Pediatrics shelf exam and USMLE - Pediatrics shelf exam and USMLE Flashcards
1
Q
vaccinations given at birth
A
hep b
2
Q
vaccinations given at 1 month
A
hep b, only if not given at birth
3
Q
vaccinations given at 2 months
A
Pediarix (HBV, DTaP, IPV)
Prevnar (pneumococc)
Rotavirus
Hib
4
Q
what is in pediarix
A
HBV
DTaP
IPV
5
Q
vaccinations given at 4 months
A
Pediarix
Prevnar
Hib
Rotavirus
6
Q
vaccinations given at 6 months
A
Pediarix
Prevnar
Hib
Rotavirus
7
Q
vaccinations given at 12 months
A
DTaP Hib MMR VZV Prevnar Influenza Hep A
8
Q
vaccinations given at 24 months
A
none
9
Q
vaccinations given at 4-6 yrs
A
DTaP
IPV
MMR
Influenza
10
Q
vaccinations given at 11 yo
A
Tdap
Meningococcus vaccine
11
Q
what is the schedule for well visits starting from birth
A
1 mo 2 mo 4 mo 6 mo 9 mo 12 mo 15 mo 18 mo 24 mo then annually
12
Q
why shouldn’t babies drink water
A
because their kidneys aren’t mature enough to handle the extra fluid so the babies will become hyponatremic since they can’t excrete the water, and then they can have szs
13
Q
plagylocephaly
A
mishapen head
14
Q
sunsetting sign
A
increased icp, eyes are half closed 2ndary to the increased icp on the cranial nerves
15
Q
craniosynostosis
A
premature closure of the fontanelles
16
Q
rash pattern in rmsf
A
palms and soles, then spreads to trunk
petechial
17
Q
rash pattern in rubella
A
rash on face that spreads to the rest of the body
18
Q
rash pattern in measles
A
rash starts at the head and spreads downwards and disappears in the same manner
19
Q
rash pattern for erythema infectiosum
A
slapped cheek rash; lacy, reticular
20
Q
vzv rash pattern
A
begins on trunk, followed by head, face, and extremities
21
Q
gross motor skills at 1 mo old
A
raises head
22
Q
gross motor skills at 3 mo
A
holds head up
23
Q
gross motor skills at 4-5 mo
A
rolls front to back and back/front
sits supported
24
Q
gross motor skills at 6 mo
A
sits unsupported
25
gross motor skills at 9 mo
crawls
cruises
pulls to stand
26
gross motor skills at 12 mo
walks alone
27
gross motor skills at 15 mo
walks backwards
28
gross motor skills at 18 mo
runs
29
gross motor skills at 24 mo
walks well up and down stairs
30
gross motor skills at 3 yrs
rides tricycle
| throws ball overhand
31
gross motor skills at 4 yo
alternates feet going down stairs
| skips
32
fine motor skills at 1 mo
follows eyes to midline
33
fine motor skills at 3 mo
hands open at rest
34
fine motor skills at 4-5 mo
grasps with both hands together
35
fine motor skills at 6 mo
transfers hand to hand, reaches with either hand
36
fine motor skills at 9 mo
pincher grasp
| finger feeds
37
fine motor skills at 12 mo
throws, releases objects
38
fine motor skills at 15 mo
builds 2 block tower
39
fine motor skills at 18 mo
feeds self with utensils
40
fine motor skills at 24 mo
removes clothing
| builds 5 block tower
41
fine motor skills at 3 yrs
draws circle
42
fine motor skills at 4 yrs
catches ball
| dresses alone
43
fine motor skills at 5 yrs
ties shoes
44
Simple febrile sz
```
btwn 6mo - 6yr
tonic clonic
associated with fever >100.4
sz lasts <15 mins
only 1 sz in 24 hrs
minimal post-ictal state
```
45
complex febrile sz
6 mo - 6 yrs
focal sz
>15 mins
>1 sz/24 hrs
46
management of simple febrile sz
determine the source of the fever, otherwise, no other w/u is needed
47
management of complex febrile sz
full w/u should be done, but no anti-epileptics, no eeg needed
if pt is <18 mo, LP
48
eeg abnormality associated with infantile spasm
hypsarrythmia
49
definition of recurrent abdominal pain
>3x in 3 mo
50
#1 cause of abdominal pain
gastroenteritis
51
mesenteric lymphadenitits
persistent pain following an infx
52
clinical features of HSP
```
condition preceded by uri
non-thrombocytopenic palpable purpura
hematuria (good prognosis)
proteinuria (poor prognosis)
spasmodic abdominal pain
ileus, n/v
ugi/lgi bleed
```
53
tx of hsp
steroids
54
complication of hsp
intussusception
| kidney probs
55
clinical features of kawasaki
```
CRASH and BURN
Conjunctivitis
Rash (on trunk mostly)
Aneurysm (coronary)
Skin peels off, Strawberry tongue
Hands/Feet edema
```
BURN = FEVER (x 5d)
56
phases of kawasaki dz
acute
subacute (aneurysm formation)
convaslescent
takes 2-3 months to resolve
57
tx of kawasaki
ASA
| IVIG
58
when is colicky pain associated with
constipation
59
what type of stool is seen with bacterial enterocolitis
bloody, mucinous stool
60
when will an appendix perforate in appendicitis
w/i 36 hrs
61
which infx can clinically mimic appendicitis
yersinia
| campylobacter
62
what imaging study for appendicitis
ct
63
meds used to tx of perforated appendix
amp, gent, flagyl
64
clinical presentation of intussusception
currant jelly stools
lethargy
palpable tubular mass
paucity of gas on xr or evidence of obx
65
imaging most specific for intussusception
barium (or air) enema
| is also therapeutic
66
most common location for intussusception
ileocolic
| can also develop at meckel's divertic
67
major complication of intussusception
there is impaired venous return so bowel edema develops --> ischemia, necrosis --> perforation
68
etiology of intussusception
ileum invaginates into colon at ileocecal valve
a previous viral infx --> hypertrophy of the peyer's patches... this can develop into a lead point
hsp can be association with an ileal-ileal intussusception
69
tx of intussusception
must do fluid resusc first, if needed
| hydrostatic reduction with air/barium
70
recurrence rate of intussusception
15%
71
at what age would a pt present with pyloric stenosis
1-3 mo
72
which medicaation can be associated with pyloric stenosis
erythromycin
73
best imaging for pyloric stenosis
u/s
| will also see a string sign ugi study
74
tx of pyloric stenoSIS
MUST correct fluids and lytes first!
| then pyloromyotomy
75
describe malrotation
small intestines rotate abnormally in utero, so there is an abnormal fixation posteriorly to the mesentary
it can twist on its vascular supply --> volvulus
76
clinical presentation of malrotation
bilious emesis
possibly abdominal distention/shock
+ guiac test = bowel ischemia, poor prognostic sign
77
tx of malrotation
surgery ASAP
78
tx for scd induced priapism
sedation
79
dz that scd can mimic if htere is abdominal pain
appendecitis
80
when is frontal bossing seen?
beta-thal or some other hemolytic process that requires rapid hematopoesis
81
tx for beta-thal
serial transfusion + chelation therapy (desferoxamine) b/c of fe overload
82
consequence of fe overload
hemochromatosis
83
complications of g6pd deficiency
rbcs are destroyed but there is increased amounts of hb liberated in the process --> hb-uria
84
findings in classic hemophilia
bleeding problems + hemarthrosis
85
battle's sign
basilar skull fx that leads to bleeding/bruise behind the ear
86
mechanism behind bell's palsy in neonates
forceps deliver... usually resovles
87
social milestones at 5 yo
competetive games
| understands rules and abides by them
88
social milestones at 4 yo
imaginative play
89
social milestones at 3 yo
group play
| shares
90
social milestones at 2 yo
parallel play
91
social milestones at 18 mo
plays around other children
92
social milestones at 12 mo
comes when called
| cooperates with dressing
93
social milestones at 9 mo
pat-a-cake
94
social milestones at 6 mo
recognizes strangers
95
social milestones at 4-5 mo
enjoys observing environment
96
social milestones at 3 mo
reaches for familiar objects/ppl
97
social milestones at 2 mo
recognizes parent
98
social milestones at 1 mo
fixes on face
99
developmental dysplasia of the hip
abnml relationship between head of femur and acetabulum --> instabilility and dislocation of hip joint
develops 2ndary to lack of contact of acetabulum and femur during intrauterine devevlopment
100
dx of developmental dysplasia of hip
u/s: see "false acetabulum" in lateral ileum
101
tx of developmental dysplasia of hip
pavick harness (keeps hip abducted and flexed), or body casting on older pts
102
complications of developmental dysplasia of hip
avn
| degen arthritis of hip
103
metatarsus adductus
dorsiflexion and plantarflexion are UNRESTRICTED (diff from clubfoot); heels go out and toes go in
104
tx of metatarsus adductus
stretching or a brace
| surgery not usualy needed
105
idiopathic talipes equinovarus (aka)
| appearance
congenital clubfoot
medial rotation of tibia, fixed plantar flexion, inversion of foot, forefoot adduction
CANNOT DORSIFLEX (unlike metatarsus adductus)
106
tx of clubfoot
bracing
| serial casting
107
legg-calve-perthes dz
avn of femoral head
ischemic bone is eventually resolved and re-ossification occurs
--> limp, pain referred to thigh/knee
108
what movt's are restricted in legg-calve-perthes dz
abduction
flexion
internal rotation
109
tx of legg-calve-perthes dz
bracing
surgery
observation
110
complications of legg-calve-perthes dz
collapse of femoral head
111
SCFE
gradual or acute separation of proximal femoral growth plate
fem head slipps off of femoral neck and rotates inf-post postition
112
etiology of scfe
common during puberty, could be hormonal
113
presentation of scfe
limp, pain in hip and groin, pain referred to knee
114
dx of scfe
plain film frog-leg, lateral position
115
tx of scfe
goal is to prevent further misallignment
pin fixation is done acutely
chronic cases require osteotomy
116
osgood schlatter dz
inflammation, swelling and tenderness over tibial tuberosity 2ndary to tendonitis of distal insertion of infrapatellar tendon
117
when does osgood schlatter dz occur
During growth spurt, in teens
118
tx of osgood schlatter
conservative, supportive management
119
complication related to achondrodysplasia
small foramen magnum seen in homozygotes --> brainstem compression
120
what is achondrodysplasia
d/o of cartilage calcifications and remodeling
121
why do childre have an increased risk of fx
tendons and ligaments are stronger than bones so in kids injuries often lead to fx when they would only cause sprain in adult
122
types of fx
```
spiral (twisting forces on tibia during fall)
epiphyseal fx (use salter classification)
stress fx (hairline crack from repeated activity)
torus fx (at metaphysis)
```
123
nursemaids elbow
subluxation of radial head
124
define upper airway
nose --> carina
125
sx of upper airway dz
inspiratory stridor
tachypnea
respiratory distress
126
choanal atresia
most proximal abnormality of airway
bony or membranous septum btwn 1 or both nasal passages and pharynx, preventing airflow through nose
life threatening if b/l (most young infants are obligate nose breathers)
can't pass ng tube
127
complications of long-term intubation
subglottal stenosis
128
laryngeal or tracheomalacia
floppiness that closes off airway
129
how to confirm dx of laryngeal or tracheomalacia
bronchoscopy
130
ddx for wheezing and respiratory distress
```
asthma
bronchiolitis
foreign body aspiration
gerd
te fistula
vascular sling
```
131
pathophysiology of sx in cf
cftr is abnormal --> altered cl channel
| cl stays in cells and na/water enter the cell to maintain osmotic balance --> viscous secretions
132
gi effects in cf
```
pancreatic insufficiency
bowel obx
rectal prolapse
dm
cirrhosis
lage bulky smelly stools
later in life stools --> distal obx
```
133
pathognomonic finding in cf
meconium ileus
134
tx of cf
chest pt
exercise
frequent cough
recombinant human dnase given through nebs to break down thick mucous complexes
135
other than respiratory infx, what are some other complications of cf
```
hemoptysis (>500 cc/d = emergency) tx w embolization
spontaneous ptx (1/2 will recur unless sclerosis is performemd, but if that is done then transplant is very difficult)
```
136
definition of recurrent abdominal pain
>3x in 3 months
137
mesenteric lymphadenitis leads to
persistent pain after infx
138
gi complication from hsp
ileal-ileal intussusception
139
sx of hsp
non thrombocytopenic palpable purpura in dependent areas
| an iga mediated vasculitis involving gi, skin, joints, and kidneys
140
tx of hsp
steroids
141
what is hsp usually preceded by
uri
142
gi sx of hsp
spasmodic pain, ielus, vomiting, ugi/lgi bleed
143
tx of kawasaki dz
ivig
| asa
144
3 phases of kawasaki
acute
subacute (aneurysms form)
convalescent (resolution over 2-3 mo)
145
which bacterial infx can mimic appendicitis
campylobacter
| yersinia
146
sx of intussusception
```
BOWEL OBX
currant jelly stools
lethargy
palpable tubular mass
paucity of gas on xr or evidence of obx
```
147
dx of intussusception
barium (or air) enema
148
progression of complications of intussusception
```
impaired venous return
bowel edema
ischemia
necrosis
perforation
```
149
pathophys of intussusception
most are ileocecal, and occur when the ileum invaginates into colon at ileocecal valve
150
lead points in intussusception
```
hypertrophy in peyer's patches (often p viral infx)
meckel's divertic
intestinal polyp
lymphoma
foreign body
hsp
```
151
at what age would you expect pyloric stenosis
1-3 months
152
what medication if given is associated with pyloric stenosis
erythromycin
153
dx of pyloric stenosis
u/s, see hypertrophic pyloris
| ugi study shows string sign
154
embryology behind omphalocele
when midgut loop fails to return to abdominal cavity
| see light gray shiny sac protruding from base of umbilical cord
155
embryology behind malrotation of midgut
midgut undergoes partial rotation and --> abnormal position fo abdominal viscera, can be assoc with volvulus --> compromised blood flow and gangrene
156
gastroschisis
weakness in abdominal wall --> herniation of bowel through the rectus muscle, usually to the right of the umbilicus
157
clinical features of malrotation
bilious emesis
possible abdominal distension
xr shows gas in stomach, but no gas in intestines
158
tx of malrotation
surgery stat
159
risk factors for deverloping gerd in babies
```
prematurity
esophageal dz
obx lung dz
overdistension of stomach from overeating
meds (theophylline)
```
160
dx of gerd
pH probe placement in esophagus or ugi endoscopy
| barium swallow to confirm nml anatomy
161
tx of ger/gerd
small frequent feedings
keep head up for 20mins p eating
thicken feeds with cereal
metoclopramide (increases gastric motility)
h2 blocker or ppi
last resort: nissen fundlopication (fundus of stomach is wrapped around distal esophagus to increase les pressure)
162
tx of diarrhea in children
if no serious complications, feed through the diarrhea --> decreased denudement and faster return to nml stooling patterns
don't give antidiarrheals b/c --> toxic megacolon, unless salmonella, shigella, c diff, or parasites
163
when to do w/u for diarrhea in a child
in infant 5d of enterocolitis or salmonella exposure
| any infant with + stool dx looking toxic or + blood cx should be eval for pyelo, meningiits, pna, osteo
164
when should a pt with diarrhea be admitted to hospital
>5% dehydration and can't rehydrate effectively at home
165
obstipation and complications
no bm, if after neonatal pd, #1 cause is voluntary witholding
can be caused by pain, on defacation --> fear fo defecation --> further retention
voluntary holding increaess distension of rectum, decreases rectal sensation, requiring increaesed amounts needed to receive urge
166
sx of hirschprung's
h/o diarrhea, fecal spotting alternating with constipation
167
effect on incresaed bll on bm
--> constipation
168
how to tx functional constipation
incresae fluid, decrease junk food, increase fiber, increase ingestion of undiluted juice
169
pathophys of hirschsprung's
failure of ganglion cells of myenteric plexus to migrate down colon in utero
therefore distal colon is tonically contracted and there is obx
usually limited to rectosigmoid colon
170
when to suspect hirschsprung's
in any infant who doesn't pass meconium, then --> bilious vomiting, abdominal distension, and poor feeding
171
tx of hirschsprung's
diverting colostomy with bowel that contains ganglion cells
| aganglionic segment is removed by pulling ganglionic segment through rectum
172
sx of meckel's diverticulum
remnant of vitilline duct w/i 2 inches of ileocecal valve
bleeding from divertic
melena, obx (from intussusception), diverticulitis
173
tx of meckel's diverticulum
surgical resection
174
dx of meckel's divertic
technetium-99 scan p h2 antagonist to locate hemorrhagic cells
175
encephalocele
projection of cranial content through bony skull defect in occiput --> severe mr, sz, mov't do
176
myelomeningocele
protrusion of neural and meningeal tissue
177
meningocele
meninges protrude
178
spina bifida II is associated with
chiari II malformation
179
complications of spinal bifida
caudal end of cord is tehtered to distal spine and can't ascend to adult position --> scoliosis, sphincter dysfxn, LE deformities
180
non-communicating hydrocephalus
block in exiting ventricles; above blockage, ventricles are big
181
causes of non-communicating hydrocephalus
secondary to narrowing at 4th ventricle/aqueduct or malformation at posterior fossa
chiari II malformation
spina bifida occulta
182
communicating hydrocephalus
subarachnoid villi are dysfunctional/obliterated
183
sx of motor cp
fixed lesion in immature brain -> nonprogressive d/o of mov't and posture
spasticity is #1 type from injury to motor tracts in brain
pts are hypotonic in early months then later become spastic
CONDITION IS NOT PROGRESSIVE
184
sx of extrapyramidal cp
etiology
from basal ganglia damage --> choreoathetoid mov't, postural ataxia, spasticity
kernicterus, there is usually some sort of brain insult
185
what gcs is required for a head ct to be obtained
<12
186
#1 cause of ich in kids
avm
187
what meds are associated with pseudotumor cerebri
tetracyclines
| corticosteroids
188
define encephalopathy
generalized cerebral dysfxn, ms change, disorientation
189
risk factors for developing retinopathy of prematurity
bw <32 weeks
mechanical ventilation
need for supplemental o2
190
causes of leukocoria
retinoblastoma (--> death and visceral mets in all cases)
cataracts (most common cause)
retinopathy of prematurity
191
amblyopia
visual impairment not corrected by glasses and not due to an ocular lesion
often from strabismus
192
tx of amblyopia
occlusion of better seeing eye forces development of affected eye and visual cortex of affected eye
193
at what age will tx not be successful in ambylopia
after 8yo
194
tx of retinoblastoma
enucleation (removal of the affected eye)
radiation tx
chemo
195
complications of neonatal cataracts
if not remoed by 3-4 months, there is irreversible amblyopia
196
course of retinopathy of prematurity
most regress spontaneously
if not, cryotherapy can be performed to reduce progression
are still at risk for amblyopia even if treated
197
dacryostenosis
congenital nasolacrimal duct obstruction
causes overflow tearing - 6% of neonates
2ndary to failrue of distal membranous end of nasolacrimal duct to open
198
tx of dacryostenosis
probing of nasolacrimal dut at 12-15 mo
| although most resolve spontaneously by 1 yo (in 96% of infants)
199
ophthalmia neonatorum
conjunctivitis occurring in first month of life
| p/w eyelid edema, conjunctival hyperemia and ocular d/c
200
when is it normal for there not to be tears
in the first few weeks of life
201
age of onset of gonococcal ophthalmia neonatorum
2-4 days
202
age of onset of chlamydia ophthalmia neonatorum
4-10 days
203
clinical features of gonococcal ophthalmia neonatorum
eyelid edema
chemosis
purulent d/c
204
complications of gonococcal ophthalmia neonatorum
```
sepsis
meningitis
arthritis
corneal ulceration
blindness
```
205
complications of chlamydia ophthalmia neonatorum
corneal scarring
| PNA
206
tx of chlamydia ophthalmia neonatorum
oral and topical erythromycin
tx parents
tx with erythromycin despite the risk of developing pyloric stenosis
207
tx of gonococcal ophthalmia neonatorum
topical erythromycin
IV cefotaxime
tx parents
208
when should steroid containing eye drops not be given in conjunctivitis
if hsv-1 is suspected etiology
| can make dz worse
209
hordeolum
acute infection of sebacous tarsal glands
| staph aureus is usually cause
210
tx of hordeolum
warm compresses
211
chalazion
area of sterile lipogranulomatous reaction within meibomian glands that can enlarge
can be chronic and recurrent
212
is periorbital or orbital cellulitis an emergency
orbital cellulitis
213
sx of periorbital cellulitis
skin around eye is indurated, warm, and tender
no eye pain
may have si/sx of sinus infx
214
sx of orbital cellulitis
severe pain with eye movement
proptosis
vision changes
decreased ocular mobility
215
dx of orbital cellulitis
ct scan
216
organisms to cover with orbital cellulitis
strep
h. flu
m. cat
217
tx of periorbital cellulitis
iv abx
| can --> meningitis, tx agressively with vanco, pcn, 1st gen cephalosporin
218
orgs to tx in periorbital cellulitis
strep
h flu
m cat
219
features of fragile x syndrome
```
hyperactive
mr
large body
long face
prominent jaw and ears
thickened nasal bridge
large testes
+/- autism
```
220
facial features of xyy
long asymmetric ears
| incresaed length: breadth in hands, feet, and cranium
221
nutritional deficiencies in goat's milk
decreased vit d, iron, folate, b12
222
infectious dz associated with drinking raw cow's milk
brucellosis
223
what supplements should moms receive if they are vegan
b12 to prevent buildup of mma
224
effects of excess vit d
hypercalcemia
azotemia
poor growth
n/v/d
225
vit e deficiency in premies -->
hemolytic anemia
226
b1 defic -->
beriberi
(neuritis, edema, chf)
hoarseness
anorexia
227
b2 deficiency -->
photophobia
cheilosis
glossitis
corneal vascularity
228
b3 deficiency -->
pellagra (dermatitis, dementia, diarrhea)
229
pathophys of primary hypophosphatemia
defective po4 resorption
| no conversion of 25-vit D --> 1,25-vit D in proximal tubules
230
lab studies in primary hypophosphatemia
ca
po4
alk phos
low/nml
low
high
231
clinical findings in primary hypophosphatemia
smooth LE bowing (not angular, as is seen in ca defic)
intraglobulin dentin deformities (ca deficiency --> enamel defects)
coarse trabecular bone and fraying
232
somogyi phenomenon
nocturnal hypoglycemia manifested as night terrors, early am sweating, then later has hyperglycemia, ketonuria, glucosuria (sugars increase because of glucagon release)
233
what is an absolute contraindication for DTaP
if first dose --> encephalophaty or encephalitis
234
clinical presentation of pb poisoning
emotional lability
abdominal pain
achy bones
intermittent vomiting and constipation
235
at what BLL should tx be initiated
>45
236
clinical presentation of acute hg poisoning
```
gi pain
fever
chills
HA
visual changes
cough
cp
```
237
clnical presentation of chronic hg poisoning
gingivostomatitis
tremor
neuropsych features
238
clinical presentation of acute arsenic poisoning
```
n/v/d, abdominal pain
3rd spacing
hemorrhage
hypovolemic shock
vtach
qt prolongation
```
239
narcosis
deep stupor, unconsciousness
240
clinical presentation of cerebral palsy
postural hypotonia
failure ot reach for toys
gross and fine motor delay
cognitive and sensory deficits
241
complications of cp
sz
| mr
242
differences in etiology for quadriplegia and paraplegia
quadriplegia results from umn damage
| paraplegia results from lmn or spinal cord damage
243
most likely organisms ot --> pna in cf
staph or pseudomonas
244
clinical presentation of meconium ileus
vomiting
abdominal distension
distended bowel loops
"soap bubble" on axr
245
pathophys of meconium ileus
obx begins in utero --> underdeveloped distal lumen
246
tx of meconium ileus
surgical emergency
| gastrograffin enema
247
vitamin a deficiency -->
pseudotumor cerebri (among other things)
will see bulging fontanelles, ha, n/v
may be seen as first presenting sign in a pt with cf
248
what effect does phenobarb have on jaundice
it improves it by increaseing gluocoronyl transferase
249
cancer that is associated with (germline) retinoblastoma
osteosarcoma is most common
melanoma
squamous cell ca
250
conditions associated with aniridia
congenital glaucoma
surge-weber
marfan
neurofibromatosis
251
presentation of malrotation
obx
typically normal for first few days of life than malrotation worsens --> abdominal fullness, especially in ruq --> bilious vomiting --> ischemia and necrosis
252
#1 malrotation
volvulus
253
pathophys of volvulus
cecum fails to move to rlq and never adheres to abdominal wall
mesentary and sma are tethered to narrow stalk and twist about itself
band of adhesive tissue can extend from cecum to ruq -> duodenal obx
254
presentation of children with 2ndary htn
ha
epistaxis
visual sx
easy fatiguability
255
describe how biliary atresia can occur post-natally
from scarrin gan dinflammation of intrahepatic or extrahepatic biliary ducts
etiology is unclear
256
describe findings of prenatal biliary atresia
gb is absent
257
sx of congenital toxo
chorioretinitis
hydrocephalus
intracranial calcifications
258
complement levels in post-strep gn
decreased c3
259
what are "currant jelly stools"
bloody stools
| indicative of intussusception
260
tx of intussusception
barium/air enema
261
germinal matrix
```
embryonic tissue present near caudate nucleus, often gets damaged by hypoxia/ischemia
#1 place for intraparenchymal bleed
```
262
progression of intraparenchymal bleed in a newborn
blood can flow into ventricles w/i 3 days of life
263
what bvs are damaged in shaken baby syndroem
bridging veins
264
what bvs are involved in sah
circle of willis
265
signs of svt
hr 220-270
| no p waves
266
pathophys of strawberry hemangioma
vascular tissue fails to communicate with adjoining tissue
| enlarges --> raised tumor
267
most common causes for pna in a child > 6 yo
mycoplasm
| strep pneumo
268
cardiac complications in marfan syndrome
aortic root dilatation, aortic dissection
| mvp
269
most common orgs in peritonsillar abscess
anaerobes
| GAS
270
physical findings of patau syndrome
forebrain fails to develop (holoprosenceph)
midface developmental abnormalities
abnml genitalia
severe mr
271
which chromosomes are associated with
1. edwards
2. patau
```
Edwards = Election age (18)
Patau = Puberty age (13)
```
272
porencephaly
cyst/cavity in brain that communicates with ventricles
273
causes of euvolemic hyponatremia
siadh
glucocorticoid deficiency
hypothyroid
water intoxication
274
vacterl
```
vertebral
anal
cardiac
trach
esophageal
renal
limb
```
275
gastrografin
way to dx meconium ileus
is demonstates unused microcolon and pellets of meconium higher up
can draws water into lumen and meconium gets unplugged (dx and tx)
276
features of neonatal listerosis
respiratoyr distress at 5 days
| meningitis
277
clinical presentation of congenital hypothyroid
```
constipation
jaundice
ftt
enlarged fontanelle
umbilical hernia
```
278
presentation of neuroblastoma
```
asx abdominal mass
horner's
dancing eyes
dancing feet
blueberry muffin lesions
htn
```
279
patau's or edwards syndrome:
| microcephaly
patau
280
patau's or edwards syndrome
| prominent occiput
edwards
281
patau's or edwards syndrome
| narrow forehead
edwards
282
patau's or edwards syndrome
| microphthalmia
patau
283
patau's or edwards syndrome
| cutis aplasia
patau
284
patau's or edwards syndrome
| micrognathia
edwards
285
patau's or edwards syndrome
| low-set malformed ears
edwards
286
patau's or edwards syndrome
| cleft lip
patau
287
patau's or edwards syndrome
| congenital heart dz
both
288
patau's or edwards syndrome
| omphalocele
patau
289
patau's or edwards syndrome
| clenched hands with overlapping fingers
both
290
patau's or edwards syndrome
| rocker bottom feet
edwards
291
patau's or edwards syndrome
| polydactyly
patau
292
patau's or edwards syndrome
| polycystic kidney dz
patau
293
patau's or edwards syndrome
| horseshoe kidney
edwards
294
patau's or edwards syndrome
| crytorchidism
patau
295
patau's or edwards syndrome
| agenesis of corpus callosum
patau
296
genetic changes in prader willi
paternal deletion, 2 defective maternal chromosomes
297
physical appearance of pts with prader willi
obese
almond shaped eyes
downturned mouth
small hands and feet
298
genetic changes in angelman's
maternal deletion, 2 deffective paternal chromosomes
299
physical appearance of angelman's
large mouth
short stature
tiptoe walk
szs
300
galactosemia
galactose 1-p builds up and accumulates in liver and brain
301
complications of galactosemia
increased risk of e coli sepsis
LD
premature ovarian failure
302
tx of galactosemia
eliminate galactose containing foods from diet
303
complications of pku during pregnancy
if diet not followed, baby can develop microcephaly, mr, and congenital heart dz
304
physical features of homocystinemia
marfan like appearance
| dislocaed lens
305
what effect does sepsis have on bilirubin
disrupts the bbb so it can cause diffusion of bili into the brain
306
what effect does temp have on bili
cold temperature can --> bili dissociation from albumin
307
protocol for neonates whose mom developed varicella infection just after delivery
if mom develops sx w/i 2 days of delivery or during end of pregnancy, treat baby wiht ivig and acyclovir. if greater amt of time is lapsed, no tx needed
308
consequences of neonatal asphyxia
```
cerebral edema
irritability
sz
cardiomegaly
renal and heart failure
DIC
RDS
```
309
what is the apt test
used to differentiae fetal from maternal blood
310
which drugs are contraindicated for breastfeeding
```
lithium
cyclosporin
antineoplastic drugs
ergots
bromocriptine
tetracyclines
```
311
classic finding on xr for nec
pneumanitis intestinalis
312
consequences of cold temparature in a premie
increased metabolic rate in order to raise body temp, but their ventilation rate increased as well
but, b/c of respiratory problems in premies they can't oxygenate enough so lactic acide accumulates --> metabolic acidosis
313
which is worse:
| ABO incompat or Rh incompat
Rh incompat
314
lab findings in abo incompat
increased retic count
| weakly + coomb's
315
lab findings in rh incompat
strongly + coombs
316
pathophys of transient apnea of the newborn
immature respiratory centers, esp in premies
317
how to id the underlying cause of congenital hypothyroid
iodine uptake scan
318
late development of clavicle fx during delivery... when does this occur?
callous formation in anterior shoulder
| 1 week
319
physical findings of subgaleal hemorrhage
feels like cephalohematoma that crosses midline
| can lose 1/3 of
320
onset of gonococcal conjunctivitis in a newborn
DOL 2-5
321
onset of chlamydia conjunctivitis
DOL 5-14
322
what effects does surfactant deficiency have on lung compliance and lung volume
cardiac effecT
decreases both
| R-->L shunt
323
what should be given to newborns whose moms are infected with Hep B
Hep B Ig and HBV
324
effect of propanolol in utero
iugr
decreased ability of asphyxiated nb to incresae hr and co
associated with hypoglycemia and apnea
325
when is surgery for cleft lip done
3 mo
326
when does transient tachypnea of nb resolve
DOL #3
327
significance of 5th finger polydactyly
in black infants, no consequence
| in white infants, can be associated with cardiac abnormalities, must do an echo
328
twin twin transfusion
donor twin --> oligohydramnios, anemia, ypovolemia
recipient twin --> polyhydramnios, larger size (20% difference in body weight), hyperviscocity, respiratory distress, hyperbili, hypocalcemia, renal vein thrombosis
329
when does serum bili peak
DOL 3-5
