Pediatrics Flash Cards - Case 1 - Eval of Neonate
Start prophylaxic antibiotics if baby was born __ hours after maternal ROM?
≥18 hrs
TABC of neonatal resuscitation?
Temp (warm and dry), Airway (suction and position head), Breathing (stimulate to cry), circulation (assess color/HR)
APGAR mnemonic?
Appearance (color) | Pulse (HR) | Grimace (reflex irritability) | Activity (tone) | Resp
TORCH stands for
Toxo; Other; (HIV, hepB, parvovirus, & syph); Rubella; CMV; HSV2
Blood glucose ref range for neonate?
> 45 mg/dL (2.5 mmol/L) is normal for a newborn infant.
Contraindications to breastfeeding?
RARE: mom HIV+; active, untx’d TB; active mom drug abuse; infants w/ galactosemia.
Maternal benefits of breastfeeding?
decreased risk of breast and ovarian cancer and osteoporosis.
Short-term benefits of breastfeeding for neonate?
↓ diarrhea, acute and recurrent otitis media, and UTIs
Long-term benefits of breastfeeding for infants?
↓ obesity, cancer, adult coronary artery disease, certain allergic conditions, DM1, and IBD; neurocognitive and motor development, too
Physical exam findings of CMV in neonate at birth?
microcephaly, jaundice, hepatosplenomegaly, low birth weight, and petechiae at birth
Test for CMV in neonate?
a + urine w/in the first three weeks = congenital CMV
Children present by six months of age with hepatomegaly, ataxia, seizures, and progressive neurologic degeneration. Fundoscopic exam reveals a “cherry-red” macula.
Nieman-Pick, lysomsomal storage disease, caused by defect in sphingomyelinase
Individuals present with hypoglycemia, hepatomegaly, and metabolic acidosis.
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
Pts w/ cerebellar lesions tend to fall (towards/away from) the side of the lesion?
toward
Pts w/ cerebellar lesions tend to have nystagmus (towards/away from) the side of the lesion?
towards
which imagine modality is best at visualizing the posterior fossa?
MRI»_space; CT
Top four most common types of brain tumors in children?
Medulloblastoma (20%),; Juvenile pilocytic astrocytoma (20%); Lo-grade astrocytoma (15%); Hi-grade astrocytoma (7%)
Brainstem gliomas: Px and TX?
prognosis highly variable based on invasiveness; tx is surgicaly resection only
Ependymomas: presenting S/Sx, Px and Tx?
Grow near 4tyh ventricle so s/sx of hydrocephalus; 5-yr surv rate is %50; tx is resection then radiation
In which age groups are infratentorial vs. supratentorial tumors more common?
Supra (0-2 y/o) -> Infra (childhood) Supra -> (adolescents and adults)
Astrocytoma of the cerebellum: Px and Tx?
> 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
All states screen neonates for which metabolic d/o?
PKU and congen hypothyroidism
Define microcephaly
Head circumference < 10th percentile for gestational age
Classic triad of s/sx for TORCH infections?
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)”
Things to look out for in CMV
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.
Presentation of congenital rubella?
sensorineural deafness, eye abnormalities (retinopathy, cataracts), and patent ductus arteriosus
PKU in kids who were never screened presents as?
vomiting, hypotonia, musty odor, developmental delay, and decreased pigmentation of the hair and eyes
Nieman-Pick enzymopathy? Presenting s/sx?
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.
Hurler syndrome enzymopathy? Presenting s/sx?
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 =/
von Gierke’s disease defect? Presenting s/sx?
defect in glucose-6-phosphatase -> glycogen storage dz. autosomal recessive. P/w hypoglycemia, hepatomegaly, and metabolic acidosis.
