1.2 MTB Step 3 - The Newborn (Abnormalities) Flashcards

Cards Complete Day 1: 4/30/19 * Day 2: 5/2/19 * Day 3: 5/10/19 * Day 4: 5/30/19 Day 5: 6/29/19

1
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Congenital Dermal Melanocytosis?
  2. What is (1) Association with Congenital Dermal Melanocytosis?
A
  1. Blue/Gray Macules on Presacral back/posterior Thighs
  2. Usually Fades in first few years
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2
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Erythema Toxicum?
A
  1. A Firm, Yellow-White Papules/Pustules with Erythematous bases, which Peak on 2nd Day of Life.
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3
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Port Wine Stain (Nevus Flammeus)?
  2. What is (1) Association with Port Wine State (Nevus Flammeus)?
A
  1. Permanent, Unilateral Vascular malformation on Head and Neck.
  2. Sturge-Weber Syndrome = AV malformation which results in:
    • Seizures
    • Mental Retardation
    • Glaucoma
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4
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Hemangioma?
  2. What is (1) Association with Hemangioma?
A
  1. Red, sharply demarcated, Raised lesions appearing in the First 2-months, rapidly expanding, then involuting by age 5 - 9 years old.
  2. Consider underlying Organ involvement with Deep Hemangiomas.
    • If it involves the Larynx, it can cause Obstruction.
    • May cause High Output Cardiac Failure when Large
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5
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Preauricular Tags/Pits?
  2. What are (2) Associations with Preauricular Tags/Pits?
A
  1. Preauricular Tags/Pits as seen in the picture
  2. Hearing Loss, Genitourinary abnormalities
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6
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Coloboma of the Iris?
  2. What are (2) Associations with Coloboma of the Iris?
A
  1. Defect in the Iris
  2. Other Eye abnormalities & CHARGE syndrome
    • Coloboma
    • Heart Defects
    • Atresia of the nasal choanae
    • Retardation of Growth
    • Genitourinary abnormalities
    • Ear abnormalities
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7
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Aniridia?
  2. What is (1) Association with Aniridia?
A
  1. Absence of the Iris
  2. Wilms Tumor
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8
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Branchial Cleft Cyst?
  2. What is (1) Association with Branchial Cleft Cyst?
A
  1. Mass LATERAL to Midline
  2. Remnant of Embryonic Development associated with Infections
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9
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Thyroglossal Duct Cyst?
  2. What are (2) Associations with Thyroglossal Duct Cyst?
A
  1. Mass in MIDLINE that moves with Swallowing or Tongue Protrusion
  2. Infections, may have Thyroid Ectopia

A Thyroglossal Duc Cyst may be formed anywhere along the Thyroglossal Tract, which is formed from the descent of the Primordial Thyroid Gland at the Base of the Tongue. The Duct usually atrophies, but a Cyst may form.

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10
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Definition of Omphalocele?
  2. What is the Clinical Manifestation of Omphalocele?
  3. What are (2) Associations with Omphalocele?
A
  1. Omphalocele - Failure of GI sac to retract at 10 - 12 weeks of gestation.
  2. GI tract protrusion through the Umbilicus with Sac
  3. Malformations, Chromosomal Disorders

In Embryology, the Intestines are formed OUTSIDE the Abdomen and extend into the Umbilical Cord until 10 weeks gestation. At that time, they migrate into the abdomen.

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11
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Gastroschisis?
  2. What is (1) Association with Gastroschisis?
A
  1. Abdominal defect LATERAL to midline WITHOUT sac
  2. Intestinal Atresia
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12
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Umbilical Hernia?
  2. What is (1) Association with Umbilical Hernia?
A
  1. Congenital Weakness where vessels of the Fetal and Infant umbilical cord exited through the Rectus Abdominis muscle.
  2. Congenital Hypothyroidism
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13
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Hydrocele?
  2. What is (1) Association with Hydrocele?
A
  1. Scrotal Swelling with Transillumination.
  2. Inguinal Hernia
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14
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Undescended Testes?
  2. What is (1) Association with Undescended Testes?
A
  1. UNILATERAL Absence of Testes in Scrotal Sac.
  2. Malignancy if > 1 yo
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29
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Hypospadias?
  2. What are the (2) Most Common Associations with Hypospadias?
A
  1. Urethral opening on VENTRAL surface of the penis.
  2. Other GU anomalies, most commonly:
    • Undescended Testes
    • Inguinal Hernias
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30
Q

ABNORMALITIES IN THE NEWBORN

  1. What is the Clinical Manifestation of Epispadias?
  2. What is (1) Association with Epispadias?
A
  1. Urethral opening on DORSAL surface of the penis.
  2. Urinary Incontinence (form of urinary extrophy).
31
Q

ABNORMALITIES IN THE NEWBORN

What is the Clinical Manifestation of Inguinal Hernia (usually indirect)?

A

Inguinal bulge or Reducible Scrotal swelling

32
Q

ABNORMALITIES IN THE NEWBORN

“You are called to see a 9.5-pound newborn boy who is jittery 30-minutes after birth. The pregnancy was compllicated by prolonged delivery with shoulder dystocia. Physical exam reveals a large, plethoric infant who is tremulous. A Pansystoloic murmur is heard.” What is the Best INITIAL Test for this patient?

A

Blood Glucose

  • This is the Best INITIAL Test to evaluate in Infants that present Large for Gestation, Plethora, and Jitteriness.*
  • Most likely dx in these infants = Infant of a Diabetic Mother (IODM).*
33
Q

ABNORMALITIES IN THE NEWBORN

INFANT OF A DIABETIC MOTHER (IODM)

What are (2) Clinical Manifestations to look for in a suspected case of IODM?

A
  1. Macrosomia (all organs except the brain are enlarged)
  2. Signs/History of Birth Trauma
34
Q

ABNORMALITIES IN THE NEWBORN

INFANT OF A DIABETIC MOTHER (IODM)

What are (5) Lab Abnormalities in a patient with IODM?

A
  1. Hypoglycemia (after birth)
  2. Hypocalcemia
  3. Hypomagnesemia
  4. Hyperbilirubinemia
  5. Polycythemia
35
Q

ABNORMALITIES IN THE NEWBORN

INFANT OF A DIABETIC MOTHER (IODM)

What are (3) Disorders associated with IODM?

A
  1. Cardiac Abnormalities (ASD, VSD, Truncus Arteriosus)
  2. Small Left Colon Syndrome (Abdominal Distension)
  3. Increased Risk of developing Diabetes and Childhood Obesity
36
Q

ABNORMALITIES IN THE NEWBORN

INFANT OF A DIABETIC MOTHER (IODM)

Why do IODMs become Hypoglycemic AFTER Delivery?

A

In utero, they acclimate to High-Glucose environment by producing More Insulin, becoming Hyperinsulinemic.

At birth, upon leaving this High-Glucose environment, IODMs’ High Insulin level makes them Hypoglycemic.

37
Q

ABNORMALITIES IN THE NEWBORN

INFANT OF A DIABETIC MOTHER (IODM)

What are the (2) Main Criteria to be considered a Neonate with Fetal Macrosomia?

A
  1. Those ABOVE the 90th percentile of Weight for Gestational Age, or
  2. More Than 4,000 g at Birth