O+G + Paeds

Question 1

How do you assess the development of a child?

Answer 1

Ask parent about concerns

Gross motor, fine motor, social, language and hearing

Question 2

How do you assess the gross motor milestones of a 1 yr old?

Answer 2

Pulling to stand (6m)
Sitting with support (6m)
Sitting without support (10m)
Crawling/bum shuffle (10m)
Cruising (1yr)

Question 3

How do you assess the fine motor milestones of a 1 yr old?

Answer 3

Reaching for small objects (5m)
Putting small objects in mouth (5m)
Transferring hand to hand (6m)
Pincer grip (9m)
Builds a tower of 3-4 cubes (18m)

Question 4

How do you assess the social milestones of a 1yr old?

Answer 4

Smiles (6w)
Stranger anxiety (6m)
Waves bye bye (1yr)

Question 5

How do you assess the language and hearing milestones of a 1 yr old?

Answer 5

Turns head to sound (6m)
Babbling (10m)
Strings 2 words together (2yrs)
Simple commands, co-operates with dressing (1yr)

Question 6

What does a SFH tell you?

Answer 6

From 16-36 weeks SFH (cm) roughly correlates with gestational age (weeks)
+/-2cm
After 36w head engages and SFH regresses

Question 7

What level should the fundus of a pregnant abdo be at 12, 24 & 36 weeks?

Answer 7

12 weeks: pubic symphysis
24 weeks: umbilicus
36 weeks: xiphoid sternum

Question 8

When is the fundus at the umbilicus?

Answer 8

24 weeks

Question 9

What do you look for in general inspection & peripherally in an obstetric exam?

Answer 9

Pain/comfortable
Colour
Temp, cap refill, HR, BP
Conjunctival pallor

Question 10

What do you look for in a pregnant abdo?

Answer 10

Fetal movement
Striae
Linea nigra
Bruising
Scars

Question 11

What do you feel for in a pregnant abdo?

Answer 11

Bimanual palpation
Single/multiple fetuses?
Transverse/oblique/longitudinal lie
Position of baby's head and back
Engagement? Station?
Movement?
Measure SFH
Amniotic fluid vol?

Question 12

What do you auscultate for?

Answer 12

Fetal HR w/doppler probe (120-160 normal)

Question 13

What do you check pt’s feet for?

Answer 13

Ankle oedema

Clonus

Question 14

Explain steps of a bimanual examination

Answer 14

WIPE
Knees up w/feet together, relax apart
Give blanket for dignity
Wash hands, don gloves and lubricating gel
Inspect pubic hair (live/excoriation)
Inspect for warts, ulcers, rash, discharge
1 hand on abdo, other hand parts labia and 2 fingers into vagina
Feel for cervix (cervical motion tenderness)
Feel 2 fornixes
Size and mobility of uterus (fibroids?)
Pain?