Unit 1 Flashcards
Transient mottling when infant is exposed to decreased temperature
Cutis Marmorata
cyanosis of hand and feet in response to cold
acrocyanosis (underlying cardiac defect should be expected if more intense in feet)
Whitish, moist, cheeselike substance - mixture of sebum and skin cells on newborn
Vernix Caseosa (protective)
Fine, silky hair covering newborn
Lanugo (shed within 10-14 days)
Flat, deep pink, localized areas usually seen in back of neck
Telangiectactic nevi (stork bites)
Irregular areas of blue/blue-gray pigmentation usually in sacral and gluteal regions (predominantly in african, native american, asian, or latin descent)
Dermal Melanocytosis (Mongolian spots)
Pink papular rash with vesicles superimposed
Erythema toxicum (may apear 24-48 hours after birth)
Hyperbilirubinemia risk factors
breast feeding, hemoltyic disease, infection, cephalhematoma, cutaneous or subcutaneous bleeds
preferred treatment for hyperbiligubinemia
Bili lam and bili blanket
Present in 50% of newborns and appears to be an inability of the liver to conjugate bilirubin present in the bloood
physiologic jaundice
if jaundice is present in the first 24 hours or it is intense and persistent it is considered
pathological
What does tenting indicate
dehydration and malnutrition
What is schamroth technique
Placing nail surfaces of corresponding fingers together: normal - diamond shaped, Clubbed - angle between distal tips increases
Small, white, discrete papules on the face and bridge of the nose - common during the first 2-3 months
Milia (plugged sebaceous glands)
Caused by occlusion of sweat ducts during periods of heat and high humidity
Milaria (heat rash)
Scalp lesions that are scaling, adherent, thick, yellow, and crusted
Seborrheic dermatitis (cradle crap)
Honey colored crusts caused by staph or strep
Impetigo
Tuft of hair overlying the spinal column usually lumbosacral area
Faun Tail Nevus (spina bifida occulta)
Evenly pigmented patches present at birth or shortly after
Cafe au lait spots (suspect neruofibromatosis if >5 patches >1cm diameter in children under 5)
What is axillary freckling or inguinal freckling associated with
neurofibromatosis
periodic cessation of breathing during sleep do to airflow obstruction
Obstructive sleep apnea
Which lymph nodes is it NEVER normal to be enlarged in children
Supraclavicular
Initial symptoms: pharyngitis, fever, fatigue, malaise. Exam findings: enlarged anterior and posterior cervical chains, splenomegaly, hepatomegaly
Infectious Mononucleosis (eptstein-barr virus)
Initial symptoms: sore throat and runny nose, headache, fatigue, and abdominal pains
Strep Pharyngitis (throat culture needed to confirm)
Subcutaneous edema, crosses suture lines, MC occiput, soft, poorly defined margins
Caput Succedaneum
Subperosteal bleed, does not cross sutures, MC parietal, firm, well-defined edges
Cephalhematoma
Premature union of cranial sutures - small head circumference, rigid sutures, misshapen skull
craniosynostosis (usually not accompanied by mental retardation)
No ridging, ear on flat side migrates forward, forehead protrudes, bald spot on side flattening
Positional head deformity
Palpaple ridge, ears even or ear on flat side appears to be more posterior, forehead does not protrude, no bald spot or central bald spot
Craniosynostosis
At what months do the anterior and posterior fontanels close
Posterior about 2 mos.
Anterior about 24 mos.
What condition results from a hematoma that can be palpated shortly after birth and becomes a fibrous mass 2-3 weeks later
torticollis (wry neck)
which condition elicits setting sun sign (sclera visible above the iris)
hydrocephalus (enlarged head, bossing, widening of sutures and fontanels)
Softening of the skull, demonstrated by pressing the bone along the suture line
craniotabes - associated with rickets and hydrocelphalus
Asymmetry of facial features
Bell’s Palsy
Depressed nasal bridge, epicanthal folds, mongolian slant of eyes, low set ears, large tongue
down syndrome
Smooth philtrum, widespread eyes, hirsute forehead, short nose, thin upper lip
Fetal Alcohol Syndrome
Widely spaced eyes - may be associated with mental retardation
Hypertelorism
Loss of functional pupil, often associated with other congenital abnormalities
coloboma “keyhole pupil”
White specks in a linear pattern around the circumference of the iris
Brushfield spots (suggests down syndrome)
Congenital non-progressive horizontal opthalmoplegia primarily affecting the abducens nucleus and nerve and lateral recuts muscle
Duane syndrome
Eye chart used for children usually about 3 years old
Snellen E chart
What might a 2 line difference (20/50 and 20/30) indicate
Amblyopia
At what age is 20/20 vision expected. At what age is it 20/50
6 yo
3 yo
Congenital malignant tumor initially recognized from a white reflex
retinoblastoma
What should the tip of the auricle cross in an infant
imaginary line between outer canthus of eye and the prominent portion of EOP
What are poorly shaped auricles associated with
renal disorders and congenital abnormalities
Itching of ear canal, intense pain with movement of pinna, discharge may be watery at first, then purulent and thick mixed with pus and epithelial cells, conductive hearing loss
Otitis externa
Infection of the middle ear, fever, feeling of blockage, deep-seated earache, discharge if tympanum ruptures, conductive hearing loss
Bacterial Otitis Media
Collection of liquid in the middle ear, cracking sound when yawning, pain is uncommon, feeling of fullness, discharge is uncommon, conductive hearing loss
Otitis media with effusion
Congenital nasal obstruction of the posterior nares
Choanal atresia (will breathe when crying)
Which sinuses are developed at birth
maxillary and ethmoidal (sphenoid not till puberty, frontal sinus not until 7-8 yo)
appear along buccal of the gums, pearl-like cysts, disappear in 1-2 months
Retention cysts (epstein pearls)
Multiple brown caries on upper and lower incisors
Baby bottle syndrome (bedtime bottle of juice/milk)
Enamel dysplasia
Mottled or pitted teeth (d/t tetracycline treatment during tooth development)
unconscious grinding of the teeth
bruxism
Caused by haemophilus influenzae type B, most common in 3-7 yo, croupy cough, sore throat, appears anxious, tripod position
epiglottitis
autosomal recessive exocrine glands, frequent pulmonary infections, sticky foul stool, tastes salty
cystic fibrosis
Cartilage of larynx is floppy, larynx closes in response to varying pressures of inspiration and expiration resulting in noisy breathing
Laryngomalacia
RSV, MC
bronchiolitis
Parainfluenza virus, very young, boys > girls, often begins in evening after child has gone to sleep, harsh stridorous cough (bark of seal)
croup
COPD characterized by airway inflammation, mucosal edema, increased secretions, bronchoconstriction
athsma
inflammatory response of the bronchioles and alveolar space to an infective agent, exudates lead to consolidation
Pneumonia
inflammation of the mucus of the bronchial tube with fever and chest pain
acute bronchitis
In fetal circualation blood travels directly from R to L atrium through this
foramen ovale
In fetal circulation RV pumps blood through thIS
ductus arteriosus
Leads to increased workload for RV and increased pressure in the pulmonary circulation, Machinery murmur (harsh, loud, continuous murmur, 1-3rd intercostal space,
Patent Ductus Arteriosus
Apical impulse location in infant and age it reaches adult position
3rd-5th intercostal, age 7
MC on left side, shifts heart to the right
diaphragmatic hernia
If consistently above this percentile in BP it is considered severe and could be renal disease, renal artery disease, or coarctation of aorta
95th
Narrowing in a portion of the aorta, MC descending arch near origin of left sublcavian artery
coarcation of the aorta
Oxygenated blood leaks from the LA to the RA
atrial septal defect
Allows oxygenated blood to leak from left ventricle into the right (holosystolic murmur)
ventricular septal defect
Pulmonary valve stenosis, RV hypertrophy, overriding aorta, VSD
tetralogy of fallot
What are “tet spells”
central cyanosis, paraxysmal dyspnea with loss of conciousness
Complication of strep, pharangitis, CT disease, may result in cardiac mitral or aortic valve involvement
Acute rheumatic fever (5-15)
fever, conjunctivitis, rash, strawberry tongue MC
kawasaki disease
midline separation of recuts abdominis usually resolves by 6 yo
Diastasis recti
MC intraabdominal tumor in childhood, malignant,
Nephroblastoma
Absence of parasympathetic ganglion cells in a segment of the colon… no peristalsis
Hirschprung Diseease (congenital aganglionic megacolon)
Sausage, shaped mass in left or right upper quadrant, MC 3-12 mos, etiology unknown
intussusception (ABCDEF)
Olive-shaped mass in upper RQ immediately after the infant vomits
pyloric stenosis
hypertrophy of the circular pylorus or obstruction of the pyloric sphincter, projectile vomiting, feeding irregularly
Pyloric Stenosis
relaxation or incompetence of the lower esophagus persisting beyond the newborn period, regurgitation and vomiting, weight loss, failure to thrive, repsiratory problems
Gastroesophageal reflux
Congenital obstruction or absence of some or all of the bile duct system, jaundice, hepatomegaly, abdominal distention
biliary atresia
Thickening and hardenin gof meconium in lower intestine - intestinal obstruction, failure to pass meconium 1st 24 hours after birth must consider cystic fibrosis
meconium ileus
Outpouching of the ileum, MC congenital anomaly of the GI tract
Meckel diverticulum
