Pediatrics Flashcards
What are the dosages of erythromycin ointment and vitamin K to be given at birth?
.5% erythromycin ophthalmic ointment
1 mg of vitamin K IM
Penicillins are bacteri-____
cidal
Which clotting factors are vitamin K dependent?
II, VII, IX, and X
2, 7, 9, and 10 (Think 1972)
Protein C inhibits factor
V, so Protein C deficiency increases the risk of DVT!
Without protein C, factor V will cause clots without inhibition.
What are the vitamin K dependent anticoagulants?
Proteins C and S
If mom is HBsAg positive, administer ___ along with the hep B vaccine to baby
hepatitis IVIG
What needs to be done before newborn can be discharged?
Hep B vaccine or IVIG Vitamin K Erythromycin ophthalmic ointment hearing test Neonatal screening tests for PKU, galactosemia, congenital hypothyroidism, etc.
How to treat erythema toxicum of newborn?
Self-limited
How to treat Sturge-Weber syndrome?
Give anticonvulsants and evaluate for glaucoma
If hemangiomas are large or interfere with organ function, treat with
steroids or pulsed laser
Preauricular tags/pits can be associated with
GU abnormalities and hearing loss
CHARGE syndrome =
Coloboma of the eye Heart defects Atresia Retardation GU abnormnalities Ear abnml
Aniridia is a/w
Wilms tumor, so screen w/ abdominal ultrasound Q3 months until age 8
Mass in the midline of the neck that moves with swallowing or tongue protrusion =
thyroglossal duct cyst; remove surgically
Omphalaceles develop due to failure of
GI sac retraction at 10-12 weeks gestation.
Screen for trisomy 13, 18, and 21
If epispadias is present, evaluate for
bladder exstrophy
Lab abnormalities in infants of diabetic mothers:
hypoglycemia
hypocalcemia
hypomagnesemia
hyperbilirubinemia
polycythemia
Baby that’s puffy, ruddy, and fat =
IODM
Neonate born early with tachypnea, nasal grunting, and intercostal retractions within hours of birth =
RDS
Best predictive test for RDS is
Lecithin-sphingomyelin ratio on amniotic fluid prior to birth
What are three complications of O2 delivery to newborn?
Retinopathy of prematurity
Intraventricular hemorrhage
Bronchopulmonary dysplasia
Fetuses in distress often pass ___ before birth, leading to ___
meconium
meconium aspiration syndrome
What is the workup for jaundice in the first 24 hours of life?
Total and direct bili Blood type of infant and mother Direct Coombs test CBC retic count, blood smear UA and culture if elevated direct bili!
Prolonged jaundice + elevation of conjugated bilirubin =
cholestasis; do LFTs and ultrasound and liver biopsy (most specific)
Features in common with all TORCH infections =
IUGR, HSM, jaundice, MR
Never give naloxone ton infant born from a mother with
known narcotics use
Magnesium in utero can cause
respiratory depression,
just like anesthetics and barbiturates
Sulfonamides in utero can cause
displacement of bilirubin from albumin
Phenobarbital in utero can cause
Vitamin K deficiency
ACE inhibitors in utero can cause
craniofacial abnormalities
Newly diagnosed down syndrome kiddos require what work up?
Hearing exam
Echo
GI
TSH
Infant with aniridia requires what workup?
Wilms Tumor
Aniridia
GU anomalies
Mental Retardation
80 percent of Angelman syndrome kids develop
epilepsy
Has pincer grasp, knows own name, creeps/crawls
9 months
Cruises, says 1 or more words, plays ball
12 months
Builds 3-cube tower, walks alone, makes lines and scribbles
15 months
Builds 4-cube tower, walks down stairs, says 10 words, feeds self
18 months
Builds 7-cube tower, runs well, goes up and down stairs, jumps with 2 feet, threads shoelaces, handles spoon, says 2-3 sentences
24 months
Walks downstairs alternating feet, rides tricycle, knows age and sex, understands taking turns
36 months
Hops on 1 foot, throws ball overhead, tells stories, participates in group play
48 months
When should you workup a child for growth problems?
When they’ve crossed two major growth percentiles
Contraindications to breastfeeding:
galactosemia HIV HSV if breast lesions Acute maternal disease if absent in infant (TB, sepsis, etc) Maternal cancer receiving treatment Substance abuse
Nonretentive encopresis is associated with
abuse
Treat croup with
dexamethasone and/or racemic epi
