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Newborn 2

Pediatrics

QuestionAnswer
Most common fracture resulting from birth trauma is to the: clavicle
Epstein pearls = benign white beady papules on the hard palate (keratin cysts)
Cloudy cornea from cataracts or glaucoma Leukocoria
Tachypnea in an infant is a rate >__ 60
What are signs of respiratory distress in an infant Tachypnea, retractions, grunting
Transient tachypnea of the newborn is from retained secretions, and usually resolves within: 24-36 hours
Murmurs heard at birth should be considered __ in etiology until proven otherwise Valvular
Congenital heart disease is present in what percent of infants? 0.8%
__ due to PACs is not uncommon in the first few days of life Irregular heart rate
Newborn has excessive drooling and choking with attempted feeding. Dx by CXR after placement of NG tube. Surgical tx required. Dx = Tracheo-esophageal fistula
Abdominal wall defect to right of umbilicus. Intestines/stomach/bladder/liver are outside the peritoneal cavity Gastroschisis
Liver and stomach covered by peritoneum at the umbilical orifice Omphalocele
Umbilical hernias are found in up to what percent of black infants? 40
Umbilical hernias less than what size usually close by age 5? 1.5 cm
What are signs that an umbilical hernia needs surgical repair? >1.5 cm at 2 years of age, or signs of incarceration
Congenital absence of intramural colonic ganglion cells in rectosigmoid. Inability of bowel complex to relax causes functional bowel obstruction. In first 24-48 hrs, failure to pass meconium, abdominal distention, bilious vomiting = Hirschsprung disease. Dx requires rectal biopsy
How is hypoglycemia defined in the infant? <35-40 mg/dL
What are the symptoms of infant hypoglycemia? Lethargy, poor feeding, irritability, jitteriness, seizures
What is the treatment for infant hypoglycemia? IV glucose D10W @ 2ml/kg
Neonatal mortality: from birth to 28th day
Perinatal mortality: 20th week of gestation to 7th day after birth
Low Birth Weight = <2500 gm. 7% live births & 70% neonatal mortality
Very Low Birth Weight <1500 gm
Fetal scalp ABG of ____ indicates fetal hypoxic compromise <7.20
Fetal scalp ABG of ____ is borderline & needs repeat test 7.20 - 7.25
Soft creamy layer on skin in preterm infants = vernix caseosa; also often see lanugo in preterm
transient blue/black macules on lower back/buttocks in 90% AA, Indian, Asian infants Mongolian spots
Salmon patch = Nevus simplex: pink macular hemangiomas; neck, eyelids, forehead
With portwine stain (AKA _____), consider: AKA nevus flammeus; Sturge Weber syndrome
White eye, cat eye: retinoblastoma
Most common congenital anomaly of nose choanal atresia (stenosis). Possible respiratory distress/apnea at birth. Sx: cyanosis that improves with crying
Micrognathia, cleft palate, airway obstruction are features of: Pierre Robin syndrome
Persistence or aggravation of pulmonary vasoconstriction results in: persistent pulmonary hypertension of the newborn (PPHN)
Transient tachypnea of the newborn (TTN) = Failure to replace pulmonary alveolar fluid completely with air can lead to respiratory distress; retained secretions; usually resolves in 24-36 hrs
Periodic breathing normal crescendo breathing followed by a brief apneic period
Capillary vs cavernous hemangiomas capillary: raised, red lesions; cav: deep blue masses; Both enlarge after birth & resolve at 1-4 yo; may produce high-output heart failure or plt trapping/ hemorrhage
Erythema toxicum: erythematous, papular-vesicular rash; common in neonates; involves eosinophils in the vesicular fluid
Pustular melanosis: more common in AA; small, dry vesicle on a pigmented brown macular base
Bacterial infections in newborn sepsis, pneumonia, meningitis, UTIs, omphalitis
Perinatal viral infections: HSV, hepatitis B, C
Congenital infections in newborn CMV, rubella, varicella, toxoplasmosis, syphilis, TB
Observe infants born to GPS-positive moms for how long? 48 hrs
Severe cardiac defects & infection present in: 6 hours
More common in AA; small, dry vesicle on a pigmented brown macular base pustular melanosis
To what nursery level do healthy infants go? Level 1
What is a level 3 nursery? Regional center for critical infants
Infant conjunctivitis is common or uncommon? Common
Hematoma contained in skull suture lines Cephalohematoma
Hematoma that crosses skull suture lines Caput succedaneum
Premature fusion of the cranial sutures is called: Craniosynostosis
Intermittent strabismus is normal up to: 3-6 months
Cloudy cornea from cataracts or glaucoma Leukocoria
Macroglossia is associated with: Trisomy 21, Beckwith-Wiedemann
Where is a branchial cleft cyst located? Anterior to SCM
Where is a thyroglossal duct cyst located? Neck midline
Where is a cystic hygroma located? Posterior to SCM
Common neck masses Branchial cleft cyst, thyroglossal duct cyst, cystic hygroma
Large fontanelles may signify: hypothyroidism; trisomy 13, 18, or 21; or bone disease
What nursery level will an infant >30 weeks and 1200 gm not requiring ventilation or circulatory support go to? Level 2
Premature birth, fetal maturity: mgmt Give corticosteroids
Meconium-stained amniotic fluids Fetal distress
SIDS epidemiology 1/1000 live births. Peak at 2-4 months old; 90% are <6 months. 40% reduction since Back to Sleep. 2-10% may be undiagnosed abuse
Created by: Abarnard