childhood disease objectives

Question 1

define APGAR score

Answer 1

• Newborn assessment = evaluate the physiologic conditions and responsiveness which correlate to chances of survival
• APGAR score (0-10)
• based on Color, Heart rate, Respiration, Reflex, Muscle tone (0-2)
• 0-1 = 50% death rate in 5 mins
• 4 = 20% death rate in 5 mins
• 7 = 0% death rate in 5 mins

Question 2

Bronchopulmonary dysplasia (BPD)

Answer 2

• Chronic lung disease (CLD)
• Hyperplasia and squamous metaplasia of the bronchial epithelium; alveolar wall thickening, peribronchial and interstitial fibrosis
• Alveolar hypoplasia is attributed to oxygen and inflammatory cytokines blocking alveolar septation at the saccular stage level
• Respiratory failure and predisposition to respiratory syncytial virus infection may cause re-hospitalization and death

Question 3

Caput succedaneum

Answer 3

• edema of the presenting portion of the scalp

- significant only if there is an underlying skull fracture

Question 4

cephalhematoma

Answer 4

• hemorrhage under the periosteum, sometimes underlined by skull fracture

Question 5

Congenital

Answer 5

• defined as morphologic defects that are present at birth

- not just genetic basis, but can be cosmetic or functional

Question 6

Hyaline membrane disease (HMD)

Answer 6

• Most common cause of Neonatal respiratory distress syndrome (RDS)
• Caused by deficiency of alveolar sulfactant
  1) lack of sulfactant results in atelectasis followed by hypoxemia and increased CO2 (hypercarbia)
  2) triggers pulmonary artery vasoconstriction and hypoperfusion
  3) ischemia damages alveolar and endothelial cells allowing leakage of plasma proteins (fibrin) into the alveolar spaces
  4) proteins and cellular debris in alveolar ducts form the hyaline membranes

Question 7

how to diagnosis Hyaline membrane disease

Answer 7

• amniotic fluid phospholipids; at maturity the amniotic fluid lecithin/sphingomyelin ratio is >2 and phosphatidylglycerol is present
• arterial blood gases show hypoxemia and hypercarbia
• chest X-ray shows atelectasis (ground-glass appearance)

Question 8

define Hydrops fetalis

Answer 8

• Edema in fetus

Question 9

what are the causes of fetal hydrops

Answer 9

• Immune hydrops = blood group incompatibility

- Nonimmune hydrops = infections, chromosomal anomalies, twin pregnancy, cardiovascular defects

Question 10

describe immune hydrops fetalis

Answer 10

• Mother Rh D-; Father Rh D+
• maternal immunization to RhD antigen
• transplacental passage of maternal anti-D IgG antibodies
• Binding anti-D IgG to fetal Rh+ RBC
• destruction of anti-D IgG-RBC complex

Question 11

Hydrops fetalis

Answer 11

• generalized edema of the fetus

Question 12

cystic hygroma

Answer 12

• localized edema accumulation in the soft tissues of the neck

Question 13

premature

Answer 13

• gestational age less than 37 weeks

- second most common cause of neonatal mortality