Pediatrics Flashcards
Vital signs babies HR
120-160
Vital Signs babies Resp
40-60
Vitals Signs babies BP
systolic 65
diastolic 50
APGAR
Appearance Pulse Grimace Activity Respiration
Appearance
2: pink
1: pink torso/blue extremities
0: blue all over
Pulse
2: >100
1: 60-100
0:
Grimace
reflex and irritability
2: sneeze, cough, loud cry
1: grimace/feeble cry
0: no response
Activity
muscle tone
2: Active movements
1: some flexion
0: no movement
Respiration
2: strong
1: weak irregular
0: absent
APGAR doesn’t predict
cerebral palsy
newborn eye problems day one? day 2? 1 wks? 3 wks?
day 1: chemical irritation
day 2: n. gonorrhea
1 week: chlamydia
3 weeks: herpes simplex
Vitamin K
factors?
Method of giving?
Factors 2, 7, 9, 10
IM injection
Transient Polycythemia of the Newborn
Increased RBCs
secondary has increased EPO
Causes hyperviscosity, decreased perfusion, thromboses
most often a problem with LGA, SGA, IDM
Transient Tachypnea of the newborn
> 60 bpm
Tx: as though it is sepsis. Start oxygen, antibiotics, work up with CBC and chest x-ray
Transient Hyperbilirubinemia
Increased production of unconjugated bilirubin
Caput succedanum
crosses suture lines
cephalohematoma
does not cross the suture line
Erb-Duchenne Palsy
waiters tip
C5-C6
Klumpke Paralysis
C7-T1
claw hand plus horner syndrome
Clavicular fracture
will heal on it’s own or you can give a figure 8 split
Neonatal Sepsis
Early
mom infections
E. Coli + Group B strep + Listeria
Tx: ampicillin, gentamycin, cefotaxime
Neonatal Sepsis
Late
After the first week
Staphylococci, E. Coli, Group B strep
Tx: ampicillin, gentamycin, cefotaxime
Chorioretinitis, hydrocephalus, ring enhancing lesions
Toxoplasmosis
Tx pyrimethamine and sulfadiazine
rash on palms/soles, snuffles, frontal bossing, hutchinson 8th n palsy, saddle nose
syphilis
Tx Penicillin IV
PDA, cataracts, deafness, hepatosplenomegaly, low plts, elevated bilirubins
Rubella
Tx: supportive
Periventricular calcification, microcephaly, chorioretinitis, hearing loss
CMV
Tx: Gangciclovir
Shock and DIV
Vesicular skin lesions
encephalitis
Herpes
Tx: acyclovir and supportive care
polyhydraminos
too much fluid
assoc with overproduction, esophageal atresia, cns malformations
Oligohydraminos
too little fluid
caused by post-term pregnancies, renal agenesis and renal failure
Omphalocele
midline covered sac
assoc. with imperforate anus, congenital heart defects, conjoined twins, trisomy 18, beckwith weidemann syndrome
tx: surgery
Gastrochisis
no sac covering
lateral wall defect
Wilm’s tumor
asymptomatic flank mass, hematuria, hypertension and aniridia
first diagnostic test? U/S
MC diagnostic test : CT
Neuroblastoma
painful abdominal mass, neurological findings, diarrhea
commonly involves adrenal gland
Hydrocele
painless, benign, fluid filled
cryptochidism
undescended testis, increased cancer risk
surgical correction after 6 months
hypospadias
ventral surface opening, surgery
Epispadias
dorsal surface opening, surgery
Cyanotic heart defecs
Tetralogy of Fallot Transposition of great vessels Hypoplastic left heart syndrome Truncus arteriosus total anomalous pulmonary venous return
Tetralogy of Fallot
pulmonary stenosis
VSD
Overriding Aorta
Right ventricular hypertrophy
Transposition of the Great Vessels
Right and left heart circulations
defect must have a VSD, ASD, or PDA
Tx: PGE1 -keeps it open
Hypoplastic left heart
absent pulses
right ventricular heave
mild cyanosis/gray
Truncus Arteriosus
one great vessel
pulmonary hypertension
Tx: surgery
Total Anomalous Pulmonary Venous Return
pulmonary veins return to the right atrium
two types
TAPVR with obstruction
early in life with resp distress and severe cyanosis.
Test: echo
Tx: surgery
TAPVR without obstruction
Presents later at 1 -2 year with heart failure
Test: Echo
Tx: surgery
Acyanotic Heart Defects
VSD
ASD
PDA
Coarctation of the aorta
88
88
Barking cough, coryza, stridor
respiratory distress
Steeple sign
Croup
Viral Parainfluenza/ RSV
Tx: racemic epinephrine
Moderate severity: steroids
Severe: racemic epinephrine and steroids
fever, drooling, respiratory distress
Thumbprint sign
Epiglottitis
MCC: bacterial
Tx: Intubate, empiric antibiotics,
Epiglottitis micro?
H. Influenza type B
Streptococcus and nontypeable H. influenza
