NGR 6301 EXAM 2 QUESTIONS AND ANSWERS
What are the early findings of DDH (developmental dysplasia of the hip)? - Answers -
Early findings include those found between 2 and 3 months of age ("loose phase").
They include:
- +Ortolani and Barlow
- unequal gluteal and upper thigh folds
How is DDH (developmental dysplasia of the hip) treated? - Answers - If DDH is caught
at birth then the patient simply gets a hip cast (referral required).
Subluxation can correct by two weeks of age. If a "click" is heard then re-evaluate in two
weeks and refer out if still present.
If the limb is dislocatable, refer to ortho.
How is infant GERD diagnosed? - Answers - The s/s include frequent but not forceful
spitting up and chronic but mild URI s/s.
Chronic URI s/s may lead to chronic cough and cause severe pain.
How is infant GERD treated if the patient does not have a cough and isn't in pain? -
Answers - Treat with reflux precautions, nasal saline for congestion, and probiotics.
Most infants will outgrow by one year.
What are the symptoms of volvulus in infants? - Answers - *bilious emesis* (more green
than yellow in a newborn), irritability
How is volvulus treated in infants? - Answers - Volvulus is a surgical emergency as it is
a malrotation of the intestine.
What are the symptoms of pyloric stenosis in infants? - Answers - mild emesis
progressing to projectile vomiting, metabolic and fluid derangements if missed,
sometimes an olive or fluid wave can be palpated at the pylorus
How is pyloric stenosis treated? - Answers - pyloromyotomy to cut through hypertrophic
muscle
What are the symptoms of intussusception in infants? - Answers - Triad: intermittent
colicky abdominal pain, vomiting, bloody mucousy stools (usually at least one present)
(may also palpate fullness in RUQ)
, How is intussusception treated? - Answers - surgical emergency if not reduced by
radiologist during diagnostic barium or air enema
What are some red flags for autism in infants? - Answers - - lack of appropriate gaze
- lack of warm, joyful expressions with gaze by 4mo
- lack of alternating to-and-fro vocalizations by 6mo (ASD continues to vocalize)
- lack of recognition for caregiver's voice
- disregard for vocalizations (name) but keen on environmental sounds
- delayed babbling past 9mo
- decreased use of pre-speech gestures
- delayed or absent joint attention
When should a vision screenings begin? - Answers - 6-9 months (with computer-based
screens)
What is the Bruckner? (How is it performed?) - Answers - The Bruckner Test screens
for amblyopia, strabismus, refractive error and media opacities.
To Perform:
1. Dim the lights
2. Have the child sit arm's length away from you, and look straight at you.
3. Shine the light directly at the child's eyes using the large white spot, and focus on the
iris. Use the lowest light on the rheostat that will allow you to see the red reflex.
What is an abnormal result of a Bruckner and what does it reveal? - Answers - There
are several abnormal results of a Bruckner Test.
1. hyperopia (lighter crescent at top of eye)
2. myopia (lighter crescent at bottom of eye)
3. astigmatism (cornea is a football shape)
4. anisometropia (unequal in both eyes)
5. corneal abrasions and scars (black marks)
6. cataracts
7. retinoblastoma ("white reflex")
8. strabismus (asymmetry, unequal pupils, displacement of central reflex)
9. eostropia (inward turning of eye)
10. extropia (outward turning of eye)
11.
What is an abnormal result of a corneal light reflex? - Answers - The corneal light reflex
is used to detect strabismus. The provider sits approximately 12-14 inches away from
the patient and shines a light at his or her eyes. Asymmetrical reflections indicate
strabismus is present.
What are the early findings of DDH (developmental dysplasia of the hip)? - Answers -
Early findings include those found between 2 and 3 months of age ("loose phase").
They include:
- +Ortolani and Barlow
- unequal gluteal and upper thigh folds
How is DDH (developmental dysplasia of the hip) treated? - Answers - If DDH is caught
at birth then the patient simply gets a hip cast (referral required).
Subluxation can correct by two weeks of age. If a "click" is heard then re-evaluate in two
weeks and refer out if still present.
If the limb is dislocatable, refer to ortho.
How is infant GERD diagnosed? - Answers - The s/s include frequent but not forceful
spitting up and chronic but mild URI s/s.
Chronic URI s/s may lead to chronic cough and cause severe pain.
How is infant GERD treated if the patient does not have a cough and isn't in pain? -
Answers - Treat with reflux precautions, nasal saline for congestion, and probiotics.
Most infants will outgrow by one year.
What are the symptoms of volvulus in infants? - Answers - *bilious emesis* (more green
than yellow in a newborn), irritability
How is volvulus treated in infants? - Answers - Volvulus is a surgical emergency as it is
a malrotation of the intestine.
What are the symptoms of pyloric stenosis in infants? - Answers - mild emesis
progressing to projectile vomiting, metabolic and fluid derangements if missed,
sometimes an olive or fluid wave can be palpated at the pylorus
How is pyloric stenosis treated? - Answers - pyloromyotomy to cut through hypertrophic
muscle
What are the symptoms of intussusception in infants? - Answers - Triad: intermittent
colicky abdominal pain, vomiting, bloody mucousy stools (usually at least one present)
(may also palpate fullness in RUQ)
, How is intussusception treated? - Answers - surgical emergency if not reduced by
radiologist during diagnostic barium or air enema
What are some red flags for autism in infants? - Answers - - lack of appropriate gaze
- lack of warm, joyful expressions with gaze by 4mo
- lack of alternating to-and-fro vocalizations by 6mo (ASD continues to vocalize)
- lack of recognition for caregiver's voice
- disregard for vocalizations (name) but keen on environmental sounds
- delayed babbling past 9mo
- decreased use of pre-speech gestures
- delayed or absent joint attention
When should a vision screenings begin? - Answers - 6-9 months (with computer-based
screens)
What is the Bruckner? (How is it performed?) - Answers - The Bruckner Test screens
for amblyopia, strabismus, refractive error and media opacities.
To Perform:
1. Dim the lights
2. Have the child sit arm's length away from you, and look straight at you.
3. Shine the light directly at the child's eyes using the large white spot, and focus on the
iris. Use the lowest light on the rheostat that will allow you to see the red reflex.
What is an abnormal result of a Bruckner and what does it reveal? - Answers - There
are several abnormal results of a Bruckner Test.
1. hyperopia (lighter crescent at top of eye)
2. myopia (lighter crescent at bottom of eye)
3. astigmatism (cornea is a football shape)
4. anisometropia (unequal in both eyes)
5. corneal abrasions and scars (black marks)
6. cataracts
7. retinoblastoma ("white reflex")
8. strabismus (asymmetry, unequal pupils, displacement of central reflex)
9. eostropia (inward turning of eye)
10. extropia (outward turning of eye)
11.
What is an abnormal result of a corneal light reflex? - Answers - The corneal light reflex
is used to detect strabismus. The provider sits approximately 12-14 inches away from
the patient and shines a light at his or her eyes. Asymmetrical reflections indicate
strabismus is present.
