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Gestation and Birth Flashcards

1
Q

What is the MC congenital heart defect?

A

VSD

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2
Q

At what gestational week is the heart formed?

A

week 7

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3
Q

At what gestational week does the midgut return from the umbilical cord to the abdominal cavity?

A

week 10

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4
Q

When does foramen ovale close?

A

around 3 months of age

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5
Q

What results with a failure of foramen ovale to close?

A

ASD

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6
Q

Failure of inter ventricular foramen to close results in?

A

VSD

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7
Q

What is ductus venosus?

A

continuation of the umbilical vein (oxygenated blood from placenta) to the IVC, past the left and right portal veins.

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8
Q

How does the ductus arteriosus close?

A

After birth, lungs expand and pulmonary artery pressure drops; then, aortic pressure is greater than the pulm. art., and this pushes the ductus arteriosus closed.

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9
Q

When does ductus arteriosus close?

A

within the first few days of life.

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10
Q

How does foramen ovale close?

A

increased pulmonary return increases LA pressure to higher than the RA

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11
Q

When is closure of foramen ovale complete?

A

by three months of life

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12
Q

What drug facilitates ductus arteriosus closure?

A

Indomethicin

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13
Q

What drug aborts ductus arteriosus closure?

A

Prostaglandin E1

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14
Q

When are fetal kidneys functional?

A

9 weeks gestation

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15
Q

What is a gestational complication of horseshoe kidney?

A

gets caught on the IMA during abdominal ascent

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16
Q

What is cryptorchidism?

A

failure of testicles to descend

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17
Q

What causes gastroschisis?

A

failure of intestines to return to the abdominal cavity

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18
Q

When does surfactant production begin?

A

24 weeks gestation

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19
Q

What is spin bifida?

A

failure of neural tube to close (unfused vertebral arch, possibly unfused dura mater and spinal cord)

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20
Q

What indicates fetal lung maturity?

A

amniotic fluid lecithin to sphingomyelin ratio > 3

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21
Q

What are the two sides of the placenta?

A

Amnion (maternal, from endometrium)

Chorion (fetal, from chorionic sac)

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22
Q

Name two drugs that do not cross the placenta

A

Heparin

Insulin

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23
Q

When is maternal alpha-fetoprotein high?

A

multiple gestations
fetal neural tube defects
gastroschisis

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24
Q

When is maternal AFP low?

A 
Trisomy 21 (Down's)
Trisomy 18 (Edward's)
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25
Name clinical features of congenital toxoplasmosis
microcephaly, hydrocephalus, intracranial calcifications, choreoretinitis, and seizures
26
Name clinical features of early congenital rubella
meningoencephalitis, microcephaly, cataracts, sensorineural hearing loss, and congenital heart disease (patent ductus arteriosus and pulmonary artery stenosis)
27
Name clinical features of congenital CMV
IUGR, low birth weight, petechiae and purpura, jaundice and hepatosplenomegaly, microcephaly, chorioretinitis, and intracranial calcifications. 5% neurologic deficits.
28
What is the MCC of abnormal AFP?
incorrect dates
29
What is the MC teratogen?
alcohol
30
Name clinical features of fetal alcohol syndrome
microcephaly and mental retardation, IUGR, facial dysmorphism (midfacial hypoplasia, micrognathia, short- ened nasal philtrum, short palpebral fissures, and a thin vermillion border), renal and cardiac defects, and hypospadias
31
Name clinical manifestations of congenital cocaine
intracranial hemorrhage, necrotizing enterocolitis, | cardiac, skull, and GU malformations, SIDS
32
Congential Tetracycline causes?
tooth discoloration; inhibits bone formation
33
What cardiac defect is assoc. w/ maternal Accutane use?
aortic arch abnormalities
34
Warfarin exposure in utero causes?
mental retardation, deafness, blindness, cartilage inhibition
35
What are the TORCH infections?
Toxoplasmosis, Other (HBV, syphilis, Varicella), Rubella, CMV, HSV/HIV
36
What cardiac effect does maternal lupus have?
First-degree AV block
37
What is the APGAR scale for?
assessing need for resuscitation scale of 0-10 (7-10 is normal) assess at 1 and 5 minutes
38
What prophylaxis is given at birth?
1% silver nitrate drops and Erythromycin or Tetracycline ointment (for GC) Vitamin K IM (prevent hemorrhagic disease)
39
Name the APGAR categories
Activity, Pulse, Grimace, Appearance, Respiration
40
Erythema Toxicum?
pustular rash; tunk, face, extremities; resolves in 1 week.
41
Mongolian Spots?
bluish; buttocks and back; African, Asian, Native American descent; fade over one year.
42
Capillary Hemangiomas?
AKA stork bites; pink spots; eyelids, forehead, back of neck; fade with time
43
When does the anterior fontanelle close?
9-12 months
44
Large fontanelle ddx?
hypothyroidism, osteogenesis imperfecta, chromosomal abnormalities
45
Macroglossia (large tongue) ddx?
hypothyroidism, Down's, Beckwith-Wiedemann
46
Brushfield spots?
salt-and-pepper speckling of iris, in Down's
47
What does leukocoria indicate?
retinoblastoma
48
Subconjunctival hemorrhage in newborn?
can occur after a traumatic delivery
49
Name the umbilical vessels!
two umbilical arteries, one umbilical vein
50
Signs of spina bifida?
back dimples or tufts of hair
51
What is hypospadia? epispadia?
Hypo- urethral opening on ventral penis | Epi - urethral opening on dorsal penis
52
Early vs Late onset "Small for Gestational Age"?
``` Early = before 28 wks; symmetric. Late = after 28 wks; asymmetric (normal head circumference) ```
53
Large for Gestational Age vs. Macrosomia?
``` LGA = > 90th percentile weight Macrosomia = > 4 kilograms ```
54
MC bone fx during delivery?
clavicle fx
55
Diminished femoral pulses, think ____
Coarctation of the aorta!
56
MCC newborn abdominal mass?
enlarged kidney
57
Caput succedaneum?
Crosses midline and suture lines! | Edema of the area of scalp the presents during a vertex delivery; assoc. w/ bruising & petechiae.
58
Cephalohematoma?
Does not cross suture lines! | Bleeding below periosteum (usually of parietal bone)
59
What is molding?
Skull asymmetry from overlapping bones after delivery; normal head shape regained in 1 week
60
What is Klumpke's Palsy?
Hand paralyzed, absent grasp reflex, Claw hand; Affects C7, C8 and T1 nerve roots; often accompanied by Horner's
61
What is Erb's Palsy?
Arm adducted, extended, internally rotated; grasp reflex intact Affects C5, C6 nerve roots
62
How does early onset Group B Streptococcus infection present in the newborn?
shortly after birth, sepsis-like (resp. distress, apnea, cyanosis, hypotension)
63
How does late onset GBS infection present in the newborn?
after 1st week of life; meningitis (bulging fontanelle, lethargy, irritability, vomiting, and seizures)
64
What is the principal cause of gram-negative sepsis and meningitis in newborn?
E. coli
65
What are the 3 patterns of HSV infection acquired at birth?
1) Cutaneous (after 7-10 days) 2) Encephalitic (2nd to 3rd week) 3) Disseminated (sepsis-like)
66
How does Chlamydia acquired at birth present?
1) Conjunctivitis (few to several days) | 2) Pneumonia (3-19 weeks)
67
Name some common features of congenital Syphilis
intermittent fever, osteitis and osteochondritis, hepatosplenomegaly, lymphadenopathy, persistent rhinitis, maculopapular rash (palms and soles)
68
Name late manifestations of congenital Syphilis
saddle nose deformity, saber shins, frontal bossing, Hutchison teeth, mulberry molars, Clutton's joints
69
How can vertical transmission of HIV be reduced?
Maternal AZT in the 2nd trimester
70
Signs of HIV in the newborn?
persistent thrush, lymphadenopathy, hepatosplenomegaly, severe diarrhea, failure to thrive, recurrent infections
71
What are signs of developmental dysplasia of the hip?
asymmetry of groin skin folds, shortening of affected leg
72
What is the Ortolani maneuver?
ABDUCTION of the hips by using gentle inward and upward pressure over the greater trochanter
73
What is the Barlow maneuver?
ADDUCT the hips by using the thumb to apply outward and backward pressure; clicks of reduction and dislocation are elicited in patients with hip dislocation
74
What is the MC presentation of cystic fibrosis in the neonate?
meconium ileus
75
How does meconium ileum present?
failure to pass stool, abdominal distention, vomiting
76
Signs & Sx of Diaphragmatic Hernia?
Respiratory distress at delivery, tachypnea, poor breath sounds on affected side, SCAPHOID ABDOMEN

Pediatrics (5 decks)

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