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  • Ped Usmle Secrets

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    Prince Du
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    peds usmle secrets

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    52 просмотров8 страниц

    Ped Usmle Secrets

    Загружено:

    Prince Du
    peds usmle secrets

    Авторское право:

    © All Rights Reserved
    Скачайте в формате PDF или читайте онлайн в Scribd
    Отметить как неприемлемый контент
    из 8
    1 as Ly Give the average ages at which the following commonly tested milestones are wed. tmesToNE ee Socal smile 1-210 ong 24100 Whi prone its head up 80° 40 Fale ato back 45m0 Voluntary grasp (0 rena) Smo ‘Stanger anity 69m Sts wh na sport Tmo Pals stan 90 Wares yee" 107m ounary grasp with voluntary tease tome Pays patacate s-10m0 First worse 12m Iniaes ater’ sande 12m ‘Separation ay 1-158 m0 Wakes witout help 130 Gan bul tower of 2 cubes 13415 mo Understands t-step commands jo gesture) 15 mo ‘od wea eup and spoon 15-180 an bull tone of 6 cubes 2 une well a Tes soolcas Sy “Roiys hae of rate ne et 2 years fr asses eet For xp con ber afr ast fants, boc 3 rte Yon ree ap Tete, Pe xb (son poriorm en at marta wher De 8 mens pment is more important than the age at which individual milestones are reached ‘rus The eac ages ota npertan asthe overall pate nlnog fr dysfunctional develon- Imei Whe in dub, sea formal developmental est. 3. What screening and preventive care measures should be dane at every pediatric visit? Hea eight blood presse, developmental behav assessment nd anpatory guidance {eouselnglscussn bout ge-aproprte concerns told be done al every peda ist. | CHAPTER? PEDIATRICS ‘True of false: Screening and preventive care are important mainly during a well checkup. Fale. Screening an preventive care ae an mpartant part of every encounter wih patient (alt ‘or hl USMLE questions may ty fol ou ons pol. Fer examps a mathe compas that ‘or 4-year chil logps 11 hours every ight Ths is normal behav. The answer tote queston, “what seul you do net” may be to gv an objet hearing exarinato, whch sa robe sereaning procedure ina 4-year cid ‘What are the commonly performed sereening tests for metabolic and congenital disorders? ‘Slats vary wel inthe pliies regarding newbam screerng Astle screen fr hyptyris- ist and phenykatnaria tit seens must be done win the frst ont oft. Most states Seren or galactosemia and hemoglbnopahies such as sic cel eiscae. Some slats include seeing for homosysnutia maple syrup rn disease, congenial areal hyperplasia cystic ‘ross onidase detciery,tyrsnemia end toxplsmas'. any of these screens are paste, theft step is toner a cotmatory test tw make sure tat the screening test gave ate postive esa ‘What are the frequently tested items under the umbre using “anticipatory guidance"? Tel pres the felowne: ' Keep te water heater under 11°F to 120° 1 Use prover car estas (chit stety sat, bostr sea), "tthe infant slap on i et sg back to he prevent sudon infant deat synarome {09, the mast corm cause of death in chen ages 1 fo 12 months, ' oot uss nfant walkers because they cause ris "Wate out for smal objects, whien may be asprate. * oot gue hone before 1 year of age ' Donat give cow's milk etre 1 year of age * Inrosuce sl foods gradual. starting a6 mnths of ge ' Supeis cite in Bathubs and swimming poo primary prevention 1d head circumference be measured? What How often should height, weight, do they signity? Head ccumoronce shoul be measured a ovr vst the Sst 2 years hight and weight haul ‘be measured rovtnay ul aduthood Al toe pares ae markers of genera wel bang: sbrormal values may suggest ease ‘Whatif a child has low height, weight, or head circumference compared with peers? “he pate a growth alog pleted growth curves over tia which you may be ask to Inerget os you mre than any sng measurement. a cid has alway ben aw rNgh ‘compare wth pets, general ha patter is benign. patent wh goa ram a normal aan nema are is much mare wersome, Parent earanonly bing a ci wth laos phys ‘al growth or delayed puberty. You nes to know when to eassre and wien odo further testing and quesonig, 3. Define failure to thrive. What causes it? Theres ncansenss into orale tote, but oman used efron inci ahead euérence het or welsh thet percetl for age a wah ess ban 20% ea ‘we ght forage: or weight gan hat causes a decease nto or mere major pacentage nes on the rnc, abe othe sos common ares of syns or nctna cles ach {erin of eset and oh ture, Organi cases uly have spect ceo ager you suspic, 40 14 12 48, 4 16 16. ‘HAPTER 29 PEDIATRICS ‘What conditions are suggested by obesity in children? Obesty usualy is caused by overeating and too le actly (295% of cass) Less than 5% of cases nearest of eganc cases fe, Cushing sya, Pade syncoma, ‘What conditions should you consider ina child with an abnormal head circumference? Increases ead ckcumference may mean ysrocephais ort whereas decreased hea crcum- ference may mean microcephaly ¢9. orconjenal TORCH infect), Aa, pate of head lcunfetenc overtime ted on a roth curve mest hell in efring pata. How are hearing and vision screened?” eating ant visn stold be mesures objectly at wast once by & years ot ag. Arte nil serea, measure evry aw yar unt aculthae or mare often if testy so dates. In what situations should you worry about hearing loss? ' Afr aout of menngts rearing ls is tre ast common neuoaglecomplcton) ' Wi congenital txptasmoss, ober fe yp, HN, rbel,etomagalovis, herpes sinpex (TORCH) infections 1 With meas & mums ' With ehrone migite oa eftusins or ernie or recurent ots mesa 1 With te use at ost drugs, aminogleasides) ‘What i the red reflex? What should an abnormal reflex suggest? {hac ors ofthe red ete at ith an outed thereat to detect congenital cataracts or cul urs. When a penlight s shined ate ppl you usualy sere beacause of the unceying ‘undus a cataract timo) is presentn the ee. the re eter dssppears and you see white (eroun asleukacora an cassia caused by etnolastoma ip.70-; Plate 6) ‘True oF false: Before a certain age, intermittent strabismus is normal rue. is nomal ofan to nav ocasional our msalgnent sabisrus ant 3 rons of ge. ter 3 mons wih constant eve deviation, strabismus shouldbe evaiated and managed by an ophnamaoysto prevent poste Bindess nthe aete ye How is screening for anemia done? fecommansabors of rain seeening for nema (ith a cmp bled coun ar hema hamatort vary and are changing. Nanogen or heratet messuemantiseconenended at ‘2 ments of ag, bt may be requis alter nes a tae by istry and ik assessmk. Recammendans fr sereering during adsescencs vary, bt adolescents sou be sreened at lest nce any sk fet fr ton Getic are preset crn infancy (ematritylw ith ‘wot ingestion of cow's ik ef 1 yea of age, hw tary ike, sociezonoi status ‘suuan wth 2 comple blood rout or ameslcbin and hematcr gente opr. Far 1 Loot py ela ol carmen arg are lwo at fayette nary potas Sell, rom Ka 1 clea aos ephaPab ‘tes ps Moby, 006 Fi 883. Couey of Una) | CHAPTER? PEDIATRICS 17 48 18. 24 ‘True or false: All children should be given prophylactic iran supplements. Fates xsd tasted inane dont require supementatn. late een sul esie “supplementation. Start an supplements In fl-ar infarts at 6 mors of ge an in preterm las a2 months fae, Most if formulas and creas conta eon, us separate supplements ne usualy not rege. How and when do you screen forlead exposure? Sreenng or ad ony contoera. Ravine steenig i no langer recommended, However, all Mesiat-gbe cre must be screened. Consider sereninghigh~ik chien thase who Ive ino bugs, ave a sng or playate with lad txt. eat pant cis, le ner abatery ‘ecjling plant or have aparent who wees ata ater eyeing plang, Screen fr lead exposure by ong a serum ead evo. the nal ead vel is bora high, dose folow-up an invention tne races, Te bes fst taps a stp th exposure ‘True or false: Most children need fluoride supplementation. False Bezause most ate i uote, supplementation sot needed. However acid es an area wher he water's inafequtl fucridatod (a or he chs ed exis rom pre ed, eyo formule (hich se nanturste wat), rid spelen: shout be gn 3. True of false: Broastfed infants are more lily to requite vitamin D supplements than formula-fed infants. ‘us The American Academy of Peds econends that excushely and paraly breasted infants eee vain supplement shot birth and cantnue url hey ae weaned and eonsue formu o le ik. Forma evant 6 not equ supplant nthe United Stats ‘because al formulas contain tain D soplmens ‘When should children be screened for tuberculosis? Universal screening fr uberculss is not ecormended. Tere no need ta screen citen who ‘havo nak airs. isk assessment shuld occu roglaty unl 2 years of ae, than anual Tes, ‘hoe atigh rk ami ember wth bere amy member wih a postve beret st, {chil born in aigh-sk county acid who has Wave oa igs county, or child whe has ‘consumed unpasteuuot miko cheese ‘True of faze: Screening c recommended. “Tus However you should seoan fr congentavanatomic abnormal (9 vesiouretera fun) ‘feeble urinary act infectinincren 2 marth o 2 year of age by geting an ultascurd and eter vldngeytourevegram (ICU) or radon ystoyram (AND, Screening ar the aye ‘2 yours is more contoversia and Tey wortbe aquest onthe USMLE on for renal disease with a urinalysis is not ‘True of false: Current vaccine recommendations and schedules are always provided on the USMLE. False. However, because he ining of ramalinmarizations i being updated constantly, the administration schedule for cmon vaccines may be proved onthe Step 2 examination, Higher yeinfrmation reas to special patient populations fe. sve preumocoeal acne {opatnts vty sie cl dlseaseorslenectony) and vaccine conandcatons no meas !munps-uele or infanca vaccines for egal patents, nove vaccines for immunocor- promised patents, ‘True oF fase: Sexually active teenaged gits need screening for chlamydial infection and gonorrhea. “fue Thre are hgh numbers of repured cas of anya. and gana a yunger women, The Cotas fr Disease Carol and Preven (D0) acommends anual soanng fr chara for 25, 2. a 3. True of fae: I the under HAPTER 29 | al sual ctv females aged 25 nd younger Te CDC recaimendssreennghighisksemaly act foals to gorathea ‘When should you recommend that a child see a dentist forthe first timo? roan 2:03 yao 98 ‘What are the Tanner stages? When de they occur? “he Taner stages measur the stages of puberty Stage 1 is preadoescent, stage Sis tu Avancng stages are assignee testicular and pene grow in boys an reas groan gts loth male and female stages also use pub ha development. Te average ago puberty hon patent ist hax changes ftom te preadolescent stage 1) 10.5 yar in gis and 1.5 yeas in boys. Te lassi stevens of puberty are etc eslargement in boys and beast development ingi Define delayed puberty, What is the most common cause? Delayed puberty i defines by lek of esteuar enlargement in boys by age 14 years of & Tack a breast development or pubic hair in ils by age 12 years. The most common cause Is consututnal deta, a normal variant, Watch for parents wth asim history of being “ate bloomar.” The chs growth curve consistently lags behind that of prs, ut hain presen the eis growth cure is paral tothe normal growth cure retmentis reassurance any, ‘What are other causes for delayed puberty? -aoly, daly puberty s caused by primary testicular eet syndos, eye ‘ds, histor of cheraterapy gona dagenes) or vain flue (unr sycrome, gonadal ‘ysqenesis. Even mre aay, delayed puberty is cause by a ypothdanipitary detect, such Kallman syndrome or una ‘What causes precocious puberty? Precocious puberty i usaly opaic bt may be caused bythe McCune Abright syndrome 5, ovran tumors ens oct o gonadblstor tesla tumors (etic tumors conval neous jem (2S) disoase ortrauma trend nal, of congenital aera Inpeplasia, hich causes precocious puberty ony in bys and usuay case by 21-ntrontase dateeney ing cause for precocious puberty is uncorrectable or idiopathic after diagnostic workup, patients should receive treatment. “rup-Mst patents ae gon long-acting gonadtopin~leasnghorane agonists to supcess ‘te progression of puberty. This approach els prevent rematire epiphyseal cose wt shor. sae, How are cavernous hemangiomas treated? Caverausnemrgiomas are benign vascular tumors that fen are st nticns afew days ater ‘ith, They tnd to increase in so ater ith fometimes beconig ul ge) ad gradually resolte within the fs 2 years of He (9,27; Plt 6 The est wetants odo nthng but ‘observe an alow, 2. Distinguish between caput succedaneum and cephalohematoma, How are these conditions treated? Bh condos a noted in nabs ater vaginal dlr, Capt sucetareum dens diss _sweling or dara the sab that cases theme, benign, and requires ro fuer Ivesigaton ‘or teatret Cephlobomatomas ar sutperostelbamoages alae sharply los by sues {nd do nt cross the mine Ceplohematomas are usualy benign anésl-esoking, but rae | CHAPTER? PEDIATRICS Fare 26-2. earn Tese is gon andy de st fw mat efi ne ey a our are byw aspera ans ay ee eave ced a ta avi stare. elt san yea re apo eas, and oneal eure Soe Pte. Fem

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