Peds Midterm pt3

Question 1

fetal newborn transition btwn birth-4 mo includes closure of: (3)

Answer 1

ductus venosus
Foramen ovale
Ductus arteriosus

Question 2

Erb-Duchenne Palsy involves what nerve roots?

Klumpke palsy?

Answer 2

C5-C6

C8-T1

Question 3

Hematoma that stays on one side of the head is called:

If it moves around it’s called:

Answer 3

Cephalhematoms

Caput Succedoneum

Question 4

What drug did mom do?
Still baby (dies in utero), placental abruption, preterm deliv, symmetric IUGR, irritability.

Answer 4

Cocaine

Question 5

What drug did mom do?
High pitched cry, seizure, excessive salivation, irritable, hypertonicity, poor feeding, incessant hunger, nasal congestion, sneezing, sweating, yawning (stress), hyperthermia.

Answer 5

Opioids (4-5x inc. risk of SIDS)

Tx of withdrawal: Morphine

Question 6

What drug did mom do?

IUGR, Neurodevelopmental handicap

Answer 6

Tobacco

Question 7

What drug did mom do?
Large anterior fontanels, prematurity, IUGR, Microcephaly, craniofacial abnormalities, hair patterning abnormality, nail hypoplasia, developmental delay.

Answer 7

Toluene (huffing fumes)

Question 8

Membrane-covered herniation of abdominal contents into base of umbilical cord

Answer 8

Omphalocele

Question 9

uncovered (no membrane) intestine spills out of a small abd wall defect to the right of umbilicus.

Answer 9

Gastroschesis

Question 10

Severe resp distress, you see on x-ray they have Scaphoid abdomen
Dx, immediate Tx before surgery, what are they prone to?

Answer 10

Diaphragmatic Hernia
(chromosomal)
Tx: NG decompression, prone to pneumothorax

Question 11

Bile-stained emesis is a sign of:

Answer 11

short bowel obstruction

Question 12

Toxoplasma gondii freq sx are Mental retardation, maculopapular rash.
Dx?

Answer 12

dx: serum IgA or IgM within 6 mo. of birth

Question 13

What TORCH infxn? and Dx
Microcephaly, Encephalitis, cardiac defects, cataracts, retinopathy, IGR, hepatosplenomegaly, thrombocytopenia & purpura, deafness

Answer 13

Rubella.

Dx: inc serum rubella IgM

Question 14

What is the most common virus transmitted in-utero in the developed world?

Answer 14

CMV

Question 15

CMV
Key sx (2)
Dx
Tx

Answer 15

Sx: *Sensorineural hearing loss, blueberry muffin spots.
Dx: Amniotic fluid culture for antigen detection
Tx: Ganciclovir

Question 16

Which TORCH?

Sensorineural hearing loss, blueberry muffin spots.

Answer 16

CMV

Question 17

Congenital Herpes is localized where? (3)
Sx for 5-14 days (3)
Sx for 14-28 days (3)

Answer 17

Eye, skin, mouth
Initial sx: Pneumonia, shock, hep
next sx: Lethargy, fever, sepsis

Question 18

Which TORCH? Dx? Tx?

Severe anemia, myocarditis, nonimmune hydrops, URI beforehand, LACY-RETICULATED RASH ON ARMS, RED CHEEKS.

Answer 18

Parvovirus B19 aka 5th Disease
Dx: serologic testing
Tx: Inutero transfusions

Question 19

What is the classic rash seen in Parvovirus B19?

Answer 19

slapped cheek rash, lacy-reticulated rash on arms

Question 20

Which TORCH?

Newborn has Jaundice, edema, thrombocytopenia, ↑ nucleated RBC’s, hepatosplenomegaly, meningitis

Answer 20

Syphilis

Question 21

Which TORCH?

3-12 week old has Pseudoparalysis, hepatosplenomegaly, snuffles, mucopurlulent discharge, rash on palms/soles/body.

Answer 21

Syphilis

Question 22

Which TORCH?
baby has decompressed nasal bridge, scars around nose and mouth (Rhagades), high forehead, peg-shaped incisors with central notch

Answer 22

Syphilis

those are hutchinson’s teeth

Question 23

Which TORCH?
Mental retardation, deaf, spasticity, abnormal pupils, abnormal CSF, speech defecits, saber shins (thickened anterior tibia periosteum), gummas on nasal septum, palate, long bones, & subcutaneous tissue

Answer 23

Meningovascular Syphilis

Question 24

How to dx congenital syphilis(4)

Answer 24

4x mother’s nontreponemal titer
Darkfield antibody from placenta or cord blood
VDRL
Wimberger sign - long bone x-ray shows metaphyseal lucent bonds, periostitis, osteomyelitis, with pathologic frx.