Newborn care and common genetic disorders Flashcards
Caput succedaneum
edema of scalp, reabsorbs within 1-3 days
Cephalohematoma
clotted blood between periosteum and skull. Reabsorbs within a couple weeks
Leukocoria
not a normal finding, one eye does not have red reflex
Eythema toxicum
benign rash
Harlequin sign
abnormal sign indicating genetic disorder
Hypo or epi spadius
abnnormal finding of urethra position
pilonidal dimple
located on lower back, abnormal
galactosemia
inability to metabolize galactose because of a congenital disorder
How much vit D supplement should mom give?
400
Dysmorphic Infant
face to body measurements, asymmetrical
Chromosomal disorder examples
Downs, turners, cystic fibrosis, cleft lip
How many days after discharge do you see infant?
3-5 days
Where does bilirubin come from?
breakdown of Hgb or immature liver metabolism
when does hyperbilirubinemia peak in a full term infant?
3-5 days
when does hyperbilirubinemia peak in a premature infant?
5-7 days
Anytime there is an increase of ___mg/dl/day of bilirubin we will be concerned
5
breast milk jaundice treatment
no treatment
when does breast milk jaundice peak?
10-15 days
TORCH
toxoplasmosis, other (strep B), rubella (vision and hearing loss), cytomegalovirus, herpes
Kernicterus
brain damage caused by bilirubin depositing in the brain, causes yellow discoloration of certain areas of brain
which areas of the brain does Kernicterus effect?
basal ganglia and hippocampus
does unconjugated bilirubin diffuse easily into brain?
yes
what determines the amount of unconjugated bilirubin that gets diffused into brain?
the concentration
what increases Kernicterus toxicity?
decreased bilirubin binding
Risk Factors for Kernicterus
Sepsis, age post conception, hypoxia, low serum albumin
Kernicterus stage 1 s/s
hypotonia, lethargy, decreased suck
Kernicterus stage 2 s/s
spasticity with opisthotonus and seizures
Kernicterus stage 3 s/s
spasticity is decreased
Kernicterus stage 4 s/s
spasticity, athetosis, deafness and mental retardation
belirubin red flag and what kind of work up should you do
<24 hours of age at onset
check for UTI, hemolytic probs, congenital viral infection
which test/lab results would indicate that an infant was at high risk for a bacterial infection if any are positive?
positive UA with nitrates >5, WBC>20,000, temp 39.6 and age <13 days
What are you concerned about in the 1st 24hrs with jaundice?
hemolytic disorders, TORCH
what are you concerned about in the 2nd day-3rd week with jaundice?
physiological, breaks milk, sepsis, polycythemia, cephalhematoma,
what are you concerned about in the 3rd week with jaundice?
breast milk, hypothyroidism, pyloric stenosis, cholestasis
non-physiologic hyperbilirubinemia starts when?
jaundice before 36 hours
jaundic persists for how many days withnon-physiologic hyperbilirubinemia
> 8 days
non-physiologic hyperbilirubinemia: Direct bilirubin is >__mg/dl
2
non-physiologic hyperbilirubinemia: Rise in bilirubin is >__5mg/dl/day
5
how is bilirubin excreted?
its conjugated with water-soluble substances
