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Clin Med 1 Final > Peds - Neonate > Flashcards

Peds - Neonate Flashcards

1
Q

newborn vitals

A

HR: 100-160 bpm, RR: 40-60, BP varies, Temp - 98.6 rectally

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2
Q

full-term

A

37-42 weeks gestation

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3
Q

post-term

A

42 + weeks

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4
Q

preterm

A

> 37 weeks

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5
Q

LBW

A

<2500 grams

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6
Q

VLBW

A

<1500 g

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7
Q

ELBW

A

<1000 g

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8
Q

Appropriate for Gestational age

A

AGA - 10-90th percentile

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9
Q

SGA

A

small for gestational age, <10th percentile

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10
Q

LGA

A

large for gestational age, above 90th percentile

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11
Q

APGAR

A

a- activity/ muscle tone, p - pulse, g- grimace or reflex, a - appearance or skin color, r-respiration

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12
Q

neonatologists

A

specialized pediatricians that can follow sick babies until they are 2 or 3

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13
Q

S&S of significant illness in newborn

A

tachypnea, grunting, cyanosis, temperature instability/fever, poor perfusion, hypoglycemia

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14
Q

routine meds in first 48 hrs of life

A

vitamin K, opthalmic ointment

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15
Q

Physical Exam of newborn - basics

A

vitals, wt in kg (2.2 lbs/kg), length in cm (2.54 cm/ in), head cricumference in cm

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16
Q

PE of newborn - eyes

A

red reflex - retinoblastoma or congenital cataracts, full EOMs, subconjunctival hemorrhages

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17
Q

PE of newborn - ears

A

shape, size, placement, skin tags or preauricular pits, if abnormal - check renal system that develops at same time

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18
Q

PE of newborn - nose and mouth

A

patency of nares (choanal atresia), obligate nose breathers until 3 months of age

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19
Q

PE of newborn -mouth

A

hard and soft palates, epstein pearls, epithelial cysts, natal teeth

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20
Q

PE of newborn - neck

A

ROM, cysts and masses, thryomegaly

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21
Q

PE of newborn - chest

A

clavicle fracture, pectus excavatum, breast buds, supernumerary nipples

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22
Q

PE of newborn - cardiovascular

A

Central cyanosis, cardiac mumurs, femoral pulse, pulse ox before discharge for critical congenital heart disease

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23
Q

PE of newborn - abdomen

A

masses or organomegaly, abdominal wall defects, umbilical cord - 2 arteries and avein - smiley face

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24
Q

PE of newborn - genetalia

A

male - hypospadius, hydrocele, cyrptorchidism, inguinal hernias, female - swollen labia majora or physiological vaginal discharde, both - anus patency

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25
Q

PE of newborn - spine

A

sacral dimples, hair tufts - both suggest spina bifida occulta, Mongolian spots

26
Q

PE of newborn - extremeties

A

fingers and toes, talipes equinovarus - club foot, developmental dysplasia of the hip

27
Q

PE of newborn - neurological

A

overall tone, reflexes - rooting, sucking, asymmetric tonic neck, palmar grasp, plantar grasp, moro relex

28
Q

Uncircumcised risk

A

UTIs, STDS and HIV, penile cancer

29
Q

Hearing screening

A

in first 48 hours

30
Q

otoacoustic emission

A

OAE, screening for hearing, sounds presented to ear canal and microphone measures response in ear canal

31
Q

auditory brainstem response

A

screening for hearing loss, ABR, sounds presented and surface electrodes measure brainstem activity

32
Q

Before discharge - parent care

A

umbilical cord, cricumcision, feeding, bathing, sleeping patterns and positions, car seats, safety

33
Q

Call if baby has…

A

fever > 100.4F, respiratory distress, irritability, lethargy, decreased feeding, dehydration

34
Q

Preterm birth risk factors - maternal

A

preeclampsia, drug abuse (cocaine), chronic medical condition, infection

35
Q

preterm birth risk factors - fetal

A

multiple gestation, premature rupture of membranes, placenta previa, fetal distress

36
Q

Viability limits

A

22-25 weeks, 400-750 grams, use new ballard

37
Q

common problems in prematurity

A

temperature instability, apnea, bradycardia, feeding issues - fluids, electrolytes, nutrition - protein, fat, carbs, aa, vitamins, minerals

38
Q

erythema toxicum

A

very common in newborns, erythematus macules and papules that evolved into pustules, look like flee bites, face, truck and extremities but no palms or soles, self-limited, no tx

39
Q

cutis marmorata

A

reticulated mottling of skin, symmetric on trunk and extremities, vascular response to cold, resolves with warmed skin, no tx needed

40
Q

harlequin phenomenon

A

newborn lies on side and erythema on one side with blanching on the contralateral side, develops suddenly and persists for a time, no tx needed

41
Q

transient neonatal pustular melanosis

A

vesiculopustular rash, more common in black newborns, no erythema, lesions rupture and leave a scaly, pigmented macule (Ddx), entire body can be affected

42
Q

acne neonatorum

A

closed comedones on forehead, nose and cheeks, can be open comedones, papules and pustules too, sebaceous gland stimulation from infant or maternal androgens, resolve spontaneously within4 months, can tx if longer than 4 months or extensive with benzoyl peroxide, severe/unrelenting - hyperandrogenism?

43
Q

milia

A

1-2 mm pearly white or yellow papules due to retention of keratin within dermis, forehead, cheeks, nose and chin, spontaneously resolve, self-limited

44
Q

miliaria

A

sweat retention due to partial closure of eccrine structures, 1-2 mm vesicles without erythema on head,neck, and truck, vesicle ruptures and desquamates, avoid overheating, remove excess clothing, air conditioning, self-limited and benign

45
Q

seborrheic dermatitis

A

cradle cap - scalp, face,ears, neck, erythema and greasy scales, can spread to diaper, self-limited in most children, scales can be removes with a brush after shampooing followed by tar shampoos if needed

46
Q

congenital melanocytic nevi

A

dirupted migration of melanocytes precursors in neural crest, brown to balck - flat or raised, potential for melanoma in a small % of kids, removal if large or changes in color, shape or thickness with regular followup

47
Q

dermal melanosis

A

mongolian spots, flat bluish-gray brown lesions from trapped melanocytes, back or buttocks and lock like bruises, make sure to document, self-limited and fade by 2 years of age

48
Q

hemangiomas

A

strawberry in infants, most involute and disappear by 10 years old (90%), may leave atrophy, telangiectasias, hypopigmentation or scars, can tx if getting near school age, tx if near orifice with prednisone, multiple - look for them in liver and GI tract too

49
Q

nevus flammeus

A

port-wine stain, vascular birthmark, dark red to purple, do not fade ofer time, don’t require tx but can use laser to lighten , if near opthalmic distribution of trigeminal nerve watch for glaucoma - Sturge-Weber syndrome

50
Q

nevus simplex

A

salmon patch, stork bites, angel kisses, flat salmon-colored lesions caused by telangiectasias in dermis, blanch readily, symmetric, benign and resolve

51
Q

skin markers of spinal dysraphism

A

incomplete fusion of midline elements of the spine, midline lumbosacral skin lesions - lipomas, dimples, dermal sinuses, tails, hemangiomas, etc are cutaneous markers - image (MRI or ultrasound) to check especially with 2+ lesions at midline

52
Q

cafe-au-lait spots

A

coffee with milk, normal is small

53
Q

sucking blister

A

suck in utero, self-limited

54
Q

lanugo

A

fine hair that will slough off, common with preterm babies

55
Q

intraventricular hemorrhage

A

occurs in gelatinous subependymal germinal matrix of the premature infant, predisposed - premature, RDS, hypoxic-ischemic inury, incr. or decr. cerabral blood flow, hypovolemia

56
Q

retinopathy of prematurity

A

retinal vessel development interrupted and restarted causing scar tissue beyond the plane of retina, risk - hyperoxia, extreme prematurity, can cause cataracts, glaucoma, and blindness

57
Q

Respiratory Distress Syndrome (RDS)

A

hyaline membrane disease, caused by surfactant deficiency - not produced by fetal lungs until 26-28 weeks, develop tachypnea, grunting, retractions, nasal flaring, cyanosis, tx- intubate, oxygen, surfactant, complications - bronchopulmonary dysplasia (chronic lung disease) or oxygen toxicity

58
Q

Group B Strep Infection

A

Major cause of sepsis in newborns, moms screened at 35-57 wks gestation and given intrapartum antibiotics if needed, signs in neonate - respiratory distress, apnea, bradycardia, hypoglycemia, fever/hypothermia, lethargy, meningitis, if any symptoms - evaluate and empiric therapy

59
Q

Transient tachypnea of the newborn (TTN)

A

term and pre-term infants can get this, risk with C-section, fetal lung fluid retention, tachypnea, grunting, nasal flaring, retractions with clear lungs, CXR: hyperinflated, prominent vascular markings, spontaneously resolves in 48-72 hours and has no long-term complications

60
Q

hyperbilirubinemia

A

jaundice in the first 24 hours of life is pathologic, physiologic - breakdown fetal RBCs and decreased bilirubin clearance, may be affected due to breast-feeding - lower fluid vol and frequency of stool or breastmilk - fatty acid impede bilirubin clearance, visible if >7 mg/dl, treat with phototherapy at >15, >20 risk for kernicterus, tx with ad-lib feedings and supplement with formula if needed, exchange transfusion at critical levels

61
Q

Premie discharge criteria

A

no recent apnea or bradycardia, feed via breast or bottle, maintain temp, steady wt gain, medical conditions stable and clear follow-up plan

62
Q

long-term complications of preterm birth

A

physical - ROP/visual, sensorineural hearing loss, smaller and shorter though may catch up by 2nd year, higher mortality rate at <2 years of age, risk for developmental delay, mental retardation, or cerebral palsy

Clin Med 1 Final (6 decks)

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