Pediatrics Flashcards
What effects on the fetus is associated with maternal use of heroin/opiates during pregnancy? what should these children be monitored for?
increase risk of: fetal growth restriction placental abruption fetal death preterm labor intrauterine passage of meconium infants should be monitored for NEONATAL ABSTINENCE SYNDROME (uncoordinated sucking reflex = poor feeding, irritability, high pitched cry)
what is the cause: 3 day old infant large bump on head scleral icterus, abdominal jaundice swelling over parietal bone - does not cross suture lines
Cephalohematoma
what is the best tx for osgood-schlatter disease?
ibuprofen
What is the caloric requirement for most 1. healthy babies 2. preterm babies 3. VLBW (very low birth weight) infants = <1500g in the first 1 to 2 months of life?
- 100 cal/kg/day 2. 115 to 130 cal/kg/day 3. 150 cal/kg/day
when does a child double their birth length?
4 years of age
what is the Ballard Assessment tool?
uses signs of neurologic and physical maturity to estimate gestational age
For a 18 month old child what are the milestones for: 1. gross motor 2. fine motor 3. language 4. social/adaptive
- walks alone, may climb stairs/runs, can help undress 2. drinks from cup/spoon, make tower of 2 cubes 3. 6 words in vocabulary 4. points to show what he wants, shakes head no
What is the disease: 5 year old with newly discovered cardiac murmur. elfin facies, mild retardation what kind of cardiac defect?
Williams-Beuren syndrome - also HTN, short status Bicuspid Aortic Valve –aortic regurg –aortic stenosis develops 40s-50s
For a 6 month old child what are the milestones for: 1. gross motor 2. fine motor 3. language 4. social/adaptive
- rolls over, sits unsupported, no head lag when pulled to sit from supine 2. reaches for objects, looks for dropped items 3. turns to voice, babbles 4. feeds self, demonstrates stranger recognition (prelude to stranger anxiety)
What is the most likely inborn error of metabolism in a 2 day old infant with severe metabolic acidosis?
Glutathione synthetase deficiency –severe metabolic acidosis + jaundice + hemolytic anemia
what is the infective agent: 7 year old w low grade fever, headache, pruritic rash. Rash began on cheeks, spread to trunk and extremities. Physical exam shows maculopapular rash w lacy, reticulated appearance
Erythema infectiosum - parvovirus B19
cal/mL for 20 cal formula?
0.67 cal/mL
Neonate IV fluids +/- feeds
Increase 20-30 mL/kg/day until 150-160 mL/kg/day Day 1: 60-80 mL/kg/day Day 2: 80-100 mL/kg/day Day 3: …etc… 60+(20day)= max limit
What is dz and defect? Tall 10 year old, arachnodactyly, ligamentous laxity, pectus excavatum
Marfan syndrome - fibrillin
what is the etiology: infant born w part of small bowel protruding from abdomen to the right of the umbilicus.
Gastroschisis —involution of the second umbilical vein
how old is the child: Child says “mama” and “dada” w meaning, follows one-step commands, shows objects to parents to share interest. plays interactive games (peekaboo, waves bye bye). points to desired object
12 months
What electrolyte abnormalities is most often seen in infants of diabetic mothers?
hypoglycemia hypocalcemia hypomagnesemia
what is the dx? 1 month old with head circumference > 100th percentile. mother had no prenatal care. Macrocephaly w no other dysmorphic features. Transillumination of the head is positive.
hydranencephaly
cal/mL for 24 cal formula?
0.80 cal/mL
What will a coin appear like in an AP CXR if in the 1. esophagus 2. trachea
- Round – The coin will face you 2. Linear – You are looking at the coins edge. A Sagital CXR needed to see the front/back of the coin.
Identify the pathogen: 12 day old infant w bilateral eye discharge. conjunctival injection, lid swelling, scant mucopurulent discharge. no rashes
chlamydia trachomatis
What are the two most prevalent causes of acute otitis media?
Streptococcus pneumoniae Haemophilus influenzae, nontypeable
Fluid management for neonate
Based on weight until day 7 Feeding q 3 hours
What is the definition of Small of Gestational age?
Less than 10% for Birth Weight At Term = <2500g At 37 wk = <2000g At 34 wk = <1500g At 31 wk = <1000g At 24 wk = <500g