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67 Cards in this Set

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The BP on the thigh is the same or lower than the arm
Coarctation of the aorta
what is the heart rate range for infants at birth?

Average rate?
90-190

Avg rate: 140
What is the best single physical finding for ruling out pneumonia?
Absence of tachypnea

Tachypnea:
infants 0-2 months >60/min
infants 2-12 months >50/min
children >12 months >40/min
T/F During childhood, extremely high fever (up to 104 F or 40C) is common
TRUE
This is a bluish, mottled appearance on the trunk, arms and legs in response to cooling or chronic exposure to radiant heat
cutis marmorata
What is acrocyanosis?
Blue cast to hands and feet when exposed to cold(common in newborns)
Causes of central cyanosis
Congenital heart disease such as:

Tetrology of fallot
Transposition of the G.vessels
what are the 4 components of Tetrololy of Fallot?
VSD (severe)
Pulmonic Stenosis
Overriding Aorta
Right Vent Hypertrophy
Name some causes of peripheral cyanosis (acrocyanosis)?
Coarctation of the aorta
ASD
VSD
PDA
A "clunk" or palpable movement of the femoral head back into place.
This is a positive Ortolani's sign for hip dysplasia
T/F A positive Barlow's sign is diagnostic of hip dysplasia.
FALSE, but it indicates laxity and a dislocatable hip; baby needs to be reexamined in the future
when do bowleggedness and knock-knees correct themselves?
Bowleg(genu varum) ~18months
Knock-knees(genu valgus) ~9-10 y/o
Name 2 pathologic causes of extreme bowing of the legs
Rickets
Tibia Vara(Blount's disease)
What is a positive Galeazzi or Alice test?
Femoral shortening, demonstrated by noticing a difference in knee heights when the baby is supine and knees are flexed.
where is the best area to look for central cyanosis?
toungue and oral mucosa
Name some noncardiac findings in infants with cardiac disease
Faiulure to thrive
Irritablility
Tachypnea
Hepatomegaly
Poor feeding
Clubbing
MC dysrythmia in children
PSVT or PAT
which perinatal problems increase the risk of hearing defects
Low birth weight
Anoxia
Ototoxic meds(amino glycosides, glycopeptides)
congenital infections
severe hyperbilirubinemia
meningitis
What are the components of the APGAR score?
Appearance (color)
Pulse (heart rate)
Grimace (irritability)
Activity (muscle tone)
Respiration

Perform at 1 min and 5 min
what is the normal term age and weight?
37-42 weeks
>2500 grams
Preterm AGA infants are more prone to these conditions
RDS
Infections
PDA
Apnea
Preterm SGA infants are more likely to experience these conditions
Asphyxia
Hypoglycemia
Hypocalcemia
Name some causes of failure to thrive
GI
Renal
Environmental
Endocrine
Neuro
Psychosocial
Cardiac
causes of macrocephaly
Hydrocephalus
Subdural hematoma
Brain tumor
what is the normal systolic BP at birth?

At 1 yr?
~70mm Hg

1 yr: ~100/50
Extremely rapid and shallow respiration in a newborn are often seen with these conditions
Cyanotic cardiac disease(normal lungs but right-to-left shunting)
Metabolic acidosis
Bronchiolitis
Pneumonia
T/F Fever (>38 C or 100 F) in infants <2-3 months is very common and may be seen even with minor infections
FALSE: This is a sign of serious infection or disease and the infanct should be eval promptly

It is common in early childhood
T/F Jaundice can be normal
TRUE: occurs in half of all new borns and appears on the 2nd or 3rd day and disappears within a week
When is jaundice pathologic?
When it appears within the first 24 hrs or persist beyond 2-3 weeks

Suspect hemolytic disease
Biliary obstruction or
Liver disease
Significant edema of the hands and feet of a newborn may suggest?
Turner's syndrome
why is it important to inspect the fontanelles?
depression may be a sign of dehydration

Bulging, tense fontanelle is indicative of >ICP
what is a cephalohematoma?
localized swelling of the scalp due to subperioteal hemorrhage from the trauma at birth; resolves withing 3 wks. A bony rim with a soft center may be palpable after the hemorrhage resolves and calcifies
what is a positive Chvostek's sign?
Percussion of the cheek produces repeated contractions of the facial muscles

Due to hypocalcemic tetany or tetany due to hyperventilation
Unconsolable, irritable infant
Meningitis
what is esotropia?
convergent strabismus
what are Brushfield spots?
a ring of white specks in the iris; strongly suggest Down syndrome
Absense of the red reflex can be caused by?
If dark light reflex:
Catarats
retinopathy

If white light reflex:
cataract
retinal detachment
chorioretinitis
retinoblastoma
Name 2 conditions that can lead to amblyopia(lazy eye)
strabysmus
anisometropia(eyes with different refractive errors)
what test can you do to assess conjugate gaze?
cover-uncover test
Corneal reflex test
common in infants, these whitish lesions are difficult to wipe away and bleed when removed
Oral candidiasis
T/F Persistent splitting of S2 is normal in children
False: it may indicate right vent volume load such as ASD or anomalies of pulmonary venous return, or chronic anemia
Abnormal abdominal masses in infants can be assoc. with?
Bladder-urethral obstruction
Kidney-hydronephrosis
Bowel-Hirshprung's or intussusception
Tumors
A "pot-belly" appearance may indicate?
malabsorption due to:
Cystic Fibrosis
Celiac disease
Constipation
Aerophagia
what is meconium ileus?
When meconium becomes thickened and congested in the ileum; it may be the first simptom of cystic fibrosis
urethral opening on the ventral surface of the penis
hypospadias
A defect in the neural tube affecting the vertebral bodies and spinal cord
Spina Bifida (ie myeolomeningocele)
what is ankle clonus?
rapid, rhythmic plantar flexion of the foot in response to abruptly dorsiflexing the ankle
describe the Moro/startle reflex
Abruptly lowering the baby causes the:

Arms to abduct and extend
hands open
legs flex
describe the Asymmetric tonic neck reflex
with baby supine, turn head to one side, holding jaw over shoulder

The arms/legs on side to which head is turned extend while the opposite arm/leg flex

Persistence beyond 2 months suggest neurologic disease
describe the rooting reflex
Stroke the perioral skin at the corners of the mouth

The mouth opens and baby will turn the head toward the stimulated side

Absence suggest severe generalized or CNS disease
Describe the Galant reflex (trunk incurvation)
Stroke one side of the back 1 cm from midline, from shoulder to buttocks

The spine will curve toward the stimulated side

Persistence may indicate delayed developement
Absence suggest a transverse spinal cord lesion or injury
what is the Ballard scoring system used for?
to determine gestation age in weeks
Give examples of benign birthmarks
Cafe-au-lait spots(less than 5)
Eyelid Patch
Salmon Patch
Mongolian Spots
Give examples of Neurocutaneous syndromes
Neurofibromatosis(5 or more cafe-au-lait spots)
Axillary freckling
Lish nodules
Tuberous Sclerosis
"Setting sun" eyes
Hydrocephalus
what are the characteristics of fetal alcohol syndrome
Short palpebral fissures
microcephaly
mental retardation
Fish mouth
what are the characteristics of congenital hypthyroidism(cretinism)
Enlarged anterior fontanelle
Enlarged tongue
Hoarse cry
Cold extremities
Myxedema
Sparse eyebrows
A child presents with open mouth(cannot breath through the nose), edema and discoloration of the lower orbitopalpebral grooves
Perennial allergic rhinitis
Name one cause of ambiguous genitalia
congenital adrenal hyperplasia
What is Rickets?
a softening of the bones in children potentially leading to fractures and deformity(bowlegs)
What is the Gower maneuver?
The manner in which children with muscular dystrophy rise from a supine to a standing position
Grey coating on the posterior pharynx
Diphtheria
localized swelling that crosses over suture lines and resolves within 1 or 2 days
Caput succedaneum
What is preeclampsia?
HTN and proteinuria in pregnancy
What is HELLP
OB emergency related to preeclampsia

Hemolytic anemia
Elevated Liver Enzymes
Low Platelets
Most likely cause of LGA
Diabetes
describe the snout reflex
pursing of the lips that is elicited by light tapping of the closed lips near the midline