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Pediatrics > Gestation and Birth > Flashcards

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
Q

Name clinical features of congenital toxoplasmosis

A

microcephaly, hydrocephalus, intracranial calcifications, choreoretinitis, and seizures

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26
Q

Name clinical features of early congenital rubella

A

meningoencephalitis, microcephaly, cataracts, sensorineural hearing loss, and congenital heart disease (patent ductus arteriosus and pulmonary artery stenosis)

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27
Q

Name clinical features of congenital CMV

A

IUGR, low birth weight, petechiae and purpura, jaundice and hepatosplenomegaly, microcephaly, chorioretinitis, and intracranial calcifications. 5% neurologic deficits.

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28
Q

What is the MCC of abnormal AFP?

A

incorrect dates

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29
Q

What is the MC teratogen?

A

alcohol

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30
Q

Name clinical features of fetal alcohol syndrome

A

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

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31
Q

Name clinical manifestations of congenital cocaine

A

intracranial hemorrhage, necrotizing enterocolitis,

cardiac, skull, and GU malformations, SIDS

32
Q

Congential Tetracycline causes?

A

tooth discoloration; inhibits bone formation

33
Q

What cardiac defect is assoc. w/ maternal Accutane use?

A

aortic arch abnormalities

34
Q

Warfarin exposure in utero causes?

A

mental retardation, deafness, blindness, cartilage inhibition

35
Q

What are the TORCH infections?

A

Toxoplasmosis, Other (HBV, syphilis, Varicella), Rubella, CMV, HSV/HIV

36
Q

What cardiac effect does maternal lupus have?

A

First-degree AV block

37
Q

What is the APGAR scale for?

A

assessing need for resuscitation
scale of 0-10 (7-10 is normal)
assess at 1 and 5 minutes

38
Q

What prophylaxis is given at birth?

A

1% silver nitrate drops and Erythromycin or Tetracycline ointment (for GC)
Vitamin K IM (prevent hemorrhagic disease)

39
Q

Name the APGAR categories

A

Activity, Pulse, Grimace, Appearance, Respiration

40
Q

Erythema Toxicum?

A

pustular rash; tunk, face, extremities; resolves in 1 week.

41
Q

Mongolian Spots?

A

bluish; buttocks and back; African, Asian, Native American descent; fade over one year.

42
Q

Capillary Hemangiomas?

A

AKA stork bites; pink spots; eyelids, forehead, back of neck; fade with time

43
Q

When does the anterior fontanelle close?

A

9-12 months

44
Q

Large fontanelle ddx?

A

hypothyroidism, osteogenesis imperfecta, chromosomal abnormalities

45
Q

Macroglossia (large tongue) ddx?

A

hypothyroidism, Down’s, Beckwith-Wiedemann

46
Q

Brushfield spots?

A

salt-and-pepper speckling of iris, in Down’s

47
Q

What does leukocoria indicate?

A

retinoblastoma

48
Q

Subconjunctival hemorrhage in newborn?

A

can occur after a traumatic delivery

49
Q

Name the umbilical vessels!

A

two umbilical arteries, one umbilical vein

50
Q

Signs of spina bifida?

A

back dimples or tufts of hair

51
Q

What is hypospadia? epispadia?

A

Hypo- urethral opening on ventral penis

Epi - urethral opening on dorsal penis

52
Q

Early vs Late onset “Small for Gestational Age”?

A 
Early = before 28 wks; symmetric.
Late = after 28 wks; asymmetric (normal head circumference)
53
Q

Large for Gestational Age vs. Macrosomia?

A 
LGA = > 90th percentile weight
Macrosomia = > 4 kilograms
54
Q

MC bone fx during delivery?

A

clavicle fx

55
Q

Diminished femoral pulses, think ____

A

Coarctation of the aorta!

56
Q

MCC newborn abdominal mass?

A

enlarged kidney

57
Q

Caput succedaneum?

A

Crosses midline and suture lines!

Edema of the area of scalp the presents during a vertex delivery; assoc. w/ bruising & petechiae.

58
Q

Cephalohematoma?

A

Does not cross suture lines!

Bleeding below periosteum (usually of parietal bone)

59
Q

What is molding?

A

Skull asymmetry from overlapping bones after delivery; normal head shape regained in 1 week

60
Q

What is Klumpke’s Palsy?

A

Hand paralyzed, absent grasp reflex, Claw hand;
Affects C7, C8 and T1 nerve roots;
often accompanied by Horner’s

61
Q

What is Erb’s Palsy?

A

Arm adducted, extended, internally rotated; grasp reflex intact
Affects C5, C6 nerve roots

62
Q

How does early onset Group B Streptococcus infection present in the newborn?

A

shortly after birth, sepsis-like (resp. distress, apnea, cyanosis, hypotension)

63
Q

How does late onset GBS infection present in the newborn?

A

after 1st week of life; meningitis (bulging fontanelle, lethargy, irritability, vomiting, and seizures)

64
Q

What is the principal cause of gram-negative sepsis and meningitis in newborn?

A

E. coli

65
Q

What are the 3 patterns of HSV infection acquired at birth?

A

1) Cutaneous (after 7-10 days)
2) Encephalitic (2nd to 3rd week)
3) Disseminated (sepsis-like)

66
Q

How does Chlamydia acquired at birth present?

A

1) Conjunctivitis (few to several days)

2) Pneumonia (3-19 weeks)

67
Q

Name some common features of congenital Syphilis

A

intermittent fever, osteitis and osteochondritis, hepatosplenomegaly, lymphadenopathy, persistent rhinitis, maculopapular rash (palms and soles)

68
Q

Name late manifestations of congenital Syphilis

A

saddle nose deformity, saber shins, frontal bossing, Hutchison teeth, mulberry molars, Clutton’s joints

69
Q

How can vertical transmission of HIV be reduced?

A

Maternal AZT in the 2nd trimester

70
Q

Signs of HIV in the newborn?

A

persistent thrush, lymphadenopathy, hepatosplenomegaly, severe diarrhea, failure to thrive, recurrent infections

71
Q

What are signs of developmental dysplasia of the hip?

A

asymmetry of groin skin folds, shortening of affected leg

72
Q

What is the Ortolani maneuver?

A

ABDUCTION of the hips by using gentle inward and upward pressure over the greater trochanter

73
Q

What is the Barlow maneuver?

A

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
Q

What is the MC presentation of cystic fibrosis in the neonate?

A

meconium ileus

75
Q

How does meconium ileum present?

A

failure to pass stool, abdominal distention, vomiting

76
Q

Signs & Sx of Diaphragmatic Hernia?

A

Respiratory distress at delivery, tachypnea, poor breath sounds on affected side, SCAPHOID ABDOMEN

Pediatrics (5 decks)

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