Pediatrics Flash Cards - Case 1 - Eval of Neonate

Question 1

Start prophylaxic antibiotics if baby was born __ hours after maternal ROM?

Answer 1

≥18 hrs

Question 2

TABC of neonatal resuscitation?

Answer 2

Temp (warm and dry), Airway (suction and position head), Breathing (stimulate to cry), circulation (assess color/HR)

Question 3

APGAR mnemonic?

Answer 3

Appearance (color) | Pulse (HR) | Grimace (reflex irritability) | Activity (tone) | Resp

Question 4

TORCH stands for

Answer 4

Toxo; Other; (HIV, hepB, parvovirus, & syph); Rubella; CMV; HSV2

Question 5

Blood glucose ref range for neonate?

Answer 5

> 45 mg/dL (2.5 mmol/L) is normal for a newborn infant.

Question 6

Contraindications to breastfeeding?

Answer 6

RARE: mom HIV+; active, untx’d TB; active mom drug abuse; infants w/ galactosemia.

Question 7

Maternal benefits of breastfeeding?

Answer 7

decreased risk of breast and ovarian cancer and osteoporosis.

Question 8

Short-term benefits of breastfeeding for neonate?

Answer 8

↓ diarrhea, acute and recurrent otitis media, and UTIs

Question 9

Long-term benefits of breastfeeding for infants?

Answer 9

↓ obesity, cancer, adult coronary artery disease, certain allergic conditions, DM1, and IBD; neurocognitive and motor development, too

Question 10

Physical exam findings of CMV in neonate at birth?

Answer 10

microcephaly, jaundice, hepatosplenomegaly, low birth weight, and petechiae at birth

Question 11

Test for CMV in neonate?

Answer 11

a + urine w/in the first three weeks = congenital CMV

Question 12

Children present by six months of age with hepatomegaly, ataxia, seizures, and progressive neurologic degeneration. Fundoscopic exam reveals a “cherry-red” macula.

Answer 12

Nieman-Pick, lysomsomal storage disease, caused by defect in sphingomyelinase

Question 13

Individuals present with hypoglycemia, hepatomegaly, and metabolic acidosis.

Answer 13

A defect in glucose-6-phosphatase occurs in Von Gierke’s disease, a glycogen storage disease. Von Gierke’s disease is inherited in an autosomal recessive pattern

Question 14

Pts w/ cerebellar lesions tend to fall (towards/away from) the side of the lesion?

Answer 14

toward

Question 15

Pts w/ cerebellar lesions tend to have nystagmus (towards/away from) the side of the lesion?

Answer 15

towards

Question 16

which imagine modality is best at visualizing the posterior fossa?

Answer 16

MRI&raquo_space; CT

Question 17

Top four most common types of brain tumors in children?

Answer 17

Medulloblastoma (20%),; Juvenile pilocytic astrocytoma (20%); Lo-grade astrocytoma (15%); Hi-grade astrocytoma (7%)

Question 18

Brainstem gliomas: Px and TX?

Answer 18

prognosis highly variable based on invasiveness; tx is surgicaly resection only

Question 19

Ependymomas: presenting S/Sx, Px and Tx?

Answer 19

Grow near 4tyh ventricle so s/sx of hydrocephalus; 5-yr surv rate is %50; tx is resection then radiation

Question 20

In which age groups are infratentorial vs. supratentorial tumors more common?

Answer 20

Supra (0-2 y/o) -> Infra (childhood) Supra -> (adolescents and adults)

Question 21

Astrocytoma of the cerebellum: Px and Tx?

Answer 21

> 90% 5-yr if completely resected, less if partial; if complete resection, no rad needed; otherwise partially resectable and/or hi-grade neoplasms get surg + rad

Question 22

All states screen neonates for which metabolic d/o?

Answer 22

PKU and congen hypothyroidism

Question 23

Define microcephaly

Answer 23

Head circumference < 10th percentile for gestational age

Question 24

Classic triad of s/sx for TORCH infections?

Answer 24

microcephaly, organomegaly, and rash; 90% of kiddos born w/ congen CMV have no s/sx, but “if present, are most likely to include signs involving the skin, CNS and hepatobiliary system (jaundice, chorioretinitis, hearing loss, intracranial calcifications)”

Question 25

Things to look out for in CMV

Answer 25

MR or CP w/ assoc’d microceph and intracranial calcs; hearing loss; chorioretinitis (need reg optho screening); HSM and rash (the non-neuro abnormalities) resolve spontaneously within weeks.

Question 26

Presentation of congenital rubella?

Answer 26

sensorineural deafness, eye abnormalities (retinopathy, cataracts), and patent ductus arteriosus

Question 27

PKU in kids who were never screened presents as?

Answer 27

vomiting, hypotonia, musty odor, developmental delay, and decreased pigmentation of the hair and eyes

Question 28

Nieman-Pick enzymopathy? Presenting s/sx?

Answer 28

sphingomyelinase; Lysosomal storage disease. Children present by six months of age with hepatomegaly, ataxia, seizures, and progressive neurologic degeneration. Fundoscopic exam reveals a “cherry-red” macula.

Question 29

Hurler syndrome enzymopathy? Presenting s/sx?

Answer 29

defect in alpha-L-iduronidase; autosomal recessive lysosomal storage disease. No sx until 1yo. Sx: HSM, coarse facial features, frontal bossing, corneal clouding, and dev delay. Affected indiv usu die < 15 y/o =/

Question 30

von Gierke’s disease defect? Presenting s/sx?

Answer 30

defect in glucose-6-phosphatase -> glycogen storage dz. autosomal recessive. P/w hypoglycemia, hepatomegaly, and metabolic acidosis.