Aquifer #2

Question 1

Where in the body is kernicterus happening?

Answer 1

Basal Ganglia and Cranial nerve nuclei

Question 2

What is physiologic jaundice?

Answer 2

Basically normal because conjugating capability is not there yet

Question 3

What is breastfeeding jaundice?

Answer 3

Lack of breast milk jaundice, decreased motility that causes meconium to be retained and it deconjugates the bilirubin

Question 4

What is breast milk jaundice?

Answer 4

The breast milk itself deconjugates the bilirubin

Question 5

What supplement is recommended for babies who are breastfed?

Answer 5

Vitamin D

Question 6

2 physical findings you might see on baby head in the presence of high bilirubin?

Answer 6

Cephalohematoma and bruising

Question 7

What are the 5 components of the APGAR test?

Answer 7

Activity
Pulse
Grimace
Appearance, skin color
Respiration

Question 8

What is the pulse for 0 point 1 point and 2 points for APGAR?

Answer 8

Absent
Below 100
Over 100

Question 9

0 1 and 2 points for respiration for APGAR?

Answer 9

Absent, slow and irregular, and vigorous cry.

Question 10

Activity for 0 1 and 2 points of APGAR?

Answer 10

Absent
Flexed arms and legs
Active

Question 11

What type of cough is found in asthma and lower respiratory infections?

Answer 11

Dry

Wet

Question 12

What 4 conditions have a paroxysmal cough?

Answer 12

Pertussis
Chlamydia
Mycoplasma
Foreign body

Question 13

What is the most common chronic disease in children in developed countries?

Answer 13

Asthma

Question 14

Symptom frequency, nighttime awakenings, Saba use, and interference with activity for intermittent asthma?

Answer 14

Less than 2 days a week
Less than 2 month
Less than 2 day
None

Question 15

Symptom frequency, nighttime awakenings, Saba use, and interference with activity for mild persistent asthma?

Answer 15

More than 2 days a week
1-4 month
Greater than 2 days a week but not daily
Minor limitation

Question 16

How do we big picture treat intermittent asthma vs. persistent asthma?

Answer 16

Intermittent, SABA

Persistent, daily controller/preventer and SABA

Question 17

What are the 3 most common indoor aeroallergens that are responsible for triggering asthma?

Answer 17

Dust mites
Animal dander
Cockroaches

Question 18

What is the most effective medicine to treat allergic rhinitis?

Answer 18

Topical nasal steroids

Question 19

Transient synovitis often occurs during or following a what?

Answer 19

Viral infection

Question 20

Criteria for juvenile idiopathic arthritis?

Answer 20

Less than 16 and have arthritis in at least one joint for more than 6 weeks

Question 21

What is the most common hip disorder in adolescents?

Answer 21

Slipped capital femoral epiphysis

Head falls off and impairs internal rotation of hip

Question 22

What is the relationship of arthritis and Lyme dx?

Answer 22

It is the second most common manifestation of Lyme disease showing up about a month after the rash. It is the most common manifestation of late Lyme dx.

Question 23

What is the most common childhood cancer?

Answer 23

Leukemia

Question 24

How do we diagnose slipped capital femoral epiphysis?

Answer 24

AP and lateral x ray followed by internal reduction of the femoral head

Question 25

Most common organisms causing septic arthritis in neonates, older children and adolescents?

Answer 25

Staph, group b strep and E. coli Staph, hib, and strep pneumonia Neisseria

Question 26

Babies lose how much birth weight and when do they get it back? Define failure to thrive? Two categories of failure to thrive, which one is most common?

Answer 26

Between 5 and 10 percent 2 weeks Less than 5th percentile in weight Non organic and organic, non organic being the most common with psychosocial being the most common

Question 27

What are 5 organic causes of failure to thrive?

Answer 27

``` Congenital heart defects Cystic fibrosis Reflux Neuro problem Metabolic dx ```

Question 28

What is the hallmark finding of an ASD?

Answer 28

Wide splitting s2

Question 29

3 clinical signs of coarctation of the aorta?

Answer 29

Murmur, hypertension in the UE, lower BP in the LE

Question 30

What is the hallmark of VSD?

Answer 30

Holosystolic blowing murmur starting at s1

Question 31

Hallmark feature of PDA?

Answer 31

Continuous machine like murmur with bounding pulses

Question 32

Most common congenital heart defect?

Answer 32

VSD

Question 33

What is the most common cyanotic heart defect?

Answer 33

Tetralogy of fallout

Question 34

What is the most common heart defect presenting with cyanosis in the newborn period?

Answer 34

Transposition of the great vessels

Question 35

4 murmurs that can presents with signs of congestive heart failure?

Answer 35

VSD PDA AS Coarctation of the aorta

Question 36

3 hallmark findings on x ray of left to right shunt congenital defect?

Answer 36

Cardiomegaly, Pulmonary edema, and increased pulmonary vascular makings

Question 37

What is the patho of tetralogy of fallout? | What is the patho of a VSD?

Answer 37

Because of the obstruction of the right outflow tract, there is a right to left shunt through the VSD and the baby becomes cyanotic. With a VSD, there is a persistent left to right shunt causing pulmonary overload and persistent volume overload in the left ventricle. Cardiac output also sucks.

Question 38

Why is the VSD not picked up in the nursery and why does it present later?

Answer 38

Because initially there is elevated pulmonary vascular resistance in the newborn because the pulmonary pressure is higher. That will eventually drop and the shunt can actually flow left to right.

Question 39

Three meds to use for treatment of kids with CHF and VSD?

Answer 39

Loop diuretics to shed the volume. Furosemide is drug of choice in kids with CHF. Digoxin Ace inhibitors to drop systemic vascular resistance in hopes that the left ventricle will flow the blood forward and not through the VSD because the resistance has dropped. Enalapril and captopril.