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NB peds Flashcards

1
Q

Normal RR for NB?

A

40-60 breaths per min

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2
Q

Normal HR for NB?

A

120-160 BPM

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3
Q

most likely cause of conjunctivitis in NB at day 1?

A

chemical irritation (due to silver nitrate)

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4
Q

most likely cause of conjunctivitis in NB at day 2-7?

how do you tx it?

A

Neisseria gonorrhea

ceftriaxone

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5
Q

most likely cause of conjunctivitis in NB at day >7?

tx?

A

Chlamydia trachomatis

tx: oral erythromycin

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6
Q

most likely cause of conjunctivitis in NB in NB >3weeks?

tx?

A

herpes simplex

tx: systemic acyclovir, topical vidarabine

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7
Q

2 abx drops given to NB to prevent ophthalmia neonatorum?

A

erythromycin or tetracycline ointment

silver nitrate solution

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8
Q

what screening tests MUST be performed before d/c?

A

PKU, CAH, biotinidase, B thal, galactosemia, hypothryoid, homocysteinuria, CF

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9
Q

G6PD deficiency

A

Xlinked R
defect -> dec. glutathione -> inc. RBC susceptibility to ox. stress -> HA

(enzyme needed to regen NADPH, which is nec to regen reduced glutathione)

triggers: sulfa drugs, antimalarials, infxn, fava beans
- back pain/hemoglobinuria a few days later
- Heinz bodies and bite cells

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10
Q

PKU

A
  • AR
    cause: deficient in phenylalanine hydroxylase (PAH) or tetrahydrobiopterin cofactor (less common)
  • symptoms: MR, light skin, seizures, musty body odor
    tx: avoid phenylalanine until 16, increase tyrosine in diet
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11
Q

classic galactosemia

A

AR

  • lack of galactose 1Puridyltransferase (can’t convert galactose1P to glucose1P)
    symp: FTT, MR, jaundice, heptatomeg, infantile cataracts
    tx: exclude galactose and lactose from diet
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12
Q

galactokinase deficiency

A

AR
can’t convert galactose to galactose 1P
- mild: galactose in blood/urine, infantile cataracts,

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13
Q

what does NB hearing test exclude?

A

congenital sensorinerual hearing loss

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14
Q

transient polycythemia of the NB

A

hypoxia during delivery -> EPO stim -> inc RBCs

infants first breath inc O2, drops EPO, normalizes

splenomegaly is NORMAL in NB

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15
Q

transient tachypnea of the NB

A

MC in C section (vaginal canal compresses rib cage, helping remove excess pulm. fluid)

  • excess fluid -> hypoxia
  • if >4 hrs of tachypnea = sepsis, get cx
  • if neuro signs (irritable, lethargic, temp, feeding probs) -> LP w/ CSF and cx
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16
Q

transient hyperbilirubinemia

A

infantile spleen removes excess RBCS w/ HbF

- breakdown of RBCs-> physiological release of Hb -> rise in bilirubin

17
Q

what cause subconjunctival hem in the NB?

A
  • passing thru birth canal: inc in intrathoracic pressure as chest compressed
18
Q

what are the major types of skull fx in the NB?

A
  1. linear (MC, no symp, no tx)
  2. depressed (can cause further cortical damage if no sx; elevate)
  3. basilar (most fatal)
19
Q

scalp injuries in NB?

A
  1. caput succadaneum (crosses suture lines; swelling of soft tissue)
  2. cephalohematoma (superiosteal hem; does NOT cross)
20
Q

Which roots are involved in Erb-Duchenne palsy?

A

C5-C6
unable to abduct, ext rotate, or supinate
best tx: immobilized

21
Q

Which roots involved in Klumpke?

A

C7/8 and T1

  • claw hand (lack of grasp reflex)
  • paralyzed hand w/ HORNER’s
22
Q

what causes facial nerve palsy in NB?

A

forceps injury

23
Q

causes of polyhdramnios?

A
  • neurologic: Werdnig-Hoffman (unable to swallow)

- GI: intestinal atresias

24
Q

causes of oligohydramnios?

A
  • prune belly syndrome
  • renal agenesis (incompatible w/ life)
  • flat facies
25
Q

what kind of defects to elevated AFP levels indicate?

A
  • neural tube and abdominal wall
26
Q

when should surgery be perfromed for umbilical hernia?

A

after age 4

likely to close spont by age 3

27
Q

what is the most common abdominal mass in kids?

A

wilms tumor

- highly assoc w aniridia

28
Q

Wilms tumors

A

aka nephroblastoma

  • large palpable unilat flank mass, and/or hematuria
  • lof mut of WT1/2 on chrom 11
  • dx 1) abd U/S 2) confirm w/ contrast CT

Beckwith Wiedemann syndrome (WT, macroglossia, organomegaly, hemihypertrophy)

WAGR (WT, aniridia, GU abnormalities, mentral Retardation)

29
Q

neuroblastoma

A
  • adrenal medulla tumor similar to pheochromocytoma
    • hypsarrthymia on EEG and opsomyoclonus **
      dx: increased VMA and metanephrines in urine
  • MC cancer in infancy
  • MC extracranial solid malignancy
30
Q

what is hydrocele a remnant of?

A

tunica vaginalis

- most resolve w/in 6 months

31
Q

after what age is orchipexy performed for cryptorchidism?

A
  • age 6mo-1yr
32
Q

hypospadias

A

opening or urethra on ventral side of penis

  • assoc w/ cryptorchidism/inguinal hernia
  • circumcision CI
33
Q

epispadias

A
  • opening on dorsal surface
  • assoc w/ urinary incont
  • eval for bladder extrophy

*****aPeds (6 decks)

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