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Pedia > Neonate, Misc + CDB > Flashcards

Neonate, Misc + CDB Flashcards

1
Q

60% of newborns are jaundiced b/c spleen removes excess RBCs carrying HbF -> hemolysis -> high blood Hb -> high bilirubin

A

Transient hyperbilirubinemia of the newborn

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2
Q

when is jaundice in the newborn considered pathologic

A

Any of the following:

1) if appears on 1st day of life or after 1st 2 wks or persists after 2 wks
2) total bilirubin >5 mg/dL/day or >0.5 mg/dL/hr
3) total bilirubin >15 mg/dL
4) direct bilirubin >10% of TB
5) Persists beyond 1 week in term and 2 weeks in preterm

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3
Q

whats the most serious complication of pathologic jaundice in the newborn

A

kernicterus

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4
Q

how to treat pathologic jaundice in the newborn

A
  • phototherapy w/ blue-green light (12-20 mg/dL; 270 nm breaks down bilirubin to prevent kernicterus, toxic to retina)
  • exchange transfusion: if bilirubin >20-25 mg/dL
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5
Q

Icteric sclera, bilirubin level

A

> 2 mg/dL

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6
Q

AKA retrolental fibroplasia; ↓ vascularity of retina

A

ROP

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7
Q

Absence of UGDP causing an increase in indirect bilirubin. These infants present in the first 24 hrs and die within the 1st yr of life.

A

Crigler Najjar

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8
Q

Milder form of Crigler Najjar

A

Gilbert

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9
Q

___–>↑ UGDP enzyme–>↑ conjugation of bilirubin–>↓ unconjugated bilirubin; can help ↓ neonatal jaundice

A

Phenobarbital

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10
Q

Peak B1 at 12 mg/dL at 3rd DOL or 15 mg/dL at 5th DOL for premature infants

A

Physiologic jaundice

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11
Q

Criteria for physiologic jaundice

A

1) after 48 hrs of life 2) TB not increasing > 5 mg/dL/day 3) DB less than 10% of TB 4) Resolves by 1 week in term and 2 weeks in preterm

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12
Q

Jaundice is ALWAYS pathologic if

A

Bilirubin >15mg/mL; at first day of life

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13
Q

What are the two inborn disorders of metabolism that lead to an UNCOJUGATED hyperbilirubinemia?

A

Gilbert’s and Crigler-Najjar

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14
Q

Physiologic hyperbilirubinemia is seen ___, peaks at ___, and resolves over ___

A

After the first 24 hours of life, 3 days, 2 weeks

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15
Q

What are the Danger Signs in Jaundiced Infants?

A

(1) Family history of significant hemolytic disease, (2) Vomiting, (3) Lethargy, (4) Poor feeding, (5) Fever, (6) Onset of jaundice after the third day, (7) High-pitched cry

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16
Q

MCC of jaundice?

A

Unconjugated hyperbilirubinemia (indirect): physiologic and breastfeeding associated

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17
Q

Management for breast milk jaundice

A

stop breast feeding for 2-3 days, using formula instead; then resume nursing

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18
Q

Type of bilirubin increased in breast milk jaundice

A

Unconjugated

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19
Q

Onset of breastfeeding jaundice

A

3-4 DOL

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20
Q

Onset of breastmilk jaundice

A

7th DOL

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21
Q

Increases risk of physiologic jaundice

A

Preterm, diabetic mother, asian

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22
Q

Bilirubin levels drop rapidly when breastfeeding stops

A

Breastmilk jaundice

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23
Q

Causes of pathologic jaundice

A

1) Extrahepatic cholestasis (biliary atresia, choledochal) 2) Intrahepatic cholestasis (neonatal hepatitis, inborn errors of metab, TPN cholestasis) 3) Dubin-Johnson 4) Rotor 5) TORCH

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24
Q

To reduce incidence of breastfeeding jaundice

A

Frequent breastfeeding (>10/24h), discourage 5% dextrose or water

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25
Q

Bilirubin level if breastfeeding is continued in breast milk jaundice

A

Gradually decreases but may persist up to 10 weeks at lower levels

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26
Q

Type of bilirubin increased in breastfeeding jaundice

A

Unconjugated

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27
Q

Metabolic causes of direct hyperbilirubinemia

A

DiRect: Dubin Johnson and Rotor

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28
Q

Enzyme responsible for conjugation in liver

A

UDP glucuronyl transferase

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29
Q

Inherited form of non-hemolytic jaundice

A

Crigler-Najjar syndrome

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30
Q

More severe type of Crigler-Najjar syndrome

A

Type I

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31
Q

Crigler-Najjar syndrome, arias syndrome

A

Type II

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32
Q

Autosomal recessive disorder that causes increase of conjugated bilirubin without elevation of liver enzymes

A

Dubin-Johnson

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33
Q

MC hereditary cause of increased bilirubin

A

Gilbert

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34
Q

Non-itching jaundice

A

Rotor

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35
Q

Mechanism of phototherapy for jaundice

A

Geometric photoisomerization of unconjugated bilirubin (lumirubin)

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36
Q

Inhibits heme oxygenate hence may be used in treatment of hyperbilirubinemia

A

Metalloporphyrins

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37
Q

In exchange transfusion ___% of circulating RBCs is replaced when an equivalent of 2 neonatal blood volumes is used

A

85%

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38
Q

T/F Hyperbilirubinemia in neonates is benign in most cases

A

T

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39
Q

Absence or reduction in number of bile ducts; results from progressive destruction of the ducts

A

Alagille syndrome

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40
Q

Jaundice, approximate levels for involvement: 4 to 8 mg/dL

A

Head and neck

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41
Q

Jaundice, approximate levels for involvement: 5-12 mg/dL

A

Upper trunk

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42
Q

Jaundice, approximate levels for involvement: 8-16 mg/dL

A

Lower trunk and thighs

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43
Q

Jaundice, approximate levels for involvement: 11-18 mg/dL

A

Arms and lower legs

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44
Q

Jaundice, approximate levels for involvement: 15 mg/dL

A

Palms and soles

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45
Q 
Unconjugated hyperbilirubinemia (indirect): When an infant’s indirect (unconjugated )serum bilirubin level is >
\_\_\_
A

10 mg/dL

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46
Q

Serious sequelae of NEC

A

Intestinal strictures, malabsorption, fistulae, and short bowel syndrome (in case of surgery)

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47
Q

Caused by proliferation of immature retinal vessels due to excessive use of oxygen; Can lead to retinal detachment and blindness in severe cases

A

ROP

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48
Q

Male vs female infants, more susceptible to neonatal infections

A

Male

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49
Q

Sepsis that may be seen from birth to 7 days, transmitted vertically or from the mother’s genital tract

A

Early-onset

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50
Q

Sepsis that may be seen from 8-28 days, transmitted vertically or from the postnatal environment

A

Late-onset

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51
Q

Sepsis with a fulminant course and associated with multi system pneumonia

A

Early-onset

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52
Q

Sepsis with a more insidious course and associated with focal infection (meningitis common)

A

Late-onset

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53
Q

Common risk factor for early and late onset sepsis

A

Prematurity

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54
Q

Sepsis that occurs most commonly among low birth weight infants

A

Nosocomial sepsis

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55
Q

Transplacentally transmitted infections

A

CMV, rubella, listeria, T. pallidum

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56
Q

Route of vertical transmission

A

Ascending or from passage through birth canal

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57
Q

Predominant pathogens in late-onset sepsis

A

S. aureus, coagulase negative staph, fungal infection, enterococcus, G- enteric bacilli

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58
Q

what are the TORCH organisms in congenital infections

A
  • T: toxoplasmosis
  • O: others; like syphilis, HepB, varicella
  • R: rubella
  • C: cytomegalovirus
  • H: herpes simplex
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59
Q

presentation of congenital toxoplasmosis

A

TRIAD:

  • chorioretinitis
  • hydrocephalus
  • multiple ring-enhancing lesions on CT (calcification)
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60
Q

how to dx congenital toxoplasmosis

A
  • IgM to toxoplasma(initial)

- PCR(accurate)

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61
Q

how to treat neonatal sepsis

A

-ampicillin + gentamicin

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62
Q

What is the main cause of Gram (-) sepsis and meningitis in the newborn?

A

E. coli

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63
Q

how to treat congenital toxoplasmosis

A

-pyrimethamine & sulfadiazine (with leucovorin for 1 year)

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64
Q

___ is given to patients treating with toxoplasmosis to counteract bone marrow depression in patients taking pyrimethamine and sulfadiazine

A

folinic acid

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65
Q

during what trimester is toxoplasma causes severe disease

A

1st trimester

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66
Q

test for toxoplasmosis

A

sabin felman dye test

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67
Q

Only in ___ can T. gondii complete its life cycle and produce oocysts

A

Cats

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68
Q

Transmission of T. gondii

A

Transplacentally during first trimester (17%, more severe); 3rd trimester (65%, transplacental or vaginal delivery, mild or inapparent)

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69
Q

Asymptomatic patients with toxoplasmosis are still at high risk of developing abnormalities especially ___

A

Chorioretinitis

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70
Q

T/F Treatment with TMP-SMX in toxoplasmosis will eradicate encysted parasite

A

F

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71
Q
  • rash on palms & soles
  • snuffles
  • frontal bossing(prominent forehead)
  • hutchinson triad: 8th nerve deafness + interstitial keratitis(corneal scarring) + hutchinson’s teeth
  • saddle nose
A

Congenital syphilis

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72
Q

how to dx congenital syphilis

A
  • VDRL/RPR (initial)

- FTA-ABS/dark field microscopy (accurate)

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73
Q

Olympian brow

A

-congenital syphilis: Frontal bossing

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74
Q

Higoumenaki’s sign

A

-congenital syphilis: Unilateral or bilateral thickening of the sternoclavicular portion of the clavicle

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75
Q

Mulberry molars

A

-congenital syphilis: Abnormal 1st lower molar

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76
Q

Rhagades

A

Congenital syphilis - linear scars on mouth, anus, genitals

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77
Q

Clutton joint

A

Congenital syphilis - painless knee joint swelling with sterile synovial fluid

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78
Q

Pseudoparalysis of Parrot

A

Congenital syphilis - Refusal to move involved extremity

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79
Q

Earliest manifestation of congenital syphilis

A

Snuffles

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80
Q

Transplacental transmission of syphilis can occur as early as as

A

6 weeks AOG

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81
Q

Phase of maternal syphilis wherein infection can most likely be transmitted

A

Primary or secondary, rather than latent disease

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82
Q

T/F Majority of affected live-born infants who have congenital syphilis are asymptomatic at birth

A

T

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83
Q

Early signs of congenital syphilis appear during

A

First 2 years of life

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84
Q

Early signs of syphilis is analogous to ___ phase of acquired syphilis

A

Secondary

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85
Q

Late signs of syphilis appear during

A

First 2 decades of life

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86
Q

Early vs late sign of syphilis: Periostitis of long bones

A

Early

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87
Q

Early vs late sign of syphilis: Renal involvement

A

Early

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88
Q

Early vs late sign of syphilis: CNS involvement

A

Early

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89
Q

Early vs late sign of syphilis: Mucous patches and condylomatous lesions

A

Early

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90
Q

Late signs of syphilis

A

Olympian brow, Saber shin, Hutchinson teeth, mulberry molars, saddle nose, rhagades, juvenile paresis, juvenile tabes, 8th nerve deafness, Clutton joint

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91
Q

Teeth manifestations of syphilis erupt when

A

6 y/o

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92
Q

Asymptomatic infants considered at risk for congenital syphilis should be evaluated if

A

1) Maternal treatment was inadequate, unknown, or undocumented 2) Maternal treatment was less than or equal to 30 days before delivery 3) Mother was treated with erythromycin or neopenicillin regimen 4) Maternal treponemal tigers did not decrease sufficiently to demonstrate a cure four-fold or greater

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93
Q

T/F Varicella infection is a contraindication to breatfeeding

A

T

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94
Q

Treatment for immunocompromised child/newborn exposed to varicella

A

VZIG

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95
Q

if the mother has varicella __ days prior to delivery she may pass the virus to the child but it is attenuated since there is Ab of the mother passed also.

A

more than 5 days

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96
Q

maternal varicela IgG can pass through the placenta at what aog

A

by 30 wks

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97
Q

neonate with cicatrical skin scarring with limb hypoplasia and neurologic manifestation

A

congenital varicella syndrome

98
Q

varicella vaccine is given when

A

total of 2 dose on 12-15 months and 4-6 year old

pag catch up na less than 12 – 2 dose 3 months apart and pag more than 12, 2 dose na 1 months apart

99
Q

new borns whose mother has varicella 5 days before delivery or 2 days after delivery should be given

A

1 vial of Varicella Ig

100
Q

Mode of admin of varicella vaccine

A

SC

101
Q

Content of varicella vaccine

A

Cell-free, live attenuated varicella virus

102
Q

Vaccine contraindicated in patients with anaphylactic reaction to vaccine, neomycin, or gelatine and those with altered immunity

A

Varicella vaccine

103
Q

Congenital Varicella Syndrome is caused by maternal varicella infection in ___ weeks of pregnancy

A

first 20 (VZV embryopathy) or last 3

104
Q

T/F Maternal varicella may cause premature delivery and miscarriage

A

T

105
Q

Congenital varicella causes ___ during 6-12 weeks AOG

A

Interruption of limb development

106
Q

Congenital varicella causes ___ during 16-20 weeks AOG

A

Eye and brain involvement

107
Q

T/F Varicella can congenitally cause ophthalmologic problems including Horner syndrome

A

T

108
Q

Treatment for infants with severe varicella

A

Acyclovir

109
Q

T/F, VZIG is not beneficial after clinical disease has developed

A

T

110
Q

Neonate

  • microcephaly
  • cataracts
  • sensorineural hearing loss
  • hepatosplenomegaly
  • thrombocytopenia
  • blueberry muffin rash
  • hyperbilirubinemia
A

Congenital rubella

111
Q

Congenital heart disease associated with rubella

A

PDA (other: pulmonary artery stenosis

112
Q

how to treat congenital rubella

A

supportive

113
Q

Dx test Rubella

A

Maternal IgM in neonatal serum

114
Q

in congenital rubella infection, what trimester results in severe defects (congenital rubella SYNDROME)

A

1st 8 wks of pregnancy

115
Q

Majority of infants acquire maternal rubella infection before ___ weeks

A

11

116
Q

MC clinical manifestation of rubella

A

Sensorineural hearing loss (then cataracts and glaucoma)

117
Q

Neonate

  • intracranial (periventricular) calcifications
  • microcephaly
  • chorioretinitis
  • hearing loss
  • petechiae
A

CMV (cytomegalic inclusion disease)

118
Q

how to dx congenital CMV

A
  • urine & saliva viral titers (initial)

- urine/saliva PCR (BEST)

119
Q

how to treat congenital CMV

A

-ganciclovir: if signs of end organ damage (not for asymptomatic infants due to side effects)

120
Q

Occurs when a mother has a primary CMV infection in the 1st trimester of pregnancy–>death of baby; greater risk of feral infection

A

Symptomatic congenital disease

121
Q

Occurs in the event of reactivation of CMV infection during pregnancy, maternal IgG passes transplacentally, protecting the infant from serious infection; less risk of feral infection

A

Asymptomatic congenital disease

122
Q

MCC of congenital infection

A

CMV

123
Q

MC manifestation of CMV

A

Chorioretinitis

124
Q

T/F Majority of infants with congenital CMV are asymptomatic at birth

A

T

125
Q

T/F Majority of congenital CMV develop long term complications (learning and hearing deficits)

A

T

126
Q

___ antibody test is of little diagnostic value in congenital CMV because it also reflects maternal Abs

A

IgG

127
Q

Negative ___ antibody test excludes diagnosis of CMV

A

IgG

128
Q

___ antibody test lacks sensitivity and specificity and unreliable for diagnosis of congenital CMV

A

IgM

129
Q

Neonate

  • skin eye mouth infections
  • CNS/systemic infection
A

HSV

130
Q

Treatment for congenital HSV

A

-acyclovir + supportive (14 days if limited to skin, eye, and mouth; 21 days if disseminated or localised in the CNS)

131
Q

CMV transmitted intrapartum, through infected blood or through breast milk, is not associated with ___ deficits

A

neurologic

132
Q

how to prevent conjunctivitis in a newborn (ophthalmia neonatorum) & who takes this precaution

A
  • erythromycin/tetracycline ointment + silver nitrate solution
  • given in delivery room to ALL newborns
133
Q

what are the 2 most common causes of ophthalmia neonatorum

A
  • n gonorrhoeae

- chlamydia trachomatis

134
Q

how to dx congenital herpes

A
  • tzanck smear(initial)

- PCR(accurate)

135
Q

presentation of congenital herpes by week

A
  • week 1: shock & DIC
  • week 2: vesicular skin lesions
  • week 3: encephalitis
136
Q 
Conjunctivitis, Most Likely Cause if symptoms start at:
Day 1-
Day2-7-
>7 Days-
>3 weeks-
A

Day 1- chemical irritation
Day 2-7- Neisseria gonorrhea
>7 Days- Chlamydia trachomatis
>3 weeks- herpes

137
Q

HSV is primarily transmitted through

A

Maternal genital tract from passage through birth canal

138
Q

Plan of delivery if primary herpes is detected in the 3rd trimester

A

Planned CS offered

139
Q

Plan of delivery if (+) herpes but no active lesions

A

Vaginal

140
Q

Hallmark of neonatal herpes

A

Vesicular rash present at birth or shortly thereafter

141
Q

Gold standard for diagnosis of HSV encephalitis

A

PCR

142
Q

T/F Serology is useful in neonatal HSV

A

F

143
Q

____ are very effective in reducing head injury by 85%

A

Helmets

144
Q

Pedestrian injury occurs during the day and peaks on

A

The afterschool period

145
Q

Major street should not be crossed until the child is ___ yrs old

A

10

146
Q

Begins at birth and includes the 1st mo of life

A

Newborn/neonatal period

147
Q

The average length and head circumference in a newborn

A

50 cm (20inch) and 35cm (14inch)

148
Q

low birth weight infants is defined as infants weighing less than ___

A

2.5 kg

149
Q

very low birth weight infants weighs ___

A

less than 1.5kg

150
Q

when fetal growth stops and over time decline to less than the 5th percentile of growth for gestational age or when growth proceeds slowly but absolute size remains less than 5th percentile

A

IUGR

151
Q

the first audible heart tones by fetoscope are detected at

A

18-20 weeks

152
Q

___ a rare cause of vomitting in infants that is demonstrated as obstruction at the cardiac end of the esophagus without organic stenosis

A

infantile achalasia ( cardiospasm)

153
Q

absence of rectal gas at 24 hours is abnormal. True or False?

A

TRUE

154
Q

a common early GI sign of Hirschsprung disease

A

vomiting with obstipation (severe or complete constipation)

155
Q

if there is increased indirect bilirubin with (+) Coombs test what is the possible diagnosis

A

Rh, ABO, other blood group

156
Q

jaundice in breastfed infants seen after the 7th day of life with maximal concentrations as high as 10-30mg/dl

A

breastfeeding jaundice

157
Q

breastmilk jaundice is attributed to the presence of ___ in some breast milk causing an increase in intestinal absorption of bilirubin

A

glucoronidase (pregnanediol: milk glucuronidase)

158
Q

kernicterus results from the deposition of un conjugated bilirubin in the ____

A

basal ganglia and basal nuclei

159
Q

what are the common initial signs of kernicterus

A

lethargy, poor feeding and loss of Moro

160
Q

dark greyish brown skin discoloration in infants undergoing phototherapy

A

bronze baby syndrome

161
Q

90% of Rh incompatibility is __ type

A

D type

162
Q

in Rh incompatibility the mother is Rh __ and the infant is Rh ___

A

mother is Rh (-) and child is Rh (+)

163
Q

injection of ____ into the mother immediately after the delivery of Rh + infant is successful in reducing Rh hemolytic disease

A

anti-D gamma globulin

164
Q

__ is performed to determine fetal hemoglobin levels and to transfuse packed RBC in serious fetal anemia

A

percutaneous umbilical blood sampling

165
Q

what is the treatment of choice for fetal anemia

A

intravascular (umbilical vein) transfusion packed RBC

166
Q

what are the indications for umbilical vein transfusion

A

hydrops

167
Q

Blue with feed

A

Choanal atresia

168
Q

Blue with cry

A

Tetrology of Fallot

169
Q

d/t estrogen withdrawal from mom

A

Newborn vaginal bleeding

170
Q

Sacral hair

A

Spina bifida occulta

171
Q

Acrochordon

A

Skin tag

172
Q

Midline cyst

A

Thyroglossal cyst (thyroid comes down from tongue)

173
Q

Lateral cyst

A

Branchial cleft cyst

174
Q

Extra nipples are always on ___ line

A

vertical

175
Q

Umbilical stump bleeding

A

Factor 13 deficiency

176
Q

Delayed umbilical cord separation (6 wk)

A

Leukocyte adhesion deficiency

177
Q

Congenital hip dislocation, spread both hips Out, feel for clunk

A

Ortolani [OUTolani]

178
Q

Congenital hip dislocation, bend knee & hip, feel for clunk w/ middle finger → do US

A

Barlow maneuver

179
Q

discrepancy btw chronological age & mental age

A

MR

180
Q

Touch cheek → they turn toward it

A

Rooting

181
Q

spread arms symmetrically when startled

A

Moro

182
Q

Used to support self on a surface, “fencing reflex

A

Tonic-Labyrinthine reflex

183
Q

what is the indication for intubation & ABG for a newborn

A

-if RDS or not breathing

184
Q

what are the normal newborn vitals(RR, HR)

A
  • RR: 40-60

- HR: 120-160

185
Q

what is the purpose of apgar score & when is it done?

A
  • quantifiable measure whether or not theres need for resuscitation
  • 1 min after birth(evaluates labor/delivery) & 5 min after birth(evaluates resuscitation response)
186
Q

is a low apgar score assoc w/ risk of cerebral palsy

A

no

187
Q

what is the apgar criteria

A
  • appearance(skin color): 0 = body is blue; 1 = normal except extremities; 2 = normal
  • pulse: 0 = 100
  • grimace(reflex irritability): 0 = no response; 1 = feeble cry; 2 = sneeze/cough
  • activity(tone): 0 = none; 1 = minor flexion; 2 = active movement
  • respiration: 0 = absent; 1 = weak/irregular; 2 = strong
188
Q

what is the most common complication that occurs to newborns who didn’t receive routine newborn care

A

-vit K deficiency: example = bright red blood per rectum/urine/umbilicus or intracranial bleeding(lethargy)

189
Q

does breast milk have vit K?

A

not enough

190
Q

what in the colon flora is required to produce sufficient vit K & what clotting factors need vit K

A
  • e coli

- 2, 7, 9, 10, C, S

191
Q

what prevention routine is taken in newborns to prevent vit k def bleeding

A

-single intramuscular vit K

192
Q

during hearing test in newborn, what is does this test exclude?

A

-congenital sensory-neural hearing loss: necessary for early detection to maintain speech & assess need for cochlear implants

193
Q

how to dx cystic fibrosis in newborn

A
  • sweat chloride test(initial): elevated sweat chloride

- genetic analysis of CFTR gene(accurate)

194
Q

what normal finding in the newborn is indicative of transient polycythemia of the newborn

A

-splenomegaly

195
Q

-hypoxia during delivery -> stimulates erythropoeitin -> highered RBC’s -> first breath -> highered O2 -> lowered erythropoeitin -> Hb normalization

A

transient polycythemia of the newborn

196
Q

if transient tachypnea of the newborn lasts >4 hrs, what is the new dx? and what must you do to evaluate it?

A
  • sepsis until proven otherwise

- blood & urine cultures

197
Q

if transient tachypnea of the newborn lasts >4 hrs, & pt also has presents w/ neuro signs, what tests must you order

A

-besides blood & urine cultures for sepsis eval: LP(CSF & culture)

198
Q

-benign minute hemorrhages caused by rapid intrathoracic pressure as chest compressed thru birth canal

A

subconjunctival hemorrhage of the newborn

199
Q

MC skull fracture in newborn

A

Linear

200
Q

Most fatal skull fracture in newborn

A

Basilar

201
Q

Skull fracture in newborn that needs surgery

A

Cortical

202
Q

swelling of soft tissues of scalp that crosses suture lines

A

caput succedaneum

203
Q

subperiosteal hemorrhage that does not cross suture lines

A

cephalohematoma

204
Q

the incidence of brachial palsy of the newborn is most common in

A

macrosomic infants of DM mothers

205
Q

how to treat any type of brachial palsy of the newborn

A

immobilization

206
Q

what is the most common newborn frx due to shoulder dystocia

A

clavicular

207
Q

what is the most common cause of facial nerve palsy of the newborn

A

-forcep trauma of the facial nerve during delivery

208
Q

how to treat facial nerve palsy of the newborn

A

-no treatment: recovers in time

209
Q

no abdominal muscles -> no urination

A

prune belly

210
Q

what is the most common cause of elevated AFP

A

-incorrect dating

211
Q

what congenital disease is omphalocele highly assoc w/

A

-edwards syndrome(trisomy 18)

212
Q

what congenital disease is umbilical hernia highly assoc w/

A

-congenital hypothyroidism

213
Q

when is surgical intervention indicated for umbilical hernia & why

A
  • after age 4: most spontaneously close at age 3

- prevent bowel strangulation & necrosis

214
Q

Most common causative agent of neonatal conjunctivitis

A

Chlamydial conjunctivitis

215
Q

When to not breastfeed

A

HIV infection, active pulmonary TB, malaria, typhoid fever, septicemia, women undergoing cancer tx, lithium, most Ab (except tetra); Very few contraindications. Everything else, BREASTFEED.

216
Q

Crying makes respiration better (improvement of cyanosis) b/c they use their mouths

A

choanal atresia

217
Q

Newborns lose weight right after birth, when do they regain their birth weight?

A

by 2 wks of age.

218
Q

PALMAR GRASP, when does it disappear?

A

by 2-3 months

219
Q

MORO reflex, when does it disappear?

A

4 MONTHS

220
Q

schwarzeneggar pose (passively turning the child’s head to one side causes the ipsilateral arm to extend and the contralateral arm to flex at the elbow )

A

Asymmetric Tonic Neck Reflex

221
Q

Asymmetric Tonic Neck Reflex, when does it disappear?

A

6 months

222
Q

must disappear before walking possible

A

plantar grasp reflex

223
Q

BABINSKI, when does it disappear?

A

persists up to 1-2 years

224
Q

most sensitive test for detecting developmental dysplasia of the hip

A

UTZ

225
Q

What age do most children start sleeping through the night?

A

4-6 months

226
Q

By what ages do children double and triple their birthweight?

A

double at 5mo, triple at 12mo.

227
Q

When do most children reach double their birth length?

A

4 years

228
Q

What are some possibilities when you cannot elicit the red reflex on eye exam?

A

ataracts, glaucoma, retinoblastoma and chorioretinitis

229
Q

postdates, grunting respirations, meconium staining, signs of air trapping, RR>100

A

meconium aspiration

230
Q

Most common cause of abdominal mass in a newborn?

A

enlarged kidney

231
Q

Infants above how many Kg are considered Macrosomic?

A

4kg

232
Q

What is considered Small for Gestational Age (SGA)?

A

birth weight

233
Q

How many blood vessels are in a normal umbilical cord? What are they?

A

2 arteries, 1 vein

234
Q

What are brushfield spots?

A

“salt and pepper” speckling (white spots) on the iris seen in downs

235
Q

What might a large fontanelle imply?

A

hypothyroidism, Osteogenesis imperfecta, chromosomal anomalies

236
Q

Maternal LUPUS (SLE) might lead to what in the neonate?

A

FIRST degree AV block

237
Q

When should stool switch from meconium and to what do they switch?

A

By the 3rd day of life, they should begin to appear yellow.

238
Q

How often/day and for how long do babies typically nurse

A

Babies usually nurse 8-12 times in 24 hours, and the feedings may initially range from 20 to 60 minutes (although consistently lengthy feeds may indicate a problem)

239
Q

Primitive reflexes

A

Palmar, rooting, moro, parachute

240
Q

Important risk factor for congenital hip dislocation

A

Female sex

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