Peds NBEO1.txt

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cjensen20
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297479
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Peds NBEO1.txt
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2015-03-03 20:45:15
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Peds NBEO optometry
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Peds1 NBEO optometry
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  1. what are the placental transfer classifications?
    • high placental transfer
    • Crosses the placenta rapidly and at equilibrium
    • Limited placental transfer
    • Fetal concentrations are lower than mothers
    • Excess placental transfer
    • Fetal concentrations are higher than mothers
  2. how do antibiotics cross the placenta?
    • penicillins: High ampicillin, amoxicillin, methicillin
    • Cephalosporins limited cefotamine, cefuroxime
    • Aminoglycosides limited gentamycin, kanamycin
  3. Q: what antiviral drugs cross the placenta?
    A: Antiviral high acyclovir, ganciclovir
  4. Q: what are postnatal factors that effect vision?
    • Malnutrition
    • Environmental imbalances
    • Medication during breast feeding
    • O2 deprivation

    MEMO
  5. Q: what is the progression of the grasp?
    • A: before 4 mo purely reflex
    • By 4 mo can grab objects at will
    • By 6 mo move objects between hands
    • By 8 mo grab and release obj at will
    • By 1 yr pincer grasp
  6. Q: what are the gross motor milestones?
    • A: by 4 mo roll over
    • By 7 mo lift head, creep (20% only do ipsilateral)
    • 5-8 mo sit
    • 8-10 mo crawl
    • 9-10 mo first aided steps
    • 11 mo stand up alone with furnature
    • 12 mo walk
    • 15 mo kneel and stand up
    • 18-24 mo coordinate different movements
    • 24 mo jump, run, tiptoe, walk up and down stairs one at a time
    • 36 mo accelerate, turn, and stop
    • 3-5 yr alternate step going up and down stairs
    • 4 yrs balance, climb trees
  7. Q: what are the fine motor milestones?
    • A: by 6 mo put things in mouth
    • 12 mo pincer grasp
    • 24 mo pick up book
    • 36 mo self- feed with spoon
    • 3-4 yr manipulate writing instruments in tripad form
    • 5 yr cut with scissors
  8. Q: what are the 4 periods of cognitive development?
    A: sensorimotor Preoperational Concrete operations Formal operations
  9. Q: what are the visual motor initegration milestones?
    • A: by 2 yr | copy
    • 36 mo - copy
    • 39 mo O copy
    • 40 mo | draw byself
    • 3 yr draw l and O byself
    • 4 yr 1 mo +
    • 4 yr 4 mo /
    • 4 yr 6 mo draw a square
    • 4 yr 7mo
    • 4 yr 11 mo oblique cross
    • 5 yr 3 mo triangle
    • 5 yr 6 mo open square and circle
    • 5 yr 9 mo 3 line cross
    • 8 yr 1 mo vertical diamond
    • 10 yr 11 mo horizontal diamond
  10. Q: what are the 6 stages of sensory motor?
    • •Stage1: reflex, birth to 1 month
    • Cannot distinguish self from environment

    • •Stage 2: primary: circular reaction, 1-4 months
    • Hand-mouth coordination, anticipates
    • simple events

    • •Stage 3: secondary: circular motion, 4-10 months
    • Imitate, hand-eye coordination, increased
    • manipulation of objects

    • •Stage 4: coordination schemas, 10-12 months
    • Anticipates events at specific times,
    • uses learned responses in different situations

    • •Stage 5: tertiary: circular reaction, 12-18 months
    • Learn from trial and error, uses
    • different objects to explore surroundings

    • •Stage 6: symbolic representation, 18-24 months
    • Imitate in absence of mode, imagination
    • starts to show, imagination is used to represent objects, starts to solve problems which indicate “thought”, “memory” creation is essential
  11. Q: what is sensorimotor?
    • A: birth to 2 yrs, thinking associated with immediate sensorymotor
    • Needs immediate interaction with object to exist
  12. Q what is the preoperation period
    • A: 2- 7 years, symbol systems evolve, develops concept of time, space and quantitiy
    • Cannont conceive changes from one state to another
    • Learns to classify ideas and things into categories
  13. Q: what is the concrete operations period?
    A: 7-11 years, conceives how objects change, conservation of mass, reverse thinking, decentration
  14. Q: what is the formal operations period?
    A: 11 yrs +, abstract thought, thoughts about objects and thoughts, considers different alternatives for same problem, deals with ideas contrary to fact, metaphors or symbols of symbols
  15. Q: What are the language development milestones?
    • A: 6 mo imitation, (ma-ma, da-da)
    • 7 mo understands pitch
    • 12 mo simple words
    • 13-15mo visual and auditory memory
    • 15-18 mo follows simple instrutions
    • 21 mo 50 words
    • 24 mo complete sentences
    • 3 yr 900 words, 3-5 word sentences
    • 5 yr 1500 words
    • 7 yr elaborate conversations
  16. Q: what are the emotional development milestones
    • A: 6 mo attachments
    • 7-8 mo anxiety
    • 7-10 mo optimal attachments
    • 12 mo loose attachments
    • 24 mo potty training, temper tantrums
    • 3-4 yr develops self estem
    • 6-7 yr nervous tics
  17. Q: what is the growth progression of the volume of the orbit?
    • A: from birth to 1 yr more than doubles biggest growth
    • From 1-5 yrs nearly doubles again
    • 5 ys to adult nearly doubles again
  18. Q: what is the shape of the orbit like at birth compared to an adult?
    • A: opening more circular,
    • Lacrimal fossa more conical (lateral in adults)
    • Roof larger and flatter
    • Palbebral fissure grows vertical then horizontal
  19. Q: what conditions might change the shape of the developing orbit?
    • A: Lymphangioma
    • Rhabdomyosarcoma
    • Neuroblastoma
    • Dermoid cysts
    • Teratoma
    • Fibrodysplasia
  20. Q: what is the normal IOP in newborns?
    A: 9.56
  21. Q: when are the EOMs adult relations reached?
    A: by 20 mo.
  22. Q: what are the cones like in an infant?
    A: shorter and broader, less densely packed
  23. Q: when do cones become adult-like?
    A: by 4 yo
  24. Q: what is the total refractive power of a newborn eye
    A: +85D
  25. Q: what is the expected refractive condition of a newborn?
    A: +2.4D
  26. Q: What is the avg axial length of a newborn eye?
    A: 6 mm smaller than adult (15.74mm)
  27. Q: how long does emmetropization follow expected pattern?
    A: up to 4-6 years
  28. Q: What is the expected spherical error in infants?
    • A: newborns (pl - +4D)
    • By 6-8 yo (-0.62D - +0.62D)
  29. Q: what is the predicted astigmatism magnitude in children?
    • A: newborns 1.5D
    • 18 mo 0.75
  30. Q: what is the order of speed in reduction of astigmatism?
    A: WR > OA > AR
  31. Q: What are the trends of variations of refractive conditions
    • A: premies tend to be myopic at birth
    • If hyperopia is equal non/cyclo (w/i 0.75D) Tends to remain hyperopic
    • If hyperopia is greater with cyclo regression to emmetropia
    • If myopia is milder w. cyclo myopia likely to decrease
    • If high myopia w/o cyclo tend to be stable myopia
  32. Q: what are the predisposing factors to developing myopia?
    • A: spherical error +0.50D to pl by ages 5-6yo
    • AR astigmatism by 5 yo
    • Esophoria
    • Inheritance 40% if one parent has myopia, 70% if both have myopia
    • Congenital tends to remain high through life
  33. Q: what do you need to know about juvenile myopia?
    • A: age of onset 6-15 yo
    • Avg progression 0.5D/yr for up to 6 yrs
    • Seldom progresses more than 6D
  34. Q: what do you need to know about young adult myopia?
    • A: mostly seen in college students
    • Progression 2-3D
  35. Q: what drugs have limited placental transfer?
    • Cephalosporin (antibiotic)
    • Aminoglycosides (antibiotic)
  36. Q: what drugs have excessive placental transfer?
    • Anticonvulsants
    • Benzodiazepines (anxiolytics and sedatives)
  37. Q: What are the four basic models of vision care?
    • Medical
    • Optical
    • Functional
    • Behavioral
  38. Q: what are the ethnic factors in myopia?
    • A: blacks higher incidence of severe myopia, lower for juvenile and young adult myopia
    • Chinese/Japanese higher incidence of high myopia by adolescence
    • Jews

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