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329 Cards in this Set

  • Front
  • Back
vaccinations given at birth
hep b
vaccinations given at 1 month
hep b, only if not given at birth
vaccinations given at 2 months
Pediarix (HBV, DTaP, IPV)
Prevnar (pneumococc)
Rotavirus
Hib
what is in pediarix
HBV
DTaP
IPV
vaccinations given at 4 months
Pediarix
Prevnar
Hib
Rotavirus
vaccinations given at 6 months
Pediarix
Prevnar
Hib
Rotavirus
vaccinations given at 12 months
DTaP
Hib
MMR
VZV
Prevnar
Influenza
Hep A
vaccinations given at 24 months
none
vaccinations given at 4-6 yrs
DTaP
IPV
MMR
Influenza
vaccinations given at 11 yo
Tdap
Meningococcus vaccine
what is the schedule for well visits starting from birth
1 mo
2 mo
4 mo
6 mo
9 mo
12 mo
15 mo
18 mo
24 mo
then annually
why shouldn't babies drink water
because their kidneys aren't mature enough to handle the extra fluid so the babies will become hyponatremic since they can't excrete the water, and then they can have szs
plagylocephaly
mishapen head
sunsetting sign
increased icp, eyes are half closed 2ndary to the increased icp on the cranial nerves
craniosynostosis
premature closure of the fontanelles
rash pattern in rmsf
palms and soles, then spreads to trunk

petechial
rash pattern in rubella
rash on face that spreads to the rest of the body
rash pattern in measles
rash starts at the head and spreads downwards and disappears in the same manner
rash pattern for erythema infectiosum
slapped cheek rash; lacy, reticular
vzv rash pattern
begins on trunk, followed by head, face, and extremities
gross motor skills at 1 mo old
raises head
gross motor skills at 3 mo
holds head up
gross motor skills at 4-5 mo
rolls front to back and back/front
sits supported
gross motor skills at 6 mo
sits unsupported
gross motor skills at 9 mo
crawls
cruises
pulls to stand
gross motor skills at 12 mo
walks alone
gross motor skills at 15 mo
walks backwards
gross motor skills at 18 mo
runs
gross motor skills at 24 mo
walks well up and down stairs
gross motor skills at 3 yrs
rides tricycle
throws ball overhand
gross motor skills at 4 yo
alternates feet going down stairs
skips
fine motor skills at 1 mo
follows eyes to midline
fine motor skills at 3 mo
hands open at rest
fine motor skills at 4-5 mo
grasps with both hands together
fine motor skills at 6 mo
transfers hand to hand, reaches with either hand
fine motor skills at 9 mo
pincher grasp
finger feeds
fine motor skills at 12 mo
throws, releases objects
fine motor skills at 15 mo
builds 2 block tower
fine motor skills at 18 mo
feeds self with utensils
fine motor skills at 24 mo
removes clothing
builds 5 block tower
fine motor skills at 3 yrs
draws circle
fine motor skills at 4 yrs
catches ball
dresses alone
fine motor skills at 5 yrs
ties shoes
Simple febrile sz
btwn 6mo - 6yr
tonic clonic
associated with fever >100.4
sz lasts <15 mins
only 1 sz in 24 hrs
minimal post-ictal state
complex febrile sz
6 mo - 6 yrs
focal sz
>15 mins
>1 sz/24 hrs
management of simple febrile sz
determine the source of the fever, otherwise, no other w/u is needed
management of complex febrile sz
full w/u should be done, but no anti-epileptics, no eeg needed
if pt is <18 mo, LP
eeg abnormality associated with infantile spasm
hypsarrythmia
definition of recurrent abdominal pain
>3x in 3 mo
#1 cause of abdominal pain
gastroenteritis
mesenteric lymphadenitits
persistent pain following an infx
clinical features of HSP
condition preceded by uri
non-thrombocytopenic palpable purpura
hematuria (good prognosis)
proteinuria (poor prognosis)
spasmodic abdominal pain
ileus, n/v
ugi/lgi bleed
tx of hsp
steroids
complication of hsp
intussusception
kidney probs
clinical features of kawasaki
CRASH and BURN
Conjunctivitis
Rash (on trunk mostly)
Aneurysm (coronary)
Skin peels off, Strawberry tongue
Hands/Feet edema

BURN = FEVER (x 5d)
phases of kawasaki dz
acute
subacute (aneurysm formation)
convaslescent

takes 2-3 months to resolve
tx of kawasaki
ASA
IVIG
when is colicky pain associated with
constipation
what type of stool is seen with bacterial enterocolitis
bloody, mucinous stool
when will an appendix perforate in appendicitis
w/i 36 hrs
which infx can clinically mimic appendicitis
yersinia
campylobacter
what imaging study for appendicitis
ct
meds used to tx of perforated appendix
amp, gent, flagyl
clinical presentation of intussusception
currant jelly stools
lethargy
palpable tubular mass
paucity of gas on xr or evidence of obx
imaging most specific for intussusception
barium (or air) enema
is also therapeutic
most common location for intussusception
ileocolic
can also develop at meckel's divertic
major complication of intussusception
there is impaired venous return so bowel edema develops --> ischemia, necrosis --> perforation
etiology of intussusception
ileum invaginates into colon at ileocecal valve
a previous viral infx --> hypertrophy of the peyer's patches... this can develop into a lead point
hsp can be association with an ileal-ileal intussusception
tx of intussusception
must do fluid resusc first, if needed
hydrostatic reduction with air/barium
recurrence rate of intussusception
15%
at what age would a pt present with pyloric stenosis
1-3 mo
which medicaation can be associated with pyloric stenosis
erythromycin
best imaging for pyloric stenosis
u/s
will also see a string sign ugi study
tx of pyloric stenoSIS
MUST correct fluids and lytes first!
then pyloromyotomy
describe malrotation
small intestines rotate abnormally in utero, so there is an abnormal fixation posteriorly to the mesentary
it can twist on its vascular supply --> volvulus
clinical presentation of malrotation
bilious emesis
possibly abdominal distention/shock
+ guiac test = bowel ischemia, poor prognostic sign
tx of malrotation
surgery ASAP
tx for scd induced priapism
sedation
dz that scd can mimic if htere is abdominal pain
appendecitis
when is frontal bossing seen?
beta-thal or some other hemolytic process that requires rapid hematopoesis
tx for beta-thal
serial transfusion + chelation therapy (desferoxamine) b/c of fe overload
consequence of fe overload
hemochromatosis
complications of g6pd deficiency
rbcs are destroyed but there is increased amounts of hb liberated in the process --> hb-uria
findings in classic hemophilia
bleeding problems + hemarthrosis
battle's sign
basilar skull fx that leads to bleeding/bruise behind the ear
mechanism behind bell's palsy in neonates
forceps deliver... usually resovles
social milestones at 5 yo
competetive games
understands rules and abides by them
social milestones at 4 yo
imaginative play
social milestones at 3 yo
group play
shares
social milestones at 2 yo
parallel play
social milestones at 18 mo
plays around other children
social milestones at 12 mo
comes when called
cooperates with dressing
social milestones at 9 mo
pat-a-cake
social milestones at 6 mo
recognizes strangers
social milestones at 4-5 mo
enjoys observing environment
social milestones at 3 mo
reaches for familiar objects/ppl
social milestones at 2 mo
recognizes parent
social milestones at 1 mo
fixes on face
developmental dysplasia of the hip
abnml relationship between head of femur and acetabulum --> instabilility and dislocation of hip joint
develops 2ndary to lack of contact of acetabulum and femur during intrauterine devevlopment
dx of developmental dysplasia of hip
u/s: see "false acetabulum" in lateral ileum
tx of developmental dysplasia of hip
pavick harness (keeps hip abducted and flexed), or body casting on older pts
complications of developmental dysplasia of hip
avn
degen arthritis of hip
metatarsus adductus
dorsiflexion and plantarflexion are UNRESTRICTED (diff from clubfoot); heels go out and toes go in
tx of metatarsus adductus
stretching or a brace
surgery not usualy needed
idiopathic talipes equinovarus (aka)
appearance
congenital clubfoot
medial rotation of tibia, fixed plantar flexion, inversion of foot, forefoot adduction
CANNOT DORSIFLEX (unlike metatarsus adductus)
tx of clubfoot
bracing
serial casting
legg-calve-perthes dz
avn of femoral head
ischemic bone is eventually resolved and re-ossification occurs
--> limp, pain referred to thigh/knee
what movt's are restricted in legg-calve-perthes dz
abduction
flexion
internal rotation
tx of legg-calve-perthes dz
bracing
surgery
observation
complications of legg-calve-perthes dz
collapse of femoral head
SCFE
gradual or acute separation of proximal femoral growth plate
fem head slipps off of femoral neck and rotates inf-post postition
etiology of scfe
common during puberty, could be hormonal
presentation of scfe
limp, pain in hip and groin, pain referred to knee
dx of scfe
plain film frog-leg, lateral position
tx of scfe
goal is to prevent further misallignment
pin fixation is done acutely
chronic cases require osteotomy
osgood schlatter dz
inflammation, swelling and tenderness over tibial tuberosity 2ndary to tendonitis of distal insertion of infrapatellar tendon
when does osgood schlatter dz occur
During growth spurt, in teens
tx of osgood schlatter
conservative, supportive management
complication related to achondrodysplasia
small foramen magnum seen in homozygotes --> brainstem compression
what is achondrodysplasia
d/o of cartilage calcifications and remodeling
why do childre have an increased risk of fx
tendons and ligaments are stronger than bones so in kids injuries often lead to fx when they would only cause sprain in adult
types of fx
spiral (twisting forces on tibia during fall)
epiphyseal fx (use salter classification)
stress fx (hairline crack from repeated activity)
torus fx (at metaphysis)
nursemaids elbow
subluxation of radial head
define upper airway
nose --> carina
sx of upper airway dz
inspiratory stridor
tachypnea
respiratory distress
choanal atresia
most proximal abnormality of airway
bony or membranous septum btwn 1 or both nasal passages and pharynx, preventing airflow through nose
life threatening if b/l (most young infants are obligate nose breathers)
can't pass ng tube
complications of long-term intubation
subglottal stenosis
laryngeal or tracheomalacia
floppiness that closes off airway
how to confirm dx of laryngeal or tracheomalacia
bronchoscopy
ddx for wheezing and respiratory distress
asthma
bronchiolitis
foreign body aspiration
gerd
te fistula
vascular sling
pathophysiology of sx in cf
cftr is abnormal --> altered cl channel
cl stays in cells and na/water enter the cell to maintain osmotic balance --> viscous secretions
gi effects in cf
pancreatic insufficiency
bowel obx
rectal prolapse
dm
cirrhosis
lage bulky smelly stools
later in life stools --> distal obx
pathognomonic finding in cf
meconium ileus
tx of cf
chest pt
exercise
frequent cough
recombinant human dnase given through nebs to break down thick mucous complexes
other than respiratory infx, what are some other complications of cf
hemoptysis (>500 cc/d = emergency) tx w embolization
spontaneous ptx (1/2 will recur unless sclerosis is performemd, but if that is done then transplant is very difficult)
definition of recurrent abdominal pain
>3x in 3 months
mesenteric lymphadenitis leads to
persistent pain after infx
gi complication from hsp
ileal-ileal intussusception
sx of hsp
non thrombocytopenic palpable purpura in dependent areas
an iga mediated vasculitis involving gi, skin, joints, and kidneys
tx of hsp
steroids
what is hsp usually preceded by
uri
gi sx of hsp
spasmodic pain, ielus, vomiting, ugi/lgi bleed
tx of kawasaki dz
ivig
asa
3 phases of kawasaki
acute
subacute (aneurysms form)
convalescent (resolution over 2-3 mo)
which bacterial infx can mimic appendicitis
campylobacter
yersinia
sx of intussusception
BOWEL OBX
currant jelly stools
lethargy
palpable tubular mass
paucity of gas on xr or evidence of obx
dx of intussusception
barium (or air) enema
progression of complications of intussusception
impaired venous return
bowel edema
ischemia
necrosis
perforation
pathophys of intussusception
most are ileocecal, and occur when the ileum invaginates into colon at ileocecal valve
lead points in intussusception
hypertrophy in peyer's patches (often p viral infx)
meckel's divertic
intestinal polyp
lymphoma
foreign body
hsp
at what age would you expect pyloric stenosis
1-3 months
what medication if given is associated with pyloric stenosis
erythromycin
dx of pyloric stenosis
u/s, see hypertrophic pyloris
ugi study shows string sign
embryology behind omphalocele
when midgut loop fails to return to abdominal cavity
see light gray shiny sac protruding from base of umbilical cord
embryology behind malrotation of midgut
midgut undergoes partial rotation and --> abnormal position fo abdominal viscera, can be assoc with volvulus --> compromised blood flow and gangrene
gastroschisis
weakness in abdominal wall --> herniation of bowel through the rectus muscle, usually to the right of the umbilicus
clinical features of malrotation
bilious emesis
possible abdominal distension
xr shows gas in stomach, but no gas in intestines
tx of malrotation
surgery stat
risk factors for deverloping gerd in babies
prematurity
esophageal dz
obx lung dz
overdistension of stomach from overeating
meds (theophylline)
dx of gerd
pH probe placement in esophagus or ugi endoscopy
barium swallow to confirm nml anatomy
tx of ger/gerd
small frequent feedings
keep head up for 20mins p eating
thicken feeds with cereal
metoclopramide (increases gastric motility)
h2 blocker or ppi
last resort: nissen fundlopication (fundus of stomach is wrapped around distal esophagus to increase les pressure)
tx of diarrhea in children
if no serious complications, feed through the diarrhea --> decreased denudement and faster return to nml stooling patterns
don't give antidiarrheals b/c --> toxic megacolon, unless salmonella, shigella, c diff, or parasites
when to do w/u for diarrhea in a child
in infant <3mo, do blood cx
0-12 mo, do stool cx
do blood and stool cx if >5d of enterocolitis or salmonella exposure
any infant with + stool dx looking toxic or + blood cx should be eval for pyelo, meningiits, pna, osteo
when should a pt with diarrhea be admitted to hospital
>5% dehydration and can't rehydrate effectively at home
obstipation and complications
no bm, if after neonatal pd, #1 cause is voluntary witholding
can be caused by pain, on defacation --> fear fo defecation --> further retention

voluntary holding increaess distension of rectum, decreases rectal sensation, requiring increaesed amounts needed to receive urge
sx of hirschprung's
h/o diarrhea, fecal spotting alternating with constipation
effect on incresaed bll on bm
--> constipation
how to tx functional constipation
incresae fluid, decrease junk food, increase fiber, increase ingestion of undiluted juice
pathophys of hirschsprung's
failure of ganglion cells of myenteric plexus to migrate down colon in utero
therefore distal colon is tonically contracted and there is obx
usually limited to rectosigmoid colon
when to suspect hirschsprung's
in any infant who doesn't pass meconium, then --> bilious vomiting, abdominal distension, and poor feeding
tx of hirschsprung's
diverting colostomy with bowel that contains ganglion cells
aganglionic segment is removed by pulling ganglionic segment through rectum
sx of meckel's diverticulum
remnant of vitilline duct w/i 2 inches of ileocecal valve
bleeding from divertic
melena, obx (from intussusception), diverticulitis
tx of meckel's diverticulum
surgical resection
dx of meckel's divertic
technetium-99 scan p h2 antagonist to locate hemorrhagic cells
encephalocele
projection of cranial content through bony skull defect in occiput --> severe mr, sz, mov't do
myelomeningocele
protrusion of neural and meningeal tissue
meningocele
meninges protrude
spina bifida II is associated with
chiari II malformation
complications of spinal bifida
caudal end of cord is tehtered to distal spine and can't ascend to adult position --> scoliosis, sphincter dysfxn, LE deformities
non-communicating hydrocephalus
block in exiting ventricles; above blockage, ventricles are big
causes of non-communicating hydrocephalus
secondary to narrowing at 4th ventricle/aqueduct or malformation at posterior fossa
chiari II malformation
spina bifida occulta
communicating hydrocephalus
subarachnoid villi are dysfunctional/obliterated
sx of motor cp
fixed lesion in immature brain -> nonprogressive d/o of mov't and posture
spasticity is #1 type from injury to motor tracts in brain
pts are hypotonic in early months then later become spastic
CONDITION IS NOT PROGRESSIVE
sx of extrapyramidal cp

etiology
from basal ganglia damage --> choreoathetoid mov't, postural ataxia, spasticity

kernicterus, there is usually some sort of brain insult
what gcs is required for a head ct to be obtained
<12
#1 cause of ich in kids
avm
what meds are associated with pseudotumor cerebri
tetracyclines
corticosteroids
define encephalopathy
generalized cerebral dysfxn, ms change, disorientation
risk factors for developing retinopathy of prematurity
bw <1250 g
age <32 weeks
mechanical ventilation
need for supplemental o2
causes of leukocoria
retinoblastoma (--> death and visceral mets in all cases)
cataracts (most common cause)
retinopathy of prematurity
amblyopia
visual impairment not corrected by glasses and not due to an ocular lesion
often from strabismus
tx of amblyopia
occlusion of better seeing eye forces development of affected eye and visual cortex of affected eye
at what age will tx not be successful in ambylopia
after 8yo
tx of retinoblastoma
enucleation (removal of the affected eye)
radiation tx
chemo
complications of neonatal cataracts
if not remoed by 3-4 months, there is irreversible amblyopia
course of retinopathy of prematurity
most regress spontaneously
if not, cryotherapy can be performed to reduce progression
are still at risk for amblyopia even if treated
dacryostenosis
congenital nasolacrimal duct obstruction
causes overflow tearing - 6% of neonates
2ndary to failrue of distal membranous end of nasolacrimal duct to open
tx of dacryostenosis
probing of nasolacrimal dut at 12-15 mo
although most resolve spontaneously by 1 yo (in 96% of infants)
ophthalmia neonatorum
conjunctivitis occurring in first month of life
p/w eyelid edema, conjunctival hyperemia and ocular d/c
when is it normal for there not to be tears
in the first few weeks of life
age of onset of gonococcal ophthalmia neonatorum
2-4 days
age of onset of chlamydia ophthalmia neonatorum
4-10 days
clinical features of gonococcal ophthalmia neonatorum
eyelid edema
chemosis
purulent d/c
complications of gonococcal ophthalmia neonatorum
sepsis
meningitis
arthritis
corneal ulceration
blindness
complications of chlamydia ophthalmia neonatorum
corneal scarring
PNA
tx of chlamydia ophthalmia neonatorum
oral and topical erythromycin
tx parents
tx with erythromycin despite the risk of developing pyloric stenosis
tx of gonococcal ophthalmia neonatorum
topical erythromycin
IV cefotaxime
tx parents
when should steroid containing eye drops not be given in conjunctivitis
if hsv-1 is suspected etiology
can make dz worse
hordeolum
acute infection of sebacous tarsal glands
staph aureus is usually cause
tx of hordeolum
warm compresses
chalazion
area of sterile lipogranulomatous reaction within meibomian glands that can enlarge
can be chronic and recurrent
is periorbital or orbital cellulitis an emergency
orbital cellulitis
sx of periorbital cellulitis
skin around eye is indurated, warm, and tender
no eye pain
may have si/sx of sinus infx
sx of orbital cellulitis
severe pain with eye movement
proptosis
vision changes
decreased ocular mobility
dx of orbital cellulitis
ct scan
organisms to cover with orbital cellulitis
strep
h. flu
m. cat
tx of periorbital cellulitis
iv abx
can --> meningitis, tx agressively with vanco, pcn, 1st gen cephalosporin
orgs to tx in periorbital cellulitis
strep
h flu
m cat
features of fragile x syndrome
hyperactive
mr
large body
long face
prominent jaw and ears
thickened nasal bridge
large testes
+/- autism
facial features of xyy
long asymmetric ears
incresaed length: breadth in hands, feet, and cranium
nutritional deficiencies in goat's milk
decreased vit d, iron, folate, b12
infectious dz associated with drinking raw cow's milk
brucellosis
what supplements should moms receive if they are vegan
b12 to prevent buildup of mma
effects of excess vit d
hypercalcemia
azotemia
poor growth
n/v/d
vit e deficiency in premies -->
hemolytic anemia
b1 defic -->
beriberi
(neuritis, edema, chf)
hoarseness
anorexia
b2 deficiency -->
photophobia
cheilosis
glossitis
corneal vascularity
b3 deficiency -->
pellagra (dermatitis, dementia, diarrhea)
pathophys of primary hypophosphatemia
defective po4 resorption
no conversion of 25-vit D --> 1,25-vit D in proximal tubules
lab studies in primary hypophosphatemia
ca
po4
alk phos
low/nml
low
high
clinical findings in primary hypophosphatemia
smooth LE bowing (not angular, as is seen in ca defic)
intraglobulin dentin deformities (ca deficiency --> enamel defects)
coarse trabecular bone and fraying
somogyi phenomenon
nocturnal hypoglycemia manifested as night terrors, early am sweating, then later has hyperglycemia, ketonuria, glucosuria (sugars increase because of glucagon release)
what is an absolute contraindication for DTaP
if first dose --> encephalophaty or encephalitis
clinical presentation of pb poisoning
emotional lability
abdominal pain
achy bones
intermittent vomiting and constipation
at what BLL should tx be initiated
>45
clinical presentation of acute hg poisoning
gi pain
fever
chills
HA
visual changes
cough
cp
clnical presentation of chronic hg poisoning
gingivostomatitis
tremor
neuropsych features
clinical presentation of acute arsenic poisoning
n/v/d, abdominal pain
3rd spacing
hemorrhage
hypovolemic shock
vtach
qt prolongation
narcosis
deep stupor, unconsciousness
clinical presentation of cerebral palsy
postural hypotonia
failure ot reach for toys
gross and fine motor delay
cognitive and sensory deficits
complications of cp
sz
mr
differences in etiology for quadriplegia and paraplegia
quadriplegia results from umn damage
paraplegia results from lmn or spinal cord damage
most likely organisms ot --> pna in cf
staph or pseudomonas
clinical presentation of meconium ileus
vomiting
abdominal distension
distended bowel loops
"soap bubble" on axr
pathophys of meconium ileus
obx begins in utero --> underdeveloped distal lumen
tx of meconium ileus
surgical emergency
gastrograffin enema
vitamin a deficiency -->
pseudotumor cerebri (among other things)
will see bulging fontanelles, ha, n/v
may be seen as first presenting sign in a pt with cf
what effect does phenobarb have on jaundice
it improves it by increaseing gluocoronyl transferase
cancer that is associated with (germline) retinoblastoma
osteosarcoma is most common
melanoma
squamous cell ca
conditions associated with aniridia
congenital glaucoma
surge-weber
marfan
neurofibromatosis
presentation of malrotation
obx
typically normal for first few days of life than malrotation worsens --> abdominal fullness, especially in ruq --> bilious vomiting --> ischemia and necrosis
#1 malrotation
volvulus
pathophys of volvulus
cecum fails to move to rlq and never adheres to abdominal wall
mesentary and sma are tethered to narrow stalk and twist about itself
band of adhesive tissue can extend from cecum to ruq -> duodenal obx
presentation of children with 2ndary htn
ha
epistaxis
visual sx
easy fatiguability
describe how biliary atresia can occur post-natally
from scarrin gan dinflammation of intrahepatic or extrahepatic biliary ducts
etiology is unclear
describe findings of prenatal biliary atresia
gb is absent
sx of congenital toxo
chorioretinitis
hydrocephalus
intracranial calcifications
complement levels in post-strep gn
decreased c3
what are "currant jelly stools"
bloody stools
indicative of intussusception
tx of intussusception
barium/air enema
germinal matrix
embryonic tissue present near caudate nucleus, often gets damaged by hypoxia/ischemia
#1 place for intraparenchymal bleed
progression of intraparenchymal bleed in a newborn
blood can flow into ventricles w/i 3 days of life
what bvs are damaged in shaken baby syndroem
bridging veins
what bvs are involved in sah
circle of willis
signs of svt
hr 220-270
no p waves
pathophys of strawberry hemangioma
vascular tissue fails to communicate with adjoining tissue
enlarges --> raised tumor
most common causes for pna in a child > 6 yo
mycoplasm
strep pneumo
cardiac complications in marfan syndrome
aortic root dilatation, aortic dissection
mvp
most common orgs in peritonsillar abscess
anaerobes
GAS
physical findings of patau syndrome
forebrain fails to develop (holoprosenceph)
midface developmental abnormalities
abnml genitalia
severe mr
which chromosomes are associated with
1. edwards
2. patau
Edwards = Election age (18)
Patau = Puberty age (13)
porencephaly
cyst/cavity in brain that communicates with ventricles
causes of euvolemic hyponatremia
siadh
glucocorticoid deficiency
hypothyroid
water intoxication
vacterl
vertebral
anal
cardiac
trach
esophageal
renal
limb
gastrografin
way to dx meconium ileus
is demonstates unused microcolon and pellets of meconium higher up
can draws water into lumen and meconium gets unplugged (dx and tx)
features of neonatal listerosis
respiratoyr distress at 5 days
meningitis
clinical presentation of congenital hypothyroid
constipation
jaundice
ftt
enlarged fontanelle
umbilical hernia
presentation of neuroblastoma
asx abdominal mass
horner's
dancing eyes
dancing feet
blueberry muffin lesions
htn
patau's or edwards syndrome:
microcephaly
patau
patau's or edwards syndrome
prominent occiput
edwards
patau's or edwards syndrome
narrow forehead
edwards
patau's or edwards syndrome
microphthalmia
patau
patau's or edwards syndrome
cutis aplasia
patau
patau's or edwards syndrome
micrognathia
edwards
patau's or edwards syndrome
low-set malformed ears
edwards
patau's or edwards syndrome
cleft lip
patau
patau's or edwards syndrome
congenital heart dz
both
patau's or edwards syndrome
omphalocele
patau
patau's or edwards syndrome
clenched hands with overlapping fingers
both
patau's or edwards syndrome
rocker bottom feet
edwards
patau's or edwards syndrome
polydactyly
patau
patau's or edwards syndrome
polycystic kidney dz
patau
patau's or edwards syndrome
horseshoe kidney
edwards
patau's or edwards syndrome
crytorchidism
patau
patau's or edwards syndrome
agenesis of corpus callosum
patau
genetic changes in prader willi
paternal deletion, 2 defective maternal chromosomes
physical appearance of pts with prader willi
obese
almond shaped eyes
downturned mouth
small hands and feet
genetic changes in angelman's
maternal deletion, 2 deffective paternal chromosomes
physical appearance of angelman's
large mouth
short stature
tiptoe walk
szs
galactosemia
galactose 1-p builds up and accumulates in liver and brain
complications of galactosemia
increased risk of e coli sepsis
LD
premature ovarian failure
tx of galactosemia
eliminate galactose containing foods from diet
complications of pku during pregnancy
if diet not followed, baby can develop microcephaly, mr, and congenital heart dz
physical features of homocystinemia
marfan like appearance
dislocaed lens
what effect does sepsis have on bilirubin
disrupts the bbb so it can cause diffusion of bili into the brain
what effect does temp have on bili
cold temperature can --> bili dissociation from albumin
protocol for neonates whose mom developed varicella infection just after delivery
if mom develops sx w/i 2 days of delivery or during end of pregnancy, treat baby wiht ivig and acyclovir. if greater amt of time is lapsed, no tx needed
consequences of neonatal asphyxia
cerebral edema
irritability
sz
cardiomegaly
renal and heart failure
DIC
RDS
what is the apt test
used to differentiae fetal from maternal blood
which drugs are contraindicated for breastfeeding
lithium
cyclosporin
antineoplastic drugs
ergots
bromocriptine
tetracyclines
classic finding on xr for nec
pneumanitis intestinalis
consequences of cold temparature in a premie
increased metabolic rate in order to raise body temp, but their ventilation rate increased as well
but, b/c of respiratory problems in premies they can't oxygenate enough so lactic acide accumulates --> metabolic acidosis
which is worse:
ABO incompat or Rh incompat
Rh incompat
lab findings in abo incompat
increased retic count
weakly + coomb's
lab findings in rh incompat
strongly + coombs
pathophys of transient apnea of the newborn
immature respiratory centers, esp in premies
how to id the underlying cause of congenital hypothyroid
iodine uptake scan
late development of clavicle fx during delivery... when does this occur?
callous formation in anterior shoulder
1 week
physical findings of subgaleal hemorrhage
feels like cephalohematoma that crosses midline
can lose 1/3 of
onset of gonococcal conjunctivitis in a newborn
DOL 2-5
onset of chlamydia conjunctivitis
DOL 5-14
what effects does surfactant deficiency have on lung compliance and lung volume
cardiac effecT
decreases both
R-->L shunt
what should be given to newborns whose moms are infected with Hep B
Hep B Ig and HBV
effect of propanolol in utero
iugr
decreased ability of asphyxiated nb to incresae hr and co
associated with hypoglycemia and apnea
when is surgery for cleft lip done
3 mo
when does transient tachypnea of nb resolve
DOL #3
significance of 5th finger polydactyly
in black infants, no consequence
in white infants, can be associated with cardiac abnormalities, must do an echo
twin twin transfusion
donor twin --> oligohydramnios, anemia, ypovolemia
recipient twin --> polyhydramnios, larger size (20% difference in body weight), hyperviscocity, respiratory distress, hyperbili, hypocalcemia, renal vein thrombosis
when does serum bili peak
DOL 3-5