CLIPP 9 - hypothyroid Flashcards
How much weight do babies lose in the first few days of life?
Average = 5.8% 2SD = 11-12%
Signs of hunger in infants (4)
- increased alertness
- increased physical activity
- mouthing
- rooting
suggested frequency of breastfeeding
every 2-3 hours
Assessing feeding adequacy (3)
- weight gain
- wet diapers (3-5voids per day by 3-5 days of age)
- every 2-3 hours for 10-15 minutes per side
Which babies get vitamin D?
-all breastfed infants, regardless of formula supplementatin
lethargy signs
- failure of child to recognize parents or interact with environment
- significant sluggishness
listlessness signs
-no interest in what is happening around them
toxic appearing signs
appearance of pending physiologic collapse
distress signs
working hard to maintain physiologic stability
Large fontanel DDX (5)
- skeletal disorders (rickets, osteogenesis imperfect)
- chromosomal abnormalities (T21)
- hypothyroidism
- malnutrition
- increase ICP (NAT)
Small fontanel DDX (4)
- microcephaly
- craniosynostosis
- hyperthyroidism
- normal variant
sunken fontanel DDX (1)
-dehydration
Bulging fontanel DDX (4)
- meningitis
- hydrocephalus
- subdural hematoma
- lead poisoning
DDX infant poor feeding, decreased activity (10)
- CAH
- congenital hypothyroidism
- shaken baby syndrome
- T21
- sepsis
- inborn error of metabolism
- botulism
- HIE
- polycythemia
- hyperbilirubunemia
Causes of congenital hypothyroidism (6)
- aplasia
- hypoplasia
- ectopic gland
- maternal autoimmune thyroiditis
- maternal antithyroid drug use (PTU)
- iodine deficiency
Features of congenital hypothyroidism (9)
- feeding problems
- decreased activity
- constipation
- prolonged jaundice
- skin mottling
- umbilical hernia
- large tongue
- hoarse cry
- puffy, myxedematous facies
Treatment of congenital hypothyroidism
levothyroxine
Components of newborn screening system (5)
- newborn testing
- followup of abnormal screening results
- diagnostic testing
- disease management
- continuous evaluation and improvement of screening system
Newborn screen timing
- within one week
- if done within first 24 hours of life, repeat at 2 weeks
Benefits of newborn screening (3)
- detection of serious, treatable disorders before symptom onset
- treatment to prevent serious problems
- carrier detection
Risks of newborn screening (4)
- false negatives
- parental anxiety after false-positives
- revelation of misattributed paternity
- detection of disorders with no treatment
Newborn visit checklist (4)
- pregnancy history
- birth history
- feeding history
- parent questions/concerns
Routine newborn care in hospitals (6)
- HepB vaccine
- vitamin K
- erythromycin eye ointment
- CCHD screen
- hearing screen
- metabolic screening
Mean fontanel size
2.1 cm(0.6-3.6)
