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97 Cards in this Set
- Front
- Back
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Features of Fetal Alcohol Syndrome
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Thin Lip
Small for Gestational Age, Smooth Phiitrum Flat nose Cleft Lip and Palate Mental Retardation |
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Features of Down Syndrome
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Protruding Tongue
Brushfield Spots Redundant Neck Skin Mental Retardation Micrognathia Upslanting Palpaberal Fissures Epicanthal Folds Palmar Crease Endocardial Cushion Defect VSD |
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Features of Alport's Syndrome
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Nephritis
Deafness Ocular Problems |
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Features of Infant's of Diabetic Mothers
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LGA
Small Left Colon Heart Defects Hypoglycemic Caudal Regression Syndrome |
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Factors that potentiate unconjugated bilirubin movement into the brain
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Sepsis
Metabolic Acidosis Drugs - Sulfisoxazole Hypoalbuminemia |
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Treatment for Choanal Atresia
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Surgical correction with placement of nasal tubes
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Diagnosing Choanal Atresia
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Failure to pass a catheter through the nose to the pharynx or failure of fog to develop on a metal plate under the nose
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How do each of the following increase the risk of neurologic damange in hyperbilirubinemia: sepsis, sulfisoxazole, metabolic acidosis
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Sepsis - interrupts blood-brain barrier
Sulfisoxazole - binds to albumin displacing the unconjugated bilirubin Metabolic Acidosis - removes charge from albumin thus reducing binding ability of UCB |
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When should a newborn be given Varicella-Zoster passive Ig?
Med that can be used on infants exposed perinatally |
If the mother had been diagnosed within 5 days prior to delivery or within 2 days after delivery. That window is tight enough to worry the baby got it
Acyclovir |
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Contraindications for breast feeding
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HIV, Pulmonary TB, malaria, septicemia, antineoplastic meds
but...MASTITIS can keep feeding |
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Sequale of a meconium asphyxia at birth
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Cerebral edema, seizures, heart failure, liver failure, DIC, renal failure, RDS, increased pulm artery pressure
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During which trimester is transmission of CMV to fetus most likely
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First Semester
Most common congenital infection |
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Most common congenital infection
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CMV
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Manifestations of congenital CMV
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Microcephaly, Neurologic problems, hearing problems, HSM, jaundice, petechia
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Outcome of pregnancy if previously affected CMV mother has a virus that reactives during pregnancy
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Baby is safe via moms IgG that diffuse across placenta
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Diagnosis of CMV
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Isolation from urine, saliva, or other secretions
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If a child passes blood through his stool or vomit in the first few hours of life, what should be the first test done?
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Apt Test - determines if blood is maternal or babies - if maternal no need to worry
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Medications which are contraindicated in breast-feeding
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Lithium, Carbamazapine
Cyclosporin Antineoplastic agents Cocaine, Heroin Amphetamines Ergotamines Bromocriptine Tetracyclines |
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Major blood group antigens versus Rh in its role on hemolytic anemia
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Major blood group mismatch is less severe - weakly Direct Coomb's positive
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Clinical presentation of NEC
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Vomiting, Less Active, Distended Abdomen, Decreased Bowel Sounds, Bloody Stools
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Radiographic findings in NEC
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Pneumatic Intestinalis - Distended loops of bowel with air
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Management of NEC
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If perforated - surgical consult, laparatomy and removal of necrotic gut; may cause short bowel syndrome
If no perforation - bowel rest, antibiotics |
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Hypothermia presentation in a newborn
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Tachypnea - as they try to increase their temp by elevating their metabolic rate, they must increase their ventilation rate to get O2 and prevent metabolic acidosis
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Complications associated with small-for-gestational age infants
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Infants born at date but smaller are at increased risk for:
-Congenital Malformations -Meconium Aspiration -Neonatal Asphyxia -Hypoglycemia |
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Primary cause of apnea in premies
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Immaturity of the respiratory center
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Inheritence pattern of galactosemia
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Autosomal Recessive
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Diagnosing and Presentation of Galactosemia
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Part of the newborn screen;
Presents with jaundice, hepatomegaly, convulsion/seizures, lethargy, vomiting, poor weight gain, mental retardation |
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Management of Galactosemia
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Avoidance of galactose - d/c breast milk and replace with soy formula
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Long-term effects of galactossemia regardless of intervention
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Ovarian failure, decreased bone mineral density, developmental delay
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Most commonly fractured bone at birth? Presentation?
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Clavicle - may present days to week later when a callus forms a tender, nodule on the bone
Occurs in the birthing process |
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Management of a fracture clavicle at birth
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Reassurance and monitoring
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Erb-Duchenne paralysis and cause of it in newborns
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Injury to C5-C6 resulting in an inability to abduct or externally rotate arm at shoulder;
Caused by difficult delivery where traction applied to head and neck |
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Presentation of diaphragm paralysis
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Remains elevated on inspiration on the paralyzed side; Upon inspiration the negative pressure on the normal side shifts the mediastium contents to the normal side further impeding airflow
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Mechanism by which pregnancy-induced hypertension can produce seizures in a newborn infant
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The lack of oxygen produces hypoxemia which causes reactive erythrocytosis leading to polycthemia leading further to hyperviscosity
Hyperviscosity Syndrome - inhibits blood flow to brain resultin seizures, also can form thrombi, NEC, renal infarction Treat by lactate ringer solution or saline - not phlebotomy |
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Complication of maternal analgesics during delivery
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Crossing placenta causing depression to the baby -
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Management of narcotic exposure to a newborn during delivery
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Manage the ABCs
Administer naloxone, 0.1 mg/kg IM or IV |
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Complications in postmature but LBW infants
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Increased risk of asphyxia and meconium aspiration - should receive sunctioning and if HR < 100 be intubated
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Onset of Gonococcal Conjunctivitis
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2-5 days after birth
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Treatment of gonococcal conjunctivitis
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Topical treatment and systemic antibiotics
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Onset of Chlamydial Conjunctivitis
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5-14 days - treated with systemic abx to prevent pneumonia
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Complication in infants that receive erythromycin
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Hypertrophic pyloric stenosis
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Cause of Hyaline Membrane Disease (Infant Resp Distress Syndrome)
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Surfactant Deficiency
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Management of a baby born to HIV infected mother
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Antiretroviral meds to mother during perinatal period and to the baby upon birth a course of Zidovudine
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Results of ELISA in a baby born to HIV infected mom
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Positive b/c of transmission of maternal antibodies but is useless in determining if baby actually has disease
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Findings in Turner Syndrome
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Short Stature
Edema in dorsum of hand/feet Webbed neck Shield Chest Coarctation of Aorta Streak Gonads Horseshoe kidney |
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Only vaccine administered at birth
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Hepatitis B
Vit K is injected to prevent bleeding d/o |
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Presentation of a mongolian spot
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Bluish-gray, well-defined lesion on buttocks or back; Common in blacks, asians, and latinos; Not palpable; Disappears by 1-2y
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Cause of diaphragmatic hernia
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Passage of abdominal contents through a congenital or traumatic defect in the diaphgram
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Presentation of a diaphragmatic hernia
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Profound respiratory distress with high mortality; Presents with respiratory failure, scaphoid abdomen, and bowel sounds in chest
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Management of diaphragmatic hernia
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O2 support via high-freq oscillatory ventilation and ECMO, surgery
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When does maternal transmission of hep B usually occur
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During Delivery
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Prevention strategy for mother with Hepatitis B
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Passive Ig and Hep B vaccine given at birth to any infant whose mother is HBsAg positive
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Affects of propranolol if infant is exposed at delivery
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B-blocker will decrease infants ability to increase heart rate and cardiac output in the event he/she has asphyxiated
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Characteristics of physiologic jaundice
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Apparent on 2nd to 3rd day of life, peaks to no higher than 12 mg/dl, and disappears by end of the week
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Presentation of Duodenal Atresia
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Regurgitation with billous vomit
Polyhydroaminos |
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Radiographic sign of duodenal atresia
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Double-Bubble
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Associated diseases that should be investiaged in patients with duodenal atresia
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Down's Syndrome
Heart defects |
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Complications that may occur in cleft lip/palate despite good anatomical closure of defect
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Recurring otitis media, hearing loss, and speech difficulty
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Signs of congenital hypothryoidism
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Sublte, may not appear at first; Signs include umbilical hernia, distended abdomen, hypothermia, poor feeding, jaundice, slow heart rate, anemia, constipation
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Prenatal marker for an open-neural tube defect
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Elevated AFP in the amniotic fluid
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Recommendations to reduce the risk of open neural tube defect
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Women capable of becoming pregnant take 400 mcg of Folic Acid Daily
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Cause of Transient Tachypnea of the Newborn
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Retained Fetal Lung Fluid
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Presentation of Transient Tachypnea of the Newborn
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Tachypnea, Retractions, Grunting, and Cyanosis; Pulmonary congestion on CXR;
Clears in 3-5 days |
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Characterisitics of congenital syphilis
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-Infiltrative Maculopapular peeling rash on hands, soles, palms
-Rhinitis -Hepatosplenomegaly -Lymphadenopathy -Syphilitic Hepatitis -Inflamation of Cornea - Keratitis -Hutchison Teeth -Murberry Molars |
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Onset of heroine withdrawal in a newborn
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Usually 2 days of life
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Signs of substance withdrawal in a newborn
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-Hyerirritability
-Fever -Vomiting -Diarrhea -High Pitched Cry -Hyperventilation |
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Drugs that don't produce withdrawal
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Cocaine, Marijuana, Tobacco
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Common identifiable causes of apnea in term infants
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-Congenital Heart Defect
-GERD -Hypoglycemia -Seizures -Airway Obstruction -Sepsis |
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Signs of meningitis in neonates
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-Lethargy w/ poor feeding
-Temperature Instability -Diarrhea -Vomiting -Jaundice All non-specific signs |
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Twin-to-Twin transfusion
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Phenomena that occur in monochorionic twins where blood transfers - one twin has a high HCT the other one has a low one
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Sequale in the recipient of a twin-to-twin transfusion
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-Hyperviscosity
-Hyperbilirubinemia -Seizure -Renal Vein Thrombosis -CHF |
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Amniotic fluid levels that correlate to Trisomy 18
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Polyhydraminos in 80% of cases
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Important causes of neonatal sepsis
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-Cytolomegalic Incluscion Disease
-Toxoplasmosis -Syphillis -Rubella |
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Manifestations of congenital rubella
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-IUGR
-Microphthalmia -Cataracts -Blueberry muffin rash -Heart Defects - PDA *Rubella is only TORCH that causes "structural" heart defects |
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Period of maternal HSV transmission
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In-Utero, Intrapartum, Postnatally
Most commonly during intrapartum period |
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Manifestations of congenital HSV
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Fever, Focal Seizures, Rash
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Classic Triad of congenital toxoplasmosis
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-Hydrocephalus
-Intracranial Calcifications -Chorioretinitis |
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Manifestations of Cytolomegalic Inclusion Disease
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-IUGR
-Hepatosplenomegaly -Jaundice -Chorioretinitis -Intracranial Calcifications -Sensorineural Hearing Loss |
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Manifestations of Potter's Sequence
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Potter's Facies - parrot beak nose, low-set ears, wide spaced eyes;
Bilateral Renal Agenesis - oligohydroaminos Pulmonary Hypoplasia *not compatible with life |
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Groups at increased risk for bronchiolitis
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-Premature
-Kids with congenital heart defect -Kids with lung problems -Kids that are immunosuppresed |
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Method for diagnosing Bronchiolitis
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Viral antigen in nasal secretions
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Treatment for bronchiolitis
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Supportive
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Cause of Galactosemia
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Deficiency in enzyme Galactose-1-P uridyl Transferase resulting in accumulation of Galactose 1P
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Organs affected by Galactosemia
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Brain. Liver, Eyes
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Manifestations of Galactosemia
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-Lethargy
-Hypotonia -N/V -Diarrhea -FTT -Hepatomegaly w/ Jaundice -Cataracts |
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Management of Galactosemia
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Avoid all lactose containing substance
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Cause of PKU
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Autosomal Recessive disorder that results in loss of enzyme that turns Phenylalanine into Tyrosine
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Associated abnormalities with Wilm's tumor
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-Aniridia
-Genitourinary Anomalies -Retardation |
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Presentation of Wilm's Tumor
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-Abdominal Mass
-Abdominal Pain -Hematuria -Hypertension |
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Features of Waardenburg Syndrome
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-Autosomal Dominant Trait
-Lateral Displacement of medial canthi -Broad nasal bridge -Medial Hyperplasia of Eyebrows -Partial Albinism |
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Presentation of Sturge-Weber Syndrome
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Flat capillary vascular malformation in the distribution of the trigeminal nerve
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Complications of Sturge-Weber
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-Grand mal Seizures
-Mental Deficiency -Hemiparesis -Hemianopsia |
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Features of Tuberous Sclerosis
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-Autosomal Dominant
-Ash leaf spots -Cerebral sclerotic tubers -Seizures |
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Features of a subgaleal hemorrhage
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-Increased fronto-occipital head circumference
-Squishy feeling scalp -Tachycardia -Feels like a cephalohematoma that crosses midline -can be deadly |
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Define caput succedaneum
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Soft-tissue swelling of the scalp involving the presenting delivery portion of the head; Ecchymotic lesion that can cross suture lines
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Highest incidence group for intraventricular hemorrhage
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Premature babies; Higher risk with smaller size
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Differences between cephalohematoma and a subgaleal hemorrhage
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Cephalohematoma do not cross midline
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