Pedia Er And Neonatology Flashcards
What are the possible causes of jaundice in firsts day of life?
What are the possible causes of jaundice in baby mor than 2-3 days?
Etiology of hyperlipidemia according to conjugated and unconjugated????
In physiological jaundice , what is the bilirubin cut of point that it should not be exceeded ???
No more that 12 mg/dl in full term
No more than 15 mg/dl in pre term
Normally, raises 5 mg /dl per 24 hrs
Child should be healthy not febrile and eat well!!!
What are the characteristics of pathological jaundice?
What r the complications of kernicterus ?
Ttt of neonatal jaundice???
What are the differences between gilbert syndrome and najjar ??
What is the difference between breast feeding jaundice and breast milk jaundice???
(In time of occurance/ cause)
When to give Rh IG ??
28 wks of gestation and after 2,3 days of delivery
And some resources recommend a dose at 34 week of gestation
Note** Rh hemolysis occurs more im second pregnancy and get secere every time
What do ABO hemolysis ?
What are the complications of phototherapy??????
Up gase palsy, in whick stage of kernictirus??
How many stages for kernicterus and what are they?
Baby with prolonged jaundice, give me 4 ddx??
Rooting reflex, when to start and when to disappear??
Stop at 4 months!!!
Start at 28 weeks of gestation
Stepping reflex , start and disappear ?
Start at birth
Disappear at 2 month (2 legs!)
Moro reflex , start and disappear?
28 gestation weeks,
4-6 months
Asymmetrical tonic reflex st and disa??
Start ..?
Disappear: 4 months
Planter grasp st and disa??
St: 32 wks of gestation
Dis: 6-12 months
Palmer grasp st and dis?
Start : 32 wks of gest
End: 3-4 month
Baby have hemangioma , it’s large and cover the eyelid, what is the first thing to do ????
Q2 And when u will consider ttt or reassurance in hemangioma ???
Q 3What is ttt of hemangioma??? (First line ttt???)
Referral to ophthalmology
Q2 see the pic
Q3 1st line ttt is propranolol ,others, steroid , vincristine , interferon
Baby just delivered, amniotic fluid was stained by meconium, what is the cause of this color???
What do u think this color will cause?
What is the best action for the baby?????
Cause of this color is fetal distress
This will lead to meconium aspiration syndrome!
Best action is. Admission in NICU and observation unless if APGAR score more than 9 or above or crying vigorously!!! No need for admission
What are the risk factors for neonatal sepsis !! Give me 4
Small or infection!!!
Give me all lab and radiology investigations in :
Early neonatal sepsis
Late neonatal sepsis
How to know it’s early or late neonatal sepsis ?
What are the most common causative organisms in neonatal sepsis???
By duration!!!
What is the ttt of neonatal sepsis if baby have:
Pneumonia
Meningitis
??
Baby born by CS , 27 wks, developed respiratory distress, what is the cause?
Hyaline membrane dis!
Causes of respiratory distress:
What are the complications of hyaline dis??give me 4
Full term baby for gestational diabetic mom delivered by CS , now baby is Tachycardiac and tachypenic, x ray shows grunting a d fluid in lung fissure , dx?? And what is the ddx??
TTN ( transient tachypnea of newborn)
Ddx congenital pneumonia!
Risk factors: gestational diabetes, CS , common in full term
Usually no complications
NITRIC OXIDE > because there is pulmonary HTN
Golden slide of neonatal lung disease!!!
Apgar score 🥲🥲🥲🥲 it’s the time to start memorising it🥲🥲
What are the RF for retinopathy of prematurity? And when to screen for it??
Newborn full term for DM mom, now respiratory distress, and desat , everything else is normal, next step???
ICU , monitor blood glucose and observation,
If baby still in distress after observation, then baby will need to be supported with o2 supply
What are the complications of infant who’s mother is diabetic??
+ pneumonia , HMD ,TTN, CVS( septal hypertrophy )
Metabolic: hypo Ca , hypo glycemia , hypo mg , Renal vein thrombosis (because of polycythemia )
A dose of 300 mcg of Rh iG will cover how much of fetal blood?
30 mL of fetal blood!
Newborn with microcephaly and hepatosplenomegaly and cataracts, what is ur next step???
Congenital infection screening to look for TORCH infection
4 days Newborn , purulent eye discharges and swelling around the eye, red eye, culture showing diplococci , ttt?? And causes ??
When to say it’s chlamydia infection if u don’t have culture??? And what is the ttt??
Neonatal conjunctivitis ,ttt is single dose iv ceftriaxone
Premature with abdominal distention and air on bowel wall, dx??
What are the 2 best measures to prevent this case??
Give me 2 RF for this case??
Necrotizing enterocolitis
Best prevention: slow and gradual feeding and breast feeding
RF :PDA and spesis
Newborn with scaphoid abdomen, baby diagnosed with diaphragmatic hernia , what is the first step to do??
Intubation!!!!
Then
NGT to drain the bowel
Causative organisms of meningitis in newborn??????(less than 3 months?)
More than 3 months??
SLE mother , what u expect her child will have?
Immune cytopenia
rash
Congenital heart block
Low platelet
PDA,VSD,ASD
NOTE**
Congenital rubella present with PDA but never with heart block!
What is the maximum glucose concentration can be given to hypoglycaemic baby by peripheral line ? ( by %)
Q2, what is the root of administration of 20% glucose to hypoglycaemic baby?
12.5%
Q2, central line
5 days neonate ,rash and intracranial haemorrhage, platelet was 4,000 (very low, Hb is low, what is. Ur dx??
Alloimmune thromocytopenia
Newborn with depressed nasal bridge and dysmorphic face, next step?
Chromosomal testing
Baby delivery with ventose , what type of abnormality u will expect to see in his head??
Cephalohemtoma / caput saccedanum
Note*
Subgleal bleeding
Child first time DKA , what is the most important thing to do before discharge???
Q2 , same but Recurrent episodes of DKA , ??
Q1: Well written plan
Q2: listen to the child concerns
Child, hx of high blood glucose , Tachypenia ,next step?
Dipstick
DKA pt, after management, developed headache and seizure , how to manage??
Over what time u should give iv fluid and replace deficit??
Over 24 hours
Note*
Serum Na should be decreased or increased by 10 to 12 mmol per day
Indications of iv hydration ??? Give me 4
Child has gastroenteritis for 2 weeks , started ORS and now he imrpoved, next day started food he developed diarrhea, dx?
3yo baby, present with signs and symptoms of severe dehydration, what is the estimated fluid loss in %?
9%
Paediatric pt needs NIPPV , where it should started?
PICU
Infant, respiratory distress,wheezing and O2 sat was 90% , next step?
A- Nebuliazer
B- O2
C- Chest x ray
D- Antibiotics
ABCD» O2 and hydration
Infant, respiratory distress,wheezing and O2 sat was 90% , next step?
A- Nebuliazer
B- O2
C- Chest x ray
D- Antibiotics
ABCD» O2 and hydration
What are the 2 most concerning signs of croup? And what is the difference between croup and acute epiglottis (by organism, year, exact location, onset, cough, salivation and fever)
LOC and cyanosis,
Name of sign and where can u see (thumb sign)??
Steeple sign in croup
Thumb sign in acute epiglottis
Child with croup, epinephrine is given , symptoms happened again, next step?
Repeat epinephrine every 30 min
Or
Steroid
??
Repeat epinephrine!!
2 yo , hx of atopic dermatitis and inspiratory stridor , dx????
Spasmodic croup
Non immunised child, fever, cough, multiple lymph node enlargement, dx??complications?? Ttt??
Diphtheria
Complications: see the pic
Ttt: anti toxin + macrolide
Child with camr with fever and cough and improved and after 1 week he acme with high grade fever, drooling of saliva
• Most likely diagnosis?
Bacterial tracheitis (super infection by staph)
Tell the commonest toxicity symptoms for each medication below:
Organophosphate:
Paracetamol:
Narcotics:
TCA:
Aspirin:
Alcohol:
Child ingested large amount of NSAID , next step?
Charcol
Aspirin antidot?
Na bicarbonate
Organophosphate antidot?
Atropin
Narcotic antidot
Naloxone
Benzodiazepines antidot?
Flumazenil
Paracetamol antidot
N acetyl cystine
Methanol antidot
Ethanol, fomepizole
TCA antidot
Na bicarbonate
Metoclopramide antidot
Diphenhydramine or atropine
Child, come after 3 hours of ingesting high amount of paracetamol, next step???
Charcol!!
150mg per kg is the toxic dose in children
In ER, Serum level should be measured at 4 hour post ingestion
,then plot in the chart
When to give N acetyl cystine????
See the pic
Child ingested high amout of paracetamol, what are the 4 stages of paracetamol toxicity ???
Child, ingested 20 tablets of iron, best action?
What are the 4 defoxamine indications to start???
Iv deforoxamine
Child ingested high amounts if iron, now he have mild symptoms, no metabolic acidosis , his serum iron less than 500 mcg/dl, now under observation, how to observe him?
What are the 5 stages of iron toxicity?
Neonate just delivered and having a seizure, his mom is Diabetic, u wanted to take blood sample, from where u get it???
Capillary, or (heel stick )
Child with ambiguous genitalia, low Na, high K , hypoglycaemia, next step??
Normal saline and glucose then take blood sample for hormonal test then give stress dose cortisone
Intussusipssion initial and diagnostic test??
A
Note**
High recurrent after reduction not surgery, zero % after surgery!!
Give me 4 ways to prevent sudden infant death syndrome ?
