity and unresponsiveness
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what is at tonic clonic seizure?
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bilateral symmetrical tonic contraction than bilateral clonic contraction
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what is a myoclonic seizure?
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a sudden, brief involuntary contraction of muscles or group of muscle
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what is an atonic seizure?
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sudden brief, 1-2 second decrease in tone without a breeding myoclonic or tonic event
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in a simple partial seizure how is consciousness affected?
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consciousness is NOT altered
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in a complex partial seizure how is consciousness affected?
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consciousness IS affected
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what is the classic EEG finding of an absence seizure
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3-Hz spike and wave pattern
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what is the most common age presentation of an absence seizures?
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4-12yo bc that is when kids are in school and it is noticed
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what is the MC seizure disorder during childhood? when is the peak?
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MC is febrile seizures peaks 6 months - 6 years highest before age 1
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how does a febrile seizure present?
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brief tonic-clonic seizure associated with a fever
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a febrile seizure lasting >15 min is suggestive of...?
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organic cause such as meningitis or toxin exposure get a CSF sample
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if a febrile seizure is brief (<15 min) what is the workup?
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good examination and laboratory evaluation to find cause of fever CT/EEG is not needed
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what si the MC drug used for absence seizures?
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ethosuxamide
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what si the MC common partial epilepsy?
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benign rolandic epilepsy
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what are the s/s of benign rolandic epilepsy? when does it usually occur?
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seizure occurs during sleep with facial moment onset age 3-13 and resolves MC by age 16
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a child with a port wine stain should make you think of ?, which is what?
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sturge-weber syndrome abnl development of the meningeal vasculature
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what are common bacterial sources of meningitis in a child *< 3 months*
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group B strep e coli listeria
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what are common bacterial sources of meningitis in a child *> 3 months*
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strep pneumonia H flu type B niserria meningitis
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what is the term aseptic meningitis used to describe?
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describe syndrome of meningism and CSF leukocytosis cured by viruses and bacteria
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wha are S/S of meningitis?
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fever, headache and *nuccal rigidity* photophobia, myalgia Brudzinski and Kerning sign
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CSF--interpret the cause appearance: clear Cells : mononuclear Leukocytes : 50-75% of serum glucose
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NORMAL
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CSF--interpret the cause appearance: turbid Cells : polymorphs Leukocytes : 100-1000 Protein : 100-500 Glucose : decreased
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bacteria
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CSF--interpret the cause appearance: clear Cells : mononuclear Leukocytes : 50-1000 Protein : 50-200 Glucose : generally normal
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viral
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CSF--interpret the cause appearance: clear Cells : mononuclear Leukocytes : >100 Protein : 25-200 Glucose : <50
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fungal
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a neonate with meningitis is caused by what organism? tx?
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group B strep gram negative enteric bacilli listeria e coli TX with ampicillin + 3rdG cephalosporin
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a child age 1-10 with meningitis is caused by what organism? tx for them?
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strep pneumonia -- TX with 3rdG cephalosporins neisseria meningitis H flu type B TX these with vancomycin until susceptibility is known
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a child age 10-19 with meningitis is caused by what organism? tx for them?
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streptococcus pneumonia - TX 3rdG cephalosporin Neisseria meningitis -- Vanco until susceptibility known
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what are the most common types of viral meningitis?
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ENTEROVIRUS (85%) echovirus, coxsackievirus, or non paralytic poliovirus
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what is the classic organism for fungal meningitis?
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crytococcus (usually in immunocompromised pt)
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omg im not typing sxs of Down syndrome
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sorry
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down syndrome is known as?
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trisomy 21
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what is a known RF for developing DS?
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advanced maternal age
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what is a complication many people with down syndrome have?
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alzheimer's demential early on in life
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in a baby with DS presenting with bilious vomitting look for....?
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duodenal atresia
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what is the MC cardiac abnormality in a child with DS?
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Atrioventricular septal defect
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diagnosis of down syndrome can be made before a baby is born and the amniocentesis will have _____ levels of AFP, ____ levels of estriol, and _____ levels of B-HCG
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low AFP low estriol HIGH BHcg
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a newborn infant is born with lymphedema of the hands and feet, extra skin folds, an a short neck with widely spaced nipples and femoral pulses dx?
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turners sundrome
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what is the etiology of turner's syndrome?
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45XO, missing 1 X chromosome
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what is the MCC of primary amenorrhea?
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turner's syndrome
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what are S/S of turner's syndrome?
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female short stature webbed neck lymphedema of hands and neck small mandible coarctation of aorta + bicuspid arotic valve epicanthial folds impaired dhearing ovarian dysgensis
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what is Klinefelter syndrome etiology?
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47, XXY (extra X chromosome)
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S/S of Klinefelter syndrome?
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hypogonadism small testes but poverty occurs at normal age azoospermia tall stature female hair distribution, gynecomastia delayed learning and motor skills
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what is a common heart condition seen in turner's syndrome?
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coarctation of the aorta
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