Peds: Newborn

Question 1

Tachypnea, nasal grunting and intercostal retractions in premature neonate. Dx? Best predictor for development? Rx? Primary prevention? Complications

Answer 1

Respiratory Distress Syndrome. LS ratio. 02 and nasal CPAP. Exogenous surfactant. Antenatal bethamethasone ( 24 hrs before delivery at < 34 weeks gestation) and avoid prematurity (give tocolytics) Retinopathy of prematurity, bronchopulmonary dysplasia, intraventricular hemorrhage.

Question 2

Tachypnea after C-section or rapid 2nd stage of labor in term infant. Dx? Test? Rx?

Answer 2

Transient Tachypnea of the newborn related to retained lung fluid. CXR 02.

Question 3

Respiratory distress and scaphoid abdomen. Dx? Test? Rx?

Answer 3

Diaphragmatic hernia. CXR. Immediate intubation followed by surgical correction.

Question 4

Severe respiratory distress and hypoxemia in a term neonate with hypoxia or fetal distress in utero. Dx? Test? Rx?

Answer 4

Meconium Aspiration. CXR. Positive pressure ventilation, High frequency ventilation, NO therapy.

Question 5

Drooling with first feed. No respiratory distress. Dx? Test? Associated with what?

Answer 5

Tracheoesphageal fistula. NG tube confirms diagnosis. VACTERL. (vertebral defecs, Anal atresia, cardiac, Tracheoesphageal fistula with esophageal atresia, radial and renal anomalies, limb syndrome

Question 6

Low Apgar scores, bloody stools, apnea, lethargy, abdominal wall erythema and distention. Dx? Test? Rx?

Answer 6

Necrotizing enterocolitis. AXR. Stop all feeds, Decompress gut, broad spectrum abx, surgical resection.

Question 7

Genetics: Upward slanting of palprebal fissues, speckling iris, inner epicanthal folds, mental retardation. Dx?

Answer 7

Trisomy 21 Down syndrome

Question 8

Genetics: Low set ears, rocker-bottom feet, hammer toe, omphalocele. Dx?

Answer 8

Trisomy 18 (Edwards Syndrome)

Question 9

Genetics: Defect midface, holoprocenphaly, microcephaly, cleft lip palate. Dx?

Answer 9

Trisomy 13 (Patua Syndrome)

Question 10

Genetics: Aniridia, GU Anomalies, Mental Retardation.

Answer 10

WAGR syndrome

Question 11

Genetics: Low IQ, slim with long limbs, gynocomastia. Dx?

Answer 11

Klienfilter (XXY)

Question 12

Genetics: Macrocephaly, larges ears, large testes, mental retardation.

Answer 12

Fragile X syndrome.

Question 13

Genetics: Multiorgan enlargement, macrosomia, macroglossia.

Answer 13

Beckwith-Wiedeman syndrome.

Question 14

Genetics: Obesity, mental retardation, binge eating.

Answer 14

Prada-Wili

Question 15

Mental retardation, inappropiate laughter, absent speech, < 6 words

Answer 15

Angelman syndrome