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Flashcards in CLIPP 4 Deck (47)
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1
Q

A BMI greater than the percentile for age is considered obese.

A

95th

2
Q

weight and height ages

A

weights or heights at which the patient’s weight or height would plot at 50th %tile

3
Q

core ADHD sx

A

inattention, hyperactivity, impulsivity that often lead to issues at home/school - need sx in 2+ settings, typically dx before 7 yo

4
Q

what is one of the most common chronic health conditions in kids

A

adhd

5
Q

when should objective vision and hearing tests start

A

vision - at 3yo

hearing - at birth and then resume at 4yo

6
Q

ADHD and sleep hygiene

A

people w/ adhd might have poor sleep hygiene but aren’t overly tired

7
Q

childhood depression can convert into

A

bipolar disorder

8
Q

learning disorders manifest as and can lead to

A

problem involving academic skills - many states require documentation of normal IQ and discrepant academic performance , can lead to behavioral problems, screen for adhd and LD as they can have comorbidity

9
Q

Oppositional defiant disroder vs conduct disorder

A

ODD - hostility towards authority, defiance, negativity

Conduct disorder - more severe, habitual rule breaking, aggression, stealing, truancy, lying, destruction

10
Q

which other mental disorder has highest comorbid rates w/ adhd

A

ODD/CD

11
Q

what % of kids respond to adhd meds like sustained release methyphenidate

A

80%

12
Q

4 adverse effects of stimulants

A

appetiet suppression, slowing of grwhto velocity that diminished by year 3 but no compensatory mechanism seen, insomnia esp early on in meds, and tic disorder that can stop if you stop the med

13
Q

cv risk with stimulants?

A

higher in adults probably, and also seen in kids w/ heart disease that is known.

14
Q

children’s TOTAL MEDIA time should be limited to __ daily

A

1-2 hours of quality programming

15
Q

avg child watches __ hr tv/day, and __ hr total media time/day

A

3, 6.5

16
Q

what does maternal diabetes and high birth weight put you at risk for

A

obesity

17
Q

is breastfeeding a risk factor for obesity

A

no - feeding helps prev obeisty

18
Q

early menarche associated with

A

bmi >85th%

19
Q

slipped capital femoral epiphysis

A

displacement of the femoral head from the femoral neck through the physeal plate

  • onset is in puberty in obese pt w/ delayed pubertal onset
  • sx is antalgic gait to avoid referred pain, and limited ROM on internal rotation of hip
  • dx on X-ray of pelvis which shows widening of physses
20
Q

most prominent risk factor in dvpt of type 2 dm

A

obesity

21
Q

steatohep 3 sx

A

hypERechoioc liver, fatty infiltration and fibrosis on bx, elevated transaminases

22
Q

type 1 vs 2 DM as related to insulsin

A

type 1 = deficiency

ype 2 = resistant

23
Q

4 diagnostic criteria for DM

A

2h OGTT glucose of >=200 after loading w 75g, fasting 8+hours of >=126, sx of hypergly+random =>200, a1c >= 6.5%

24
Q

is age helpful to distinguish between type 1 vs 2 DM

A

no - type 2 now dx earlier but type 1 often in early childhood

25
Q

though most pt w/ type _ dm do not present in dka (bc typically not absolute insulin def), often have __ at dx

A

2, ketonruia

26
Q

presentation course in type 1 vs 2 dm

A

type 1 is more acute, type 2 more indolent and can be accidental

27
Q

pediatrics DM screening

A
if ovweright (BMI>85%ile, weight:ht >85th, or weight >120% for height) + any of 2 following: signs of insulin resistance (actanthosis nigricans, pcos, dyslipidemia, htn), maternal hx of diabetes or gestational dm during pregnancy, fam hx of type 2 in first or second degree rel, race/ethnicitiy (asian/pacific islander, NA, AA, hispanic) 
-screen at 10 or onset of puberty (whichever is first), q3years and can use hgba1c, ogtt, or fasting glucose
28
Q

three things impacting BP readings

A

white coat htn, using cuff too small or inappropriately normal cuff (obese 9 yo can’t use normal 9yo cuff), or positioning arm below heart - should be at level of heart

29
Q

approp bp cuff size

A

bp cuff should cover 2/3 of upper arm and internal bladder should encircle 80-100% of circ

30
Q

prehypertension in adol

A

bp >=120/80 but %tile <95

31
Q
BP percentile	Classification
< 90th
90th-95th
95th-99th plus 5 mm Hg	 
> 99th plus 5 mm Hg
A

normal
Prehypertension
Stage 1 hypertension
Stage 2 hypertension

32
Q

Guidelines ___ recommend a diagnostic work-up for a secondary cause of hypertension for children with blood pressure values in the prehypertension range unless there is a concern for a possible underlying cause in the patient’s medical history, exam, or family history.

A

do not

33
Q

meds in pediatric htn

A

typically reserved for children with Stage 2 HTN, children with secondary hypertension, and children with evidence of target-organ effects

34
Q

causes of 2ndary htn in kids

A

umbilical access when neonate –>renovasc dz, uti, coartc, fmaily hx (ask about dialysis as away to see how bad end organ damage got), excess catecholamines as in pheo or NB

35
Q

rotavirus vaccine sched

A

started by 15w and finished by 8m, no catchup

36
Q

influenza schedule for 1st immunization

A

w either type of flu vaccine, need 2 doses in first year of getting it, 1 m apart if 9 yo or younger

37
Q

who is a catch up hepA vaccine recommended for

A

babies>23 m who live in areas where vaccines target older kids, at incr risk of infection or who want hepA immunity

38
Q

endocrine causes that cause weight gain also typically would have ___ that we look for

A

limited growt–>short stature, whereas obesity stimulates statural growth and leads to tall stature for age. It also typically advances bone age and leads to early puberty.

39
Q

prochaskas stages of change

A

precontemplation, contemplation, determinatino, action, maintenance, relapse

40
Q

elevated urinary VMA, urinary HVA, urinary metanephrines, and serum glucose

A

pheo

41
Q

Catecholamine excess

A

pheo or NB, test urine

42
Q

overweight vs obese %ile

A

A child is considered overweight when his or her BMI is between the 85th and 95th percentile for age. Obesity is considered > 95th percentile.

43
Q

what can steroids do to BP

A

increase - acts like cortiol–>fight or flight–>raise BP. amphetamines on the other hand, mimc NE.

44
Q

childhod depression can –>

A

bipooalr

45
Q

anti social personality disorder

A

inability to conform to societal norms, disregard of the rights of others, and often criminality. These individuals often exhibit impulsiveness due to their lack of consideration of the consequences of their actions. Males are affected more than females. However, a diagnosis of anti-social personality disorder can be made only in individuals older than 15 years, earlier than which a diagnosis of conduct disorder is appropriate.

46
Q

conduct disorder vs anti social

A

conduct if before age 15

47
Q

rhetts

A

X-linked pervasive developmental disorder seen only in females; affected males die in utero or at birth. The characteristic symptoms involve regression of language and development, mental retardation, ataxia and hand-wringing. This disorder is typically diagnosed much sooner, at about age 1-4.