SARAH MICHELLE CRASH COMPREHENSIVE EXAM
UPDATED QUESTIONS AND ANSWERS SURE A+
✔✔Developmental milestones - ✔✔-anterior and posterior fontanelles close- 2-3 months
-strabismus clear up- 4-6 months
-roll tummy to back- 6 months
-palmar grasp goes away- 6 months
-sit up unassisted- 9 months
-feed self with fingers- 9 months
-anticipate separation anxiety- 9 months
-pull to a stand- 12 months
-say mama/dada-12 months
-hold a spoon-12-18 months
-walk- 18 months
-say worders other than mama/dada-18 months
-scribble- 18 months
-kick a ball- 2 years
-cop a circle/throw a ball/ride a tricycle- 3 years
-When should bowlegs go away? - 3 years
-draw a cross- 4 years
-draw a person with body parts- 4 years
-catch a large ball- 4 years
-counting to 10- 5 years
-hopping on 1 foot- 5 years
-riding a bicycle-5-6 years
Sunken fontanels- concerning for dehydration- ED
Birth weight doubles at 6 months
Birth weight triples at 12 months
✔✔Reflexes present at birth - ✔✔-rooting
-tonic-neck
-grasp
-moro
-stepping
✔✔effective breastfeeding - ✔✔-6-8 wet diapers a day
-gaining weight
-vitamin D supplements
✔✔Start giving live vaccines - ✔✔-12 months because maternal antibodies can interfere
with immunity prior to this age.
✔✔Children that should not get a live vaccine - ✔✔immunocompromised (such as on
high doses of steroids or IG).
,✔✔Patient doesn't know vaccination status - ✔✔give them everything
-< 7- DTAP
-> 7- TDAP
✔✔Older child with no vaccines - ✔✔-IPV, TDAP, MMR, Meningitis, HPV, HBV, HIM,
Varicella, Flu, pneumonia, HEB.
-Xray: thumbprint
✔✔Newborns - ✔✔-a bilirubin > 15 indicates need for phototherapy
✔✔Rhino blastoma or congenital cataract - ✔✔-parents bring a child in and you find
leukocoria on fundoscopic exam.
✔✔Tanner stages - ✔✔Girls
1: nothing
2: budding
3: 1 mound
4: 2 mounds/start of period
5: everything
Boys
1: nothing
2: nothing
3-4: growth spurt/penis grows the most length
5: everything
✔✔Puberty - ✔✔-starts in tanner stage 2
-2-3 years after puberty is when a girls starts period
-age 16, no period, investigate further
-start period, grow 2-3 more inches within 2 years
too early for puberty
-< 8 year old in girls
-< 9 year old in boys
✔✔Anorexia and Bulimia - ✔✔-high risk for bone loss and heart disease (anorexia)
-dental erosion, esophageal issues (bulimia)
-sx improvement: anorexia, increases menses, weight gain
✔✔Salter-Harris fractures - ✔✔-occurs along growth plate in long bones
-if not corrected, may stunt child's growth
-type 3 refer to ortho
✔✔Cryptorchidism - ✔✔-testes that are not within the scrotum
-worried about testicular cancer in the future
, ✔✔hydrocele - ✔✔-abnormal accumulation of fluid around the testes
-can be born with it or with injury/inflammation
-reassure parents, typically resolves on own, surgery if persists pass 2 years of age.
✔✔Slate gray nevi (Mongolian spots) (congenital dermal melanocytosis) - ✔✔-bluish
discoloration on a two-week-olds back
-not painful
-flat and smooth
-likely resolve on own by 6-10 years of age
✔✔Acute otitis media in pediatrics - ✔✔-bulging inflamed TM
-Amoxicillin
-PCN allergy: cephalosporins, azithromycin, Bactrim
-untreated- mastoiditis, worsening pain, postauricular tenderness, fever
-refer to ENT
✔✔Otitis externa (swimmers' ear) in pediatrics - ✔✔-drainage is very malodorous
-external ear tenderness
-usually, pathogen is pseudomonas aeruginosa
-ABX ear gtt- ofloxacin, sometimes steroid gtts added
✔✔Tympanic membrane rupture - ✔✔-ear pain, sudden bloody drainage
-likely will heal on own, can refer to ENT
-recheck in 4 weeks
✔✔chronic otitis media - ✔✔-can lead to possible hearing loss, which could delay
speech
✔✔cholesteatoma - ✔✔-cauliflower like growth
-refer to ENT
✔✔otitis media with effusion - ✔✔-likely related to allergies
-effusions can last up to 12 weeks
-watch and wait
✔✔coarctation of the aorta - ✔✔-heart defect, typically present at birth
-Increased BP in arms, Decreased BP in legs
-diminished LE pulses
✔✔Symptoms an infant can show with undiagnosed heart defect - ✔✔respiratory
distress, increased RR, retractions, nasal flaring, diaphoresis, pulmonary edema.
✔✔VUR: Vesicoureteral reflex - ✔✔-urine flow backs up into the ureters and leads to
dilation of the kidneys
UPDATED QUESTIONS AND ANSWERS SURE A+
✔✔Developmental milestones - ✔✔-anterior and posterior fontanelles close- 2-3 months
-strabismus clear up- 4-6 months
-roll tummy to back- 6 months
-palmar grasp goes away- 6 months
-sit up unassisted- 9 months
-feed self with fingers- 9 months
-anticipate separation anxiety- 9 months
-pull to a stand- 12 months
-say mama/dada-12 months
-hold a spoon-12-18 months
-walk- 18 months
-say worders other than mama/dada-18 months
-scribble- 18 months
-kick a ball- 2 years
-cop a circle/throw a ball/ride a tricycle- 3 years
-When should bowlegs go away? - 3 years
-draw a cross- 4 years
-draw a person with body parts- 4 years
-catch a large ball- 4 years
-counting to 10- 5 years
-hopping on 1 foot- 5 years
-riding a bicycle-5-6 years
Sunken fontanels- concerning for dehydration- ED
Birth weight doubles at 6 months
Birth weight triples at 12 months
✔✔Reflexes present at birth - ✔✔-rooting
-tonic-neck
-grasp
-moro
-stepping
✔✔effective breastfeeding - ✔✔-6-8 wet diapers a day
-gaining weight
-vitamin D supplements
✔✔Start giving live vaccines - ✔✔-12 months because maternal antibodies can interfere
with immunity prior to this age.
✔✔Children that should not get a live vaccine - ✔✔immunocompromised (such as on
high doses of steroids or IG).
,✔✔Patient doesn't know vaccination status - ✔✔give them everything
-< 7- DTAP
-> 7- TDAP
✔✔Older child with no vaccines - ✔✔-IPV, TDAP, MMR, Meningitis, HPV, HBV, HIM,
Varicella, Flu, pneumonia, HEB.
-Xray: thumbprint
✔✔Newborns - ✔✔-a bilirubin > 15 indicates need for phototherapy
✔✔Rhino blastoma or congenital cataract - ✔✔-parents bring a child in and you find
leukocoria on fundoscopic exam.
✔✔Tanner stages - ✔✔Girls
1: nothing
2: budding
3: 1 mound
4: 2 mounds/start of period
5: everything
Boys
1: nothing
2: nothing
3-4: growth spurt/penis grows the most length
5: everything
✔✔Puberty - ✔✔-starts in tanner stage 2
-2-3 years after puberty is when a girls starts period
-age 16, no period, investigate further
-start period, grow 2-3 more inches within 2 years
too early for puberty
-< 8 year old in girls
-< 9 year old in boys
✔✔Anorexia and Bulimia - ✔✔-high risk for bone loss and heart disease (anorexia)
-dental erosion, esophageal issues (bulimia)
-sx improvement: anorexia, increases menses, weight gain
✔✔Salter-Harris fractures - ✔✔-occurs along growth plate in long bones
-if not corrected, may stunt child's growth
-type 3 refer to ortho
✔✔Cryptorchidism - ✔✔-testes that are not within the scrotum
-worried about testicular cancer in the future
, ✔✔hydrocele - ✔✔-abnormal accumulation of fluid around the testes
-can be born with it or with injury/inflammation
-reassure parents, typically resolves on own, surgery if persists pass 2 years of age.
✔✔Slate gray nevi (Mongolian spots) (congenital dermal melanocytosis) - ✔✔-bluish
discoloration on a two-week-olds back
-not painful
-flat and smooth
-likely resolve on own by 6-10 years of age
✔✔Acute otitis media in pediatrics - ✔✔-bulging inflamed TM
-Amoxicillin
-PCN allergy: cephalosporins, azithromycin, Bactrim
-untreated- mastoiditis, worsening pain, postauricular tenderness, fever
-refer to ENT
✔✔Otitis externa (swimmers' ear) in pediatrics - ✔✔-drainage is very malodorous
-external ear tenderness
-usually, pathogen is pseudomonas aeruginosa
-ABX ear gtt- ofloxacin, sometimes steroid gtts added
✔✔Tympanic membrane rupture - ✔✔-ear pain, sudden bloody drainage
-likely will heal on own, can refer to ENT
-recheck in 4 weeks
✔✔chronic otitis media - ✔✔-can lead to possible hearing loss, which could delay
speech
✔✔cholesteatoma - ✔✔-cauliflower like growth
-refer to ENT
✔✔otitis media with effusion - ✔✔-likely related to allergies
-effusions can last up to 12 weeks
-watch and wait
✔✔coarctation of the aorta - ✔✔-heart defect, typically present at birth
-Increased BP in arms, Decreased BP in legs
-diminished LE pulses
✔✔Symptoms an infant can show with undiagnosed heart defect - ✔✔respiratory
distress, increased RR, retractions, nasal flaring, diaphoresis, pulmonary edema.
✔✔VUR: Vesicoureteral reflex - ✔✔-urine flow backs up into the ureters and leads to
dilation of the kidneys
