Newborn, Well Child

Question 1

Name 3 types of newborns susceptible to polycythemia Vera?

Answer 1

Small for gestational age, large for gestational age, DM.

Question 2

Most common cause of new born polycythemia. How does this correct itself ?

Answer 2

Due to cord clamping -> kidney raises epo. Once the baby starts to breathe -> epo goes down.

Question 3

Test? Rx? Present with crepitus and assymetric moro reflex.

Answer 3

Shoulder dystocia, clavicular fracture. X-ray. Immobilize.

Question 4

Rash on palms and soles, frontal bossing, Hutchinson 8th palsy, saddle nose. Dx? Test? Rx?

Answer 4

Late congenital Syphilis. Initial test: VDRL/RPR and FTA/ABS is Confirmatory. Most Accurate Test is Dark Field Microscopy to check for the spirochete. Rx: IV Pen G or Doxycycline.

Question 5

Painless Asymptomatic Flank Mass with Painless Hematuria, HTN and Aniridia. Can occur at any age during childhood (2-5 years of life.). Dx? Test? Rx?

Answer 5

Wilms tumor (Most common primary neoplasm of Childhood). Do Abdominal US first. CT confirms. Rx: Surgery, Chemo and Radiation.

Question 6

Involves the adrenal glands but a turmor of the sympathetic ganglia. Newborns present with Painful or Painless Abdominal Mass. Myoclonus, Diarrhea, Hypokalemia. Occurs in the FIRST 2 years of life Dx? Test?

Answer 6

Neuroblastoma. AXR can reveal calcifications. Test: Elevated urinary levels of VMA, HVA confirms.

Question 7

What is commonly associated with Cryptorchidism? Rx?

Answer 7

Testicular cancer. Surgical correction after 6 months if testes have not descended.

Question 8

Baby presents with conjunctival injection on day 0. Dx? Rx?

Answer 8

Chemical irritation from Prophylaxis Rx. Occurs in developing countries.

Question 9

Baby presents with conjunctival injection on days 2-7. Dx? Rx?

Answer 9

Neissria Gonorrhea. Rx with Ceftriaxone.

Question 10

Baby presents with conjunctival injection on days 7-21. Dx? Rx?

Answer 10

Chlamydia Trachomatis. ORAL erythromycin.

Question 11

Baby presents with conjunctival injection after days 21. Dx? Rx?

Answer 11

Herpes Simplex Systemic. Acyclovir or Topical Vidarabine.

Question 12

Name 3 things that would indicate poor breast feeding.

Answer 12

Less than 6 wet diapers a day, less then 7 feedings a day. >10% drop in weight.

Question 13

Ruddy, plethoric, jaundice, macrosomic, cardiomegaly Renal Vein Thrombosis. Lazy left colon syndrome. Dx? Rx?

Answer 13

Gestational Diabetic Baby. Give IV glucose (dextrose) if hypoglycemic. Taper down to decrease insulin levels.

Question 14

What does APGAR stand for? What is normal?

Answer 14

Appearence, Pulse, Grimace, Activity and Respiration. 7-10 is normal.

Question 15

Diffuse swelling of the soft tissues of the scalp that CROSSES SUTURE LINES.

Answer 15

Caput Succedaneum.

Question 16

Diffuse swelling fo the soft tissues of the scalp that DOES NOT CROSS SUTURE LINES. What can this condition generate?

Answer 16

Cephalohematoma. Jaundice, common cause of neonatal jaundice.

Question 17

Firm, white papules; inclusion cyst Dx?

Answer 17

Milia

Question 18

Lacy Reticulated Vascular Pattern over most of the body when the baby is cooled, improves over the first month. Mottling of the skin. Dx?

Answer 18

Cutis Marmorata.

Question 19

Pale, pink vascular macules on the forehead that get worse when the baby cries Dx?

Answer 19

Salmon Patch

Question 20

Blue to slate gray macules. Mostly seen in non white infants. Dx?

Answer 20

Mongolian Spots

Question 21

Erythematous papules on face due to High Maternal Androgen. Dx?

Answer 21

Neonatal Acne.

Question 22

Cyst lateral to midline? What is it medial to midline?

Answer 22

Brachial cleft cyst. Thyroglossal duct cyst.

Question 23

Painless benign fluid filled that transilluminates. Dx? Rx?

Answer 23

Hydrocele. Rx: Drain

Question 24

Ventral opening of penis? Dorsal opening of penis? Rx?

Answer 24

Hypospadias. Epispadias. Surgery for both.

Question 25

Symptoms occur with introduction of feeds of the Newborn. Leukocytosis, Increase RR and HR. Pneumotosis intestinalis is seen on AXR. Dx? Rx?

Answer 25

Necrotizing enterocolitis. IVF, NPO, NG, Abx. Surgical resection of necrotic bowel.

Question 26

Occurs due to Glucorinidase present in some breast milk which prevents the liver from the breaking down of Bilirubin (factors in milk inhibit liver enzymes.) This has a Genetic Predisposition. Infants become Jaundice in the first 2 weeks of life.

Answer 26

Breast Milk Jaundice.

Question 27

Premature newborn presents with RDS, Apnea, Lethargy, Seizures and Bulging Fontanelle. Dx? Test? What should all infants get to check for this.

Answer 27

Intraventricular Hemorrhage (Rupture of the germinal matrix blood vessels due to hypoxic or hypotensive injury. All neonates should get Cranial US.

Question 28

Squamous Metaplasia and Hypertrophy of the small airways in premature infants. Dx? Rx?

Answer 28

Bronchopulmonary Dysplasia.

Question 29

A condition that occurs in utero, mainly seen in Post-Term Infants. Meconium is passed and as a result newborns develop hypoxia. Dx? Test? Rx? Complication (2)?

Answer 29

Meconium Aspiration. Do CXR and shows patchy infiltrates and flattening of the diaphragm. Give PEEP. Can lead to Pulmonary HTN and Pneumonitis.

Question 30

Baby is not nursing well and not getting many calories and is Jaundice!!. Dx? Rx?

Answer 30

Breast feeding jaundice. Rehydrate baby.

Question 31

Cutaneous lesions on Palms and Soles, hepatosplenomegaly, jaundice, anemia and rhinorrhea

Answer 31

Early Congenital Syphilis. Late is Saber Shins and Hutchinson teeth and Keratitis.

Question 32

1 month name the Gross motor, fine motor, language and social milestone.

Answer 32

1. Raises head from prone position 2. Tracks to midline 3. Alerts to sound 4. Regards face

Question 33

3 months name the gross motor, fine motor, language and social milestones.

Answer 33

1. Hold heads up 2. Tracks in circles 3. Coos 4. Anticipates feeling

Question 34

6 months name the gross motor, fine motor, lang and social milestones.

Answer 34

1. Sits up right 2. Transfers objects 3. Babbles 4. Stranger anxiety

Question 35

9 months name the gross, fine, lang and social milestones.

Answer 35

1. Crawls, pulls, stands 2. Immature pincer graps 3. Mama and Dada non specific 3. Plays pat-a-cake

Question 36

12 months name the gross, fine, lang and social milestones.

Answer 36

1. Walks alone 2. Uses mature pincer grip 3. mama and dad specific 4. Imitates actions, comes when called

Question 37

24 months name the gross, fine, lang, and social milestones.

Answer 37

1. Walks up and down steps without help 2. Turn pages 1 at a time 3. Knows 200 words, uses 2 word sentences 4. Engages in parallel play

Question 38

Age 3 name the gross, fine, lang and social milestones.

Answer 38

1. Tricycle 2. copies circle 3. Knows 300 words and 3 word sentences 4.Engages in group play

Question 39

Age 5 name the gross fine, lang and social milestones.

Answer 39

1. Jumps over obstacles 2. Copies triangle, tells stories 3. Prints first name 4. Abides by rules

Question 40

Slowed and steady steep drop off the growth curve?

Answer 40

1. Constitutional Growth delay, genetic then they catch up with the rest of the population.