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board exam review > Neonatal and Tanner Stages > Flashcards

Neonatal and Tanner Stages Flashcards

1
Q

Congenital Rubella Syndrome (3)

A
  1. Transplacental passage of rubella virus
  2. Dx: + viral culture, PCR, IgM antibodies
  3. Tx: isolate infant from pregnant woman; early intervention; refer to specialist
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2
Q

Congenital Rubella Syndrome, Early and Delayed S/S

A

Early S/S: cataracts, retinopathy, micropthalmost, glaucoma, retardation, congenital heart disease, deafness, FTT, blueberry muffin lesions, rash

Delayed S/S: 2-4 year delay –> diabetes, encephalopathy

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3
Q

Hepatitis B in Newborn (5)

A
  1. Transplacental passage of HepB virus
  2. Incubation: 60-150 days
  3. Dx: Serology, +surface antigen
  4. Tx: HepB vaccine in first 12 hours along with HepB gamma globulin to avoid perinatal experience
  5. Interferon used to treat chronic HepB
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4
Q

Newborn HepB S/S (8)

A
  1. Malaise
  2. Anorexia
  3. N/V and RUQ pain
  4. Fever
  5. HA
  6. Dark urine
  7. Rash
  8. Causes chronic carrier- later leads to hepatomegaly, jaundice, rash, arthralgia/arthritis
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5
Q

Neonatal HSV: Skin/Eyes/Mouth Type (2)

A
  1. Presentation in 1st 2 weeks of life

2. Cutaneous lesions where infant contacted mother’s genitals

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6
Q

Neonatal HSV: CNS Type (4)

A
  1. 2nd-3rd week presentation
  2. Seizures
  3. Apnea
  4. Neuro instability
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7
Q

Neonatal HSV: Disseminated Type (4)

A
  1. Presents in 1st week
  2. Acutely ill –> very sick
  3. Shock
  4. DIC
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8
Q

Neonatal HSV: Dx and Tx

A

Dx: + culture

Tx: Acyclovir 20mg/kg IV q8 for 21 days (CNS and Disseminated), 14 days for Skin, Eye, Mouth

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9
Q

Neonatal HSV in the context of an STI (4)

A
  1. Type 1 (Oral), or Type 2 (Genital) - sexually transmitted from asymptomatic carrier
  2. S/S: Painful vesicles/blisters with burning and irritation,, dysuria, systemic symptoms, extra-genital lesions, LAD
  3. Dx: + viral culture
  4. Tx: Acyclovir
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10
Q

Chlamydia Trachomatis in Newborn: Neonatal Conjunctivitis (3)

A
  1. Occurs 5-14 days after birth
  2. Conjunctival edema/injection, eye discharge, and pseudomembrane
  3. Tx: oral erythromycin for 10-14 days (also for pneumonia)
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11
Q

Chlamydia Trachomatis in Newborn: Neonatal Pneumonia (4)

A
  1. Occurs 2-19 weeks after birth
  2. Rhinorrhea, congestion, tachypnea with staccato cough, rales, wheezing rare
  3. Dx: culture, hyperinflation on chest x-ray with eosinophilia
  4. Tx: oral erythromycin for 10-14 days
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12
Q

Chlamydia as STI (4)

A
  1. Often asymptomatic
  2. S/S: spotting, vaginal discharge, dysuria, pyuria, mild abd pain, FB sensation in the eyes, cervicitis, conjunctivitis
  3. Dx: +culture
  4. Tx: one gram of Azithromycin PO for one dose (alternative: doxy/erythromycin or levofloxacin)
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13
Q

Newborn Gonococcal infection (5)

A
  1. Transmitted from vaginal secretions during delivery
  2. Conjunctivitis – injected/swollen conjunctiva, eye discharge that becomes thick, lid edema, can lead to blindness, corneal ulceration
  3. Other s/s - scalp abscess, sepsis, meningitis with fever, tachypnea, tachycardia
  4. Dx: culture
  5. Tx: silver nitrate/erytrhomycin opthalmic ointment, ceftriaxone/cefotaxime (if hyperbilirubinemia) for disseminated disease
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14
Q

Clinical course of HIV in newborn period (4)

A
  1. Transmitted via placenta during birth
  2. Can be asymptomatic for years
  3. Possible s/s: premature, LBW, recurrent infections, FTT, diarrhea, developmental delay, LAD, hepatosplenomegaly, CNS, parotitis
  4. Tx: ARV prophylaxis, ARV tx if positive culture and <12 months; consult ID specialist
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15
Q

Clinical Course of HPV (5)

A
  1. Viral infection
  2. Usually asymptomatic/subclinical but can cause pain
  3. S/S: warts which are cauliflower-like, appear 4-6 weeks after exposure, friable
  4. Dx: PAP test
  5. Tx: cryotherapy, podofilox solution
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16
Q

Congenital CMV (4)

A
  1. Herpes virus family, most infants are asymptomatic and CMV affects 1% of newborns
  2. S/S when symptomatic at birth: IUGR, poor growth, jaundice, purpura, hepatosplenomegaly, microcephaly, retinitis
  3. S/S (if asymptomatic at birth): sensorineural hearing loss, developmental delay
  4. Tx: primary prevention, refer to specialty for screening
17
Q

Cephalohematoma (4)

A
  1. Subperiosteal blood collection, non-ecchymotic, can overlie skull fracture, will appear several hours after delivery
  2. Does not cross suture line****
  3. Will resolve in weeks/months
  4. Can lead to prolonged hyperbilirubinemia
18
Q

Caput Succedaneum (3)

A
  1. Soft tissue edema/bruising from vaginal trauma during birth process
  2. Crosses suture line**
  3. Will resolve in 2-3 days
19
Q

Sexual Maturity Rating for Males: Development of External Genitalia Stage 1

A

Prepubertal

20
Q

Sexual Maturity Rating for Males: Development of External Genitalia Stage 2

A

Enlargement of scrotum and testes; scrotum skin reddens and changes in texture

21
Q

Sexual Maturity Rating for Males: Development of External Genitalia Stage 3

A

Enlargement of penis (length first); further growth of testes

22
Q

Sexual Maturity Rating for Males: Development of External Genitalia Stage 4

A

Increased size of penis with growth in breadth and development of glans; testes and scrotum larger and scrotum skin darker

23
Q

Sexual Maturity Rating for Males: Development of External Genitalia Stage 5

A

Adult genitalia

24
Q

Sexual Maturity Rating for Females: Breast Development Stage 1

A

Prepubertal

25
Q

Sexual Maturity Rating for Females: Breast Development Stage 2

A

Breast bud stage with elevation of breast and papilla; enlargement of areola

26
Q

Sexual Maturity Rating for Females: Breast Development Stage 3

A

Further enlargement of breast and areola; no separation of their contour

27
Q

Sexual Maturity Rating for Females: Breast Development Stage 4

A

Aerola and papilla form a secondary mound above level of breast

28
Q

Sexual Maturity Rating for Females: Breast Development Stage 5

A

Mature stage: projection of papilla only, related to recession of aerola

29
Q

Sexual Maturity Rating for Males and Females: Pubic Hair Stage 1

A

Prepubertal (can see vellus hair similar to abdominal wall)

30
Q

Sexual Maturity Rating for Males and Females: Pubic Hair Stage 2

A

Sparse growth of long, slightly pigmented hair, straight or curled, at base of penis or along labia

31
Q

Sexual Maturity Rating for Males and Females: Pubic Hair Stage 3

A

Darker, coarser and more curled hair, spreading sparsely over junction of pubes

32
Q

Sexual Maturity Rating for Males and Females: Pubic Hair Stage 4

A

Hair adult type, but covering smaller area than in adult; no spread to medial surface of thighs

33
Q

Sexual Maturity Rating for Males and Females: Pubic Hair Stage 5

A

Adult in type and quantity, with horizontal distribution (“feminine”)

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