7 Flashcards
(58 cards)
Baby is acrocyanotic, has HR 120, grimace, regular respirations, good activity, and is resisting extension of muscles. What is score
9 (1 off for acrocyanosis)
What does APGARs stand for?
Appearance Pulse Grimace Activity Respirations
What pulse in APGARS is normal?
> 100
What is normal for respirations in APGARS?
Regular
Newborn s/p c-section with grunting and chest xr that shows hyperextended and wet lungs. What is likely cause?
TTN; self-limited, resolved by 48 hours; may need to provide PPV
35 week old with little air movement and increased respiratory effort. CXR shows hypoinflated lungs and atelectasis. What is going on and what to do?
RDS, give surfactant (ideally give corticosteroids to mom prenatally when premature)
Which babies are screened for hypoglycemia?
Abnormally sized (LGA, SGA, IUGR) and IDA (infants of diabetic mothers)
What is retinopathy of prematurity?
Neoangiogenesis due to oxygen requirement, can lead to retinal detachment or blindness; tx with laser ablation
Premature baby with bulging fontanelles. What dx is important to considers in premature babies, especially < 34 weeks
IVH, vascularity of ventricles highly susceptible to bp changes before involution at 34; dx with cranial doppler
Neonate with bloody stools and air in bowel (pneumatosis intestinalis) on XR. What is it?
Necrotizing Fascitis of Bowels
When can you say “failure to pass meconium”
Nothing after 48 hours
What’s on your ddx for failure to pass meconium?
meconium ileus, imperforate anus, hirschsprungs
What to consider in neonate with imperforate anus
VACTERL deformities (vertebral, anus, cardiac, trachea, esophagus, renal, limb)
Newborn fails to pass meconium. Did not have newborn screen. Likely diagnosis?
Meconium ileus due to CF. Remove with enema. Confirm dx with sweat chloride test.
What’s the path behind hirschprung disease?
Failure of migration of inhibitory auerbach/meissner plexus
A neonate has failure to pass meconium. On examination, a finger is placed in anus and there is explosive diarrhea. What is likely diagnosis?
Hirschsprung disease. Finger released block.
You suspect a child with FTPM has hirschsprung. What to do to diagnosis?
XR followed by imaging with contrast enema. Helps identify bad colon -> then biopsy and eventually surgically remove
Polyhydraminos, downs syndrome, bilious emesis. What is it?
Duodenal atresia; XR will show double bubble PLUS no gas beyond; tx is surgery
What is an annular pancreas?
Failure of pancreas apoptosis; effectively same as duodenal atresia (surgery will give you answer); primary problem of genetics (Downs associated)
What are four causes of bilious emesis?
Malrotation, duodenal atresia, annular pancreas, intestinal atresia
What two causes of bilious emesis are associated with Downs?
Duodenal atresia and annular pancreas
Newborn in hospital has non-biliious emesis, gurgling and bubbling. What should be done to diagnose?
NG tube with XR. Does it get to stomach or does it coil up indicating TE fistula; must provide parenteral nutrition until corrected surgically
When does pyloric stenosis manifest?
2-8 weeks
2 causes of non-bilious vomiting?
TE fistula, pyloric stenosis
