Quartz 5

Pediatrics

3 min read

Vitals

Bright Futures Resource List
Red Book of ID
BiliTool™
NC Medicaid Preferred Drug List (as of 7/1/25)

Vaccine Schedule

  • Autism / Vaccine Resources

Well Visit Interview (HEEADSSS)

  • Home life
    • Who do you live with?
  • Education
    • Daycare, what year in school, etc.
  • Eating
    • Diet
  • Activities
    • Age based, from tummy time to sports
  • Drugs
    • Secondhand smoke, personal use, illicit
  • Sexuality
    • bf/gf, contraception, testing, etc
  • SI/HI/Depression
    • Screen! (>12)
  • Safety
    • Holistic & age appropriate (car seat, seatbelt, helmet, etc)

Milestones

Screenings


periodicity_schedule.pdf

  • ASQ (Ages and Stages)
  • Maternal Depression = Edinburgh
  • MCHAT (Autism)
  • PSC (Periodic Symptom Checklist)
  • GAPS (Guidelines for Adolescent)

Red Flags

  • Vital Signs
  • Dehydration
    • <3 wet diapers in 24hrs, sticky mucous membranes, slow cap refill
  • Respiratory Distress
    • tachypnea, retractions, nostril flaring
  • AMS (lethargic!)
  • Fever >5 days

Newborns and Infants

  • Neonatal Hx (<2 weeks of age)

    • Name
    • Pregnancy complications
      • Mental Health / Gestational Diabetes / Lupus
      • ID: Group BStrep / G/C / HIV / Syphilis / Herpes / Hepatitis
    • Fam Hx
    • Prior pregnancies and outcomes

  • PE

    • Listen to Heart/Lungs
    • Skull fontanelles / ears
    • Palpate clavicles
    • Bilat grip reflex
    • Listen to Belly
    • Press on belly
    • Undo diaper: femoral pulses, check genitalia, check hips
    • Reattach diaper, check feet reflexes and cap refill
    • Flip baby, check spine
    • Moro reflex
    • Swaddle
    • Mouth: light, gloved finger checks palate and suck reflex
    • RED REFLEX
    • Note skin color during exam

  • Hyperbilirubinemia

    • Put in notes
    • Phototherapy
    • Goal: prevent bilirubin encephalopathy and Kernicterus

  • Important PE Findings

    • Scleral hemorrhage (pupil spared = okay)
    • Choanal atresia (lack of patent nasal passages)
    • Torticollis (asymmetrical neck muscle tightness)
    • Murmurs (PDA, ASD/VSD, etc.)
    • Hips (@4-6 weeks: bartlow-adduction / ortolani-abduction)
      • Click / clunk or breech birth = ultrasound
      • fix= Pavlic harness
    • Feet - club feet
    • Sacral dimples / hair tufts
    • Neuro: symmetric reflexes, normal tone, etc
      • Babinski (present in first 1-2 yrs)
      • Moro (present in <6mo)
      • Grip
      • Suckle (rooting)
    • skin:
      • milia, dermal melanosis (sacral), nevus simples (stork bite), pustular melanosis

  • Red Flags:
    -Neonate

    • hypoglycemia
    • hyperbilirubinemia
    • weight loss (>10%)
      • normal for some weight loss in first few days
      • lactation consultant
    • jittery and inconsolable
      • withdrawal? drug screen, neonatal abstinence score
    • congenital abnormalities
      -Infants
    • fever > 4days
    • refusing eat/drink, decreased urine output
    • hard to wake / AMS / lethargic / inconsolable by caregiver

  • Infant Illnesses

    • Colic - 10wks to 4mo
      • paroxysmal abdominal pain
    • Pyloric Stenosis
      • projectile vomit / bilious emesis
      • olive like mass in mid-epigastrium (probably won’t feel it!!)
      • seen on US
      • fix = surgery! (not an emergency)
    • Duodenal Atresia
      • first 48hrs - congenital duodenal malformation
      • bilious vomiting
      • “double bubble sign”
      • fix = surgery (emergent)
    • Volvulus
      • <6mo
      • recurrent bile stained vomit

Toddlers, School-Age, Adolescents

Common Illnesses

-Respiratory
Croup
Bronchiolitis
Pneumonia
Epiglottitis
Pertussis
Asthma
-HEENT
Conjunctivitis
Otitis media
Otitis Externa
Pharyngitis
Corneal Abrasion
-GI
Gastroenteritis
Constipation
Intussusception
Appendicitis
-Derm

Graph View