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Old Peds > Lecture 1- 9/24 > Flashcards

Lecture 1- 9/24 Flashcards

1
Q

what are some things that can happen to an infant of a diabetic mom?

A

hypoglycemia/ hypocalcemia
cardiac disease
big baby (possibility for birth injury)

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2
Q

What time period is a baby considered a neonate?

A

First 28 days of life

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3
Q

What can moms with antiphospholipid syndrome have?

A

Start forming clots

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4
Q

What can happen with a mom with lupus?

A

baby can have a greater chance of a heart block at birth

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5
Q

What can GBS + mom cause in baby?

A

Pneumonia, sepsis

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6
Q

When do congenital infections occur?

A

Earlier in the pregnancy and have affected the infant

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7
Q

If the baby was born after PROM, what is the greater risk of?

A

Infection

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8
Q

What is the amniotic fluid needed for?

A

Cushion

Helps to grow the lungs (baby practices breathing)

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9
Q

Why does polyhydramnios occur?

A

Baby isn’t swallowing the amniotic fluid isn’t getting in and out

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10
Q

What problems can polyhydramnios indicate?

A

intestinal obstruction, inability to swallow (inherited neuromuscular disease)

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11
Q

Before baby is born, was baby’s BP higher or lower than moms?

A

Lower

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12
Q

what does the Ballard exam do?

A

Helps us figure out how old the baby is (gestation week wise)

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13
Q

What are post term infants at higher risk for

A

Asphyxia
Meconium aspiration
Trisomies and other syndromes

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14
Q

WHat is SGA?

A

Small for Gestational Age for weight, height, head circumference.
<10% for growth parameters

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15
Q

What is asymmetric SGA?

A

Head is within normal range but rest are small.

Impacted later in development (brain growth is still following normal course)

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16
Q

For symmetric SGA what should you think?

A

Infection (TORCH)

Chromosome problem

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17
Q

What should you think for asymmetric SGA?

A

problems with placenta
Mom’s HTN (decreased BF to baby)
later infection/ stress

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18
Q

Within one hour what ointment do baby’s get in their eyes?

A

Erythromycin (GC)

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19
Q

What is giving within 4 hours of a baby being born?

A

Vit K 1 mg IM

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20
Q

When is HepB vaccine given?

A

Often before discharged.

If mom is Hep B+ give vaccine + HBIG

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21
Q

What does the newborn screen look for?

A

Set of genetic conditions, inborn errors of metabolism, sickle cell, etc

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22
Q

What are 5 common problems of term newborns?

A 
Birth trauma
jaundice
hypoglycemia
respiratory distress
In utero drug exposure
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23
Q

What is HIE?

A

Hypoxic Ischemic Encephalopathy

Do whole body cooling to spare brain tissue

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24
Q

What are some reasons for jaundice?

A

Baby not pooping
Liver not working
Lot of RBCs breaking down (making a lot of bilirubin) from Rh incompatibility
Large hematoma due to extraction

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25
Q

When does jaundice peak in a term baby?

A

Days 3-5

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26
Q

When does jaundice peak in a preterm baby?

A

Days 5-7 or more

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27
Q

What does kernicteris cause?

A

Irreversible damage in the basal ganglia

bilirubin encephalopathy

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28
Q

In newborns, what is hypoglycemia?

A

<40 mg/dl

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29
Q

When can newborns be hypoglycemic?

A

LGA (high insulin)
SGA (little glucose stores)
stressed (used all glucose)
IDM

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30
Q

What is TTN?

A

Transient tachypnea of the Newborn

happens from a slow transition of amniotic fluid otu of the lungs

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31
Q

Are pneumonias typically symmetric or asymmetric?

A

Asymmetric

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32
Q

What is one way to diagnose TTN?

A

No crisp border around the heart (“shaggy border”) fluid is layering out between the lungs

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33
Q

What is congenital diaphragmatic hernia?

A

Intestines have grown where the lungs should be

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34
Q

Do cocaine and meth cause withdrawal in the baby?

A

No, but can cause small babies because of vasoconstriction

35
Q

What is the most common preventable cause of mental retardation?

A

Alcohol

36
Q

What infants will have withdrawal?

A

Moms on opioids

37
Q

What is RDS?

A

Respiratory Distress Syndrome

Means you are missing surfactant

38
Q

What are symptoms of RDS?

A

grunting
cyanosis
tachypnea
CXR showing underexpansion, haziness with air bronchograms

39
Q

Why do premies have apnea?

A

immature brainstem

40
Q

How do you treat apnea of prematurity?

A

Caffeine

41
Q

Are PDAs more of a problem for preterm or term babies?

A

Preterm

42
Q

What is NEC?

A

Necrotizing Enterocolitis
movmenet of gut flora into the bowel wall/ musculature
leads to infection, necrosis, and perf

43
Q

How do you treat NEC?

A

antibiotics if early and no perf

surgery if perf

44
Q

What are symptoms of NEC?

A

emesis
abdominal distention
blue abdomen
bloody stool

45
Q

When should you listen to an infant’s heart lungs and abdomen.

A

When the infant is quiet, in the beginning

46
Q

What is the average head circumference of an infant?

A

34-35cm

47
Q

Is phimosis normal in a infant male?

A

Yes

48
Q

What infant population is intraventricular hemorrhage common (IVH) in?

A

Born <30 weeks due to cluster of vessels near the center of the brain

49
Q

What grade of IVH is with blood at germinal matrix, has spontaneous resolution.

A

Grade 1

50
Q

What grade IVH has blood in ventricles with enlargement of ventricle.

A

Grade 3

51
Q

What grade of IVH has blood in ventricles, usually spontaneous resolution.

A

Grade 2

52
Q

What grade of IVH has bleeding beyond ventricles into the parenchyma. Can possibly lead to cerebral palsy

A

Grade 4

53
Q

How do you diagnose IVH?

A

Head ultrasound

54
Q

How do you treat IVH?

A

Supportive therapy

55
Q

Early onset newborn infection is how many days?

A

0-7 days

56
Q

Late Onset newborn infection is how many day?

A

8-28 days

57
Q

What are 4 things that can cause early onset neonatal infections?

A

GBS
E. Coli
Klebsiella
Listeria

58
Q

How do you treat early onset neonatal infections

A

Ampicillin and Gentamicin 7-10 or 14-21 days

59
Q

How do infants with early onset neonatal infections present?

A

pale
respiratory failure
hypotensive
DIC

60
Q

If a infant presents after they had went home from the hospital and are lethargic, have poor feeding, fever, bulging fontanel, and seizures what should you suspect?

A

Late onset sepsis

61
Q

What are some main causes of bacteremia?

A

E. Coli
S. aureus
S. epi

62
Q

What are some main causes of osteomyelitis?

A

GBS

Staph aureus

63
Q

What labs will you order for an infant with sepsis?

A 
CBC w/ diff
blood culture
CRP
Urinalysis and culture
CSF
Blood gas
Chem 7 
CXR
64
Q

What does TORCH stand for?

A 
Toxoplasmosis
Other (syph, parovirus, varicella)
Rubella
CMV
HSV, HIV
65
Q

What tests do you use for TORCH conditions?

A

IgM

66
Q

If a infant presents with a blueberry muffin rash (petechiae) and thromobycytopenia what should you suspect?

A

Congenital rubella

67
Q

What problems can result from congenital rubella syndrome?

A

Eye lesions- cataracts, glaucoma

Sensorineural deafness

68
Q

What is the most common congenital infection?

A

CMV

69
Q

What does human parovirus B19 cause?

A

Aplastic anemia

Bone marrow suppression

70
Q

If an infant presents with peeling rash on soles of feed and hands and bone lesions what should you suspect?

A

Congenital syphilis

71
Q

How do you treat congenital syphilis?

A

Penicillin

72
Q

If an infant presents with microcephaly, prominent eyes, blue sclerae, recurrent infections, what should you suspect?

A

HIV

73
Q

How is transmission of HIV from mom to baby decreased?

A

AZT and c-section

74
Q

birth defect in which an infant’s intestines stick out of the body through a defect on one side of the umbilical cord. Just the intestines

A

Gastroschisis

75
Q

s a birth defect in which the infant’s intestine or other abdominal organs stick out of the belly button (navel). Still a sack

A

Omphalocele

76
Q

Why is large labia major common in female infants?

A

Maternal hormones

77
Q

Describing a bend or curvature of the fifth fingers (the “little fingers”) toward the adjacent fourth fingers

A

Clinodactyly

78
Q

A condition where 2 or more digits are fused together

A

syndactyly

79
Q

single line that runs across the palm of the hand.

A

Simian crease

80
Q

What reflex is where you stroke fingernail along spine and infant should curve laterally to that side.

A

Gallant reflex

81
Q

Reflex where you drop the infant’s head a few inches and their arms and fingers should extend.

A

Moro reflex

82
Q

Reflex where you stroke at the corner of the babies’ mouth, they will open their mouth and turn to the stimulated side.

A

Rooting reflex

83
Q

a swelling over one or both parietal bones that is contained within suture lines

A

Cephalohematoma

84
Q

Edema of the scalp over presenting parts that crosses suture lines

A

caput succedaneum

Old Peds (15 decks)

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