1

Question 1

What is maternal heroin use associated with?

Answer 1

increased risk of fetal growth restriction, placental abruption, fetal death, preterm labor and intrauterine passage of meconium.

Question 2

What is neonatal abstinence syndrome?

Answer 2

uncoordinated sucking reflexes leading to poor feeding, irritability, and high-pitched cry

Question 3

When is an infant diagnosed with SGA?

Answer 3

Time of birth

Question 4

GBS + mom delivers baby who appears ill. What to do?

Answer 4

Start ppx abx for GBS and get CBC, blood culture, chest x-ray and lumbar puncture (ruling out sepsis, pneumonia and meningitis)

Question 5

Who should get intrapartum abx for GBS?

Answer 5

1) Previous infant with invasive GBS disease
2) GBS bacteriuria during any trimester of the current pregnancy
3) Positive GBS vaginal-rectal screening culture in late gestation during current pregnancy
4) Unknown GBS status at the onset of labor (culture not done, incomplete, or results unknown) and any of the following:
- Delivery at < 37 weeks’ gestation
- Amniotic membrane rupture ≥ 18 hours
- Intrapartum temperature ≥ 38°C (100.4°F)
- Intrapartum NAAT positive for GBS

Question 6

A woman with unknown GBS status shows up in labor at 36 weeks gestation. Does she get abx?

Answer 6

YES; if status unknown and < 37 weeks then get abx

Question 7

Which TORCH infection causes chorioretinitis and diffuse brain calcifications?

Answer 7

Toxoplasmosis

Question 8

Which 4 TORCH infections can cause microcephaly

Answer 8

VCRZ = Varicella, Rubella, CMV, Zika

Question 9

TORCH infection that causes cataracts?

Answer 9

CataRacts = CMV and Rubella

Question 10

These TORCH infections can lead to thrombocytopenai?

Answer 10

tHRomboCytopenia = HSV, Rubella, CMV

Question 11

These viruses leads to sensorineural hearing loss.

Answer 11

Rubella and Zika

Question 12

A kid is born and has a blueberry muffin rash, hepatomegaly, and a small head. What is he infected with and what is likely wrong with his eyes?

Answer 12

Rubella. Eyes will have cataracts, glaucoma, retinopathy.

Question 13

Which three viruses lead to brain calcifications and how are they different?

Answer 13

calCificaTionZ = CMV (periventricular), Toxoplasmosis (diffuse intracranial), Zika (subcortical)

Question 14

What are the TORCHZ infections?

Answer 14

Toxoplasmosis, Other (Varicella, Syphilis), Rubella, CMV, HSV, Zika

Question 15

What makes up APGAR?

Answer 15

Appearance, Pulse, Grimace, Activity, Respirations

Question 16

What percentile of weight constitutes SGA?

Answer 16

10th

Question 17

What sorts of things result in symmetrical SGA?

Answer 17

Congenital infections which affect brain development. All small = BAD; head-sparing = good

Question 18

What is the asymmetric tonic neck response?

Answer 18

Turning the newborn’s head to one side causes gradual extension of arm toward direction of infant’s gaze with contralateral arm flexion–like a fencer.

Question 19

What is your ddx for absent red light reflex?

Answer 19

Cataracts 
Opacified cornea (like mucopolysaccharidosis)
Inflammation of anterior chamber
Developmental anomalies 
Retinoblastoma

Question 20

Baby is born to a woman with little prenatal care. He is SGA but head is normal circumference. What is likely cause?

Answer 20

Inadequate nutrition because head-sparing. If head was also small, think TORCHZ.

Question 21

What 3 things are babies given after birth?

Answer 21

Thighs and eyes = vitamin K, first Hep B vaccine, erythromycin gel for eyes

Question 22

A pregnant woman has HBV. What should baby get at time of birth?

Answer 22

hepatitis B vaccine as well as hepatitis B immune globulin (HBIG) within 12 hours of delivery

Question 23

Why give erythromycin eye ointment to neonates?

Answer 23

prevent n gonorrhea opthalmia

Question 24

What supplementation should exclusively breastfed babies get?

Answer 24

400 IU vitD

Question 25

If want to start cows milk, when is appropriate in child?

Answer 25

1 yr

Question 26

100 kcal/kg/day is appropriate nutrition for how old?

Answer 26

1-2 mo who is full-term

Question 27

When do you expect moro reflex to disappear?

Answer 27

4 mo

Question 28

This may lead to cradle cap

Answer 28

seborrheic dermatitis

Question 29

These are two common skin findings in <2 mo

Answer 29

neonatal acne and seborrheic dermatitis

Question 30

When do you expect the babinski reflex to go away

Answer 30

By 2 years old, toes should transition to downgoing

Question 31

When should you expect babies to start sleeping through the night?

Answer 31

4-6 months

Question 32

Should an 11 year old sit in the front seat?

Answer 32

Nah, wait until 13 or older

Question 33

What are the 2 month vaccines?

Answer 33

Hep B (2nd), DTaP, IPV, PCV13, Hib, Rotavirus,

Question 34

What makes up the Pediarix?

Answer 34

HepB, IPV, DTaP

Question 35

Is MMR started at 1 y/o?

Answer 35

YES

Question 36

When do you start HepA vaccine?

Answer 36

1 y/o

Question 37

When do you expect weight to double in baby?

Answer 37

double by 5 mo, triple by 12 mo

Question 38

Up to 6 years old, when should kiddos get vaccines?

Answer 38

Time of birth, 2 mo, 4 mo, 6 mo, 1 yr, 18 mo, 4-6 yrs

Question 39

Which vaccines at 4 mo?

Answer 39

DTap, IPV, PCV13, Rotavirus, Hib

Question 40

Which vaccines at 6 mo?

Answer 40

Hep B, IPV, DTaP, PCV13, rotavirus

Question 41

How many doses of HepB before kindergarten and when?

Answer 41

3 doses Hep B; birth, 2 mo, 6 mo

Question 42

How many doses DTaP before kindergarten and when?

Answer 42

5 doses DTaP; 2 mo, 4 mo, 6mo, 18 mo, 4-6 yo

Question 43

How many doses of IPV and when?

Answer 43

4 doses IPV; 2 mo, 4mo, 6mo, 4-6 yo

Question 44

What is your differential diagnosis for a child with RUQ mass?

Answer 44

``` Hepatic neoplasm Hydronephrosis Neuroblastoma Teratoma Wilms' tumor ```

Question 45

How can neuroblastoma present?

Answer 45

painless mass in the neck, chest, or abdomen

Question 46

Path with "small round blue cells" = ?

Answer 46

Neuroblastoma

Question 47

You suspect neuroblastoma in a kid with RUQ mass. What would urine and CBC show?

Answer 47

Increased urine catecholamine and CBC with anemia or other cytopenias indicating bone marrow infiltration

Question 48

A kid with RUQ mass is found to have intrarenal mass and hematuria. What is it?

Answer 48

Wilm's tumor or nephroblastoma

Question 49

What gene test is helpful in neuroblastoma work up?

Answer 49

N-MYC gene amplification = poor prognosis

Question 50

What are favorable prognostic factors of neuroblastoma?

Answer 50

Non-amplification of the n-myc oncogene DNA index > 1 Favorable histology (Shimada classification) Age < 1 year.

Question 51

A kid has neuroblastoma. Did he likely inherit it?

Answer 51

NO, most are result of somatic mutation