Unit 6 OB Flashcards
What are the two main shunts present in fetal circulation?
Ductus arteriosus and foramen ovale
These shunts allow blood to bypass the lungs and liver during fetal development.
What is the purpose of the ductus arteriosus in fetal circulation?
Allows mixing of blood between the aorta and pulmonary artery
This helps to bypass the non-functioning fetal lungs.
What happens to the ductus arteriosus at birth?
It closes due to pressure changes
This completes the transition to extrauterine circulation.
What condition results from a patent ductus arteriosus?
Increased pulmonary blood flow
This can lead to various clinical presentations including heart failure.
What is a common clinical presentation of patent ductus arteriosus?
Systolic murmur, wide pulse pressure, bounding pulses
Patients may also be asymptomatic or present with heart failure.
What is a Ventricular Septal Defect?
An opening between the ventricles that causes blood to shunt left to right
This results in high pressure to low pressure blood flow.
What are the clinical presentations of a Ventricular Septal Defect?
Asymptomatic, failure to thrive, tachypnea, fatigue, heart murmur
Severe cases may lead to heart failure.
What diagnostic tool is used for Ventricular Septal Defect?
Echocardiogram
This imaging technique helps visualize the defect.
What treatment options are available for moderate to large Ventricular Septal Defect?
Medications (diuretics) and surgery to close the opening with a patch
Medications help delay surgery and prevent heart failure.
What is an Atrial Septal Defect?
Failure of the foramen ovale to close
This results in left to right shunting of blood.
What are common clinical presentations of Atrial Septal Defect?
Often asymptomatic, irregular heartbeat, failure to thrive, murmur
Many cases are discovered in adulthood.
What is Tetralogy of Fallot?
A congenital heart defect with four specific anomalies
It includes pulmonary stenosis, right ventricular hypertrophy, ventricular septal defect, and overriding aorta.
What are the clinical manifestations of Tetralogy of Fallot?
Cyanosis, heart murmur, irritability, poor weight gain
‘Tet spells’ may occur during feeding or crying.
What is the main complication of Coarctation of the Aorta?
Differences in blood pressure between upper and lower extremities
This can lead to left ventricular overload.
What are the clinical manifestations of Coarctation of the Aorta?
Asymptomatic to severe symptoms such as pallor, irritability, dyspnea
Severe cases may show absence of femoral pulses.
What is Endocarditis?
Bacterial infection on a heart valve
It often affects those with congenital heart disease.
What are the clinical manifestations of subacute Endocarditis?
Low-grade fever, diaphoresis, exercise intolerance, fatigue
Acute forms present with high fever and rapid decline.
What is the primary treatment for Endocarditis?
Antibiotics (2-6 weeks IV)
Treatment duration may vary based on severity.
What defines heart failure in children?
Low cardiac output
Congenital causes can lead to high cardiac output failure.
What are common clinical presentations of heart failure in children under 5?
Abdominal pain, decreased appetite, fatigue, recurrent cough
Symptoms differ with age and severity.
What is dehydration?
Excess loss of free water in the body
Most commonly caused by diarrhea and vomiting.
What are the clinical manifestations of dehydration?
Weight loss, dry mucous membranes, lethargy, sunken eyes
Severity can vary based on age and condition.
What constitutes Failure to Thrive?
Weight below the 5th percentile or decreased weight by more than 2 major percentiles
Causes can be organic or inorganic.
What are common complications associated with Cleft Lip and Cleft Palate?
Feeding issues, speech production problems, ear infections
Hearing loss is also common due to the connections with the middle ear.
What is the treatment for Cleft Lip?
Cheiloplasty at 2-3 months
Followed by palatoplasty for cleft palate repair at 9-18 months.
What are the clinical presentations of Appendicitis?
RLQ pain, guarding, lack of appetite, fever
Rebound tenderness is also a common sign.
What is GERD?
Gastroesophageal reflux disease due to a weakened lower esophageal sphincter
Symptoms can include heartburn and regurgitation.
What is the most common surgical condition in infants under 6 months?
Pyloric Stenosis
Characterized by projectile vomiting and poor weight gain.
What dietary change is necessary for Celiac Disease?
Gluten-free diet
This helps restore damage to the small intestine.
What is Intussusception?
Obstruction of the bowel due to one part telescoping into another
It commonly presents with abdominal pain and the hallmark ‘currant jelly’ stool.
What are the symptoms of Anorexia Nervosa?
Low body weight, excessive exercise, amenorrhea, fatigue
Patients may also have dental issues and muscle wasting.
What are the clinical features of Bulimia Nervosa?
Induced vomiting, use of diuretics, throat discomfort
Eroded enamel on teeth and profound dehydration are common.
What is Diabetes Insipidus?
Dysfunction of the pituitary gland affecting ADH production
Can be central (insufficient ADH) or nephrogenic (kidneys do not respond to ADH).
What is the treatment for Central Diabetes Insipidus?
Desmopressin (synthetic ADH)
Thiazide diuretics are used for nephrogenic diabetes.
What is Congenital Hypothyroidism?
Underdevelopment of the thyroid gland
Screening at birth is essential for early detection.
What are the signs of Type 1 Diabetes Mellitus?
Polyuria, polydipsia, polyphagia, weight loss
Symptoms often appear during ages 5-7 or puberty.
What are common symptoms of urinary tract infections in infants?
Nonspecific fever, irritability, abdominal fullness
Symptoms can vary based on age and severity.
What is the smell associated with ketones?
Fruity breath
What are some signs (Sx) of hypoglycemia?
- Pallor
- Sweating
- Headache
- Irregular heartbeat
- Fatigue
- Irritability
- Dizziness
What are urinary tract infections caused by?
Bacteria entering the urinary tract
How are urinary tract infections classified?
Divided into lower and upper urinary tract infections
What are the symptoms of urinary tract infections in infants (2 days to 1 year)?
- Nonspecific fever
- Irritability
- Abdominal fullness
- Foul-smelling urine
- Poor growth
- Poor feeding
- Vomiting
- Diarrhea
- Weight loss
What are the symptoms of urinary tract infections in toddlers (1 year to 3 years)?
- Fever
- Chills
- Poor appetite
- Vomiting
- Urinary frequency
- Incontinence after toilet training
- Flank pain
What are the symptoms of urinary tract infections in children and adolescents (4 years to 20 years)?
- Dysuria
- Urge to urinate
- Frequent urination
- Abdominal or flank pain
- Urinary burning
- Fever
- Constipation
- Incontinence in a previously continent child
- Chills
What is the diagnostic test for urinary tract infections?
UA with culture
What are the treatments for urinary tract infections?
- Antibiotics
- Analgesics/Tylenol
- Frequent toileting
- Proper hygiene
- Supportive care
What is glomerulonephritis?
Inflammatory response that occurs when glomerular capillaries become blocked
What are some consequences of glomerulonephritis?
- Water retention
- Sodium retention
- Decreased urine production
- Edema
What are the risk factors for glomerulonephritis?
History of streptococcal bacterial skin or throat infection
What are the clinical presentations of glomerulonephritis?
- Reduced urine output
- Oliguria
- Hematuria
- Tea-colored urine
- Periorbital edema
- Proteinuria
What diagnostics are used for glomerulonephritis?
- 24-hour urine (presence of protein and blood)
- CBC (normal)
- CMP (elevated BUN and creatinine, decreased GFR)
What supportive treatments are used for glomerulonephritis?
- Reducing water intake
- Reducing sodium
- Measuring intake and output
- Daily weights
- Antibiotics
What is nephrotic syndrome?
Increased protein permeability in glomerular membranes
What are the clinical presentations of nephrotic syndrome?
- Fatigue
- Foamy urine
- Proteinuria
- Hematuria
- Significant edema (periorbital and abdominal)
What is the treatment for nephrotic syndrome?
- Oral corticosteroids (12-week course)
- Supportive care
What is cryptorchidism?
One or both testes fail to descend into the scrotum before birth
What is the treatment for cryptorchidism?
Orchiopexy
What characterizes epispadias?
Urethral meatus located on the top of the penis
What characterizes hypospadias?
Urethral meatus located on the bottom of the penis
What is a hydrocele?
Fluid in the scrotum causing painless swelling
What is the treatment for hydrocele?
- Monitor
- Typically resolves on its own
- Surgery if needed
What is Wilms tumor?
Nephroblastoma
What are the clinical presentations of Wilms tumor?
- Palpable, nontender abdominal flank mass
- Fever
- Decreased appetite
- Weight loss
- Hematuria
- Hypercalcemia
What are the treatments for Wilms tumor?
- Nephrectomy (bilateral or unilateral)
- Chemotherapy
- Radiation
What is iron deficiency anemia?
Most common hematological deficiency of children globally today
When do iron stores deplete in infants?
By 4 months of age
What does AAP recommend for breastfed babies starting at 4 months?
Starting iron supplements
What foods are recommended to prevent iron deficiency anemia?
- Red meat
- Seafood
- Poultry
- Eggs
- Iron-fortified cereal
- Tofu
- Lentils
- Dark green leafy vegetables
What are the clinical presentations of iron deficiency anemia?
- Asymptomatic
- Decreased energy
- Poor feeding
- Tachypnea
- Irritability
What is the treatment for iron deficiency anemia?
Ferrous sulfate oral or IV
What is PICA?
Craving to eat non-food items
What effects can iron deficiency anemia have on overall health?
- Impaired cognitive function
- Developmental and growth delays
- Impaired exercise capacity
- Restless leg syndrome
- Negative effects on mental health
What types of hemophilia exist?
- Hemophilia A
- Hemophilia B
What is hemophilia A characterized by?
Insufficient or absent factor VIII
What is hemophilia B characterized by?
Insufficient or absent factor IX
What are the clinical presentations of hemophilia?
- Bleeding or bruising easily
- Hemarthrosis (bleeding in the joints)
What is the treatment for hemophilia?
- RICE
- Replace clotting factors
- Desmopressin
- Aminocaproic acid
What precautions should be taken for patients with hemophilia?
- Avoid contact sports
- Encourage ice packs and immobilization
- Wear a medical alert bracelet
What is seborrheic dermatitis also known as?
Cradle cap
What causes seborrheic dermatitis?
Inflammation of the sebaceous glands
What is the treatment for seborrheic dermatitis?
- Emollients or mineral oil
- Soft brush to remove scales
- Mild shampoo
- Ketoconazole if persistent
What is atopic dermatitis?
Eczema, a chronic disorder leading to skin inflammation
What are the clinical presentations of atopic dermatitis?
- Pruritus
- Skin flaking
- Inflammation
- Reddened lesions (solid or fluid-filled vesicles)
What is the treatment for atopic dermatitis?
- Hydrate skin with fragrance-free emollients
- Reduce triggers
- Topical corticosteroids
- Tacrolimus ointment
- Antihistamines
What causes acne?
- Excessive sebum production
- Debris blocks follicle
- Inflammation and bacteria collect
What are the types of acne?
- Infantile acne
- Mid-childhood and pre-adolescent acne
- Adolescent acne
What is the treatment for acne?
- Wash face 2x daily with pH balancing product
- Topical agents like benzoyl peroxide
- Oral antibiotics
- Hormonal medications
- Isotretinoin
What precautions are associated with isotretinoin treatment?
- 2 forms of contraception
- 2 negative pregnancy tests before initiation
- Monthly pregnancy tests
- Monitor for depression and suicidal thoughts
