Most important golden key point VS pediatrics

 Most important golden key point VS pediatrics

Growth and development in children are the continuous orderly processes.

The sequence of attainment of milestone is same in all children.

The process of development progresses in cephalocaudal direction and proximodistal direction.

The baby attains three times of its birth weight by one year of age.

The baby attains four times of its birth weight by two years and 5 times by three years of age.

The Chest Circumference (31 cm approx) is about 3 cm less than the Head Circumference at the time of birth.

Head Circumference (HC) and Chest Circumference (CC) are almost equal by 1 year of age and after that CC exceeds the HC.

The arm span is 1-2 cm less than height of children below 5 years and by 10-12 years both will be equal. Then arm span exceeds

the height

In children, arm span is greater than height in Marfan syndrome, Klinefelter syndrome and Homocystinuria.

Arm span is less than height in Achondroplașia, cretinism.

Instrument used for measurement of skin fold thickness is Lange's or Harpenden's skin fold callipers.

The first two teeth to erupt are the two bottom central incisors.

New Ballard Scale is frequently used scale for assessment of the gestational age. It assesses six external physical and six

neuromuscular characteristics.

Sigmund Freud's psychosexual development defined the terms ld, Ego and Superego.

Id is pleasure principle; ego is based on reality and superego is based on perfection.

In oral stage (0-1 year), infant's pleasure centers around mouth.

Child's pleasure focuses on anus during anal stage (1-3 years).

Child's pleasure focuses on genitals during phallic stage (3-6 years).

Loving, consistent care, including playing by parents help in infant's cognitive and psychosocial development.

Negativism is commonly seen in young children (Toddlers). It is a behavior characterized by the tendency to resist direction from

others, and refusal to comply with requests.

Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score is considered excellent if the score is 7-10.

A newborn's temperature on an average ranges from 36.5 to 37.5°C.

Newborns lose 10% of their birth weight by 3-4 days of age. Newborns gain the lost birth weight by 1Oth day of life.

The normal newborn hemoglobin level is 17-20 g/dl.

Normal birth weight of an Indian child is 2.5-3.5 kg.

Baby's birth weight doubles at 5-6 months of age.

Baby's birth weight triples at 1 year of age.

Contd..

/70 Sechon A Drug of choice for neonatal seizure: Phenobarbitone. Vitamin deficiency responsible for neonatal seizure: Pyridoxine (Vitamin B,). In Neural Tube Defect, the following markers increase in the amniotic fluid: Alpha feto protein Ach esterase Descending motor paralysis is seen in: Botulinum Polio Diphtheria Peri conceptional use of folic acid decreases the incidence of NTD by: 50-70%. Dose of folic acid for: Primary prevention of NTD: 0.4 mg/day. Secondary prevention of NTD: 5 mg/day. If a newborn's head and trunk are allowed to fall backward it elicits more reflex. Plantar grasp disappears in infant around 9 to 12 months of age. It is the last neonatal reflex to disappear. Neonatal reflex elicited by touching the cheeks of the baby is rooting reflex. The last neonatal reflex to emerge is rooting reflex. It develops at around 28 to 30 weeks of gestational age. Rooting reflex in infant disappears at 3 to 4 months. Asymmetric Moro's reflex at birth is indicative of Kernicterus: Most common seizure disorder during childhood: Febrile seizure. Most common cause of neonatal seizure: Hypoxia. Most common presentation of neonatal seizure: subtle type. Most common cause of neonatal meningitis: GP B strep> E.coli. Most common cause of meningitis in the age group of 3months-3 years: H. Influenza. Most common site of Neural Tube Defect: Lumbosacral region. The most common form of childhood brain tumor is Medulloblastoma. Phototherapy is indicated for children with hyperbilirubinemia. Artificially acquired immunity is obtained by immunization with antibody response. Antibodies are administered, not produced by the body. Breastfeeding is natural passive immunity which is obtained by immunoglobins in mothers breast milk. In children, currant jelly-like stools containing and mucus is associated with intussusception. Meckel's diverticulum is an outpouching or bulge in the lower part of the small intestine. The bulge is congenital (present at birth) and is a leftover of the umbilical cord. Cheiloplasty is the surgical management of Cleft lip. Cleft lip is usually repaired at four to six months of age and a cleft palate is usually repaired around 12 months of age. BCG vaccine is given Intradermally. In intradermal injection, needle is placed almost flat against patient's skin (15"). Anthropometry is the index for nutritional status in children. Sunset sign is seen in Hydrocephalus. In this, eyes are often rolled downward so that the white part of the eyes (sclera) is visible below the upper eyelid. Tetralogy of Fallot (TOF) is a combination of four heart defects present at the time of birth. It includes Ventricular Septal Defect (VSD), Pulmonary Valve Stenosis (PVS), overriding of aorta, Right Ventricular Hypertrophy (RVH). Immediate action by the nurse after the birth of a baby is to clear the mucus in nose and mouth that will help the baby to breathe. While assessing APGAR, pulse or heart rate has to be assessed first and then the respirations. Most infants born before 27 weeks of gestation develop respiratory distress syndrome which is associated with surfactant deficiency. Lack of stridor and adventitious breath sounds are the signs of shaken baby syndrome. Human milk contains little iron, so infants who are exclusively breastfed are at increased risk of iron deficiency after four months of age. This is more common among preterm infants as they are born with lower iron stores. A complication of erythroblastosis fetalis is kernicterus, whichis caused by deposition of bilirubin in the brain. Exchange transfusion is needed to prevent the complication. The earliest and most frequent manifestation of digoxin toxicity in infants and children is the appearance of cardiac arrhythmias, including sinus bradycardia. Drug used to keep Patent Ductus Arteriosus (PDA) open is PGE1 (Misoprost]. Drug used to treat PDA is Indomethacin. Most common heart abnormality in children is Ventricular Septal Defect. In infants, brachial pulse is used to detect the presence or absence of pulse rate during cardiac arrest (Source: ACLS Guidelines). .In an infant with ventro-peritoneal shunt, the nurse needs to measure head and abdominal circumference since there is chance of shunt malfunction in order to monitor the early sign of intra-cranial pressure and abdominal distension. Projectile vomiting is a classic symptom of hypertrophic pyloric stenosis. ontd

Color-coded treatment under Integrated Management of Neonatal and Childhood lIness (IMNCI): Green: Home care Yellow: Treatment at Outpatient Department (OPD) Pink: Urgent referral after treatment at OPD (for stabilization) Bulging sack-like lesion filled with spinal fluid and spinal cord element is known as myelomeningocele. Spina bifida occulta is a malformation of one or more vertebrae, it is also called closed or hidden spina bifida. Reye's syndrome is associated with the use of aspirin with viral illness. Reye's syndrome most often affects children. It causes swelling in the liver and brain. The ratio of lung inflation to chest compression in cardio pulmonary resuscitation is 1:3. The sequence of vital signs assessment in newborn is Respiratory Rate, Pulse and Temperature Injection vitamin K is routinely administered to a newborn to prevent bleeding. Foramen ovale is a structure with functional closure immediately after birth. Failure of the foramen ovale closure will lead to atrial septal defect. Patent ductus venouse results in irregular transmission of blood between left umbilical vein and inferior vena cava. Patent ductus arteiousus results in irregular transmission of blood between pulmonary artery and aorta. After the closure ductus venosus is known as ligamentum venosum. After the closure ductus arteriosus is known as ligamentum arteriosum. After the closure foramen ovale is known as fossa ovalis. Both Indomethacin and lboprufen are equally effective in closing Patent Ductus Arteriosus. Commonly occurring accident among newborn babies is falling from bed. Myoclonic seizure is the most common type of seizure occurring in newborn. Sternum is the best site to demonstrate capillary refilling in infants. .Surfactant production in fetus begins at 20 to 24 weeks of gestation. Total lung capacity in newborn is 150 ml. Sponge bath the baby until stump falls off because moisture will delay the stump to fall off. Immediately after the delivery baby should be placed on mother's chest. Exchange transfusion is needed in a neonate with erythroblastosis fetalis to prevent kernicterus that is caused by the deposition of bilirubin in brain cells. Anewborn who adequately breastfed will sleep at least 2 hours, pass urine 8 to 10 times a day and will gain weight. Baby Friendiy Hospital Initiative (BFHI) was launched by WHO in the year of 1991. The first milk produced after delivery is known as Colustrum. It appears thick and yellow coloured. Milk secreted following colostrum is transition milk. Foremilk (milk secreted at the start of feed) is rich in proteins, sugar and minerals whereas hindmilk is rich in fat and provides more energy. Immunoglobulin present in breast milk is lgA. Most abundant immunoglobulin of human body is lgG. Only class of immunogolobulin which is transported across the placenta is lgG. Exclusive breastfeed should be provided to the baby up to 6 months. The extra calories needed by mother during breast feeding is 500 calories. Expressed breast milk can be stored at room temperature for up to 4 hours. Cow's milk is deficient of iron. Bottle-fed babies are more prone to develop diarrhea Feeding a child with choanal atresia can cause chokes on feeding. According to the WHO report, malnutrition contributes to 45 percent of deaths of children aged under 5 years (worldwide). Diarrheal disease is the most common cause of under-five mortality rate in India. According to WHO childhood Severe Acute Malnutrition (SAM) is diagnosedwhen the weight-for-height. Wasting (low weight for height) indicates acute malnutrition. Chronic malnutrition is measured by height for age. Stunting (low height for age) indicates chronic malnutrition. Vaccine of Diptheria, Tetanus Toxoids and Pertussis (DTP) is contraindicated in progressive neurological illness. Vastus lateralis is the best choice for IM injection in infants and younger children. Oral Poliovirus (OPV) and measles are sensitive to heat and can be frozen without harm. DTP vaccine should be stored at 4-8°C. Method used for the transportation of vaccine from the site of production to the vaccination site is Cold Chain. Bacillus Calmette-Guérin (BCG) vaccine is administered through intradermal route. Measles, Mumps, and Rubella (MMR) is a live vaccine and route of administration is subcutaneous. Varicella vaccine provides protection against chicken pox. Subacute sclerosing panencephalitis may occur years after measles vaccination as a complication. Diaper rashes most commonly caused by Staphylococcus aureus.

Site of lesion in polio is ventral horn of spinal cord. Parenteral polio vaccine is also known as Salk. Oral Polio Vaccine is also known as Sabin. Intelligence quotient (1Q) is the index of intellectual brightness of the child and is calculated as: Q = Mental age/Chronological age x 100 The new terminology for mental retardation is intellectual disability. .The type of play commonly exhibited by toddlers where they play by themselves in the presence of other children is called parallel play. .The child plays intently with available materials but remains totally alone is known as solitary play. Burns are the most common documented cause of accidents in toddlers followed by choking, toxic ingestions and drowning. Passage of feces in inappropriate places after bowel control would be expected is known as Encopresis. Child's participation in decision making process about health care is termed as Assent. Normal adult hemoglobin contains two alpha chains and two beta chains. Neonatal anemia is defined as haemoglobin less than 13 g/dl. Anemia in children is defined as haemoglobin less than 11 g/dl. Treatment of choice for thalassemia major is blood transfusion and desferrioxamine. Haemophillia affects only male. A female who inherits one affected X chromosome becomes a 'carrier of haemophilia. Vitamin A deficiency leads to diarrhea and hyperkeratosis in children. Most common bacterial cause of diarrhea in children is Enterotoxic E. coli. Neonatal physiological jaundice appears after 24 hours of life due to breakdown of Red Blood Cells. Neonatal pathological jaundice appears within first 24 hours after birth. Drug used in the treatment of neonatal jaundice is phenobarbitone Eyes and genitalia need to be covered during phototherapy. Cleft palate is usually repaired around 12 months of age. Cleft lip is usually repaired at four to six months of age. Double bubble sign in the X-ray is suggestive of duodenal atresia. Continuous drooling immediately after birth indicates tracheo-esophageal fistula. Congenital absence of ganglion cells in the submucosal and myenteric plexus of the distal intestine is known as Hirschsprung's disease. Hypokalemic metabolic alkalosis is the classic electrolyte and acid-base imbalance of pyloric stenosis. Projective vomiting is a feature of hypertrophic pyloric stenosis. Drug of choice to treat scabies in younger children is 5% permethrin cream. Frequent swallowing is a sign of haemorrhage in child who underwent tonsillectomy. Drug of choice in trachoma for children is oral tetracycline. Tetracycline is contraindicated in infants and young children. .To administer eardrop in children below age 3, pull the pinna downward and backward. In adult the pinna will be hold upward and backward. Other name of mucocutaneous lymph node syndrome is Kawasaki Disease. Toddler and preschooler are more prone to accidental poisoning due to their curiosity and desire to explore the world. Damage caused by lead poisoning is irreversible in CNS, but in all other body system the damage is reversible. Folic acid helps in prevention of neural tube defect in fetus. Nurse needs to measure head and abdominal circumference in a newborn with non-communicating hydrocephalus and has a ventro peritoneal shunt inserted to monitor the function of the shunt. Most common type of meningitis that affects children less than 5 years is bacterial meningitis. Meningomyelocele is a sac-like protrusion containing meninges, Cerebrospinal Fluid (CSF) and neuralelements. .Immediate nursing care for a child with meningomyelocele is applying sterile moist non-adherent dressing to the sac to prevent the breakage and dryness of the sac. Police man tip hand condition is known as Erb's palsy. Excess or deficiency of vitamin pyridoxine leads to peripheral neuropathy. Positive Kernig's sign, Brudzinski's sign and nuchal rigidity are signs of meningitis. Brudzinski's sign: Hips and knees to flex when the neck is flexed. Kernig's sign: Inability to straighten the leg when the hip is flexed to 90°. Tetralogy of Fallot is a cyanotic heart disease. Tetralogy of Fallot is congenital heart disease which includes four heart defects, namely: Overriding aorta Pulmonic stenosis Ventricular septal defect Right ventricular hypertrophy

.In X-ray, the heart of a child with tetralogy of Fallot appears boot-shaped.

A child who is suffering from cyanotic heart diseases is more comfortable in knee-chest position.

Group A B-hemolytic streptococcus is the causative organisms for rheumatic fever.

.Drug of choice for rheumatic fever prophylaxis in penicillin allergic patient is Erythromycin.

The heart disease most commonly associated with rubella infection is Patent Ductus Arteriosus.

Common symptom of TOF is clubbing of fingers.

Deficiency of growth hormone leads to proportionate dwarfism.

Hyper secretion of growth hormone before the closure of epiphyseal plates can cause Gigantism.

Hyper secretion of growth hormone after the closure of epiphyseal plates can cause Acromegaly.

Adrenocorticotropic hormone (ACTH) secretion is highest in morning.

Term used for undescended testis is Cryptorchidism.

Unilateral renal agenesis is associated with single umbilical artery.

Wilm's Tumor is commonly present as abdominal mass.

In Acute Renal Failure (ARF), hyperkalemia is treated with calcium gluconate.

Red urine without RBC is seen in Rhabdomyolysis.

Color codes used in IMNCI are Pink, Green and Yellow.

Most common form of childhood cancer is Leukemia.

The Human Genome Project was completed in 2003.

The first human gene therapy was instituted in 1990.

The science of betterment of human race by application of the law of inheritance is called Eugenics.

Triple screen test involves Alpha-fetoprotein, Human chorionic gonadotropin, and Estriol.

X-linked recessive disorders are more common among males as compared to females.

Trisomy 13 is identified as Pataus' syndromne.

Trisomy 18 is identified as Edward's syndrome.

Trisomy 21 is identified as Down's syndrome.

A chromosomal disorder in which a female is born with only one X chromosome is known as Turner's syndrome.

Deficiency of vitamin-D in children may cause Rickets.

Chvostek sign and trousseau signs are seen in Hypocalcemia.

Restraints used during upper chest/abdominal procedure which immobilize all the extremities is Mummy restraints.

An axillary temperature should be taken for 3 minutes.

The rectal temperature should be taken in 1 minute.