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