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GEN PEDS > NEONATOLOGY > Flashcards

NEONATOLOGY Flashcards

1
Q

Seen this in a newborn

What is the finding? What is the cause?

A

Erb-Duchenne palsy

(upper brachial plexus palsy involving C5-C7)

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2
Q

Seen this in a newborn

What is the finding? What is the cause?

A

Klumpke palsy

(lower brachial plexus palsy involving C8-T1)

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3
Q

Gross hematuria, a new mass palpable in flank of a newborn

What is going on?

A

Renal vein thrombosis (RVT)

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4
Q

When does physiologic jaundice start to become apparent? (earlier jaundice would likely be pathologic)

A

48-72 hours

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5
Q

Most common causes of neonatal sepsis? (3)

A

1 - E.coli
2 - Listeria
3 - GBS

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6
Q

An newborn refuses to move arm, with XR shows extensive bone destruction in the diaphyses and solid periosteal new bone formation

What is going on? What is the underlying cause?

A

Pseudoparalysis

Caused by congenitial syphillis

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7
Q

What is this finding? What is it associated with?

A

Scaphoid abdomen

Associated with congenital diaphragmatic hernia (CDH)

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8
Q

Displaced apical impulse, respiratory distress, bowel sounds over chest

What is going on?

A

CDH

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9
Q

What are long term risks for neonate with IUGR? (2)

A

1 - Metabolic syndrome
2 - Hypertension

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10
Q

Non-blanching, non-tender, bluish, flacutuant swelling lateral to midline of lower mouth, might displace tongue slightly to left

What is it? Cause?

A

Ranula

Pseudocyst associated with sublingual & submandibular glands

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11
Q

Short palpebral fissures, ptosis, long and smooth philtrum, thin upper lip

What is going on? What is the common associated heart disorder?

A

Fetal alcohol syndrome

Septal defects (ASD, VSD)

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12
Q

Which birth weight is associated with increased risk of neonatal hypoglycemia?

A

< 2500g

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13
Q

What gestational age is associated with increased risk of neonatal hypoglycemia?

A

< 37 wks GA

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14
Q

What is Galeazzi sign? How is it helpful?

A

Asymmetry in hieght of knees due to shortening of thigh on affected side

Used to detect dysplasia of hip in patients > 3mo

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15
Q

When Barlow & Ortolani tests no longer helpful?

A

3 months of age

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16
Q

What are risk factors for dysplasia of hip (DDH) in infants? (3)

A

1 - Girl
2 - Breech
3 - Family history of DDH

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17
Q

When weight loss in first 2 weeks of life is too much?

A

> 10%

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18
Q

Fleshy-color smooth surface lesion noted to protrude from inferior portion of the vagina of the newborn

What is it? Management?

A

Hymental tag

Reassurance

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18
Q

Fleshy-color smooth surface lesion noted to protrude from inferior portion of the vagina of the newborn

What is it? Management?

A

Hymental tag

Reassurance

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19
Q

What is this finding? Which syndrome is it associated with ?

A

“Mitten hand”
Syndactyly of the 2nd, 3rd, and 4th fingers and toes

Associated with Apert syndrome

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20
Q

When does lanugo disappear from face in fetus?

A

between week 33 and 37

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21
Q

When does hair becomes fine and wooly in fetus?

A

between 28 and 36 weeks

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22
Q

When rugae begins to develop on scrotum in fetus?

A

between 28 and 35 weeks

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23
Q

When vernix starts decrease in fetus?

A

~38 weeks

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24
Q

Duodenal treasia and endocardial cushion defect

Which syndrome?

A

Trisomy 21

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25
Q

Clenched hands, cystic hygroma, horseshoe kidney

Which syndrome?

A

Trisomy 18

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26
Q

Severe midline facial abnormalities, polydactyly

Which syndrome?

A

Trisomy 13

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27
Q

Fetal hydrops, coarctation

What is going on?

A

Turner syndrome

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28
Q

Limb defects (missing arms/legs), or ear malformation in newborn

Maternal exposure to what drug ?

A

Thalidomide

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29
Q

Limb defects (missing arms/legs), or ear malformation in newborn

Maternal exposure to what drug ?

A

Thalidomide

30
Q

What are newborn defects seen in maternal exposure to warfarin during pregnancy? (2)

A

1 - Nasal hypoplasia
2- Stippled epiphyses

31
Q

What are components of WAGR syndrome?

A

1- Wilm’s tumor
2- Aniridia
3 - GU malformations
4 - Reduced intellectual capacity

32
Q

Mass located anterior to the SCM muscle in a child

What is it?

A

Brachial cleft cyst

33
Q

Indurated, reddish nodules and plaques on lower back and buttocks of an infant with history of traumatic birth?

What are they? What is the potential risk?

A

Subcutaneous fat necrosis

Risk of hypercalcemia

34
Q

What are 5 components of APGAR score?

A

1 - Breathing
2 - Heart beat
3 - Muscle tone
4 - Grimace
5 - Skin color

35
Q

Which reflex can be elicited in healthy 1-yo

A

Parachute reflex

36
Q

Which type of medications can cause oligohydramnios of fetus?

A

ACEi

37
Q

Color differences in half part of the body, quickly returns to normal (within several minutes) with reposition, in first couple weeks of life.

What is it? Management?

A

Harlequin color change

Nothing (benign).

38
Q

Scant ear cartilage with pinna returns slowly from folding

What is estimated gestational age?

A

32-35 weeks

39
Q

Thin cartilage, pinna springs back from folding

What is estimated gestational age?

A

36 - 39 weeks

40
Q

Areola first raised, but breast tissue not yet palpable

What is the estimated gestational age?

A

34 - 35 weeks

41
Q

What is recommended delivery room temperature?

A

22 - 26 C

42
Q

Newborn with bilious vomiting - contrast enema shows small-diameter sigmoid and descending colon with dilated air-filled loops of small bowel

What is going on? What is the associated disorder?

A

Meconium ileus

Associated with cystic fibrosis

(in fact 80-90% of neonate with meconium ileus has CF)

43
Q

Neonate with mom who is HBsAg-positive.

What is the management?

A

Give BOTH HepB vaccine and HBIG

44
Q

Long, wide, protruding ears

Associated with which syndrome?

A

Fragile X syndrome

45
Q

Hypoplastic testes in a male neonate?

What is the associated syndrome?

A

Klinefelter

46
Q

What is this finding?

Which are 2 congenital conditions it is associated with?

A

Arachnodactyly

1 - Neonatal Marfan syndrome
2 - Congenital contractural arachnodactyly syndrome

47
Q

Hypothermia, vomiting, frequent stools, feeding difficulties, excessive crying in a newborn

What is the drug that mother was on that can cause these?

A

SSRI

48
Q

Aplasia or hypoplasia of abdominal muscles

Which syndrome? What are 4 associated problems?

A

Prune belly syndrome

1 - Bilateral undescended testes
2 - GU tract and renal anomalies
3 - Pulmonary atresia
4 - Cardiac abnormalities
5 - MSK abnormalities

49
Q

What syndrome caused by CHD7 gene? What are the components of syndrome?

A

CHARGE syndrome

1 - Coloboma
2 - Heart defect
3 - Atresia choanae
4 - Restricted growth and development
5 - Genital anomalies
6 - Ear anomalies

50
Q

Which factor in a case of supernumerary digits on a hand would warrant orthopedic consultation

A

A bony articulation of the digit

51
Q

Soft, painless, compressible, nonpusatile mass on lateral neck that transluminates well, not involving underying tissue.

What is it? What causes it? What types of condition this finding is associated with ?

A

Cystic hygroma

Abnormal development of the lymphatic system -> obstruction of normal lymphatic flow and sequestration of lymphatic fluid

Karyotypic abnormalities (up to 70%) - trisomies, Turner, Klinfelter

52
Q

Neonate with myelomeningocele and heart issues

What antihypertensive medication in mother causes this? When was she exposed?

A

ACEi

exposed in 1st trimester

53
Q

Which illicit drug by mother can cause gastroschisis?

A

Cocaine

(vasoconstriction)

54
Q

Bilious emesis, abdominal distension, “soap bubble” appearance of portions of intestinal contents

What is going on? Likely underlying diagnosis?

A

Meconium ileus

Cystic fibrosis

55
Q

Neonate with flattened dimpled buttocks, small pelvis, absence of sacrum

What is going on? What are conditions this finding is associated?

A

Caudal regression syndrome

Associated with
1 - Diabetic mother
2 - VACTERL

56
Q

Which antiepileptic might cause neural tube defect?

A

Valproate

57
Q

What are 3 clinical features of Wiscott-Aldrich syndrome? (WAS)

A

1 - Eczema
2 - Immunodeficiency
3 - Thrombocytopenia

(eXit) (X = X-linked)

58
Q

What is the hematologic complication in neonate whose mom was on phenytoin?

A

Vitamin K deficiency bleeding

59
Q

What is the classic triad of neonatal renal vein thrombosis?

A

1 - Hematuria
2 - Flank mass
3 - Thrombocytopenia

60
Q

Short and upturned nose, stubby digits, hypoplastic nails

What is the maternal drug exposure?

A

Phenytoin

61
Q

Prevention of GBS in newborn for mom who is GBS positive

A

Penicilline (or ampicillin) every 4 hours until delivery

62
Q

What is anicosiria?

A

Unequal pupils

(might be caused by miosis in one pupil)

63
Q

What are 3 components of Horner’s syndrome?
If seen in a newborn, what is it associated with?

A

1 - Miosis
2 - Ptosis
3 - Anhidrosis

Associated with lower brachial plexus injury that involves T1

64
Q

Treatment of Criggler-Nijjar syndrome type II

A

Phenobarbital

(doesn’t work for type I where there is no UGT enzyme production at all)

65
Q

Macules with central pustules on erythematous base in neonate

What is it? When will they resolve?

A

Erythema toxicum neonatorum

Resolves within first week of life

66
Q

What are these? Treatment?

A

Milia

Nothing - benign

67
Q

What is this ? Treatment ?

A

Epstein pearl

(like milia, but in mouth)

Nothing - benign

68
Q

What is management of newborn whose mom is positive for HbsAg?

A

HBIG at birth
Hep B at birth, 1, 2 and 6 months
Test for HbsAg and anti-Hbs-Ag at 9-12 months (after completing the vaccine series)

69
Q

Inclusion bodies seen in cells of ocular discharge

What is going on? Treatment?

A

Chlamydial conjunctivitis

Oral erythromycin / azithromycin

70
Q

Descending colon with abrupt caliber transition at the splenic flexture, small sigmoid, normal rectum - seen in a newborn

What is going on? What is the associated maternal condition?

A

Small left colon syndrome

Associared with maternal diabetes

71
Q

Apnea, decreased bowel sound in all quadrants in a newborn

What is going on? What does the mother have?

A

Hypermagnesemia !

(mother has pre-eclampsia, got Mg)

72
Q

Management of CDH with respiratory distress? (3)

A

1 - Intubation
2 - Mechanical ventilation after intubation (do NOT bag mask)
3 - Passing an NG/Repogle to decompress abdominal contents

73
Q

Which maternal medication associated with persistent pulmonary hypertension in a newborn?

A

SSRIs

GEN PEDS (16 decks)

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