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OB/Peds > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

3 Risk factors for hydatidiform moles?

A

Teens
Women over 35 y.o
Previous miscarriage

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2
Q

What is the most common presenting symptom of hydatidiform moles?

A

Vaginal bleeding

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3
Q

What does a hydatidiform mole appear as on ultrasound?

A

snowstorm pattern

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4
Q

Where is the most common side of an ectopic pregnancy: Cervix, ovary, tube, or abdomen?

A

Tube (97%)

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5
Q

What condition presents with abdominal tenderness along with vaginal bleeding?

A

Ectopic pregnancy-likely ruptured

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6
Q

What is the term for a pregnancy complicated by bleeding before 20wks gestation?

A

Threatened abortion

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7
Q

What constitutes someone to have ‘recurrent spontaneous abortions’?

A

3 or more consecutive pregnancy losses

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8
Q

What accounts for 49% of spontaneous abortions (loss of preg. before 20wks)?

A

Chromosomal abnormalities

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9
Q

What is it called when the woman has a dilated cervix prior to the 20wk gestation mark?

A

Inevitable abortion

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10
Q

What is the term for implantation of the placenta over or near the internal os?

A

Placenta previa

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11
Q

Bright red, painless bleeding that occurs after 27wks gestation is most likely ___ ____.

A

Placenta Previa

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12
Q

What condition studied is NOT diagnosed via ultrasound?

A

Abruptio placentae

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13
Q

What is abruption placentae?

A

Separation of placenta after 20wks gestation; accompanied by bleeding, abdomen or back pain

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14
Q

What is the most common cause of abruption placentae?

A

Maternal hypertension (44%)

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15
Q

With twins, are you more likely to see oligohydramnios or polyhydramnios?

A

Polyhydramnios

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16
Q

T/F: Fetal ballottement is easier to perform with polyhydramnios.

A

True

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17
Q

What is gestational hypertension?

A

Blood Pressure: Over 140/90 mmHg
After 20wks gestation
NO PROTEIN IN THE URINE

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18
Q

If they have 140/90mmHg BP, after 20wks, with protein in the urine it is called ____.

A

Preeclampsia

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19
Q

Preeclampsia affects ___% of pregnancies?

A

5-7%

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20
Q

T/F: C-section is preferred if diagnosed with preeclampsia.

A

False: Vaginal is preferred unless there is physiological stress

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21
Q

What is HELLP?

A

Associated with preeclampsia; Hemolysis, Elevated Liver enzymes, Low Platelet count

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22
Q

New seizures in a woman with preeclampsia is called what?

A

Eclampsia

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23
Q

What are the two forms of treatment for eclampsia?

A

Magnesium sulfate,

Antihypertensive meds

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24
Q

Preterm labor is cervical effacement &/or dilation before __ wks of gestation.

A

37

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25
Q

What is the greatest risk factor for preterm labor?

A

Having a previous preterm delivery

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26
Q

What does tocolytic therapy do for preterm labor?

A

Slows down or halts uterine contractions

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27
Q

What do corticosteroids do with regards to preterm labor?

A

Enhance pulmonary maturity of baby

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28
Q

What is the definition of post-term pregnancy?

A

Pregnancy that reaches 42+ wks gestation

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29
Q

What is gestational diabetes?

A

A glucose intolerance that begins during pregnancy

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30
Q

T/F: Gestational diabetes increases your chances of having Type 2 diabetes later on.

A

True

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31
Q

What is the diet recommendation for gestation diabetes patients?

A

Diet that meets the needs of pregnancy but restricts carbs to 35-40% of daily calories

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32
Q

What is the most common complication of gestational diabetes?

A

Shoulder dystocia (which Google tells me is when the baby’s head is delivered but the shoulders get stuck)

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33
Q

What is puerperium?

A

Time from placenta delivery–>1st few weeks post-delivery

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34
Q

Most of uterine reduction in size and weight will occur when?

A

First 2 weeks; process called INVOLUTION

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35
Q

Lochia rubra, lochia serosa, lochia alba??

A

Vaginal discharge post partum, red (rubra) 1-3wks, brown-red (serosa), yellow (alba).

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36
Q

What is uterine atony?

A

Lack of uterine contracture to close spiral arteries and venous sinuses; may lead to hemorrhage of mom

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37
Q

What is the condition with painful, warm, swollen breasts usually accompanied by a fever and chills?

A

Mastitis

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38
Q

What is PPT?

A

Postpartum Thyroiditis; transient, destructive lymphocytic thyroiditis w/in 1st year postpartum

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39
Q

T/F: The majority of PPT moms will have permanent thyroid dysfunction.

A

False: only 10-30% have permanent damage

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40
Q

T/F: 50-70% of new mothers experience postpartum depression.

A

False: 50-70% experience postpartum BLUES…only 10-15% actually experience postpartum DEPRESSION.

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41
Q

T/F: Postpartum psychosis only lasts 2-3 months.

A

True; it’s postpartum depression that lasts 3-6months

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42
Q

What is the age bracket for toddlers?

A

1-2yrs. Below 1 yr=infant. Above 2 yrs=child

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43
Q

What is the difference between neonates and postneonates?

A

1-28 days=neonate

29 days-1 yr=postneonate

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44
Q

What does APGAR stand for?

A

activity, pulse, grimace, appearance, respirations

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45
Q

When is the APGAR done?

A

1 min after birth, and 5 min after birth

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46
Q

T/F: Maternal diabetes is a risk factor for having a preterm infant.

A

False: …risk factor for having a large for gestational age baby.

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47
Q

Where is the apical pulse found on an infant?

A

3rd-5th intercostal space in midclavicular line

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48
Q

Where is the femoral pulse found on an infant?

A

Halfway between pubic tubercle and ASIS

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49
Q

What is the ‘flush technique’?

A

A means of taking blood pressure on an infant

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50
Q

Where should you take an infants temperature?

A

Axilla; correlates well to core temp b/c small body mass

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51
Q

Length of infant increases by __% in the 1st year of life.

A

50%

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52
Q

Weight of an infant should double by __months and triple by one year.

A

6 months

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53
Q

When is it normal for the head circumference to be equal or larger than chest circumference?

A

5 months and under

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54
Q

T/F: From 5 months to 2 years the chest and head circumference should be about equal.

A

True

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55
Q

If the head circumference increases rapidly or rises above the percentile curves, what should we be concerned about?

A

Incr. intracranial pressure; such as hydrocephalus

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56
Q

Word associations with Turners Syndrome?

A

Short stature, webbed neck, lack sexual traits, fall below the growth curve

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57
Q

What is Cornelia de Lange Syndrome?

A

Microcephaly, low hairline, arched eyebrows, short upturned nose, developmental delay

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58
Q

What is cutis marmorata?

A

Transient mottling of skin when exposed to cold temps

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59
Q

The term for cyanosis of hands and feet as a response to the cold?

A

Acrocyanosis

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60
Q

What is vernix caseosa?

A

Protective mixture of sebum and skin cells covering the infants body at birth; may look like whitish cheese-like substance

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61
Q

The name for the fine, silky hair covering a newborn that usually sheds 10-14 days postpartum?

A

Lanugo

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62
Q

Other names for telangiectatic nevi?

A

Stork bites, salmon patches

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63
Q

Where is telangiectatic nevi typically seen?

A

Nape of the neck

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64
Q

Bluish-gray discoloration seen over the sacral area of a newborn, what is it?

A

Dermal melanocytosis; aka Mongolian spots

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65
Q

T/F: Erythema toxicum is a serious rash of a newborn that requires immediate attention.

A

False: pink popular rash with vesicles that will resolve after several days

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66
Q

Anatomically, when is jaundice worrisome?

A

If the jaundice descends below the nipples; indicates more than 12mg/dl of bilirubin

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67
Q

Time-wise, when is jaundice worrisome?

A

If it’s present the first 24 hrs; may indicate patholocial jaundice usually from a more serious problem

68
Q

What is the most common disorder associated with a simian line?

A

Down Syndrome

69
Q

Tenting of the skin when testing turgor can be indicative of what 2 things?

A

Dehydration or malnutrition

70
Q

What is the Schamroth Technique?

A

Placing the back of the fingers together to look for clubbing of the nails.

71
Q

What is milia?

A

Plugged sebaceous glands leading to small white papules on the face of infants between birth and 3 months

72
Q

What is the fancy name for a heat rash?

A

Miliaria

73
Q

Where are you likely to see an eczematous rash in a young child?

A

Face, elbows, knees

74
Q

What is seborrheic dermatitis?

A

Thick, yellow, crusty scalp lesions; may spread down ear and neck. AKA Cradle Cap

75
Q

Word association for honey-colored crusts?

A

Impetigo; highly contagious staph or strep infection

76
Q

What is the most common vector of ring worm affecting kids?

A

Pets

77
Q

T/F: Strawberry hemangiomas usually begin to shrink within 12 to 18 months post partum.

A

True

78
Q

What is trichotillomania?

A

Pulling out own hair; may be related to stress or OCD

79
Q

Tuft of hair overlying the lumbosacral area is called what and associated with what condition?

A

Faun tail nevus; Spina bifida occulta

80
Q

Café au lait spots and axillary freckling may be related to what disorder?

A

Neurofibromatosis

81
Q

A port wine stain over the ophthalmic division of the trigeminal nerve may be associated with what 2 problems?

A

Sturge-Weber Syndrome (seizures); ocular defects

82
Q

Supernumerary nipples are associated with defects of what organ?

A

Kidney

83
Q

T/F: Kids with excessively large palatine tonsils may develop sleep apnea.

A

True

84
Q

What are the red flags when regarding lymph noses?

A

Fixed and immoveable, growing quickly, larger than 2-3cm

85
Q

T/F: It’s common to find lymph node enlargement of cervical and occipital nodes after 2 years of age.

A

False: Postauricular and occipital node enlargement is uncommon after 2 yrs

86
Q

T/F: It’s never normal to find enlarged supraclavicular nodes.

A

True

87
Q

The Epstein-Barr virus causes what condition?

A

Infectious mononucleosis; most commonly affecting teens

88
Q

What are some symptoms of mono?

A

Pharyngitis, fever, fatigue, (spleno or hepatomegaly, & rash may also be noted)

89
Q

What is cranial molding?

A

During a vaginal birth, cranial bones may shift and overlap; normal-shaped skull should resume within 1 wk.

90
Q

What condition has subcutaneous edema on the skull and may feel like a water balloon to the touch?

A

Caput Succedaneum

91
Q

What is cephalhematoma?

A

Subperiosteal blood that doesn’t cross suture lines most commonly affecting the parietal region.

92
Q

Where is caput succedaneum most likely to occur?

A

Over the occiput area with poorly defined margins

93
Q

T/F: Premature union of the cranial sutures is usually accompanied by mental retardation.

A

FALSE

94
Q

How is a positional head deformity different than craniosynostosis?

A

Ears migrate forward, heads shaped like parallelogram, bald spot on side of flattening for positional head deformity

95
Q

When does the posterior fontanel close by? Anterior fontanel?

A

Post-2 months

Ant-2 YEARS

96
Q

What condition is associated with the ‘setting sun sign’?

A

(Sclera visible above the iris but below that superior lid) associated with hydrocephalus

97
Q

What is craniotabes and what causes it?

A

Softening of the skull; may be normal finding but associated with rickets and hydrocephalus

98
Q

What are some common features of Down Syndrome?

A

Epicanthal folds, low set ears, depressed nasal bridge, upturned eyes, large tongue

99
Q

Smooth philtrum, widespread eyes, short nose, thin upper lip…name that syndrome?

A

Fetal Alcohol Syndrome

100
Q

T/F: A coloboma is a loss of functioning pupil usually seen with other abnormalities.

A

True: aka Keyhole Pupil

101
Q

Brushfield spots, white specks in linear pattern around iris of the eye, suggests what syndrome?

A

Down Syndrome

102
Q

What is the Hirschberg’s Test looking for?

A

Asymmetry indicating strabismus; (Hirschbergs aka Corneal Light Reflex)

103
Q

If an eye moves lateral to medial during a cross-cover test, it is an _____eye.

A

Exotropic eye; esotropic moves medial to lateral

104
Q

Duane Syndrome affects what part of the ocular system?

A

Abducens nucleus and the lateral rectus muscle.

105
Q

What is amblyopia?

A

Reduced vision in an eye that appears structurally normal

106
Q

At what age should a child be able to see 20/20?

A

6 yrs.

107
Q

If you see an abnormal ‘white’ reflex in the eye, you should suspect what 2 problems?

A

Congenital cataracts

Retinoblastoma

108
Q

What are some common causes of congenital cataracts?

A

Infectious diseases (TORCH), hypoglycemia, trisomies, prematurity

109
Q

T/F: Retinoblastoma is a benign eye condition typically affecting kids.

A

False: Malignant tumor affecting kids under 2 years

110
Q

How do you pull the ear when performing an otoscopic exam of a infant?

A

Downward b/c short, upward-curving auditory canal

111
Q

How is the Eustacian tube different in kids?

A

It’s wider, shorter and more horizontal

112
Q

Low set ears are frequently associated with which organ disorders?

A

Kidney

113
Q

Why can the red reflex be seen in normal infants?

A

Crying causes dilation of blood vessels; don’t assume infection right away

114
Q

Would you expect to see tympanic membrane redness with middle ear effusions?

A

NO, that’s otitis media. Effusions have retracted membranes & yellowish color

115
Q

Nasal crease is usually seen with which common condition?

A

Allergies; also may have mouth breathing, allergic shiners, allergic salute (which causes the nasal crease)

116
Q

What is choanal atresia?

A

Congenital nasal obstruction of the posterior nares; leads to respiratory distress and difficulty feeding

117
Q

T/F: Don’t depress the tongue of an infant b/c it stimulates the tongue thrust reflex which will make mouth visualization difficult.

A

True

118
Q

What is ankyloglossia?

A

Short frenulum, ‘tongue-tied’; may lead to feeding and eventual speech difficulties

119
Q

Are retention cysts normal?

A

Yes, (AKA Epstein Pearls); pearl-like cysts along gums that should disappear in 1-2 months

120
Q

How many deciduous teeth are there?

A

20; should appear between 6 months-2 years

121
Q

What is natal teeth?

A

Teeth in a newborn, usually removed to reduce risk of aspiration

122
Q

What is baby bottle syndrome?

A

Multiple cavities on upper/lower incisors due to putting the kid to bed with a bottle of milk/juice

123
Q

What is bruxism?

A

Unconscious grinding of teeth giving them flattened edges

124
Q

If the tonsils were observed halfway between tonsillar pillars and the uvula, how would you grade their size?

A

Grade 2+; (3+ nearly touching the uvula, 4+touching each other)

125
Q

What is epiglottitis?

A

Life-threatening condition from Haemophilus influenza B, common 3-7 y.o; S/S high fever, drooling, can’t swallow, tripod position, croupy cough

126
Q

Would you further inspect with a tongue blade if you suspected epiglottitis?

A

NO, could irritate further and hasten airway closure

127
Q

Word association with salty kiss?

A

Cystic fibrosis; due to a salt loss in the sweat

128
Q

What other organs are affected by cystic fibrosis?

A

Lungs; thick mucus with frequent pulmonary infections, Pancreas so they have sticky, foul smelling stools

129
Q

The distance between the nipples should be ___ of chest circumference,

A

1/4

130
Q

When is periodic breathing a concern?

A

If apneic episodes are prolonged or baby becomes cyanotic

131
Q

T/F: Crackles and ronchi may be heard after birth b/c fluid hasn’t completely cleared.

A

True

132
Q

What is laryngomalacia?

A

Floppy larynx cartilage resulting in noisy breathing, inspiratory stridor, wheezing; usually self limited w/ age

133
Q

What condition common under 6 months old is caused by respiratory syncytial virus?

A

Bronchiolitis

134
Q

A seal-like cough, not associated with fever common to very young kids (especially boys)?

A

Croup; if they had a fever think epiglottitis

135
Q

In fetu, blood passes directly from the r. atrium to the l. atrium via the __ ___.

A

Foramen ovale

136
Q

Both the foramen ovale and the ductus arteriosus should close within - hours.

A

24-48 hours

137
Q

A patent ductus arteriosus would present with what type of murmur?

A

Machinery; harsh, loud and heard throughout

138
Q

T/F: A patent foramen ovale is usually asymptomatic w/ occasional cyanosis upon exertion.

A

True

139
Q

If the baby appears purplish, what condition are you thinking?

A

Polycythemia

140
Q

Adult heart position is reached by age __.

A

7

141
Q

Where would you find the apical impulse on a case of dextrocardia?

A

The right

142
Q

What is different between dextrocardia and sinus invertus?

A

Dextro-only heart is on right

Sinus invertus-heart and stomach on right, liver on left

143
Q

What are some red flags when discussing murmurs?

A

Lasts longer than 2nd-3rd day of life
Fills systole
Any diastole involvement
Intense or radiates widely

144
Q

T/F: You should never hear a venous hum over the internal jugular vein in kids.

A

False: quite common in kids

145
Q

If blood pressure is read high multiple times on a kid, what 3 dDx are you thinking?

A

Kidney Dz
Renal arterial Dz
Coarctation of the aorta

146
Q

Where would the high blood pressure be found in coarctation of the aorta?

A

High in upper extremities

Low in lower extremities

147
Q

What are the 4 components of Tetralogy of Fallot?

A
  1. Rt. Ventricle Hypertrophy
  2. Pulmonary Valve Stenosis
  3. VSD
  4. Overriding aorta
148
Q

Where would the murmur be heard in Tetralogy of Fallot?

A

Systolic ejection murmur heard over the 3rd intercostal space

149
Q

Acute rheumatic fever is a complication of strep that may involve what valves?

A

Mitral or aortic

150
Q

Migratory polyarthritis, erythema marginatum, and a fever could be indicative of what?

A

Acute rheumatic fever

151
Q

Who is most commonly affected by Kawasaki Disease?

A

Boys under the age of 5

152
Q

What are the S/S of Kawasaki Disease?

A

Long lasting fever, red eyes, red tongue, rash, chapped lips

153
Q

T/F: Toddlers may have a normal ‘pot-belly’.

A

True; if past toddler age be suspicious of organ enlargement, feces, or other masses

154
Q

What is an umbilical hernia?

A

Protrusion of omentum & intestine thru umbilical opening

155
Q

What is the treatment for an umbilical hernia?

A

Generally close spontaneously by 1-2 years

156
Q

T/F: Diastasis recti can occur in kids and should be fixed surgically.

A

False: can occur but shouldn’t need surgery unless a herniation occurs. Otherwise diastasis recti resolve around 6 y.o

157
Q

Another name for Wilms Tumor?

A

Nephroblastoma

158
Q

What is the most common intraabdominal tumor of childhood?

A

Nephroblastoma, malignant

159
Q

What is Hirschsprung Disease?

A

No parasympathetic ganglion cells leading to no peristalsis

160
Q

What would you suspect if you found a sausage-shaped mass in the left or right upper quadrant?

A

Intussesception

161
Q

What age group does intussesception most commonly affect?

A

3-12 months

162
Q

How would pyloric stenosis palpate?

A

Olive-shaped mass in the right upper quadrant immediately after the infant projectile vomits

163
Q

What is congenital obstruction or absence of some or all of the bile duct system called?

A

Biliary atresia

164
Q

What are some S/S of biliary atresia?

A

Jaundice apparent @ 2-3wks, hepatomegaly, abdomen distention, light colored stools, dark urine, itchy

165
Q

What condition is due to meconium hardening in the lower intestion leading to blockage and distention?

A

Meconium Ileus

166
Q

What is omphalocele?

A

Intestine present in umbilical cord or protruding thru the umbilical area

167
Q

What inflammatory disease of the GI mucosa is associated with prematurity?

A

Necrotizing Enterocolitis

OB/Peds (3 decks)

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