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Pediatrics AQ cases > 1 > Flashcards

1 Flashcards

1
Q

What is maternal heroin use associated with?

A

increased risk of fetal growth restriction, placental abruption, fetal death, preterm labor and intrauterine passage of meconium.

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2
Q

What is neonatal abstinence syndrome?

A

uncoordinated sucking reflexes leading to poor feeding, irritability, and high-pitched cry

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3
Q

When is an infant diagnosed with SGA?

A

Time of birth

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4
Q

GBS + mom delivers baby who appears ill. What to do?

A

Start ppx abx for GBS and get CBC, blood culture, chest x-ray and lumbar puncture (ruling out sepsis, pneumonia and meningitis)

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5
Q

Who should get intrapartum abx for GBS?

A

1) Previous infant with invasive GBS disease
2) GBS bacteriuria during any trimester of the current pregnancy
3) Positive GBS vaginal-rectal screening culture in late gestation during current pregnancy
4) Unknown GBS status at the onset of labor (culture not done, incomplete, or results unknown) and any of the following:
- Delivery at < 37 weeks’ gestation
- Amniotic membrane rupture ≥ 18 hours
- Intrapartum temperature ≥ 38°C (100.4°F)
- Intrapartum NAAT positive for GBS

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6
Q

A woman with unknown GBS status shows up in labor at 36 weeks gestation. Does she get abx?

A

YES; if status unknown and < 37 weeks then get abx

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7
Q

Which TORCH infection causes chorioretinitis and diffuse brain calcifications?

A

Toxoplasmosis

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8
Q

Which 4 TORCH infections can cause microcephaly

A

VCRZ = Varicella, Rubella, CMV, Zika

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9
Q

TORCH infection that causes cataracts?

A

CataRacts = CMV and Rubella

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10
Q

These TORCH infections can lead to thrombocytopenai?

A

tHRomboCytopenia = HSV, Rubella, CMV

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11
Q

These viruses leads to sensorineural hearing loss.

A

Rubella and Zika

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12
Q

A kid is born and has a blueberry muffin rash, hepatomegaly, and a small head. What is he infected with and what is likely wrong with his eyes?

A

Rubella. Eyes will have cataracts, glaucoma, retinopathy.

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13
Q

Which three viruses lead to brain calcifications and how are they different?

A

calCificaTionZ = CMV (periventricular), Toxoplasmosis (diffuse intracranial), Zika (subcortical)

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14
Q

What are the TORCHZ infections?

A

Toxoplasmosis, Other (Varicella, Syphilis), Rubella, CMV, HSV, Zika

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15
Q

What makes up APGAR?

A

Appearance, Pulse, Grimace, Activity, Respirations

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16
Q

What percentile of weight constitutes SGA?

A

10th

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17
Q

What sorts of things result in symmetrical SGA?

A

Congenital infections which affect brain development. All small = BAD; head-sparing = good

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18
Q

What is the asymmetric tonic neck response?

A

Turning the newborn’s head to one side causes gradual extension of arm toward direction of infant’s gaze with contralateral arm flexion–like a fencer.

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19
Q

What is your ddx for absent red light reflex?

A 
Cataracts 
Opacified cornea (like mucopolysaccharidosis)
Inflammation of anterior chamber
Developmental anomalies 
Retinoblastoma
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20
Q

Baby is born to a woman with little prenatal care. He is SGA but head is normal circumference. What is likely cause?

A

Inadequate nutrition because head-sparing. If head was also small, think TORCHZ.

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21
Q

What 3 things are babies given after birth?

A

Thighs and eyes = vitamin K, first Hep B vaccine, erythromycin gel for eyes

22
Q

A pregnant woman has HBV. What should baby get at time of birth?

A

hepatitis B vaccine as well as hepatitis B immune globulin (HBIG) within 12 hours of delivery

23
Q

Why give erythromycin eye ointment to neonates?

A

prevent n gonorrhea opthalmia

24
Q

What supplementation should exclusively breastfed babies get?

A

400 IU vitD

25
Q

If want to start cows milk, when is appropriate in child?

A

1 yr

26
Q

100 kcal/kg/day is appropriate nutrition for how old?

A

1-2 mo who is full-term

27
Q

When do you expect moro reflex to disappear?

A

4 mo

28
Q

This may lead to cradle cap

A

seborrheic dermatitis

29
Q

These are two common skin findings in <2 mo

A

neonatal acne and seborrheic dermatitis

30
Q

When do you expect the babinski reflex to go away

A

By 2 years old, toes should transition to downgoing

31
Q

When should you expect babies to start sleeping through the night?

A

4-6 months

32
Q

Should an 11 year old sit in the front seat?

A

Nah, wait until 13 or older

33
Q

What are the 2 month vaccines?

A

Hep B (2nd), DTaP, IPV, PCV13, Hib, Rotavirus,

34
Q

What makes up the Pediarix?

A

HepB, IPV, DTaP

35
Q

Is MMR started at 1 y/o?

A

YES

36
Q

When do you start HepA vaccine?

A

1 y/o

37
Q

When do you expect weight to double in baby?

A

double by 5 mo, triple by 12 mo

38
Q

Up to 6 years old, when should kiddos get vaccines?

A

Time of birth, 2 mo, 4 mo, 6 mo, 1 yr, 18 mo, 4-6 yrs

39
Q

Which vaccines at 4 mo?

A

DTap, IPV, PCV13, Rotavirus, Hib

40
Q

Which vaccines at 6 mo?

A

Hep B, IPV, DTaP, PCV13, rotavirus

41
Q

How many doses of HepB before kindergarten and when?

A

3 doses Hep B; birth, 2 mo, 6 mo

42
Q

How many doses DTaP before kindergarten and when?

A

5 doses DTaP; 2 mo, 4 mo, 6mo, 18 mo, 4-6 yo

43
Q

How many doses of IPV and when?

A

4 doses IPV; 2 mo, 4mo, 6mo, 4-6 yo

44
Q

What is your differential diagnosis for a child with RUQ mass?

A 
Hepatic neoplasm
Hydronephrosis
Neuroblastoma
Teratoma
Wilms' tumor
45
Q

How can neuroblastoma present?

A

painless mass in the neck, chest, or abdomen

46
Q

Path with “small round blue cells” = ?

A

Neuroblastoma

47
Q

You suspect neuroblastoma in a kid with RUQ mass. What would urine and CBC show?

A

Increased urine catecholamine and CBC with anemia or other cytopenias indicating bone marrow infiltration

48
Q

A kid with RUQ mass is found to have intrarenal mass and hematuria. What is it?

A

Wilm’s tumor or nephroblastoma

49
Q

What gene test is helpful in neuroblastoma work up?

A

N-MYC gene amplification = poor prognosis

50
Q

What are favorable prognostic factors of neuroblastoma?

A

Non-amplification of the n-myc oncogene
DNA index > 1
Favorable histology (Shimada classification)
Age < 1 year.

51
Q

A kid has neuroblastoma. Did he likely inherit it?

A

NO, most are result of somatic mutation

Pediatrics AQ cases (13 decks)

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