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After an uncomplicated delivery, what is the next step in management of the baby?
suction of mouth and nose
what is the normal rr and hr for a newborn?
what does the apgar score measure?
- appearance-- blue or not
- pulse- <60 or >60
- Grimace- no response vs response
- activity- some vs active movement
- Respiration- absent vs strong
what are the causes of conjunctivitis at day 1, day 1 to day 7? day 7 to day 21? post day 21?
- chlamydia trachomatis
with what 2 antibiotics is opthalmia neonatorum prevented with?
- silver nitrate
what diseases are screened for before newborn is released?
what congenital disorders are being screened for in a newborn?
- beta thal
which newborns shud get the hep B ig in addition to the vaccine?
the newborns with mothers that are hepB ag +
tachypnea is normal in newborns i.e 120-160 hr..if it persists past 4 hours it is considered?
- sepsis and appropriate work up is done i.e-- urine culture
- blood culture
- csf culture and analysis
which one crosses the suture lines, cephalohematoma or caput succedaneum
rx for erb-duschene palsy?
rx for klumpke's palsy?
what is the best initial test for a clavicular fracture in a new born?
- immobilization, splinting, physical therapy
causes of polyhydramnions?
causes of oligohydramnios?
cant pee it out so you get potter--flat facies and lung hypoplasia
Types of diaphragmatic hernias?
what congenital disorders are screnned for at birth?
- beta thal
what conditions elevate afp?
- neural tube defects
- abdominal wall defects
most common cause for an elevated afp ?
omphalocele vs gastroschesis?
omphalocele is midline defect in which abdominal contents protrude with a sac covering it
gastroschesis is not midline and there is no sac covering it
when are umbilical hernias surgically repaired?
after the age of 4
best initial test for wilms tumor?
most accurate test for wilms tumor?
- wilms tumor
- gernital-urinary malformation
- Retardation Mental
hallmark findings in Neuroblastoma?
- hypsarrythmia--dancing eyes
- opsoclonus-- dancing feet
- urine vma and metanephrines
hydrocele produces a fluid filled sac that transilluminates and it is a remnant of ?
rx of hydrocele/?
- resolves spontaneously
- inguinal hernia
at what age is orchiopexy indicated?
hypospadias or epispadias commonly exists with what other urinary malformation?
most common cyanotic heart disease in kids?
what is associated with chromosome 22 deletions?
- cleft palat
- abnormal facies
- thymic aplasia
- cardiac defect-TOF
3 holocystolic murmurs?
- mitral regurg
- tricuspid regurg
Edwards, Patua and Down all have what cardiac defect in common?
What cardiac defect requires PDA, ASD or VSD to maintain oxygenation?
Most common cyanoitic heart lesion during the neonatal period?
Most common form of ASD?
when is jaundice considered pathological?
- bilirubin over 20
- first day of life
- rise of more than 5/day
- direct rises above 2ml
- jaundice persists after 2nd week of life
rx for hyperbilirubinmeia?
- uv light below 20
- above 20--exchange transfusion
what condition has the olive sign?
Diagnostic tests for Tracheoesophadeal fistula?
- xray--gastric/esophageal bubble
- coiling of ng tube in the esophagus
Best initial test for pyloric stenosis?
most accurate test?
- GI series showing string sign
projectile vomiting at birth?
projectile vomiting at 1 month?
- tracheoesophageal fistula
- pyloric stenosis
rx for pyloric stenosis?
membrane between nostrils and pharynx
presentation of choanal atresia?
child is blue(cyanotic) when feeding and pink when crying
coloboma of the eye?
eye in any part of the eye
what is the charge syndrome?
- coloboma of the eye or cns
- heart defects
- ateria of the chonae
- retardation growth or developmne
- gential defects
- Ear anomalies
diagnosis of choanal atresia?
best initial test for hirshsprung dz?
- xray will show air in the large bowel
- biobsy of the transmural colon wall
what is the vacterl syndrome?
- vertebral anomalies
- anal atresia
- cardiovascular defects
- tracheoesophageal fistula
- esophageal fistula
- renal anomalies
- limb anomalies
imperforate anus is part of what syndrome?
choanal atresia is part of what syndrome?
best initial test for volvulus?
Best initial therapy?
two pathologies producing a red currant fluid?
- klebsiella pneumonia
best initial test for intussessption?
most accurate test?
- barium enema
- barium enema
most accurate test for meckels?
- technetium 99 scan
- surgical removal
diagnostic tests for diarrhea?
is loperamide used for neonatal diarrhea?
air in the bowel wall or pneumatosis intestinalis is characteristic of?
best initial therapy for a volvulus?
- endoscopical decompression
- electrolyte replacement and barium enema
most common cause of congenital adrenal hyperplasia?
21 alpha hydroxylase deficiency
How is Congenital Adrenal Hyperplasia diagnosed?
- serum electrolytes
- high 17 OH progesterone
4 variants of rickets?
- vitamin D deficient
- vitamin D dependent--kidney cant conver 25 to 1,25
- xlinked hypophosphatemic--kidney cant retain phosphate
Diagnostic tests for rickets?
- xray of ribs--rosary
- xray of leg--bowing of bones
Best initial test for toxo?
Most accurate test?
best initial step in management of croup?
in terms of presenatation how does croup differ from epiglottitis?
croup--hypoxia on presentation
diagnosis of each
- tzank is best initial--culture is most accurate
- measles--clinical--most accurate is culture
best initial management of croup vs epiglottitis?
rx for epiglottitis-
- rifampin for close contact
most accurate test for bortadella pertussis?
Congenital Hip Dysplasia affects what age?
Slipped Capital Femoral Epiphysis?
legg-calve EPthese disease
- obese adolescents
- infants to 10 year olds--avascular necrosis
causes of subcutaneous fat necrosis
- difficult labor
- perinatal hypoxia
- forcep delivery
erbs palsy affecting the diaphragm?
next best step in management?
predisposing factor to a clavicular fracture?
what causes subconjunctival hemmorhages
cutis marmorata is normal or abnormal?
normal--looks like livedo reticularis
what are salmon pathc?
- birthmarks on back of neck, face--normal variation
- it is normal
port wine stain is what part of syndrome?
mongolian spots occur where?
- lumbo-sacral area
- child abuse
dd for erythema toxicum?
plugging up pores on the nose
2 causes of cataract in a newborn?
ear malformations tend to accompany what other malformations?
what is the location of a branchial cleft cyst cs thyroglossal cyst?
- branchial cleft cyst is lateral to the midline
- thyroglossal cyst is midline
abnormalities of the limbs is associated with ?
what congenital disorder is a contraindication to breast feeding?
symmetric IUGR causes?
causes of assymetric IUGR?
- torches infections
in respiratory distress syndrome, 100% oxygen will?
- fix the saturation
- but if its cardiac then it wont be fixed
what is the transient tachypnea of the newborn? TTN?
respiratory distress due to fluid in the lungs
Respiratory causes of Respiratory Distress Syndrome?
- not enough surfactant
- Transietnt Tachypnea of the newborn
- Meconium Aspiration Syndrome
- diaphragmatic hornia--bowel sounds in chest
Best initial test for RDS?
- chest xray--ground class appearance
- Lecithin/sphingomyelin ration
Fast second stage of labor or cessarian section and respiratory distress?
Transient Tachypnea of the newborn
cause of high direct bilirubin and clay colored stool?
breast feeding janudice?rx?
breast milk jaundice?rx?
not enough feeding-->baby is dehydrated jaundice <1 week..rx is to increase breastfeeding
something in the milk, kills rbcs -->1 week jaundice..rx is observe
empiric rx for sepsis in neonate?
amp and gent
best initial test in suspecting torch infections?
Rx of toxo in mother?
- pyrimethamine sulfonomaide
How to prevent folate depletion with sulfonomaide or mtx?
Torch infection that causes snuffles?
3 causes of cholestatic jaundice?
- choledochal cyst
- annular pancreas
- biliary atresia
benefit of breast feeding?
- better protein--so less diarhhea
- better iron absorption
weight gain of neonates?
1lb/month for first 6 months
most common cause of failure to thrive?
poor mom and baby interaction
what food are fed to the baby and when?
- 4 months--cereal
- 8 months--mashed food
- 12 months--table foods
feeding proetins too early leads to?
prolactin inhibits what hormone?
2 diseases with cafe au lait spots?
- mccune albright syndrome--precocious puberty
ashen leaf spots?
abnormalities of the facial bones and nail abnormalities, fetus was exposed to what drug?
which one do you repair first? cleft palate or cleft lip?
hemihypetrophy of one limb + wilms tumore
congenital hip dysplasia maneuvers
rx for congenital hip dysplasia?
extra finger, next step?
most common cause of language delay?
when do you remove adenoids or tonsills?
when there is snoring
all reflexes dissapear by how many months?
- 4 months
- babinski---by 18 months
most common cause of miscarriage?
test of choice for intraventricular hemorrhage in the preterm?
which syndrome has midline defects such as cleft lip, palate, holoprosencephaly?
heart defect in turner syndrome?
syndrome where everything is large due to beta islet hyperplasia?
prader will syndomre chromosome?
Pierre robin sequence?
mandibular hypoplasia--large tougne--airway obstruction
Waardenburg syndrome is what inheritance?
- autosomal dominant
- white lock of hair
what has lens dislocation and mitral valve prolapse and dissecting aortic aneurysm?
smooth filtrum is seen where?
fetal alcohol syndrome
- like turners except
- boys are affected
- pulmonary stenosis
in the pressence of a single umbilical artery, next best step?
echo of the heart
pigmentation of the lips and multiple polyps of the colon?
puetz jeghers syndrome
what is the leopard association?
- ekg abnormalities
- ocular hypertelorism
- p stenosis
- abnormal genitalia
- retarded growth
how much weight does the baby gain in the first 6 months?
- 6 months--double body weight
- 12 months-triple body weight
contraindications to breast feeding?
- some drugs
- some substances
when a baby is fed what milk, do you need to supplement folate?
when do you give flouride and iron to a baby?
after 6 months
how many calories per ounce of breast milk?
when is cow milk ok?
after 1 year of age
foods to avoid in 1st year ?
- no egg whites
predisposition to osteosarcoma and ewings?
- osteo--bilateral retinoblastoma
best initial test for sle?
what antibody in pregnant sle mothers causes a heart block?
diagnostic criteria for kawasaki?
- strawberry tounge
next best step when suspecting kawasaki?
echo--look for aneurysms
purpura with normal platelts?
when are steroids given for hsp?
when there are extra renal manifestations
most accurate test for lead poisoning?
venous blood lead level
blackfan diamond vs fanconi anemia?
- blackfan--pure rbc aplasia
- short stature
- triphalangeal thumb
- fanconi--all cell lines decreased
- short stature
- absent thumbs
cause of transient erythroblastenia of chilhood/
what milk has low folate?
most accurate test of liver function in cirrhosis?
palpable cancer or courvesier sign means?
most common lekemia in childhood?
what leukemia likes to relapse in the cns?
rx for tumor lysis syndrome?
- alkalanize urine
what 2 tests are done for staging in hd?
best initial test for hodgkin and non hodgkin lymphoma?
excisiional biopsy of the lymph node
best initial test for brain tumor?
2 most common brain tumores?
craniopharyngioma causes what?
best initial test and most accurate test for wilms?
rx for stage 3 and 4 for hd?
MBIG is used for diagnosis of what tumor?
patients with myelomeningiocele have what allerigies??
rx for atypical febrile seizure?
best iniital test for wilsons disease?
enzyme in metachromatic leukodystrophy?
poor muscle tone in an infant?
werdnig hoffman syndome
most accurate test for wednig hoffman?
most accurate test for myasthenia gravis?
best initial test for mg?
most accurate test?
rx for mg?
- acetylcholine enzyme inhibitors
- thymectomy under 60
- over 60- steroids
most accurate test for duchene muscular dystrophy?
how do meninges present in neonates?
who gets dexamethasone for meningitis?
kids >6 weeks old
rifampin for meningitis prophylaxis against what organisms?
wat bacteria produces leukocytosis with lymphocytosis?
most accurate test for cat scratch disease?
rx for lyme dz?
with no rash?
arthritis or cn 7 palsy?
carditis or neurological other than cn 7 palsy?
- no rx
best initial test for fungi?
what vaccine can be given to hiv +?
most accurate test for histo?
which rash has the prodrome of cough, coryza, conjunctivitis, and koplik's spots?
which rash first begans with post auricular lymphadenopathy?
which rash has first fever and then a rash?
ebv causes what cancers?
best initial test for mono?
best test for hiv in newborn?
what is the concentration of acetominophen thats toxic?
rx for organophosphate poisoning?
Most accurate test for Organophosphate poisoning/?
decreased RBC cholinesterase
antidote for benzos?
antidote for opiates?
untill what age is the baby facing back in the back seat?
at age and weight is the booster seat used for the kid?
when can a kid be in the passenger seat?
- 1 year old-10 kg
- 4 years or 40 pound-7/9 years
- 12 years old
hematoma over the mastoid process--basal skull fracture
best test to determine in a kid spinal cord injury without radiological findings?
degress of burn?
- 3rd--full thickness
first sign of puberty in girl and boys?
- breasts enlarge
- boys--testicles enlarge
most accurate test for gonnorhea?
rx for localized impetigo?
prophylaxis in whooping c/ough?
prophylaxis for epiglottitis?
when does necrotiizng enterocolitis occur?
in neonates after introducing formula
what are breath holding spells?
when a child gets irritated and holds their breath and passes out
somoyogi and down phenomenon?
- somoyogi--too much insulin cause hypoglycemia which in turn causes hyperglycemia via glucagon, epihepnrine
- down--not enough insulin causes growth hormone to produce hyperglycemia
best initial test for aortic dissection?
angiogram is most accurate
when do you treat high LDL with 1 or no risk factors? with statin
2 risk factors
- LDL>190 >160
- LDL>160 >130
- LDL>130 >100
rx of agitation in young?
what disease should not be treated with antipsychotics for delirium?
lewy body dementia
fibromuscular dysplasia presents in what population?
women and young children
what two factors warrant a tube thoracostomy?
cutis marmorata vs mongolian spot?
cutis marmorata--looks like livedo reticularis---spider web pattern of disolocation