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Pediatrics: Case Files > MedU Clipp Cases 1 and 2 > Flashcards

MedU Clipp Cases 1 and 2 Flashcards

1
Q

Infants born to adolescent mothers are at greater risk for?

A
  • Lower birth weight
  • Vertically acquired STIs (high inidence rate)
  • Poorer developmental outcomes
  • Increased risk of Fetal death
  • Additionally, pregnant teenager has an increased risk of premature death compared to her non-pregnant peers
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2
Q

HEEADSSS Questions?

A
  • Home
  • Education / Employment
  • Eating disorder screening
  • Activities / Affiliations / Aspirations
  • Drugs (EtOH, Tobacco, Steroids)
  • Sexuality (abuse, fights, weapons, seatbelts)
  • Suicide (depression, mental health)
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3
Q

Prenatal Effects of Tobacco?

A
  • Low birth weight in the Fetus
  • Characteristic facies
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4
Q

Prenatal Effects of Alcohol?

A
  • No “Safe” amount of alcolhol during pregnancy
  • FAS is a distinct pattern of facial abnormalitis, growth defeciencies, CNS dysfunction
    • Poor Motor skills
    • Poor Eye Hand Coordination
    • Learning Problems
      • Difficulties w/ Memory
      • Attention
      • Judgment
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5
Q

Prenatal Effects of Marijuana?

A
  • Distinctive effects of Marijuana have not been identified
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6
Q

Prenatal Effects of Cocaine?

A
  • Vasoconstriction
  • -> Placental insufficiency
  • -> Low Birth Weight
  • Deficits:
    • Cognitive performance
    • Information-processing
    • Attention to tasks
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7
Q

Maternal Factors Limiting Fetal Growth in Utero?

A
  • Poor weight gain in the 3rd Trimester
  • Preeclampsia
  • Maternal Prescription
  • Illicit Drug use
  • Maternal Infections
  • Uterine Abnormalities
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8
Q

Placental Factors Limiting Fetal Growth in Utero?

A
  • Placenta Previa
  • Placental abruptions
  • Abnormal Umbilical Vessel Insertions
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9
Q

Fetal Abnormalities Limiting Fetal Growth in Utero?

A
  • Fetal Malformations
  • Metaboic Disease
  • Chromosomal Abnormalities
  • Congenital Infections
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10
Q

Prenatal Lab Screening?

A
  • Serelogical screening for Infections
    • HIV
    • Rubella
    • Hepatitis B
  • Blood Type and Rh
  • Urine Drug screen
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11
Q

Factors that Increase Risk of HIV Transmission
from Mother to Infant?

A
  • Frequent, unprotected sex during pregnancy
  • Advanced maternal HIV disease (High Viral Load)
  • Membrane rupture > 4 hours prior to delivery if mother is not on anti-retroviral therapy
  • Vaginal Delivery
  • Breastfeeding
  • Premature delivery ( < 37 weeks)
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12
Q

GBS intrapartum antimicrobial prophylaxis?

A
  • < 37 weeks
  • Ruptured > 18 hours
  • Temp > 100.4 F (38 C)
  • Positive for GBS
  • Previous infant w/ GBS
  • GBS bacturia during any trimester
  • Positive GBS vaginal-rectal screening in late gestation
  • Unknown GBS status w/ onset of Labor
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13
Q

Steps used to decrease risk of HIV Transmission?

A
  • Treatment of anti-retroviral therapy if viral load > 1000 copies/mL
  • Cessarian delivery preferred
  • Formula feed infants (NO Breastfeeding)
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14
Q

Methods to Stabilize a Infant’s Tempature?

A
  • Skin-to-Skin contact
  • Radiant warmer
  • Incubator
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15
Q

Elements of APGAR score?

A
  • Apprearance (skin color)
  • Pulse (heart rate)
  • Grimace (reflex irritability)
  • Activity (muscle tone)
  • Respirations
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16
Q

What percentalie is Small for Gestational Age (SGA)?

A
  • Weight < 10th Percentile for Gestational Age
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17
Q

What Percentage is Microcephalic?

A
  • Head circumference < 10th Percentile for Gestational Age
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18
Q

Hypoglycemia in Newborns?

A
  • Decreased Glycogen storage
  • Heat Loss
  • Hypoxia
  • Decreased Gluconeogenesis
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19
Q

Hypothermia in Newborns?

A
  • Cold stress
  • Hypoxia
  • Hypoglycemia
  • Increased Surface Area
  • Decreased Subcutaneous Insulation
20
Q

Polycythemia in Newborns?

A
  • Chronic Hypoxia
  • Maternal-fetal Transfusion
21
Q

DDx of Microcephaly and Purpuric Rash?

A
  • TORCH infection
  • Fetal Alcohol Syndrome
  • Chromosomal Abnormality
  • Prenatal Tobacco Exposure
  • HIV Infection
22
Q

What does the O in TORCH stand for?

A
  • Other Transplacental Infections
    • HIV
    • Hepatitis B
    • Human Parvovirus
    • Syphilis
23
Q

What Labs do you order for TORCH testing?

A
  • Toxoplasma - Infant Toxoplasma Titer
  • Other
  • Rubella - Maternal and Infant Rubella Titer
  • CMV - Infant Urine Culture
  • Hepatitis B - Maternal Hepatitis B Surface Antigen (HBsAg)
24
Q

What are the Routine Newborn Medications?

A
  • Vitamin K
    • prevent Hemorrhagic disease (Vit. K def.)
  • Hepatitis B vaccine
    • > 2000 grams
    • HBIG - vertical transmission of Hep. B
  • Erythromycin (also Tetracycline or Silver Nitrate)
    • Gonococcal conjunctivitis
    • Chlamydia trachomatis conjunctivitis presents with a stachato cough 7 - 14 days later and neonatal prophylaxis does little to prevent Chlamydia conjunctivitis
25
Q

Neurological CMV findings?

A
  • Intracranial calcifications
  • Diminished number of Gyri
  • Abnormally thick Cortex (Lissencephaly or Agyria-pachygyria)
  • Enlarged Ventricles
26
Q

Sequelae of Congenital CMV?

A
  • Hearing Loss (progressive)
  • Microcephaly
  • Intracranial Calcifications
  • Hepatosplenomegally
  • Rash
27
Q

What is the Treatment for Congenital CMV?

A
  • 6 months Therapy:
    • Ganciclovir or Oral Valganciclovir
28
Q

Absolute Contraindictations for Breastfeeding?

A
  • Maternal HIV
  • Active Herpes Simplex lesions on the Breats
  • Active TB
  • Drug use and abuse
  • Infants w/ Galactosemia
29
Q

Signs and Symptoms of Metabolic Disorders?

A
  • Anorexia
  • Lethargy
  • Vomiting
  • Seizures
  • Metabolic Acidosis
  • Unusual Odors
30
Q

Anticonvulsants during pregnancy?

A
  • Leads to Cardiac Defects
  • Dysmorphic Craniofacial features
  • Hypoplastic nails
  • Distal phalanges
  • IUGR
  • Microcephaly
    • Mental Retardation
31
Q

Opiate use during pregancy appears as?

A
  • CNS Findings
    • Irritability
    • Hyperactivity
    • Hypertonicity
  • High-pitched Cry
  • Tremors
  • Seizures
  • GI (vomiting, diarrhea, weight loss, hunger, salvation)
  • Respiratory (nasal stiffness, sneezing, yawning)
32
Q

Fetal Alcohol Syndrom Facial Features?

A
  • Smooth Philtrum
  • Thinning of the Upper lip
  • Small Palpebral fissures
33
Q

Clinical features of PKU?

(Phenylketonuria)

A
  • Vomitting
  • Hypotonia
  • Musty Odor
  • Developmental delay
  • Decreased Pigmentation of the Hair and Eyes
  • Phenylalanine-restricted diet is necessary
34
Q

Caloric requirement of Term Infant?

A

100 - 120 cal/kg/day

35
Q

Caloric requirement for Preterm Infant?

A

115 - 130 cal/kg/day

36
Q

Caloric requiremtn for VLBW infants?

(Very Low Birth Weight)

A

up to 150 cal/kg/day

37
Q

Car Safety Guidelines for Kids?

A
  • Children < 13 y.o. should not sit in Front Seat
  • Until 2 y.o. –> Face rearward
  • Middle of Backseat is most protected position
  • Most effective seat is a 5-point harness
38
Q

2 month immunizations?

A
  • DTaP
  • Hib
  • IPV
  • PCV13
  • RotaV
  • HepB - 2nd dose
39
Q

What age should an infant double and tripple
their birth weight?

A
  • Double - 5 months
  • Triple - 12 months
40
Q

What age will children double their birth length?

A

4 years

41
Q

Absence of Red Reflex in infants suggests?

A
  • Cataracts
  • Glaucoma
  • Retinoblastoma
  • Chorioretinitis
42
Q

6 month milestones?

A
  • Gross Motor
    • Rolls over, Sits unsupported, No Head lag pull to sit
  • Fine Motor
    • Reaches for objects, Looks at dropped items
  • Language
    • Turns toward voice, Babbles
  • Social / Adaptive
    • Feeds self, Stranger recognition
43
Q

12 Month Milestones?

A
  • Gross Motor
    • Stands alone (many can walk well)
  • Fine Motor
    • Pincer Grasp
  • Language
    • Mama, Dada, and 1 or 2 other words
  • Social / Adaptive
    • Hands parents book wants to read
    • Points when wants something
    • Plays ball with examiner
44
Q

18 months old milestones?

A
  • Walk Backward
  • Run
  • Scribble
  • 2 Block Tower
  • 3 - 6 words
  • Can help remove Garments
45
Q

Wilm’s Tumor?

A
  • A/w Beckwith-Wiedemann Syndrome
  • Genetic overgrowth syndrome
  • Omphalocele
  • Hemihypertrophy
  • Hypoglycemia
  • Large for Gestational Age
  • Dysmorphic Features
46
Q

What is a favorable characterristic for Neuroblastoma?

A

Non-ampliffication of the N-myc gene

Pediatrics: Case Files (16 decks)

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