Cases 36-40

Question 1

How tobacco affect the fetus?

Answer 1

low birth weight

Question 2

What does alcohol do to a fetus? Is there a safe amount of alcohol during pregnancy?

Answer 2

fetal alcohol syndrome (facial abnormalities, growth deficiency, central nervous system dysfunction)

There is no safe amount of alcohol to ensure fetal alcohol syndrome does not occur

Question 3

What does pot do to a fetus?

Answer 3

no destinctive effects have been identified

Question 4

What does heroin and other opioids do to a fetus? Should fetuses born to a mother with an opioid addiction be monitored?

Answer 4

fetal growth restriction, placental abruption, fetal death, preterm labor, intrauterine passage of meconium

yes

Question 5

How does cocaine affect a fetus?

Answer 5

vasoconstriction leading to placental insufficiency and low birth weight

Question 6

Define small for gestational age

Answer 6

Diagnosed at the time of birth; weight less than 10th percentile

Question 7

Define intrauterine growth restriction

Answer 7

Diagnosed DURING the pregnancy; has not reached its frowth potential at a given gestational age due to one or more causative factors

Question 8

How many (percetage) kids develop GBS complications if mother is not treated with abx?

Answer 8

1-2% of infants develop complications such as sepsis, pneumonia, and meningitis

Question 9

If a baby is born to a mother who is colonized with GBS and not treated and the baby looks ill, what should you order? (multiple things)

Answer 9

CBC, blood cx, CXR, lumbar puncture, IV antibiotics

Question 10

Define APGAR score

Answer 10

Appearance
Pulse
Grimace
Activity
Respiration

Question 11

When is a baby at term?

Answer 11

38+ weeks gestation

Question 12

Define symmetric and asymmetric IUGR

Answer 12

Symmetric= baby’s body is proportional (congenital infections can cause this)

Assymetric= body parts are not proportional (poor nutrient delivery can cause this)

Question 13

What are 3 serious risks for SGA infants?

Answer 13

Hypoglycemia (decreased glycogen stores)

hypothermia (increased surface area)

polycythemia (chronic hypoxia)

Question 14

What are the steps of newborn resuscitation?

Answer 14

ABCs
Warm and dry infant
Stimulate a vigorous cry
Suction fluid from nose and mouth
Initiate further resuscitation if required (O2, PEEP, compression, etc)

Question 15

What is the differential for ansent red light reflex (5)

Answer 15

retinoblastoma
Cataract
opacified cornea (e.g. mucopolysaccharidosis)
inflammation of anterior chamber
developmental anomalies

Question 16

Define early vitamin K deficiency bleeding. Define its characteristics

Answer 16

occurs between 0-24 hours after birth

Severe; found in infants whose mothers used meds (antiepileptic or isoniazid) that interfere with how the body uses vitamin K

Question 17

Define classical vitamin K deficiency bleeding. Define its characteristics

Answer 17

occurs 1-7 days after birth

Bruising; bleeding from umbilical cord

Question 18

Define late vitamin K deficiency bleeding. Define its characteristics

Answer 18

2-12 weeks after birth or longer

30-60% of infants have bleeding in brain; warning bleeds are rare; tends to occur in breastfed babies who have not recieved vit K

Question 19

If a mother has Hep B, what should you do for the infant?

Answer 19

give it the hep B vaccine and hep B immune globulin

Question 21

If the mother is Hep B positive and the infant was given Hep B vaccine and immune globulin, how long should you test the infant for anti-HB antibodies?

Answer 21

9-18 months of age

Question 22

What are the three routine medications given to newborns?

Answer 22

Vitamin K

Hep B vaccine

Erythromycin eye ointment

Question 23

When should children be screened for autism? (2 times)

Answer 23

18 month and 24 months

Question 24

What is the caloric requirement for an infant born at term of 1-2 month olds?

Answer 24

100 - 120 kcal/kg/day

Question 25

What is the caloric requirement for an infant born <37 weeks of 1-2 month olds?

Answer 25

115 - 130 kcal/kg/day

Question 26

What is the caloric requirement for an infant born <32 weeks at 1-2 month olds?

Answer 26

150 kcal/kg/day

Question 27

How long should a car seat be rearfacing?

Answer 27

until age of 2

Question 28

When can a child sit in the front seat?

Answer 28

13 years old

Question 29

When do infants double their birth weight? triple?

Answer 29

4-5 months

1 year

Question 30

When should new foods be introduced into an infants diet?

Answer 30

6 months

Question 31

should you take acetaminophen before a shot?

Answer 31

no. decreases efficacy

Question 32

True or False

prognosis of 4S neuroblastoma in infants <1 year of age have a possibility of spontaneously regressing

Answer 32

true

Question 33

What is the initial work-up for an abdominal mass in a kid?

Answer 33

CBC with diff
Catecholamine metabolites
CXR
Skeletal survey
Abdominal ultrasound

Abdominal XRAY

Abdominal CT

Question 34

differntial for RUQ mass in a 9 month

Answer 34

hepatic neoplasm
Hydronephrosis
Neuroblastoma
Teratoma
Wilms’ tumor (nephroblastoma)

Question 35

when should lead screening be done?

Answer 35

12 - 24 months in areas where housing was built before 1960

Question 36

When should kids be screened for TB?

Answer 36

If they are at high risk

Question 37

When should kids be screened for anemia?

Answer 37

12 months and again at preschool

Question 38

Define “weight age” and “height age”

Answer 38

Age at which patient’s weight/height would plot 50th percentile

Question 39

What are the 3 core symptoms of ADHD?

Answer 39

inattention

hyperactivity

impulsivity

Question 40

What is the difference between conduct disorder and oppositional defiant disorder?

Answer 40

Conduct disorder: habitual rule-breaking, characterized by a pattern of aggression, destruction, lying, stealing, and/or truancy

Question 41

What are 3 side effects of ADHD medications in kids?

Answer 41

Appetitie suppression
insonmia
Decrease in growth velocity

Question 42

ADA diagnostic criteria for DM

Answer 42

HbA1c ≥ 6.5% (48 mmol/mol) (Test performed in an appropriately certified laboratory.), or
Fasting plasma glucose ≥ 126mg/dL (7.0 mmol/L) (Fasting is defined as no caloric intake for at least 8 hours), or
Two-hour plasma glucose ≥ 200 mg/dL (11.1 mmol/L) during an oral glucose tolerance test following a glucose load of 75 g glucose or
In a patient with symptoms of hyperglycemia, a random plasma glucose ≥ 200mg/dL