Clipp Cases: C1 Flashcards

1
Q

Approach to the adolescent interview

What are the 3 leading causes of death for adolescents in the US

HAS

A
  • Homicide
  • Accidents
  • Suicide
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2
Q

What are the HEEADSSS questions used to survey your patients?

A
  • Home
  • Education/Employment
  • Eating disorders
  • Activities/Affiliations/Aspirations
  • Drugs (including alcohol, tobacco, steroids)
  • Sexuality
  • Suicidal behavior
  • Safety
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3
Q

What are the top 3 most abused substances in teenagers?

A
  • Alcohol (71%)
  • Marijuana (40%)
  • Inhalants (11%)
  • Cocaine (7%)

Information gathered from the Center for Disease Control and Prevention (CDC).

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4
Q

What name 3 substances that have adverse effects due to prenatal substance abuse.

TACo

A
  • Tobacco
    • increases low birth weight in fetus
    • no characteristics associated with it
  • Alcohol
    • fetal alcohol syndrome (no safe amount)
    • facial assoc: growth def and evidece of central nervous system dys.
  • Cocaine and other
    • causes vasoconstriction–> low birth weight & placental insufficency
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5
Q

What is the difference between SGA and IUGR?

A
  • SGA: small for gestational age
    • this is an overarching umberella
    • diagnoses at birth
    • due to contitutional factors determined by Maternal factors, fetal factors, Meds
  • IUGR: Intrauterine growth restriction
    • This is more of a specific theme/concept
      *
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6
Q
A
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7
Q

What are 3 factors that limit fetal growth in utero?

A
  • Maternal factors
  • Placental abnormalities
  • Fetal abnormalities
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8
Q

What 5 factors increase the risk of HIV transmission from mother to infant?

FAM VB

A
  • Freq unprotected sex during prenancy
  • Advanced maternal HIV disease (which may indicate viral load)
  • Membrane rupture greater than 4 hours prior to delivery if mother is not an antiretroviral therapy
  • Vaginal delivery
  • Breastfeeding
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9
Q

What is an important factors in treating/preventing Perinatal group B streptococcal infections?

A
  • IAP (intrapartum antibiotic prophylaxis is highly effective at preventing early onset GBS disease among infants born to colonized women.
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10
Q

What week range of gestation shoud all women undergo vaginalrectal screening for GBs colonization?

A

35-37 weeks of gestation

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11
Q

What should penicillin-allergic women with an indication for IAP receive?

A

cefazolin

  • This drug is not established as effective at preventing early-onset GBS disease*
  • it does not reach the fetal circulation or aminiotic fluid well, and an increaseing proportion of GBS isolates are resistant to it.*
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12
Q

What are 3 ways to go about decreasing the risk of vertical HIV transmission?

BC-Z

A
  • Treatment: Zidovudine (decreases teh incidence of vertical HIV transmission.
  • Cesarean delivery should be performed prior to the onset of labor and the rupture of membranes
  • HIV infected women should be counseled not to breastfeed their infants.
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13
Q

What are 4 special features to do while performing newborn resuscitation?

  • this is in addition to remebering the CABs*
  • WISS*
A
  • Warm and dry the infant and remove any wet linens immediately
  • Stimulate the infant to elicit a vigorous cry
  • Suction amniotic fluid from the infant’s nose and mouth
  • Initiate further resuscitation if required.
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14
Q

What are the compeonets of the Apgar score?

A
  • Appearance (skin color)
  • Pulse (heart rate)
  • Grimance (reflex irritability)
  • Activity (muscle tone)
  • Respiration

each child receives a score ranging from 0 to 10, we never give above a one on apperance so each baby gets an apgar score of 9/10 max.

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15
Q

When using the apgar score?

What can lower the score?

A
  • Not used for
    • predictor of neurologic developement
    • id-ing cosngenital anomalie
  • lowering score
    • preterm birth
    • drugs
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16
Q
A
17
Q

Define the ballard gestational age assessment tool

A
  • uses signs of physical and neuromuscluar maturity to estimate gestational age
  • this is helpful if no early prenatal ultrasound to help confirm dates, or if teh gestational age is in question because of uncertain maternal dates.
18
Q

What is the scoring system of Ballard maturation assessment of gestational age?

A
  • score 0= 24 weeks
  • every 5 points you go up around 2 weeks
  • e.g. 5=26, 10=28, 15=30, 20=32, etc. etc. etc.
19
Q

Whats the difference b/t symmetric vs asymmetric IUGR?

A
  • Symmetric: IUGR refers to a growth pattern in which both head and abdomen are decreased proportionately.
  • Asymmetric: IUGR refers to a greater decrease in the size of the abdomen than that of the head (head-sparing phenomenon)
20
Q

What are the 3 things SGA infants are at risk for?

Hypo, poly, hypo

A
  • Hypoglycemia
  • Hypothermeia
  • Polycythemia
21
Q

Identify primitive reflexes in an infant?

Root- PASSS

A
  • Rooting
  • Palmar and plantar grasp
  • Asymmetrical tonic neck response
  • Sucking
  • Startle (Moro)
  • Stepping response
22
Q
A