Chpt. 3 Skin, Immune and Lymphatic

Question 1

When is transient puffiness of the hands, feet, eyelids, legs or sacrum not a concern in newborns?

Answer 1

If it disappears within 2-3 days

Question 2

Skin may be what color for the first few days of life?

Answer 2

red

Question 3

Skin color is partly determined by what?

Answer 3

subcutaneous fat

Question 4

Transient mottling when an infant is exposed to decreased temperature is called what?

Answer 4

Cutis marmorata

Question 5

What is Acrocyanosis

Answer 5

cyanosis of the hands and feet

Question 6

What could be the cause of Acrocyanosis?

Answer 6

underlying cardiac defect if acrocyanosis is persistent or more intense in hands and feet.

Question 7

What is the whitish, moist, cheeselike substance that is a mixture of sebum and skin cells that covers the infants body at birth?

Answer 7

Vernix caseosa

Question 8

What is the fine, silky hair covering the newborns shoulders and back, that will shed w/in 10-14 days called?

Answer 8

Lanugo

Question 9

Fine body hair that resembles peach fuzz??

Answer 9

Lanugo

Question 10

What are flat, deep pink, localized areas seen in back of neck?

Answer 10

Talangiectatic nevi

Question 11

What is another name for telangiectatic nevi?

Answer 11

Stork bite or salmon patch

Question 12

What are irregular areas of blue/blue-gray pigmentation that is usually in sacral and gluteal regions?

Answer 12

Dermal melanocytosis

aka Mongolian spots

Question 13

In what ethnicity is mongolian spots predominately seen in?

Answer 13

African
Native American
Asian
Latin

Question 14

What is a pink papular rash with superimposed vesicles that appears 24-48 hrs after birth on the thorax, back, buttocks, and abdomen that resolves after several days?

Answer 14

Erythema Toxicum

Question 15

What two things should you look at when examining a newborn for hyperbilirubineamia?

Answer 15

1. oral mucosa and sclera

2. whole body for dermal icterus

Question 16

Are bilirubin levels high if it is only in the face (5mg/dl)

Answer 16

NO

Question 17

When are bilirubin levels worrisome?

Answer 17

When jaundice descends below the nipples (>12mg/dl)

Question 18

What are some risk factors for infants getting hyperbilirubineamia?

Answer 18

1. breast feeding
2. hemolytic disease
   3, infx
3. cephalhematoma
4. cutaneous or subcutaneous bleeds

Question 19

What is the tx for hyperbilirubineaia?

Answer 19

Bili lamp & bili blanket

Question 20

How common is physiologic jaundice present in newborns?

Answer 20

50%

Question 21

What is the cause of physiologic jaundice?

Answer 21

inability of liver to conjugate the bilirubin present in blood

Question 22

Physiologic jaundice usually starts after the first day of life and disappears when?

Answer 22

8-10 days, may persist for 3-4 weeks

Question 23

What is necessary to clear bilirubin?

Answer 23

regular bowel movements

Question 24

What is a sign of a jaundice baby other that skin appearance?

Answer 24

They are “sleepy” and may have difficulty nursing

Question 25

When must you consider pathological jaundice?

Answer 25

If jaundice is present in first 24 hrs or is intense or persistent

Question 26

What are some causes of pathological jaundice?

Answer 26

1. RBC abnormalities 2. Hemorrhage 3. Impaired hepatic fx 4. infx

Question 27

What is being evaluated by pinching a fold of the abdominal skin?

Answer 27

Skin tugor

Question 28

What would "tenting" during skin tugor indicate?

Answer 28

1. dehydration | 2. malnutrition

Question 29

What is clubbing of the nails associated with? (5 things)

Answer 29

1. Respiratory disease 2. cardiovascular disease 3. Thyroid disease 4. Cirrhosis 5. colitis

Question 30

What technique is used to determine if there is clubbing of the nails?

Answer 30

``` Schamroth Technique (normal = diamond shaped window) ```

Question 31

What condition has small white discrete papules on the fave and bridge of the nose?

Answer 31

Milia

Question 32

When is Milia MC during infants life?

Answer 32

first 2-3 months

Question 33

What is the cause of Milia?

Answer 33

plugged sebaceous glands

Question 34

What condition is caused by occlusion of sweat glands?

Answer 34

MiliaRIA aka "Heat Rash"

Question 35

Where is an eczematous rash commonly seen on younger children?

Answer 35

Face, elbow, and knees

Question 36

What is the most frequent sensitizing allergen in children?

Answer 36

cows milk protein

Question 37

What condition has scalp lesions that are scaling, adherent, thick, yellow, and crusted that can spread over the ear and nape of the neck?

Answer 37

Seborrheic Dermatitis aka "cradle cap"

Question 38

Honey colored crusts causing pruritis and burning?

Answer 38

Impetigo

Question 39

What type of infx is impetigo?

Answer 39

Highly contagious Staph. or Strep. infx

Question 40

What is the MC vector for ring worm?

Answer 40

Cats

Question 41

When is a strawberry hemangioma first noticeable?

Answer 41

1-2 months old

Question 42

When is a strawberry hemangioma growing rapidly?

Answer 42

1-6 months old

Question 43

When does a strawberry hemangioma begin to shrink?

Answer 43

12-18 months old

Question 44

What is a hair loss disease that is related to excessive emotional stress and OCD?

Answer 44

Tricholtillomania

Question 45

What is a tuft of hair overlying the spinal column usually in the lumbosacral area associated with spina bifida occulta?

Answer 45

Faun tail nevus

Question 46

What are evenly pigmented patches that are present at birth or shortly thereafter?

Answer 46

Cafe au lait sports

Question 47

What should you suspect when a child has >5 cafe au lait spots that are >1cm in a child under 5 y/o?

Answer 47

Neurofibromatosis

Question 48

What are axillary freckling or inguinal freckeling associated with?

Answer 48

neurofibromatosis in conjunction with cafe au lait spots

Question 49

A port-wine stain involving the opthalmic division of the trigeminal nerve may be associated with what? (2 things)

Answer 49

1. Sturge-weber syndrome (seizures) | 2. occular defects

Question 50

Supernumerary nipples are in association with what organ abnormalities?

Answer 50

renal