1
Q
Nommez les valeurs normales: TA, FR, FC
- < 1 an
- 1-2
- 2-5
- 5-12
- >12
A
2
Q
Nommez les fréquences des rencontres pédiatrique
A
- newborn (within 1 wk post-discharge), 1, 2, 4, 6, 9, 12, 15, 18, 24 mo
- annually between age 2-5; every 1-2 yr between age 6-18
3
Q
Name: Adverse Reactions Associated With Any Vaccine (5)
A
- Local: induration,tenderness,redness, swelling
- Systemic: fever, rash, irritability
- Allergic: urticaria,rhinitis,anaphylaxis
- Contraindications
- Moderate/severeillness ± fever
- Allergy to vaccine component
- No need to delay vaccination for mild URTI (Upper respiratory tract infections)
4
Q
Name adverse reaction (3) and contraindication (3) for this vaccination: TdaP-IPV
A
- Adverse reaction
- Prolonged crying
- Hypotonic unresponsive state (rare)
- Seizure on day of vaccine (rare)
- Contraindication
- Evolving unstable neurologic disease
- Hyporesponsive/hypotonic following previous vaccine
- Anaphylactic reaction to neomycin or streptomycin
5
Q
Name adverse reaction (2) and contraindication (4) for this vaccination: Rot-1
A
- Adverse reaction:
- Cough
- Diarrhea, vomiting
- Contraindication
- History of intussusception
- Immunocompromised
- Abdominal disorder (e.g. Meckel’s diverticulum)
- Received blood products (e.g. immunoglobulin) within 42 d
6
Q
Name adverse reaction (5) and contraindication (3) for this vaccination: MMR
A
- Adverse reaction:
- Measle-like rash (7-14 d)
- Lymphadenopathy, arthralgia, arthritis
- Parotitis (rare)
- Especially painful injection
- Transient thrombocytopenia (1/30,000)
- Contraindication
- History of intussusception
- Immunocompromised
- Abdominal disorder (e.g. Meckel’s diverticulum)
- Received blood products (e.g. immunoglobulin) within 42 d
7
Q
Name adverse reaction (2) and contraindication (2) for this vaccination: Var
A
- Adverse reaction:
- Mild varicella-like papules or vesicles
- 2 wk may get local or generalized rash
- Contraindication:
- Anaphylactic reaction to Baker’s yeast
8
Q
Name adverse reaction (1) and contraindication (1) for this vaccination: Hep-B
A
- Adverse reaction:
- Contraindication:
- Anaphylactic reaction to Baker’s yeast
9
Q
Name adverse reaction (0) and contraindication (1) for this vaccination: HepB
A
- Adverse reaction
- Contraindication:
- Anaphylactic reaction to Baker’s yeast
10
Q
Name adverse reaction (0) and contraindication (1) for this vaccination: DTaP
A
- Adverse reaction:
- Contraindication:
- 1st trimester pregnancy
11
Q
Name adverse reaction (4) and contraindication (3) for this vaccination: Inf
A
- Adverse reaction:
- Malaise, myalgia
- Febrile seizure when given with Pneu-C 13 or DTaP
- Hypersensitivity reaction
- Contraindication:
- <6 mo of age
- Immunocompromised
- Egg-allergic individuals – Live attenuated influenza vaccine is not recommended for those with an egg allergy. In these individuals, trivalent or quadrivalent vaccine can be given in environment where anaphylaxis can be managed
12
Q
Name adverse reaction (1) and contraindication (0) for this vaccination: HPV-4
A
- Adverse reaction:
- Pruritis
- Contraindication:
13
Q
Name adverse reaction (0) and contraindication (1) for this vaccination: MenB
A
- Adverse reaction:
- Contraindication:
- Anaphylactic reaction to MenB vaccine or its components in the past
14
Q
When is the most rapid growth? (2)
A
- most rapid growth during first 2 yr
- and at puberty
15
Q
Premature infants (<37 wk) use corrected GA until when?
A
age 2
16
Q
What’s the average growth at birth of this parameter: Birth Weight
- Normal
- Growth
- Comments
A
- Normal: 3.25 kg (7 lbs)
- Growth:
- Gain 20-30 g/d (term neonate)
- 2 x birth wt by 4-5 mo
- 3 x birth wt by 1 yr
- 4 x birth wt by 2 yr
- Comments:
17
Q
What’s the average growth at birth of this parameter: Length/Height
- Normal
- Growth
- Comments
A
- Normal: 50 cm (20 in)
- Growth:
- 25 cm in 1st yr
- 12 cm in 2nd yr
- 8 cm in 3rd yr then
- 4-7 cm/yr until puberty
- 1/2 adult height at 2 yr
- Comments:
- Measure supine length until 2 yr of age, then measure standing height
18
Q
What’s the average growth at birth of this parameter: Head Circumference
- Normal
- Growth
- Comments
A
- Normal:
- 35 cm (14 in)
- Growth:
- 2 cm/mo for 1st 3 mo
- 1 cm/mo at 3-6 mo
- 0.5 cm/mo at 6-12 mo
- Comments:
- Measure around occipital, parietal, and frontal prominences to obtain the greatest circumference
19
Q
Describe: Moro reflex
- Maneuver to Elicit Reflex
- Appropriate Reflex Response
- Age of Disappearance
A
- Maneuver to Elicit Reflex: Infant placed semi-upright, head supported by examiner’s hand, sudden withdrawal of supported head with immediate return of support
- Appropriate Reflex Response: Abduction and extension of the arms, opening of the hands, followed by flexion and adduction of arms
- Age of Disappearance: 4-6 mo
20
Q
Describe: Galant reflex
- Maneuver to Elicit Reflex
- Appropriate Reflex Response
- Age of Disappearance
A
- Maneuver to Elicit Reflex: Infant held in ventral suspension and one side of back is stroked along paravertebral line
- Appropriate Reflex Response: Pelvis will move in the direction of stimulated side
- Age of Disappearance: 2-3 mo
21
Q
Describe: Grasp reflex
- Maneuver to Elicit Reflex
- Appropriate Reflex Response
- Age of Disappearance
A
- Maneuver to Elicit Reflex: Placement of examiner’s finger in infant’s palm
- Appropriate Reflex Response: Flexion of infant’s fingers
- Age of Disappearance:
22
Q
Describe: ATNR reflex
- Maneuver to Elicit Reflex
- Appropriate Reflex Response
- Age of Disappearance
A
- Maneuver to Elicit Reflex: Turn infant’s head to one side
- Appropriate Reflex Response: “Fencing” posture (extension of ipsilateral arm and leg and flexion of contralateral arm and leg)
- Age of Disappearance:
23
Q
Describe: Placing reflex
- Maneuver to Elicit Reflex
- Appropriate Reflex Response
- Age of Disappearance
A
- Maneuver to Elicit Reflex: Dorsal surface of infant’s foot placed touching edge of table
- Appropriate Reflex Response: Flexion followed by extension of ipsilateral limb up onto table (resembles primitive walking)
- Age of Disappearance:
24
Q
Describe: Rooting reflex
- Maneuver to Elicit Reflex
- Appropriate Reflex Response
- Age of Disappearance
A
- Maneuver to Elicit Reflex: Tactile stimulus near mouth
- Appropriate Reflex Response: Infant turns head and opens mouth to suck on same side that cheek was stroked
- Age of Disappearance: 2-3 mo
25
Describe: Parachute reflex
* Maneuver to Elicit Reflex
* Appropriate Reflex Response
* Age of Disappearance
* Maneuver to Elicit Reflex: Tilt infant to side while in sitting position
* Appropriate Reflex Response: Ipsilateral arm extension, present by 6-8 mo
* Age of Disappearance: Does not disappear
26
Name: Developmental Red Flags (4)
* Gross motor: not walking at 18 mo rolling too early at \<3 mo
* Fine motor: hand preference at \< 18mo
* Speech: \< 10 words at 18mo
* Social: not smiling at 3 mo; not pointing at 15-18 mo
27
28
What are the dietery needs/requirements for these weights:
* \<10 kg
* 10-20 kg
* \> 20 kg
* \<10 kg: 100 kcal/kg/d
* 10-20 kg: 1000 cal + 50 kcal/kg/d for each kg \>10
* \> 20 kg: 1500 cal + 20 kcal/kg/d for each kg \>20
29
What are the Dietary Recommendations for: 0-6mo (2)
* breast milk or formula
* exclusive breast milk during first 6 mo recommended over formula unless contraindicated
30
Breastfed infants require supplements. Name them. (3)
* vitamin D (400 IU/d)
* Fluoride (after 6 mo if not sufficient in water)
* Iron (6-12 mo, only if not receiving fortified cereals/meat/meat alternatives)
31
What are the Dietary Recommendations for: \> 6 mois (8)
* \>6mo: solid food introduction– do not delay beyond 9mo
* 2-3 new foods per wk, wait at least 2 d in between each food to allow time for adverse reaction identification
* common allergens: eggs, milk, mustard, peanuts, seafood, sesame, soy, tree nut, wheat
* early introduction of highly allergenic foods is recommended
* offer lumpy, soft-cooked, pureed, mashed textured foods
* 9-24 mo: switch to homogenized (3.25%) milk, offer 16oz/d to non-breast feeding infant
* offer vegetables, fruit, grains, and full-fat milk in any order after iron-rich foods are given
* provide up to 3 large feedings (meals) with 1-2 smaller feedings (snacks), depending on child’s hunger/satiety cues
* encourage self-feeding and introduce open cup (should be done by 18 mo)
32
Name foods to avoid (7)
* honey until past 12 mo (risk of botulism)
* added sugar, salt
* excessive milk (i.e. no more than 750 mL or 24 oz/d after 1 yr)
* limit juice intake (not nutritious, too much sugar), maximum 4-6 oz (1/2 cup) daily
* anything that is a choking hazard (chunks, round foods like grapes)
* 2-6 yr: switch to 2% milk (500 mL/d)
* can maintain breastfeeding during this time complementary to solids
33
Name content of breastmilk (2)
* colostrum (first few days): clear, rich in nutrients (i.e. high protein, low fat), immunoglobulin
* mature milk: 70:30 whey:casein ratio, fat from dietary butterfat, carbohydrate from lactose
34
Name advantages: Breasfeeding (4)
* easily digested, low renal solute load
* immunologic
* reduction of acute illnesses (i.e. diarrhea, respiratory tract illnesses, acute otitis media) and may have longer term benefits
* contains IgA, macrophages, active lymphocytes, lysozymes, lactoferrin (which inhibits E. coli growth in intestine)
* lower pH promotes growth of Lactobacillus in GI tract
* parent-child bonding
* economical, convenient
35
Name: Maternalcontraindications of breastfeeding (4)
* chemotherapy, radioactive compounds, or medications known to cross to breast milk
* HIV/AIDS, active untreated TB, herpes in breast region
* \>0.5 g/kg/d of alcohol or illicit drugs
* OCPs are not a contraindication to breastfeeding (estrogen may decrease lactation, but is not dangerous to infant)
36
If poor weight gain by breastfeeding, what to do? (1)
consider dehydration or FTT and may consider formula supplementation if insufficient milk production or intake
37
Describe: Oral candidiasis (thrush) (2)
* treat baby with antifungal such as nystatin;
* can occur in breast or bottle-fed infants
38
Décrire this formula compared to breask milk: Cow’s Milk-Based (Enfamil®, Similac®)
* Indications (3)
* Content (as compared to breast milk) (2)
* Indications:
* Prematurity
* Transition to breastfeeding
* Contraindication to breastfeeding
* Content (as compared to breast milk):
* Lower whey:casein ratio
* Plant fats instead of dietary butterfat
39
Décrire this formula compared to breask milk: Fortified Formula
* Indications (2)
* Content (as compared to breast milk) (2)
* Indications:
* Low birth weight Prematurity
* Content (as compared to breast milk):
* Higher calories and vitamins A, C, D, K
* May only be used in hospital due to risk of fat- soluble vitamin toxicity
40
Décrire this formula compared to breask milk: Soy Protein (Isomil®, Prosobee®)
* Indications (2)
* Content (as compared to breast milk) (1)
* Indications:
* Galactosemia
* Desire for vegetarian/vegan diet\*
* Content (as compared to breast milk):
41
Décrire this formula compared to breask milk: Partially Hydrolyzed Proteins (Good Start®)
* Indications (2)
* Content (as compared to breast milk) (1)
* Indications:
* Delayed gastric emptying
* Risk of cow’s milk protein allergy
* Content (as compared to breast milk):
42
Décrire this formula compared to breask milk: Protein Hydrolysate (Nutramigen®, Alimentum®, Pregestimil®, Portagen®)
* Indications (2)
* Content (as compared to breast milk) (3)
* Indications:
* Malabsorption
* Food allergy including cow’s milk protein allergy
* Content (as compared to breast milk):
* Protein is 100% casein with no whey
* Corn syrup solids, sucrose, or tapioca starch instead of lactose
* Expensive
43
Décrire this formula compared to breask milk: Amino Acid (Neocate®, PurAminoTM)
* Indications (2)
* Content (as compared to breast milk) (3)
* Indications:
* Food allergy
* Short gut
* Content (as compared to breast milk):
* Free amino acids (no protein)
* Corn syrup solids instead of lactose
* Very expensive
44
Décrire this formula compared to breask milk: Metabolic
* Indications (1)
* Content (as compared to breast milk) (1)
* Indications: Inborn errors of metabolism
* Content (as compared to breast milk): Various different compositions for children with galactosemia, propionic acidemia, etc.
45
10-35% of children with cow’s milk protein allergy also have reactions to ?
soy-based formula
46
Name leading cause of death in children \>1 yr of age (2)
* Injuries
* main causes: motorvehicle crashes, burns, drowning, falls, choking, infanticide
47
Describe Injury Prevention Counselling: 0-6 mo (6)
* Do not leave alone on bed, on changing table, or in tub
* Keep crib rails up
* Check water temperature before bathing
* Do not hold hot liquid and infant at the same time
* Check milk temperature before feeding
* Appropriate car seats are required before leaving hospital
48
Describe Injury Prevention Counselling: 6-12 mo (7)
* Install stair barriers
* Discourage use of walkers
* Avoid play areas with sharp-edged tables and corners
* Cover electrical outlets
* Unplug appliances when not in use
* Keep small objects, plastic bags, cleaning products, and medications out of reach
* Supervise during feeding Appropriate car seats
49
Describe Injury Prevention Counselling: 1-2 yr (4)
* Never leave unattended
* Keep pot handles turned to back of stove
* Caution with whole grapes, nuts, raw carrots, hotdogs, etc. due to choking hazard
* No running while eating Appropriate car seats
50
Describe Injury Prevention Counselling: 2-5 yr (5)
* Bicycle helmet
* Never leave unsupervised at home, driveway, or pool
* Teach bike safety, stranger safety, and street safety
* Swimming lessons (\>4 yr), sunscreen (from 6 mo), fences around pools
* Appropriate car seats
51
Décrire: Circumcision (3)
* elective procedure
* CPS affirms that circumcision is not medically indicated, and does not recommend routine circumcision for every newborn male
* often for religious or culture reasons
52
Name benefits, complications and contraindications: Décrire: Circumcision (3)
* **benefits**:
* prevention of phimosis
* and slightly reduced incidence of UTI, STI, balanitis, cancer of the penis
* **complications (\<1%)**: local infection, bleeding, urethral injury
* **contraindications**: presence of genital abnormalities (e.g.hypospadias) or known bleeding disorder
TN Pédiatrie
flashcards
Decks in class (14)
# Cards
-
1. Primary care52
-
2. Common Complaints90
-
3. Adolescent Medecine9
-
4. Child Abuse and Neglect17
-
5. Cardiology81
-
6. Development44
-
8. Fluids and electrolytes12
-
10. Hematology21
-
12. Infectious Diseases160
-
13. Neonatology122
-
14. Nephrology57
-
16. Respirology63
-
17. Rheumatology37
-
18. Common medications9
