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Pediatrics - sb
| Question | Answer |
|---|---|
| a 9 year old boy comes in complaining of heavy vomiting, lethargy, confusion, headaches, but no fever... of note he has a virus the other day and mom gave him aspirin | reyes syndrome |
| Of the kiddo with reyes syndrome what might you find on physical exam | enlarged liver |
| What tests would you do to confirm reyes syndrome | CT, LP, ammonia levels (elevated), ALT/AST (x3 elevation), amylase and lipase (elevated), PT/aPTT (prolonged) |
| how do you treat reyes syndrome | IVF, anti-epileptics, treatments to prevent bleeding, NO MORE ASPIRIN |
| Pt has projectile non-bilious vomiting and FTT what anatomical problem should you evaluate them for | pyloric stenosis |
| Bilious vomiting makes you worried for what condition | obstruction |
| most common reason for vomiting in a kiddo | gastroenteritis (norovirus, rotovius, adenovirus, or astrovirus) |
| intermittent abdominal pain, vomiting, bloody stool that looks like jelly(?), fever. what do you worry about them having | intussusception |
| after how many days is it considered chronic diarrhea | 14 |
| most common cause of acute diarrhea | infectious usually viral |
| which diarrhea will be more bloody bacterial or viral | bacterial (invades the intestinal wall) |
| Dysenteric diarrhea | acute bloody caused by invasive microbial infection |
| Dehydration in a kid is more common because they | have a higher metabolic rate, increased body surface area to mass index, higher body water content |
| at what stage of dehydration do you get skin tenting | moderate |
| sucken eyes, pulse increased but barely palpable, sucken fontanelle all point to what stage of dehydration | severe |
| what question would you ask a mom with an infant you suspect has dehydration | how many wet diapers has she/he had in the last 24 hours |
| what finding on UA is consistent with dehydration | ketones and/or protein in the urine |
| treatment of moderate dehydration | 20mL/kg NS bolus repeat until better |
| maintenance fluids in a kiddo with dehydration | D5 + 1/2 NS +/- 20 meq KCl |
| History questions you should ask a patient with a head injury | mechanism, LOC, HA, seizures |
| When would you suspect meningitis in a newborn | fever and nonspecific symptoms, stiff neck or bulging fontanel, irritable, restless, or lethargic |
| When would you suspect meningitis in an older child | sudden fever, headache, nausea, vomiting, confusion, stiff neck, photophobia |
| Phsyical exam findings with meningitis | cyanosis, disturbed consciousness, meningeal irritation (Kernig, brudzinski) |
| A 2 week old baby comes into the ER with a fever. what diagnostic procedure should you do | LP |
| When treating meningitis | Do LP then initiation of empiric antibiotic therapy |
| What bacteria do you think you with a neonate and mengitis | Group B strep, E. coli, Listeria |
| what pathogens do you suspect with older children with menigitis | S. pneumoniae, N meningitis, staph (Hib if not vaccinated) |
| Findings on CSF with bacterial | Elevated white count mostly PMNs, glucose decreased, protein elevated |
| Findings on CSF with viral | Normal WBC (could be elevated with lymphocytes), normal glucose, normal protein |
| Treatment of meningitis/sepsis (?) with newborns | Amp + Gent |
| Treatment of meningitis/sepsis (?) with children | Ceftriaxone + Vanc |
| Drowning treatment | management of hypoxia, ET tube and mechanical ventilation may be indicated |
| How high is the fever with febrile seizures usually | >102 |
| simple febrile seizures | < 15 minutes, generalized, once during a 24 hour period, febrile child, no signs of intracranial infections, metabolic distrubances or history of febrile seizures |
| Complex febrile seizures | prolonged >15 minutes, focal, more than once in 24 hours |
| Treatment of febrile seizure in the ER | Tylenol or Motrin, LP if first one and young, monitor for return to baseline mental status, PT EDUCATION |
| Ca Blockers poisoning symptoms | Hypotension, bradycardia, N/V, stupor, confusion |
| Ca blockers treatment | IV access, telemetry PO activated charcoal, aggressive tx if bradycardia with IVF, pressors, Ca, possible ECMO |
| Beta blockers poisoning symptoms | Hypotension, arrhythmia, bradycardia, CNS depression/coma, seizures, hypoglycemia, bronchospams |
| Beta blockers poisoning treatment | admit for 24 hour obs activated charcoal if <1hr post ingestion IVF, pressors, antidote is glucagon with NS |
| Sulfonylureas poisoning symptoms | hypoglycemia, agitation, confusion, tachycardia, seizures |
| Sulfonylureas poisoning treatment | MUST ADMIT for 24h q1hr blood glucose check, give food, dextrose, or if really bad octreotide |
| Tylenol poisoning symptoms | transaminases start to increase 12 hr post ingestion, liver necrosis in 72-96h |
| Tylenol poisoning treatment | check lytes, LFTs, coags, UA and recheck qhr antidose- NAC within 8hr |
| Antidepressant poisoning symptoms | CNS depression, seizures, arrhythmias, hypotension (TCA) hypertension (SSRI) |
| Antidepressant poisoning treatment | ECG and telemetry activated charcoal gastric lavage sodium bicarb if arrhythmia |
| Iron poisoning symptoms | Stage1 abd pain, V/D, Gi hemorrhage, dehydration Stage 2 asx Stage 3 coma seizures shock hepatic dys, hypoglycemia stage 4 hepatic failure stage 5 GI tract strictures bowel obstruction |
| Iron poisoning treatment | follow abdominal radiograph, lytes, CBC do NOT use activated charcoal whole bowel irrigation if iron tablets seen antidote- desferoxamine if severe, AG acidosis, lots of pills seen |
| Ethylene glycol poisoning symptoms | Elevated anion gap metabolic acidosis CNS toxicity, tachycardia, hypoxia, CHF, ARDS, acute tubular necrosis, renal failure |
| Ethylene glycol poisoning treatment | Airway, telemetry, ethylene glycol levels, renal function, dialysis? antidote- domepizole |
| Methanol poisoning symptoms | normal or inebriated AG metabolic acidosis blindness death (6-36 hours) |
| Methanol poisoning treatment | Airway, supportive, dialysis? antidote- fomepizole |
| Poor prognosis post drowning | -Prolonged submersion(>10 min) -Delay in effective CPR -Severe met acidosis (<7.1) -Asystole on arrival to ED -GCS <5 -Fixed, dilated pupils in ED |
| early diagnosis of aspiration | respiratory distress, stridor |
| Late diagnosis of aspiration | wheezing, coughing, decreased breath sounds, fever |
| Evaluating aspiration | plain chest x-ray, inspiration/expiration xray, left and right decubitus x-ray, chest fluorscopy |
| you think a kid swallowed captain planet.. but you cant see earth wind or fire on a chest xray.. what do you do | GI endoscopy |
| How can you tell if the child is eating enough | growth charts |
| initial post-natal loss | average weight loss 3-6% in first 2 weeks after birth |
| when does a baby regain the initial post-natal loss | by day 10-14 |
| infants double birth weight by | 5-6 months |
| infants triple birth weight by | 1 year |
| Constipation | infrequent stooling, dry hard or small stools, uncommon in breast fed infants |
| Constipation of treatment | ensure proper diet and formula prep, feed water after each feeding, 2oz of juice, ensure potty training is not forced |
| Diarrhea causes | excessive fruit juice and fluid intake, low fat diet, sugar free candies |
| Diarrhea treatment | appropriate diet, whole milk, minimal fruit juice |
| When can you add cereal into the babies diet | ~6 months |
| When can you add mashed foods, fruits, veggies, grains | 6-8 months |
| When can you add foods with fine lumps, foods with soft texture | 8-10 months |
| When can you add bite sized foods | 10-12 months |
| is baby getting enough with breast feeding | audible swallowing, 6-8 wet diapers a day, 2-3 stools per day, appear satiated, breast softer after feeding |
| contraindications to breast feeding | infants with galactosemia, mother with HIV, TB, drug use, chemo/radiation, on antiretrovirals, or has human T cell lymphotropic virus |
| components of a nutritional assessment in a child | anthropometrics, biochemical analysis, history, dietary data, PE |
| Transcription | DNA to RNA |
| Translation | RNA to protein |
| Clinical presentation of down syndrome (Trisomy 21) | (6/10) Flat facies, slanted palpebral fissures, anomalous auricles, excess skin on back of neck, hypotonia, poor moro reflex, hyperflexibility, dysplasia of the mid phalanx 5th digit, pelvic dysplasia, single transverse palmar crease |
| Trisomy 18 (edwards syndrome) | IUGR, clenched hand with index overlapping 3rd and 5th overlapping 4th, inguinal or umbilical hernia, cardiac defects, low set ears, micrognathia, rocker bottom feet, apnea (90% die by 1 year) |
| Trisomy 13 | holoprosencephaly, polydactyly, seizures, deafness, sloping foreheads, cleft lip/palate, abnormal ear, microphthalmia, single umbilical artery, cardiac and urinary tract defects (70% die within 1 year) |
| Klinefelter syndrome features | (XXY) Normal to tall stature, delayed speech, behavior or learning problems, thin with long legs, hypergonadotropic hypogonaism (also gynecomastia and elbow dysplasia) |
| Klinefelter syndrome treatment | developmental or behavioral counseling, testosterone therapy |
| Turner syndrome | Single X chromosome |
| What does turner syndrome look like | congenital lymphedema, webbed neck, short stature, broad chest, triangular face, ptosis, strabismus, posteriorly rotated ears, cubitus valgus |
| horseshoe kidney seen in what genetic conditon | turner syndrome |
| Heart defects seen with downs syndrome | AV canal, VSD, ASD |
| Heart defects seen with turners syndrome | coarctation of the aorta, bicuspid aortic valve |
| Turner syndrome treatment | growth hormone at age 2-5, estrogen replacement, thyroid replacement, repair of coarctation |
| Fragile X presentation | mental retardation, autism, macrocephaly, large ears, prognathism, macroorchidism, tall stature |
| Marfans syndrome presentation | TALL, low upper-to-lower segment ration, pectus excavatum or carinatum, Archnodactyly, joint laxity, scoliosis, lens subluxation, glaucoma, aortic aneurysm, mitral valve prolapse, inguinal or femoral hernias |
| Marfans heart defect | mitral valve prolapse |
| Congenital adrenal hyperplasia | due to a deficiency in 21-hydroxylase (so no cortisol or aldosterone so high ACTH and adrenal androgens) |
| how does congenital adrenal hyperplasia look | ambiguous genitalia, pt in a salt crisis |
| Management of congenital adrenal hyperplasia | glucocorticoids +/- mineralocorticoids |
| Symptoms of an inborn error of metabolism in neonates | anorexia, lethargy, vomiting, seizures |
| pt has galactose in urine could indicate what disease | severe renal disease |
| PKU | deficiency of phenylalanine hydroxylase |
| PKU babies look | fair haired, blue eyed, developemental delays by 6months, can have ezcema seizures, and weird smelling urine (phenylacetic acid) |
| FISH is used for | detection of submicroscopic deletions and duplications |
| Perodicity table | guidelines for screening history, physical, labs, immunizations at each well visit |
| checklist for autism | M-CHAT-R/F |
| When do you attempt the eye chart | 3 years |
| When do you attempt audiometry testing (not counting new borns) | 4 years |
| Measurements of the well child visit | Length, weight, BMI, FOC, blood pressure (after age 3) |
| Screening for congenital and heritable disorders in otherwise normal infants happens when | 24-48 hours, second screen at 1-2 weeks old |
| newborn screenings include 29 disorders in what categories | Cystic fibrosis, 6 amino acid disorders, 6 fatty acid oxidation, 8 organic acid disorders, G1PD, Biotinidase deficiency, 3 sickling disorders, 2 endocrine disorders, SCID |
| when do you do anemia screenings | 12 months, 18 months, 12 years in females |
| When do you do TB screening if pt at low risk | questionnaire at 12 months, if risk then PPD |
| when do you do TB screening if pt at high risk | PPD once at 12 months, 4-6 years, and 11-17 years, questionnaire annually at age 2 |
| THSteps recommends lead screening at | 12 months and 24 months, if none prior up to 72 month |
| What kind of carseat... birth to 35lbs | infant rear-facing seat |
| What kind of carseat... toddlers/preschoolers | forward facing seat with 5 point harness at or above shoulder |
| What kind of carseat... school aged children >40lbs | booster with shoulder/lap belt, back seat only |
| when can a kid ride in the front seat | older than 13 |
| valid contraindication to all vaccines | anaphylactic reaction to vaccine, moderate or severe illness |
| Tdap contraindicated when after last vaccine | encephalopathy within 7days, fever >105 within 48 hours, collapse/shock, seizure within 3 days, crying inconsolably >3hrs within 2 days |
| Valid contraindications for any attenuated live virus vaccines such as MMR, Varivax | anaphylaxis to eggs, immunodeficiency, recent immunoglobulin |
| How would you assess development in kids (tools) | Denver, PEDS, ASQ, M-CHAT, growth charts |
| At 1 month movements are | reflexive |
| between 1 and 3 months movements are | intentional, hands to mouth, able to raise head, grasp toys |
| when can a baby roll over | 4-7 months |
| can sit without assistance, pulls up, crawls on belly, first steps, pincer grasps | 8-12 months |
| Can respond to requests | 8-12 months |
| walks alone, begins to run, climb, know names of people, short sentences | 12-24 months |
| Colic | food sensitivity, late pm feedings, and lasts a few hours |
| Colic treatment | try diet change, motion, pacifier, swaddle |
| What do you do at well child visits for newborn | weight check, labs, feedings, safety including car seat, warnings about fever, cord care |
| What do you do at well child visits for 2 months | diet, stimulation, safety- bed roll over, immunizations, fever |
| What do you do at well child visits for 4 months | new foods, sleep changes, safety, stimulation |
| What do you do at well child visits for 6 months | diet, safety with hands to mouth |
| What do you do at well child visits for 9 months | Diet- introduce cup, poison control, behavioral management |
| What do you do at well child visits for 12 months | diet- whole milk, no bottle, stimulation-reading, discipline, immunizations |
| What do you do at well child visits for 18 months | child proofing, prepare for terrible twos, talk about toilet training |
| otitis media is most commonly viral or bacterial | viral (RSV, rhinovirus, coronavirus, parainfluenza, adenovirus, enterovirus) |
| Treatment for acute otitis media | amoxicillin 80-90 mg/kg/day divided by 2 or 3 |
| pathogens with otitis externa | pseudomonas, enterobacteriacae, proteus species, fungi |
| Treatment for otitis externa | topical eardrops, wick bactrim, polymyxin b/neomycin/hydrocortisone |
| Pharyngitis- adenovirus | fever, acute follicular conjunctivitism, myalgia, malaise, GI issues |
| pharyngitis- bacterial usually caused by | group A beta hemolytic strep |
| pharyngitis- bacterial sx | fever, sore throat, *petechiae on soft palate* |
| pharyngitis- bacterial treatment | Pen VK or amoxicillin |
| your patient with strep throat starts complaining of worsening symptoms.. you look at their throat the the uvula is leaning to one side.. whats your worry | peritonsillar abscess |
| Hand foot mouth disease is caused by | coxsachie virus |
| Hand foot mouth disease symptoms | low grade fever, URI, *ulcerative pharyngitis* rash on palms and soles |
| Herpes simplex stomatitis symptoms | fever, body aches, *ulcers on lips, gums, buccal mucosa* |
| Herpes simplex stomatitis treatment | they hurt to they dont want things touching them... so dehydration common so give them popsiles or the maalox:benadryl:lidocaine cocktail |
| mononucleosis caused by | EBV |
| mononucleosis symptoms | fever, malaise, lymphadenopathy *posterior cervical*, hepatosplenomegaly |
| mononucleosis testing | monospot (IgM), or EBV serum antibody titers |
| what must you check when someone has mono | if they also have strep |
| Diphtheria | membraneous pharyngitis, bull neck (can lead to respiratory obstruction) |
| pt comes in looking toxic, high fever, muffled voice, unable to swallow, and tripod stance | Epiglottitis |
| Epiglottitis caused by | H. flu |
| on xray you see a thumb print sign | epiglottitis |
| on xray you see a steeple sign | croup |
| epiglottitis treatment | intubation 3rd gen cephalosporin |
| Croup symptoms | mucosal inflammation, increased secretions with edema, URI, seal like bark |
| Croup treatment | if mild just manage at home, systemic steroids, epinephrine (big gun) |
| Bronchiolitis caused by | RSV |
| Bronchiolitis symptoms | coryza, dry cough, respiratory distress, fine end-inspiratory crackles, high pitched wheezing |
| bronchiolitis x-ray findings | hyperinflation, atelectasis, hilar bronchial markings |
| Pertussis caused by | bordetella pertussis |
| pertussis stages | catarrhal (1-2 wks)- non-specific, paroxysmal (3-6 wks)- cough, whoop, post-tussive emesis, apnea, convalescent (1-2 wks) gradual resolution |
| Pertussis treatment | erythromycin, azithromycin, clarithromycin |
| high fever, seizures, diarrhea | shigella |
| shigella treatment | ceftriaxone, azithromycin, FQ |
| fever, conjectival infection, *red cracked lips*, rash, swollen red peeling hands and feet | Kawasaki disease |
| kawasaki disease treatment | echocardiogram (coronary aneurysms), IV immunoglobulin will decrease coronary aneurysms |
| dew drop on a rose petal | varicella |
| low grade fever, mac/papular rash on day 1 faded by day 2-3, post auricular post cervical and occipital nodes | rubella |
| measles (rubeola) | cough *rhinitis* conjunctivitis, koplick spots, *rash on day 3* starts on neck face then downward |
| mumps | fever, malaise, parotitis, *rash starts unilateral then bilateral* pain when eating |
| fifths disease "slapped cheek syndrome" | parvovirus B19 |
| fifths disease symptoms | mild URI, low grade fever, headache then 1 week later "slapped cheek" |
| roseola caused by | human herpesvirus 6 and 7 |
| roseola symptoms | high fever for 3-4 days, defervescence rash- small pink blanchable mac/papules on trunk and neck |
| genu varum | bow legs |
| genu valgum | knock knees (normal for under 3) |
| when do you worry about genu valgum | if older than 3, unilateral, pain or limp, or if >2ins |
| toe walking you should check for | tightness of achilles, mild CP, duchennes |
| Risk factors for SIDS | <1, low birth weight, siblings with SIDS, recent infection, smoking during pregnancy, drug use, poor prenatal care, low education level, single mom, multiparty |
| cystic fibrosis | abnormal ion transport across epithelial cells of exocrine glands in respiratory tract and pancreas causing think sticky build up |
| test of CF | sweat test (will show abnormally high salt) |
| CF symptoms in infancy | meconium ileus, prolonged chest infection, pancreatic exocrine insufficiency cause steatorrhea and FTT |
| CF symptoms in children | persistent loose cough, viscid mucus in small airways leads to chronic infection, *nasal polyps*, chronic pseudomonas, cirrhosis |
| CF management | regular spirometry, physiotherapy, prophylactic antibiotics, high calorie diet, daily exercise |
| Pneumonia symptoms | cough, fever, sputum production, SOB, tachypnea, tachycardia, apnea, retraction/flaring/grunting, abd pain |
| manifestations of respiratory distress | retractions (supraclavicular, intercostal, subcostal) nasal flaring, grunting, wheezing, stridor |
| asthma exacerbation treatment | B2 agonists (3 back to back treatments), Atrovent (3 back to back treatments), steroids |
| Transient tachypnea | tachypnea within 2 hours of delivery, cyanotic, symptoms resolve in 12-24 hours |
| treatment transient tachypnea | self limiting, supportive nutrition and/or oxygen |
| meconium aspiration | airway obstruction and respiratory distress in a post term meconium stained infant |
| xray findings in a meconium aspiration baby | diffuse "ropey" densities, patchy areas of atelactasis and emphysema from air trapping, hyperinflation, pneumothorax and pneumomediastinum, small PE |
| Innocent heart murmurs | soft, systolic, asx, heard at the left sternal border |
| venous hum | (type of innocent murmur) blood flow from head to heart- disappears with turning or head, when supine |
| stills murmur | (type of innocent murmur) vibratory or musical that decreases with intensity when standing |
| VSD | ventricular septum doesn't close |
| ASD | hole in atrial septum |
| presentation of VSD | holosystolic murmur @ LSB, acyanotic, prominent apical pulse, signs of heart failure |
| presentation of ASD | fixed and widely split S2, soft ejection systolic murmur at ULSB, acyanotic |
| PDA | failure of ductus arteriosus to close by 1 month after expected due date |
| presentation of PDA | continuous "machinery" systolic murmur at L2nd ICS, increased pulse pressure, acyanotic |
| EKG on PDA | normal! diagnosis with an echo and close! |
| Tetralogy of fellot 4 cardinal features | large VSD, overriding aorta, right ventricle outflow tract obstruction, right ventricle hypertrophy |
| Tetralogy of fellot presentation | loud murmur at ULSB, *cyanotic* hypercyanotic spells, squatting with exertion |
| chest xray shows a "boot shaped" heart...dx | tetralogy of fellot |
| Coarctation of aorta presentation | decreased femoral pulses, continuous murmur between scapulas |
| chest xray on coarctation | rib notching |
| patients with coarctation of the aorta often have what other heart defect | bicuspid aortic valve |
| mom has hypothyroidism what is baby at risk for | hypothyroid |
| mom has hyperthyroidism what is baby at risk for | transient thyrotoxicosis |
| mom has hypertension what is baby at risk for | IUGR |
| mom has myathenia gravis what is baby at risk for | transient myasthenia |
| mom has systemic lupus what is baby at risk for | congenital heart block, rash, anemia, thrombocytopenia, neutropenia, cardiomyopathy, stillbirth |
| mom takes anti-epileptics what could happen to baby | midface hypoplasia, CNS, limb, and cardiac malformation |
| mom takes accutane while prego what could happen to baby | miscarriage, abnormal face |
| mom takes tetracycline while prego what could happen to baby | enamel hypoplasia of teeth |
| mom takes lithium while prego what could happen to baby | congenital heart disease |
| mom takes DES while prego what could happen to baby | adenocarcinoma of cervix, |
| mom takes iodine, PTU while prego what could happen to baby | hypothyroidism |
| mom takes cytotoxic agents while prego what could happen to baby | congenital malformations |
| mom takes thalidomide while prego what could happen to baby | phocomelia (limb shortening) |
| mom smokes while prego what could happen to baby | SGA infant |
| mom drinks while prego what could happen to baby | fetal alcohol syndrome |
| mom uses cocaine while prego what could happen to baby | placental abruption |
| mom takes opiates, heroin, or methodone while prego what could happen to baby | drug withdrawal in 1st 2 weeks of life, seizures, jitteriness, sneezing, poor feeding, vomiting, diarrhea |
| what does fetal alcohol syndrome look | small head, flat midface, low nasal bridge, small eye openings, short nose, thin upper lip |
| baby has copious purulence with severe swelling of eyelids on day 2 of life | N. gonorrhea |
| baby has scant eye discharge with mild swelling on day 14 of life | C. trachomatis |
| Normal infant findings: acrocyanosis | blue cast when exposed to cold |
| Normal infant findings: harlequin color change | transient cyanosis of one half of body or one limb |
| Normal infant findings: cutis marmorata | lattice-like, bluish mottled appearance |
| Normal infant findings: milia | pinhead smooth while papules without erythema on nose, chin, forehead, usually within 1st few weeks, |
| Normal infant findings: vernic | thick grease like protection |
| Normal infant findings: lanugo | fine downy hair |
| Nevus simplex | telangectasias is dermis usually bilateral fade by 1 year |
| "stork bite" | back of head, neck |
| "angel kisses" | upper eyelids, forehead, upper lip |
| "port wine stain" nevus flammeus | reddish, purple on face or extremities, usually unilateral, capillary malformation that does NOT fade |
| capillary "strawberry" hemangiomas | grow then involute after infancy |
| dermal melanosis | dark digmentation over buttock, lower lumbar region fade by 2 years |
| melanocytic nevi | could be at risk for melanoma |
| erythema toxicum | erythematous "blotchy" macules with central pinpoint vessicles over entire body lasts for 1 week |
| Miliaria rubra | due to sweat gland obstruction, scattered vesicles on erythematous base- lasts a few weeks |
| caput seccedeum | edema, crosses suture lines and resolves in 1-2 days |
| cephalohematoma | subperiosteal bleed, does not cross suture line, resolves in 3 weeks |
| anterior fontanelle | 4-6 cm, closes by 4-26 months |
| posterior fontanelle | 1-2 cm, closes by 2 months (enlarges in congenital hypothyroidism |
| leukocoria | cataract, retinoblastoma, chorioretinitis, retinal detachment |
| natal teeth | present at birth and must be removed to prevent aspiration |
| epstein pearls | whitish-yellow cysts that form on the gums and roof of mouth |
| bohns nodules | odontogenic lamina cysts with keratin |
| umbilical granuloma | pink granulation tissue (use silver nitrate on it) |
| meconium is passed by | 12 hours |
| male genitalia hernia | processus vaginalis, which precedes the testis descent into the scrotum does not obliterate, presents as lump in scrotum or groin |
| hydrocele | thinly patent processus vaginalis, nontender scrotal swelling transilluminate |
| labial adhesion | paper thin, perineal soreness or urinary irritation use estrogen scream |
| galeazzi sign | uneven knee levels |
| barlow test | dislocate an unstable hip |
| ortolani test | reduces recently dislocated hip |
| developmental dysplasia of the hip treatment | neonates: double or triple diapers 1-6mo pavlik harness |
| erb-duchenne palsy | (upper trunk c5-c7), waiters tip position- forearm pronates, wrist flexed |
| klumpke | (lower trunk c7-t1) elbow flexed, hand up, like claw |
| physiological jaundice is always.... | unconjugated |
| conjugated hyperbilirubinemia is... | pathological |
| jaundice appears within first 24 hours of life | hemolytic disorder or infection (always means a problem) |
| kernicterus | neurological syndrome from deposition of unconjugated bili in brain cells (rare in FT babies) |
| treatment for physiologic jaundice | hydration, phototherapy |
| critical values of blood glucose | 1-3 hours <35mg/dl 3-24 hrs <40 mg/dl >24 hrs <45mg/dl |
| large for gestational age can be from | maternal obesity, maternal diabetes |
| problems with large for gestational age | birth asphyxia, shoulder dystocia, hypoglycemia, polycythemia |
| congenital infections that are transmitted | toxoplasmosis, other (parvovirus), rubella, CMV, herpes, hepatitis, HIV, syphilis |
| neonatal menigitis caused by | GBS, E.coli, listeria |
| neonatal conjunctivitis | chlamydia, gonorrhea |
| neonatal pneumonia | GBS, Ecoli, listeria, *s. aureus* *chlamydia* |
| blueberry muffin baby | congenital rubella syndrome |
| vaccine at birth | hep B |
| vaccine at 2 months | Hep B, Dtap, Hib, IPV, PCV13, Rotavirus |
| vaccine at 4 months | Dtap, Hib, IPV, PCV13, rotavirus |
| vaccine at 6 months | Hep B, Dtap, Hib, IPV, PCV13, rotavirus |
| vaccine at 12 months | Hib, PCV13, varicella, MMR, Hep A |
| vaccine at 15 months | Dtap |
| vaccine at 18 months | Hep A |
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