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what are common causes of wide fontanel?
- Down Syndrome
Do not give polio vaccine if?
Pt has streptomycin allergy
Do not give MMR?
If pt is pregnant or immunocompromised
Do not give varicella vaccine?
If pt has streptomycin allergy or pregnant or immunocompromised.
What is talipes equinovarus congenita?
All states require newborn screening for
- Sickle cell
- congential hypothyroidism
Test for hypothyroidism
check T4 and TSH
Trust vs Mistrust
Iniative vs guilt
industry vs inferiority
autonomy vs shame and doubt
identity vs role confusion
what vaccines would you not give a 7 y.o with out hx of previous immunization?
Hib, DTAP, rotavirus, pneumoccocal
what age does Infant hand to hand transfer
What age does child have stranger anxiety?
What age does child have separation anxiety?
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
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
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
Hep B vaccine should not be given to those
who have baker's yeast anaphylactic reaction
Mitral/tricuspid valve AV valves close
Aortic/pulmonic semilunar valves closure
Right upper sternal borders
left lower sternal border
left to right shunting
right to left shunting
systolic ejection murmur, heard left upper sternal border, ECG shows right ventricular hypetrophy, cardiomegaly
systolic ejection murmur, holosystolic thrill felt at LLSB, ECG-Left ventricular hypertrophy, cardiomegaly
Patent ductas arteriosis
machinery sound murmur, left and right ventricular hypertrophy, cardiomegaly
Trasnposition of the Great arteries
kids squat, systolic ejection murmur, holosystolic murmur, ECG=right ventricular hypertrophy
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
systolic thrill at right upper sternal borders, systolic ejection click , LVH
systolic loud at LUSB, ejection click decrease w/ inspiration and increase with expiration, Thrill at LUSB radiates to back and side, RVH
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.
Right ventricular hypertrophy is seen in
Pulmonary stenosis, Coarctation of aorta, Transposition of the great arteries, Tetralogy of fallot, ASD
Left ventricular hypertrophy
VSD, Patent Ductas Arterious, Aortic Stenosis
raise leg and you push down against leg
pain w/ internal roation of the right thigh
Mc Burney's point
tendernes one-third distance from anterior superio iliac spin to umbilicus