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51 Cards in this Set
- Front
- Back
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What is TTN(Transient Tachypnea)?
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Respiratory distress with retractions and grunting
Usually occurs from C-section Usually resolves within 12-24 hrs May given CPAP in the NICU |
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What are the TORCH infxns?
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Toxoplasmosis
Varicella Rubella CMV Herpes Syphllis |
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What do you have to r/o within 2 months of a fever ( 100.4 or greater)
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Do a full sepsis work up
CBC, BMP, blood cx, spinal tap |
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When do the Anterior fontanelles and Posterior fontanelles usually close by?
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Anterior Fontanlles range from 9 months up to 2 years -- the avg is 18 months
The posterior and lateral close by 6 months |
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What is the m/c TORCH infxn
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CMV
A positive CMV-IgG indicates a seropositive pregnant mother A pregnant mother with flu like sx should be worked up for CMV and other TORCH infections |
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What are Prenatal U/S signs of CMV infection in newborn?
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intrauterine fetal growth restriction, enlargement of the cerebral ventricles, intracranial calcification, microcephaly, and increase or decrease in the volume of amniotic fluid. Enlargement of the liver, spleen, or heart and hyperechogenicity of the bowel may also be seen
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What are physical exam findings in a patient with CMV infection?
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microcephaly
hepatosplenomegaly neurologic abnormality (presenting as poor tone and motor function and abnormal head lag) petechiae or purpura hearing loss. Mental retardation and sensorineural deafness are long-term complications.** Tx- IV ganacyclovir that starts 1 month after birth for 6 weeks. Known toxicity includes neutropenia |
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Cephalohematoma vs Caput Succadeum
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Cephalohematoma - hemorrhages between the skull and periosteium- IT DOES NOT CROSS THE SUTURE LINES!
Caput Succadeum- serosanguinous subcutaneous extraperiosteal fluid between the scalop and above the periosteum - presents as scalp swlling that extends across the midline and over the suture lines . Self resolving in a few days |
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Is jaundice within the first 24 hours okay? When is the Jaundice acceptable
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NO and usually occurs around 2 days
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kernicterus
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When unconjugated bilirubin( indirect) crosses the BBB because it is lipid soluble.
This causes jaundice in the newborn and warrants prompt phototherapy so the light can convert the bilirubin to water soluble to be excreted in the urine and feces. |
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When is the right time to introduce solid foods?
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4 months - cereal w/ iron
6 month veggies 8months- meat and eggs Stop breast feeding 6-12 months |
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What are the 4 findings of Tetralogy of Fallot ?
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V.O.R.P
Ventricular Septal Defect Overridding aorta RVH Pulmonic Stenosis -- harsh systolic ejection murmur at 3rd ICS Cyanosis is cause by R ight to Left shunting Babies are cyanotic and usually would have to squat down in order to have good pulmonary blood flow |
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CXR findings with TOF ?
When do they develop cyanosis? What is the Tx? |
1- BOOT shape
2- aycanotic at birth, usually develops at 6 months and have TOF spells when they become cyanotic when crying or feeding 3- IV prostaglandin E-1- This relaxes the ductus arterious smooth muscle so there is not RV outflow obstruction |
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What type of shunt is VSD?
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Left to Right shunting which causes Pulm HTN causin shunting reversal and Eishmenger syndrome ( reversal of shunt)
VSDs usually close on their own but larger ones needs surgical closure ( A Qp Qs ratio >1,5) |
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Pathopneumonic of VSD?
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holosystolic or pansystolic murmur and Pulm HTN in 10% of cases
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What is PDA?
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presistence of a fetal structure the ductus arteriousus after birth. The structure connects the pulmonary artery to the aorta which allows blood to bypass the lungs in utero. Ths structure usualy should close within 48 hours of birth
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What are RF for PDA?
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1- prematurity
2- maternal rubella 3- female gender |
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What are some signs of PDA?
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1- Large shunt can produce CHF effects in the 2-8 week of life
Machinery like murmur bouding peripheral pulses ( forceful pulses that quickly disappear) |
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Tx of PDA?
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1- Ligation
2- premature babies get indomethacin before ligation |
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What is the criteria for ARDS(Acute Respiratory Distress Syndrome)
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1- acute onset
2- b/l infiltrates on cxr - "ground glass appearance" 3- no evidence of L atrial HTN 4- PaO2/Fio2 ratio of <200 |
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What are some causes of ARDS?
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Sepsis of a pulmonary source
Sepsis from a non-pulmonary source Aspiration pnuemonia trauma burns acute pancreatitis Tx : low tidal volume ventilation abx therapy |
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Tx of CAP in neonates
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Cefotaxime, Ceftriaxone ampicillin/sulbactam AND azithromycin
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Tx of Hospita; Acquired Pneumonia
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You most cover strep. pneumonia, Hflu MRSA, E.coli Klebsielle, Enterbacter, Proteus
Use Vancomycin and Pieracillin/tazobactem or cefepine or meropenem |
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What is Coarctation of the Aorta
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Narrowing of the arota at the site of insertion of the ductur arteriousis.
This causes upper extremity hypertension or murmur |
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What types of atresias do patients usually have other congenital atresias?
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Duodenal atresia . Around 40% have trisomy 21 and some 50% have some kind of anoomaly
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Most congenital duodenal obstructions are located where?
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periampullary
The degree of obstruction dictates the amount of resulting pathology. The obstruction causes dilation of the proximal duodenum and stomach as well as hypertrophy and distension of the pylorus. A common variation is the windsock anomaly, in which the duodenum is dilated distal to the point of obstruction because of a prolapsing membrane or web |
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How do you dx is prenatally?
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U/S
polyhydaminos dilated duodeum |
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What are physical exam findings in the newborn for duodenal atresia?
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clear or bilious emesis is evident within hours of birth
emesis output of more than 20mL is an indication to work up possible obstruction |
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What is the classic sign for neonatal obstruction on plain xray
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The classic double bubble sign
Upright and contrast radiography using air or contrast may confirm the diagnosis |
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When does the anterior fontanelle usually close?
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24 months
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A baby can roll over, sit independently, smiles spontaneously and babbles. What develop age is appropriate with this child?
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6 months
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Grasp reflex/ hands and keeps hand fisted
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1 month
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pincer grasp and says mama and dada
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9 months
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hands open and brings objects to mouth and is able to trun to voice direction
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4 months
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2- 4 words , stand independely and points to what they want !
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12 MONTHS
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feeds self and waves bye bye
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9 months
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palmar grasp and babbles
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6 months
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Washes their hand by themselves
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3 years
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name 4 colors
hops on 1 foot dresses themselves with little assistance define 5 words |
48 months
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copy a circle
draw a person with 3 parts throws a pall overhead walks up the stairs with alternating feed |
36 months
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turn pages of a book
use 10-20 words feeds themselves with a spoon |
18 month
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able to feed themself
points to what they want |
12 months
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m/c/c congenital cataracts ?
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Rubella!!!
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Bbay can turn pages
point to 4 body parts walk up steps feeds herself with spoon |
18 months
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able to walk with one hand held
picked up pellet with pincer movement of forefinger and thumb says mama and dad able to play simple ball game |
12 months
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by this many months, infant will seek reassurance from a parent or making eye contact when frightened
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9 months
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rollers over the from prone to the supine position
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6 months
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4 years
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copies SQUARES
tells story counts penniess goes to toilet alone interactive play with childre |
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baby rollers over both front to back and back to front. sits with support , turns to mother's voice, smile spontaneously and brings fingers to mouth. What age?
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4 to 5 months
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In normal development, hand dominance is usually first observed around the age ?
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1 year
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names 4 colors
defines 5 words understand prepositions hops on one foot dresses herself what age? |
48 months - 4 years
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