CLIPP 25

Question 1

what to check before doing CPR

Answer 1

CAB - tap foot for response, check for breathing, if unresponsive and not breathing or is gasping for air–>CPR

Question 2

Normal 2 month old VS (rr, hr, bp, pulse ox, temp)

Answer 2

RR: 23-39
HR: 120-180 (avg 150)
BP: 100/65, 85/50
Pulse Ox: >95% RA
Temp: rectally between 96.5 and 100.4

Question 3

infant colic

Answer 3

several hours of crying on more than 5 days/week, often in evening and baby is hard to console. Typically starts after 2 weeks of age, peaks around 6 weeks and lessens by 3-4 months

Question 4

SIDS vs ALTE

Answer 4

SIDS often midnight to 6am, most deaths during night
ALTE - color change, breathing change, change in tone often not back to BL without stimulation. Deaths often daytime.
-Intervnetiosn to decrease SIDS have not decreased ALTEs

Question 5

age range for breath holding spells

Answer 5

6 mos to 6 years

Question 6

periodic breathing

Answer 6

rapid breathing with brief 3-5 sec pause (alternates between these two). it is viewed as normal in neonatal period and not associated with cyanosis or AMS

Question 7

congenital dermal melanocytosis

Answer 7

mongolian spots, fade over time and don’t change color rapidly like bruises would

Question 8

normal 2 month old neuro findings

Answer 8

fix and follow w/ eyes, coo, suck, meaningful smile. flexed at the hips. can’t control head when upright but can raise head if prone

Question 9

infant glasgow coma scale

Answer 9

based on infant’s eye opening, verbal response and motor response.
max = 15, score below 8 means infant is in coma and needs close monitoring.

Question 10

Toddler’s fracture vs fracture of femur/tibia in non-walking child

Answer 10

distal, undisplaced fx of tibia w/ spiral/oblique

VS non-accidental trauma is upper 2/3 part of tibia or midshaft typically

Question 11

prognosis for babies w/ subdural hemoatomas and retinal hemorrhage

Answer 11

vision trouble, seizure, developmental delay

Question 12

how to evaluate for subdural hematoma and what we will see on imaging

Answer 12

head CT - quicker than MRI, more sensitive, often no sedation needed. MRI can be confirmatory.
- will see concave, crescent shape on CT

Question 13

Metaphyseal fractures

Answer 13

also called “bucket handle” or corner fractures, are caused by torsional force on the limb, or by violent shaking. While these can occasionally occur in older children who test the limits of their limbs, this would be unlikely in an 10-month-old. You can never be reassured by a metaphyseal fracture, and should always have child abuse on your differential when this type of fracture is apparent

Question 14

unlikely for a patient with ___ to first present with ALTE.

these things _________…____ are more likely

Answer 14

congenital heart dz

-seizure, arrhythmia, infection, gerd