12 Flashcards
anticonvulsant during pregnancy
ardiac defects, dysmorphic craniofacial features, hypoplastic nails and distal phalanges, IUGR, and microcephaly
chorioretinitis in newborn
congenital toxoplasmosis and CMV infections
newborn with high-pitched cry, tremulousness, hypertonicity, and feeding difficulties
maternal heroin use
sensorineural deafness, eye abnormalities (retinopathy, cataracts), and patent ductus arteriosus
congenital rubella
microcephaly, jaundice, hepatosplenomegaly, low birth weight, and petechiae at birth.
congenital CMV
vomiting, hypotonia, musty odor, developmental delay, and decreased pigmentation of the hair and eyes.
PKU
Marfanoid body habitus, a hypercoaguable state, and possible developmental delay
homocystinuria
hepatomegaly, ataxia, seizures, and progressive neurologic degeneration. Fundoscopic exam reveals a “cherry-red” macula.
niemann-pick
fetal factors of SGA
chromosomal abnormalities
TORCH infections
metabolic disorders
structural defects
GBS + mom chooses not to have ppx abx, What are odds of disease for child?
1-2% of infants born to colonized women develop invasive disease (sepsis, pneumonia and meningitis)
Does APGAR predict individual neurologic outcome or mortality?
NO
What is term?
> 37 weeks
Assymetrical Tonic NEck Reflex
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.
If a child has VKDB, when and how do you expect classic presentation?
Day 1-7 with Bruising and bleeding from the umbilical cord
able to stoop and recover and walk well, put a block in a cup, have a vocabulary of a few words, wave bye-bye, and drink from a cup`
15 mo
can run, scribble, build a tower of 2 cubes, have 3-6 words in her or his vocabulary, and be able to help in the house and remove garments
18 mo
can balance on each foot for 1 second, wiggle their thumbs, name 4 pictures, name 1 color, name a friend, and brush their teeth with help.
3 years old
Beckwith-Wiedemann syndrome
Wilm’s tumor + overgrowth syndrome (large for size, macroglossia, macrocephaly) + omphalocele, hemihypertrophy, hypoglycemia, large for gestational age, and other dysmorphic features.
small blue cells
neuroblastoma, Ewing’s sarcoma and medulloblastoma
When to screen for autism
18 and 24 mo
When in front seat
13 and older
double birth weight
at 4 to 5 mo; triple by 1 yr
Cataracts
Glaucoma
Retinoblastoma
Chorioretinitis
absent red light reflex
turns towards voice and babbles
6 mo
Has a well developed, “neat” pincer grasp
1 yr
Stage 4 S Neuroblastoma
may spontaneously regress if in child < 1 yr
Elevated catecholamines by Urine or serum VMA/HVA iss seen in what RUQ mass?
neuroblastoma
painless mass in the neck, chest, or abdomen
neuroblastoma
Being able to jump in place is a ___-month-old milestone
30 months!
throw a ball overhand is expected at ___ months of age.
24 months
4 year old skills
hop on 1 foot, copy a cross, pour/cut/mash their own food, and brush teeth
Throwing a ball overhand, riding a tricycle, building a tower of 6-8 cubes, and copying a circle
3 yr old
mature pencil grasp, skip, tie a knot
5 yr old
When to screen vision with chart
3
Until what height in booster?
until they reach a height of 4’ 9” (142 cm).
States first and last name
Sings a song
Most speech clearly understandable
4 year old
Draws a person with > 6 body parts
Prints some letters and numbers
Copies squares and triangles
5 years old
Common sources of lead exposure
House paint used before 1978 Soil Plumbing, pipes Hobbies, occupational exposures Imported toys, ceramics, candy, cosmetics Folk remedies
When to screen for anemia?
screening for anemia is done at 12 months and again at preschool or kindergarten entry
chest pain, cold lower extremities, dizziness, syncope, exercise intolerance, failure to thrive, poor growth, headache, and dyspnea
coarctation of the aorta
masses associated with catecholamine excess
pheochromocytoma, neuroblastoma
Can ADHD present with motor impairment and emotional labiality?
YES
inability to conform to societal norms, disregard of the rights of others, and criminality
anti-social personality disorder
pattern of negativistic, hostile and defiant behavior
oppositional defiant disorder
prenatal and neonatal risk factors for obesity
high birth weight and maternal diabetes
displacement of the femoral head from the femoral neck through the physeal plate
SCFE -> obese with recent growth spurt
antalgic gait + widening of physis on XR
SCFE
BMI 85% and parent with Type 2 DM. Screen at 10 years old?
YES
> 99th percentil BP
Stage 2 HTN
Can Placement of an umbilical arterial or venous line during the perinatal period may predispose to renal vascular disease?
YES
What is inheritance of von Willebrand disease?
AD
No breast glandular tissue and no pubic hair
Tanner I
pubic hair across mons pubis
Tanner IV
pubic hair extends to the medial surface of the thighs
Tanner V
Order of development for girls
breast bud -> pubic hair -> growth spurt -> menarche
Which electrolyte abnormalities in anorexia lead to compromised cardiac function
calcium and magnesiu
Ecchymoses (small hematomas in areas of trauma)
Epistaxis
Menorrhagia (why vWD is diagnosed more often in women than men)
Bleeding post-to
vWD, AD inheritance, desmopressin for tx
_______ syndrome can cause syncopal episodes in late childhood or adolescence.
Long QT, puts at risk of ventricular fibrilliation and other arrhythmias
Positive family history for young cardiac death
get ecg and refer to cardiology
sudden, sporadic onset of sharp pain, usually along the left sternal border, which is often
exacerbated with deep inspiration
precordial catch syndrome, benign so reassure pt
Small amount of fine hair along the base of scrotum
and phallus
Tanner 2
Adult-type hair extending to medial surface of thighs
Tanner 5
When Men B given?
One dose at 16
When MCV4?
11 and 16
Which murmurs need further evaluation?
Louder than grade III/VI
Any diastolic murmur
Any murmur that increases with standing or Valsalva
ECG for all patients with syncope?
YES
How to exclude HCM?
Echo – sometimes ECG doesn’t reveal
premature, tachypnea, grunting
RDS
tachypnea in IDM or c-section baby, residual fluid in lungs, self-resolves
TTN
premature and ground glass appearance of lungs on XR
RDS
atelectasis, inflammation, or pulmonary edema and prolonged ventilation
bronchopulmonary dysplasia
Newborn > 90th percentile
LGA
delayed lung maturation, increased insulin in DM mothers delays surfactant production
RDS
combination of whey proteins (70%) and casein (30%
human milk
jaundice, dark urine, and acholic (pale) stools between 3 and 6 weeks of age
biliary atresia
feeding problems, large fontanelles, hypotonia, large tongue, coarse cry, and frequently an umbilical hernia
congenital hypothyroidism; usually shows up at 6 weeks once moms thyroid leaves the body
bulging fontanelles
Meningitis
Hydrocephalus
Subdural hematoma
Lead poisoning
virilized female with hyponatremia, hyperkalemia, dehydration, shock
CAH
Feeding problems Decreased activity Constipation Prolonged jaundice Skin mottling Umbilical hernia
congenital hypothyroidism
