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what are common causes of wide fontanel?
- prematurity
- IUGR
- hydrocephalus
- Down Syndrome
- hypothyroidism
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Do not give polio vaccine if?
Pt has streptomycin allergy
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Do not give MMR?
If pt is pregnant or immunocompromised
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Do not give varicella vaccine?
If pt has streptomycin allergy or pregnant or immunocompromised.
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What is talipes equinovarus congenita?
club feet
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All states require newborn screening for
- PKU
- Galactosemia
- Sickle cell
- congential hypothyroidism
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-
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Test for hypothyroidism
check T4 and TSH
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Trust vs Mistrust
Infancy
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Iniative vs guilt
preschool
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industry vs inferiority
school age
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autonomy vs shame and doubt
toddler
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identity vs role confusion
adolescence
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what vaccines would you not give a 7 y.o with out hx of previous immunization?
Hib, DTAP, rotavirus, pneumoccocal
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what age does Infant hand to hand transfer
7 months
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What age does child have stranger anxiety?
6 months
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What age does child have separation anxiety?
8 months
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Development warning signs if school-age kids
- poor adjustment to school
- not working to ability
- frequent illness/need to stay home
- lack of social interation/peer problems
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Developmental warning signs in older age kids
- Revert to dependent, shy, passive roles
- using illnes to avoid responsibilities
- cannot make or keep friends
- poor school performance
- disinteresnt in extracirricular activities
- destructive behavior to express self
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Elements of ADHD
- symptoms present before age of 7
- symptoms persist for at least 6 months
- symptoms must be more frequent and more severe than those observed in other children of same development
- symptoms interfere with functioning in at least 2 settings: home, school, play
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Hep B vaccine should not be given to those
who have baker's yeast anaphylactic reaction
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S1
Mitral/tricuspid valve AV valves close
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S2
Aortic/pulmonic semilunar valves closure
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Aortic
Right upper sternal borders
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Pulmonic
left lower sternal border
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acyantoic lesions
left to right shunting
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cyanotic lesion
right to left shunting
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ASD
systolic ejection murmur, heard left upper sternal border, ECG shows right ventricular hypetrophy, cardiomegaly
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VSD
systolic ejection murmur, holosystolic thrill felt at LLSB, ECG-Left ventricular hypertrophy, cardiomegaly
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Patent ductas arteriosis
machinery sound murmur, left and right ventricular hypertrophy, cardiomegaly
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Trasnposition of the Great arteries
kids squat, systolic ejection murmur, holosystolic murmur, ECG=right ventricular hypertrophy
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Tetrology of fallot
4 defects: Large VSD, Pulmonary stenosis, Overriding aortia, RVH
tet spells, loud systolic ejection click at the Middle and upper left sternal borders; thrill and ejection click
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Aortic stenosis
systolic thrill at right upper sternal borders, systolic ejection click , LVH
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Pulmonary stenosis
systolic loud at LUSB, ejection click decrease w/ inspiration and increase with expiration, Thrill at LUSB radiates to back and side, RVH
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Coarctation of aorta
systolic ejection murmur w/ rationd to left interscapular area, RVH Progressing to LVH, cardiomegaly, pulmonary venous congestion, *BP in lower extremities will be lower than upper extremities.
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Right ventricular hypertrophy is seen in
Pulmonary stenosis, Coarctation of aorta, Transposition of the great arteries, Tetralogy of fallot, ASD
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Left ventricular hypertrophy
VSD, Patent Ductas Arterious, Aortic Stenosis
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Psoas sign
raise leg and you push down against leg
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Obturartor sign
pain w/ internal roation of the right thigh
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Mc Burney's point
tendernes one-third distance from anterior superio iliac spin to umbilicus
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