Pediatric Medicine Overview
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Questions and Answers

Which of the following injuries is NOT mentioned as a potential sign of abuse?

  • Bruising
  • Fractures (correct)
  • Subconjunctival hemorrhages
  • Intra-oral injuries

    • What is a key concern regarding the injuries listed?

  • They are highly indicative of abuse (correct)
  • They are easily mistaken for other conditions
  • They are often caused by accidents
  • They are difficult to diagnose

    • Why might these injuries be 'poorly explained'?

  • The individuals may not be able to clearly describe the events
  • The individuals may be hesitant to disclose the true cause of the injuries (correct)
  • The injuries may have been caused by unknown factors
  • The medical professionals may not be able to properly assess the injuries

    • What is the average range for a newborn's heart rate while they are awake?

    <p>100-165 bpm (D)</p> Signup and view all the answers

    Which of the following best describes the overall tone of the content?

    <p>Serious and concerned (B)</p> Signup and view all the answers

    What is the average weight range for a full-term newborn?

    <p>3.5-6 kg (A)</p> Signup and view all the answers

    By what age do infants typically double their birth weight?

    <p>4 months (B)</p> Signup and view all the answers

    How much does a newborn's weight typically drop during the first week of life?

    <p>5-10% (C)</p> Signup and view all the answers

    What is the average head circumference of a newborn at birth?

    <p>35 cm (A)</p> Signup and view all the answers

    During the first year of life, how much does a newborn's head circumference typically increase each month?

    <p>1 cm (A)</p> Signup and view all the answers

    How much does a newborn's brain weight typically increase by 4-6 months?

    <p>Doubles (C)</p> Signup and view all the answers

    What is the average length of a full-term newborn at birth?

    <p>51 cm (C)</p> Signup and view all the answers

    How much does a newborn's length typically increase per year between the ages of 4 and puberty?

    <p>2 inches (B)</p> Signup and view all the answers

    What is the average respiratory rate (RR) for a newborn?

    <p>40-60 breaths/min (C)</p> Signup and view all the answers

    What are the common acute illnesses experienced by children?

    <p>Cold, RSV, Ear infection, Roseola (B)</p> Signup and view all the answers

    What does the APGAR score assess in newborns?

    <p>The baby's ability to breathe, heart rate, muscle tone, reflexes, and skin color (C)</p> Signup and view all the answers

    What are the differences between parent and child histories?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following is a common chronic childhood illness?

    <p>Asthma (B)</p> Signup and view all the answers

    What is one reason why medication dosage for children is not proportional to weight differences?

    <p>All of the above (D)</p> Signup and view all the answers

    What is one of the key factors that contributes to the difference in injury severity between infants and older children?

    <p>All of the above (D)</p> Signup and view all the answers

    Why is information about maternal and infant mortality considered essential for national health?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the critical APGAR score that indicates a need for immediate respiratory support?

    <p>4 or lower (C)</p> Signup and view all the answers

    What are the five components assessed in the APGAR score?

    <p>Appearance, Pulse, Grimace, Activity, Respiration (B)</p> Signup and view all the answers

    What are some of the key factors to consider when assessing a pediatric patient's history?

    <p>All of the above (D)</p> Signup and view all the answers

    Why is it important to continue collecting data on births and deaths in pediatrics?

    <p>All of the above (D)</p> Signup and view all the answers

    Why might a child experience more severe illness symptoms compared to an adult who has the same disease?

    <p>All of the above (D)</p> Signup and view all the answers

    What is one reason why it is important for parents to be truthful about their child's history?

    <p>All of the above (D)</p> Signup and view all the answers

    What are some common factors that contribute to developmental delays in children?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following is NOT a requirement for an unemancipated minor to consent to medically necessary healthcare?

    <p>The minor must have a specific medical diagnosis. (C)</p> Signup and view all the answers

    Which of the following is a valid way for a minor to become emancipated?

    <p>Being married. (C)</p> Signup and view all the answers

    What is the "Mature Minor Doctrine"?

    <p>A legal doctrine that allows minors to consent to their own healthcare in specific, limited circumstances. (B)</p> Signup and view all the answers

    Which of the following could be considered "medically necessary health care"?

    <p>Physical therapy for a sports injury. (D)</p> Signup and view all the answers

    What does the phrase "emancipated minor" refer to?

    <p>A minor who has been legally declared independent from their parents or guardians. (B)</p> Signup and view all the answers

    What is the age range for adolescents according to the CDC?

    <p>12-17 (A)</p> Signup and view all the answers

    Which of the following is NOT a key difference between pediatrics and adult medicine?

    <p>Lifestyle choices (B)</p> Signup and view all the answers

    Which age group is considered a 'toddler' according to the content?

    <p>1-3 (D)</p> Signup and view all the answers

    Why is the immature blood-brain barrier (BBB) in children important to consider in pediatric care?

    <p>It makes children more susceptible to CNS effects of medications. (C)</p> Signup and view all the answers

    Why are infants and young children considered 'obligate nose breathers'?

    <p>Their airways are shorter and narrower. (A)</p> Signup and view all the answers

    What could explain why infants and young children require lower doses or more frequent administrations of medication than adults?

    <p>Faster metabolism and absorption (C)</p> Signup and view all the answers

    Which of the following is NOT mentioned as a developmental characteristic of children?

    <p>Long life expectancy (C)</p> Signup and view all the answers

    Why are infants and young children more prone to dehydration?

    <p>They have a smaller body mass. (B)</p> Signup and view all the answers

    What does the text suggest about the importance of family history in pediatric care?

    <p>It can help predict potential health risks and genetic diseases. (D)</p> Signup and view all the answers

    Which aspect of the physical exam (PE) is specifically mentioned in the text as being important in pediatrics?

    <p>Physical milestones (A)</p> Signup and view all the answers

    What does the text suggest about the importance of a parent as a historian in pediatric medicine?

    <p>Parents can provide valuable information about a child's developmental history. (D)</p> Signup and view all the answers

    What is the MOST important factor to consider regarding medication dosages in children?

    <p>The child's weight (C)</p> Signup and view all the answers

    Why is it important to consider the 'windows of development' in pediatric care?

    <p>They help identify potential developmental delays or disorders. (D)</p> Signup and view all the answers

    What is the main reason for considering the 'co-dependent' nature of children in their care?

    <p>Children require adult assistance for their safety. (D)</p> Signup and view all the answers

    What makes pediatric medicine unique in terms of environmental exposure?

    <p>Children are exposed to different environmental factors during pregnancy and breastfeeding. (D)</p> Signup and view all the answers

    Which of the following is NOT included in the "HEADSS" adolescent psychosocial history?

    <p>Home (C)</p> Signup and view all the answers

    What is the primary focus of a pre-participation sports physical?

    <p>Identifying any existing medical conditions that could pose a risk to the athlete during participation (C)</p> Signup and view all the answers

    Which of the following is considered a sentinel injury in child abuse?

    <p>A small, superficial bruise on a toddler's thigh (B)</p> Signup and view all the answers

    Which of the following is NOT a challenge associated with transitioning adolescents into adult-centered healthcare?

    <p>Financial challenges with high healthcare costs (C)</p> Signup and view all the answers

    During an 11-year-old's visit, what is the specific focus of the physical examination (PE)?

    <p>Determining the child's sexual maturity rating (SMR) (D)</p> Signup and view all the answers

    Which of the following is NOT included in the pre-participation sports physical assessment?

    <p>Assessing the athlete's cognitive function and decision-making skills (B)</p> Signup and view all the answers

    What is the purpose of the "Transition Policy" in the transition to adult care?

    <p>Outlining the steps involved in transitioning adolescents from pediatric to adult care (B)</p> Signup and view all the answers

    What is the purpose of the "Transition Readiness" component of the transition to adult care process?

    <p>Determining the adolescent's preparedness to manage their own healthcare needs (A)</p> Signup and view all the answers

    What is the purpose of the "Transition Planning" component of the transition to adult care process?

    <p>Developing a customized plan for the adolescent's transition to adult care (C)</p> Signup and view all the answers

    At what age range does the "Transfer and/or integration into adult centered care" component of the transition to adult care process take place?

    <p>18-21 (A)</p> Signup and view all the answers

    During a pre-participation sports physical, what specific information is gathered regarding female athletes?

    <p>Their history of menstrual cycles (B)</p> Signup and view all the answers

    What are the two primary areas of health that are emphasized in pre-participation sports physicals?

    <p>Cardiovascular and musculoskeletal health (C)</p> Signup and view all the answers

    Which of the following is NOT a condition that would require a treatment plan before or during participation in sports?

    <p>A broken leg from a recent accident (C)</p> Signup and view all the answers

    What is the purpose of identifying "medical problems w risks of life-threatening complications" during a pre-participation sports physical?

    <p>To ensure that the athlete is not at risk of serious injury during participation (D)</p> Signup and view all the answers

    In the context of transition to adult care, what is the primary goal of "Transition completion & ongoing care w adult clinician"?

    <p>To monitor the adolescent's health and well-being after the transition process (D)</p> Signup and view all the answers

    Flashcards

    Unemancipated Minor

    A minor who cannot consent to medical treatment without parent/guardian's approval.

    Emancipated Minor

    A minor aged 16 or older who can make their own medical decisions due to specific conditions.

    Medical Emancipation

    A legal status allowing minors to consent to their own medical care without parental consent.

    Mature Minor Doctrine

    Legal principle allowing minors to consent to medical treatment based on maturity level.

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    Conditions for Emancipation

    Valid marriage, active duty, or declaration of emancipation can emancipate a minor.

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    Newborn Heart Rate (HR)

    Normal heart rate for newborns is 100-165 bpm when awake.

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    Newborn Respiratory Rate (RR)

    Normal respiratory rate for newborns is 40-60 breaths per minute.

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    Newborn Blood Pressure (BP)

    Normal BP for newborns is 67-84/35-53 mmHg.

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    Newborn Temperature (Temp)

    Normal temperature range for newborns is 36.5-37 C (97.7-98.6 F).

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    Infant Weight Gain

    Infants double their birth weight by 4 months.

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    Full-Term Birth Weight

    Full-term infants average 3.5-6 kg (7-13 lbs).

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    Weight Loss After Birth

    Infants can lose 5-10% of birth weight in the first week.

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    Average Newborn Length

    Average length at birth is 51 cm or 20 inches.

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    Head Circumference at Birth

    Average head circumference at birth is 35 cm.

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    Preterm Classification

    Infants born preterm are less than 42 weeks gestation.

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    Pediatric Illnesses

    Common childhood diseases include colds, RSV, ear infections, and roseola.

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    Common Childhood Chronic Diseases

    Chronic conditions in children include dental caries, asthma, cystic fibrosis, diabetes, obesity, malnutrition, developmental delays, and cerebral palsy.

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    APGAR Score

    A test assessing newborn health with five components: Appearance, Pulse, Grimace, Activity, and Respiration.

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    APGAR Components

    The five components of the APGAR score are Appearance, Pulse, Grimace, Activity, and Respiration.

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    Legal/Ethical Aspects of Pediatrics

    Considerations of consent, parental history, and ethical treatment in pediatric care.

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    Child Medication Dosing

    Children require smaller doses of medication not solely based on weight but adjusted for age.

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    Child Health Stats

    Vital statistics like maternal and infant mortality rates help measure national health levels.

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    Healthcare Pharmacokinetics

    In pediatrics, the response to medications can vary greatly due to differences in metabolism and physiology.

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    Social History in Pediatrics

    Documenting family dynamics and social environment is critical in assessing a child's health and needs.

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    Prenatal History Importance

    Understanding maternal and birth histories helps assess potential health issues in children.

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    Injury Risks in Children

    Children are more susceptible to severe injuries and illnesses due to developmental and anatomical factors.

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    Medication Trials in Pediatrics

    Few clinical trials are specifically conducted on medications for children, impacting treatment options.

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    Viral URI

    Upper respiratory infections like the common cold frequently affect children.

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    Cerebral Palsy (CP)

    A group of disorders affecting movement and muscle tone, often diagnosed in childhood.

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    Immunization History

    Tracking a child's vaccination history is essential for preventing diseases.

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    Pediatrics vs Adult Medicine

    Pediatrics considers unique developmental and physiological differences in children.

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    AAP Bright Futures

    AAP guidelines categorizing pediatric age: Infant 0-2, Child 2-12, Adolescent 12-21.

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    CDC Pediatric Age Groups

    CDC defines age groups: Infant 0-1, Toddler 1-3, Preschooler 3-5, Child 6-11, Adolescent 12-17.

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    Parent as Historian

    In pediatrics, parents provide medical and developmental histories for their children.

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    Developmental Variability

    Children's developmental stages differ significantly by age.

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    Obligate Nose Breathers

    Infants and young children primarily breathe through their noses.

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    Immature Blood-Brain Barrier

    Children have a less developed BBB, making them more susceptible to CNS effects of medications.

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    Higher Metabolism in Children

    Young children have higher metabolism and absorption, requiring careful medication dosing.

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    Shorter Airways

    Children have shorter and narrower airways, increasing the risk of respiratory issues.

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    Development of CNS

    CNS development continues throughout adolescence affecting behavior and capabilities.

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    Unique Environmental Exposures

    Children experience unique exposures that can impact health, like placental and breastfeeding.

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    Increased Risk of Dehydration

    Children are more prone to dehydration due to higher water requirements.

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    Limited Concentration Span

    Children have shorter attention spans related to their developmental age.

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    Safety and Prevention

    Children require adult assistance for safety and prevention due to their dependent nature.

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    Higher Nutritional Needs

    Children require more calories and nutrients compared to adults relative to their body size.

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    Cutaneous Injuries

    A type of skin injury including bruising and lacerations.

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    Subconjunctival Hemorrhage

    A condition where blood leaks into the conjunctiva of the eye.

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    Intra-oral Injuries

    Injuries that occur within the mouth, such as cuts or abrasions.

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    Signs of Abuse

    Injuries that may indicate cases of abuse, often needing investigation.

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    Concern for Abuse

    A heightened awareness or suspicion regarding potential abuse cases due to injuries.

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    HEADSS Assessment

    A psychosocial interview tool for adolescents involving Home, Education, Activities, Drugs, Sexuality, and Suicide.

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    11-Year-Old Visit Components

    Key elements of a visit for an 11-year-old, including history, vitals, hearing, and developmental surveillance.

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    Transition to Adult Care

    The process of moving from pediatric to adult healthcare services, involving planning and readiness.

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    Transition Readiness

    Criteria and assessments used to determine an adolescent's preparation for adult healthcare.

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    Pre-participation Sports Physical

    A medical evaluation to ensure safety in sports participation, focusing on physical health.

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    Medical Problems in Sports

    Identifying health issues that can lead to life-threatening situations during sports activities.

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    Rehabilitation of Old Injuries

    Addressing and treating previous musculoskeletal injuries before sports participation.

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    Menstrual History in Female Athletes

    Important medical information regarding females that could affect their sports performance.

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    Cardiovascular Risk Factors

    Health indicators like family history and previous surgeries that can affect a young athlete's health.

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    Developmental Surveillance

    Monitoring growth and development milestones during health visits for children.

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    Fasting Lipid Panel

    A blood test to measure cholesterol levels in children, assessing heart health risk.

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    Anticipatory Guidelines

    Advice given during medical visits to prepare for future health needs or concerns.

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    Sentinel Injuries

    Minor injuries in infants that may indicate a risk of abuse due to their age and development.

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    Child Abuse Reporting in NM

    The procedures and key contacts in New Mexico for reporting suspected child abuse.

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    Study Notes

    AAP vs CDC Pediatric Age

    • AAP Bright Futures categorizes ages as infant (0-2), child (2-12), and adolescent (12-21), with further subdivisions for adolescence (early 11-14, middle 15-17, late 18-21).
    • CDC categorizes ages as infant (0-1/0-28 days neonatal), toddler (1-3), preschooler (3-5), child (6-11), and adolescent (12-17).

    Pediatric Histories Compared to Adult Medicine

    • Pediatric histories differ from adult histories due to parent-as-historian differences between parental and child perspectives.
    • These differences encompass prenatal, birth, maternal/family, social, and immunization histories.

    Pediatric Physical Exam (PE)

    • Pediatric PE varies based on age and specific conditions, distinguishing between general and focused assessments.
    • Specific milestones for newborns, infants, toddlers, and children are evaluated for developmental progression.

    Physiological Differences

    • Body surface area (BSA) is proportionally larger in infants and children compared to adults.
    • Skin is thinner and more permeable in children.
    • Blood-brain barrier (BBB) is less developed in young children, so they present different sensitivities to medication.
    • Children, particularly infants, are obligate nose breathers.
    • Airways are shorter and narrower, lung capacity is lower, and metabolism/absorption rates are higher than those of adults.
    • Imature immune systems, along with a greater rate of tissue growth necessitate higher water and calorie intake in children compared to adults.

    Developmental Considerations

    • Immature organ systems in young children affect medication metabolism and absorption, requiring careful clinical consideration.
    • Growth and developmental skills vary with age, impacting learning and resilience.
    • Children have a longer life expectancy than adults.

    Prevention and Safety

    • Child safety and well-being require co-dependent adult assistance, particularly for unique environmental exposures (e.g., placental transfer, breastfeeding, outdoor activities).

    Disease and Injury

    • Children have unique illnesses and injuries.
    • Age at diagnosis may affect disease severity.
    • Some conditions are more common in childhood.
    • Bone fractures in children require different clinical considerations than adults because of their different physiology.
    • Some illnesses are more common in specific parts of human development.
    • Some conditions are common to certain age groups.

    Neonatal Evaluation (M2)

    • APGAR scoring assesses newborn health status one and five minutes post-birth.
    • The five areas assessed are appearance, pulse, grimace, activity, and respiration, with each component scored on a 0-2 scale.
    • The need for respiratory intervention might be a value of 4 or less.

    Newborn Vital Signs

    • Heart rate (HR)
    • Respiratory rate (RR)
    • Blood pressure (BP)
    • Temperature (Temp)
    • Infants typically double their birth weight by four months and triple their birth weight by one year.
    • Full-term newborns (average) birth weight is between 7 pounds and 13 pounds, with some drop during the first few days.
    • Normal average lengths are approximately 20 inches at birth, and approximately 10 inches during the first year.

    Newborn Complete Examination

    • Vital signs and general appearance are assessed in newborns.
    • Head, neck, chest, eyes, ears, nose, throat, mouth, cardiovascular (auscultate heart and lungs and palpate femoral pulses), stomach (palpate, auscultate, and inspect abdomen), and musculoskeletal are examined.
    • Musculoskeletal system includes inspecting genitalia and anus, back, limbs and eval of Reflexes.
    • Abnormal head shapes, typical common problems, and normal features are included as potential concerns.

    Neonatal Screening Panel

    • The screening panel covers five main categories: endocrine, hemoglobin, bilirubin, amino acids, organic acids, fatty acid oxidation, and others (e.g., congenital heart disease and hearing loss).
    • Genetic and NICU screenings (for newborns) are relevant.
    • Guidelines for critical congenital heart disease, and other testing intervals are vital.

    Common Newborn Problems

    • Jaundice, hypoglycemia, murmurs (heart sounds), respiratory distress, birth trauma, prematurity, multiple births, and infections are common issues in newborns.

    Pediatric Developmental Checks (WCC)

    • Purposes of WCC are prevention of illness, tracking development, and raising parental concerns.
    • The well-child check is a team effort, considering context, visit priorities, anticipatory guidance, and an injury or violence prevention approach.
    • Nutritional needs, general development, and injury and violence prevention guidelines are part of the check-up. Timing for WCCs includes first week (newborn), 1st week/3-5 days, one to four months, 6-9 months, 12-15, 18, 2, 2.5, and yearly visits.

    Adolescent Growth and Development (M4)

    • Puberty timing differs between boys and girls, including puberty start (age 10-12 in boys; 8-11 in girls) and end (age 16-18 in boys; 14-16 in girls).
    • Specific developmental milestones, such as testicular enlargement, pubic hair, body hair, and voice changes, differentiate genders.
    • Key physiological changes, such as appearance of breast and facial hair in each sex.

    Adolescent Health Issues

    • Adolescents experience significant emotional, cognitive, and psychosocial changes, affecting behavior.
    • Preventative care during adolescence (enrolled in primary care) covers immunizations, contraception, and testing for sexually transmitted infections (STIs).
    • ROS (review of systems) and social history assessments (including issues with sex, drug/alcohol use, and tobacco use) and common health problems will be relevant. This often correlates with poverty.

    Leading Causes of Death in Adolescents (Ages 15-29)

    • Accidents are the leading cause of death.
    • Suicide is a significant concern.
    • Firearms are a common factor in accidents and suicide related to this age group.
    • Other causes include chronic illnesses.

    Confidentiality in Pediatric Settings

    • Confidentiality varies, depending on a child's maturity, intelligence, and independence and medical conditions (e.g., chronic illness).
    • Legal parameters concerning HIPAA (Health Insurance Portability and Accountability Act) govern the release of information from a child's health records to parents.
    • Exceptions exist for imminent harm. Parental consent is typically required, except in limited circumstances of mature minors, when a child's health situation does not require parental input.

    Child Abuse Recognition (M5)

    • Common signs of child abuse, e.g., bruising, concerning locations and patterns.
    • Methods of recognizing injuries consistent with inflicted trauma, especially those in non-ambulatory infants, such as broken frenula or bruises in areas of the body not accessible to the child, are included.
    • The TEN-4 rule suggests assessing the torso, ears, neck, and frenulum for potential patterns of abuse.
    • Certain bruising patterns and sentinel injuries, e.g. intra-oral and subconjunctival hemorrhage, strongly suggest abuse.
    • There are resources for reporting of abuse.

    Other topics

    • Transition to adult care and pre-participation sports physicals are other important topics for adolescents.

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    Description

    This quiz explores key concepts in pediatric medicine, including age categorizations by AAP and CDC, differences in pediatric and adult histories, and physical examination techniques. Additionally, it highlights physiological differences and developmental milestones for children. Test your knowledge on these essential topics in child healthcare!

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