High Yield Peds Review Flashcards
What does APGAR tell you?
info about how the newborn tolerated labor (1 min) and newborn’s response to resuscitation (5 min)
Newborn PE with edema crossing suture lines
caput succedaneum
Newborn PE with fluctuance edema that doesn’t cross suture lines
Cephalohematoma
Newborn PE see area of alopecia w/ orange colored nodular skin?
nevus sebaceous
How do you treat newborn w/ nevus sebaceous?
remove before adolescnec b/c it can undergo malignant degeneration
Newborn PE see skin area w/ thick, yellow/white oily scale on inflam base?
seborrheic dermatitis
How do you treat newborn seborrheic dermatitis?
gently clean with mild shampoo
What are the 2 most important neonatal screening tests?
- Phenylketonuria
2. Galactosemia
What’s Phenylketonuria? What are s/s
Deficiency in phenal hydrolxalase; S/s: MR, vomting, athetosis, seziures, developmental delay over 1st few months, fair hair/eyes/skin, musty smell
How do you treat PKU?
low phen diet
What’s galactosemia?
deficiency in G1P-uridyl transferase leads to G1P accumuation in kidneys, liver, brain
What are s/s of glactosemia? How do you treat them?
MR with direct hyperbili & jaundice, hypoglycemic, cataracts, seizures
Tx: lactose free diet
What are newborns with galactosemia predisposed to?
predisposed to E. coli sepsis
3 day old with bili at 10, direct: 0.5. Eating and pooping well. What does he have? What causes it? Treatment?
Physiologic jaundice due to immature liver conjuncation
Should be gone by 5th DOL
7 day old with bili 12, direct: 0.5. Dry mucous membranes, not gaining weight. What does he have and what causes it?
Breastfeeding jaundice due to decreased feeding leads to dehydration, retained meconium and reabsorption of deconjungated bili
14 day old bili 12, direct: 0.5. Baby regained birth weight, otherwise healthy. What does he have and what causes it?
Breastmilk jaundice due to glucuronidase in breastmilk that deconjuncates bili
1 day old with bili: 14, direct: 0.5. What’s the biggest concern? What’s the next thing you do?
pathological jaundice on 1st DOL with bili >12, direct bili > 2 or rate of rise > 5/day. Want to do Coombs test
What does it suggest if coombs test is positive or negative for patholgical jaundice (1 day old with bili of 14, direct: 0.5)
If positive means Rh or ABO incompatability
If negative means twin/twin or mom/fetus transfusion, IDM, spherocytosis, G6PDH deficiency, etc
7 day old with dark urine, pale stool, bili 12, direct bili: 8 and elevated LFTs. What’s the concern? Tx?
biliar atresia. Bile ducts can’t drain bile causing liver failure. Needs surgery
What are some causes of direct hyperbilirubenemia in newborn?
biliary atresia (see w/ elevated LFTs, pale stool, dark urine), sepsis, glactosemia, hypothyroidism, choledochal cyst, CF, dubin johnson, rotor
What are 2 random inherited causes of indirect hyperbili?
- Gilberts: decreased glycoronyl transferase levels (norm conjugates bili)
- Crigler-Najjar (type 1): total defieciency in glycoronyl transferase
What are 2 randominherited causes of direct hyperbili?
DiRect
- Dubin Johnson: see black liver, can’t see GB, hepatocytes can’t secrete conjugated bili. benign AR
- Rotor syndrome: norm liver, benign AR
Why do we care about hyperbilirubinemia?
indirectbil can cross BBB and deposit in BG and brainstem nuclei causing kernicterus (esp if bili >20)
What’s the treatment for hyperbilirubinemia and how does it work?
phototherapy ionizes unconjugated bili so it can be excreted. Double volume exchange transfusion if that doesn’t work
What the biggest concern w/ baby born w/ respiratory distress, scaphoid abd and CXR with bowels in thoracic cavity? How do you treat it?
Diaphragmatic hernia can cause pulm hypoplasia
Tx: if dx prenatally, delivery at place w/th ECMO, let lungs mature 3-4 days then do surgery
Baby born with respiratory distress and excess drooling, concern? how to test?
TE-fistula
Dx: place feeding tube, take XR, it would coil in thorax
If a baby has TE-fistula, what else would you want to look for?
VACTER assoc anomalies: vertebral, anal atresia, cardiac, TE-fistula, radial and renal anoms
1 wk old baby becomes cyanotic with feding, pink when cries?
Choanal atresia
What else do you look for in choanal atresia?
CHARGE assoc anomalies - coloboma, heart defects, atreia choanal, retarded growth, GU anomalies, ear anomalies/deafness
32 wk premie with dyspnea, RR of 80 with nasal flairing? Tx?
RDS
Tx: O2 w/ nasap CPAP to keep alveoli open
What are prenatal dx for RDS, how do you train it?
L/S <2
Tx: antenatal betamethasone
38 wk LGA infant born by C/S to A2GDM has dyspnea and grunting? Tx?
Transient tachypnea of newborn (TTN) due to retained lung fluid
Tx: min. O2 needed, self-resolves in hours to days
41 wk AGA infant born after ROM yielded green/brown fluid? Tx?
Meconium aspiration syndrome
Tx: intubate and suction before stimulation
