Gen Peds / Neonate / Development / Immunizations Flashcards
(32 cards)
How do you calculate apgar score in newborn?
Appearance:
o 0 = completely blue
o 1 = extremities blue
o 2 = completely pink
Pulse
o 0 = absent
o 1 = 100
Grimace/rxn
o 0 = absent
o 1 = grimace
o 2 = cough/sneeze/cry
Activity/muscle tone
o 0 = limp
o 1 = some flexion
o 2 = active/spontaneous
Resp effort
o 0 = absent
o 1 = slow weak cry
o 2 = regular, good cry
What are some complications seen in SGA infants?
- polycythemia (from fetal hypoxia high EPO)
- meconium aspiration
- hypoglycemia
- hypocalcemia
- hypothermia
What are the live vaccines?
- rotavirus
- MMR
- Varicella
- Influenza (intranasal)
- Polio (oral)
What are contrainidications to specific vaccines?
all: anaphylaxis to vaccine
live: SCID, pregnancy, HIV
rotavirus: hx of intussusception, hx uncorrected congenital malformation of GI
pertussis: encephalopathy w/in 1 week of previous dose, progressive neuro d/o
When does weight double? triple?
birth weight in 2 wks
double by 5 months
triple by 12 months
What is height/weight of baby at 12 mo?
triple weight
height increase by 50%
How do you look for intraventricular hemorrhage?
screen w/ head ultrasound in patient
What are contraindications to breastfeeding?
- galactosemia
- mom abuse street drugs, alcoho, chemo, others (lithium, cyclosporine, amphetamines, ergotamines, bromocriptine)
- varicella w/in 2 days of delivery
- herpetic breast lesion
maternal HIV, active untreated TB, malaria, typhoid, septicemia - abx safe except tetracycline
Until when do you see thymus on CXR?
until 3 years old = sail sign
Is Rh or ABO jaundice expected to be more severe?
Rh = more strongly positive direct coombs
What is pattern of physiologic jaundice?
start by day 2/3, peak to no more than 12 by day 4/5
What are sx of biliary atresia? How do you diagnose?
initially well then conjugated bili in first 2 months –> jaundice, pale stool, dark urine
Dx: US or cholangiogram
What things increase risk of kernicterus?
sulfisoxazole/other drugs that displace bilirubin from albumin
met acidosis, hypoalbuminemia, neonatal sepsis
What are some risk factors for neonatal polycythemia (hct > 65)? presentation?
in maternal DM, hypertension, smoking, IUGR –> have hypoxemia/nutritional deprivation leading to increased EPO
sx: ruddy skin, hypoglycemia, resp distress, cyanosis, apnea, irritability, tachypnea, can get seizure
What are the complications of twin-twin transfusion for each twin?
donor = risk oligohydramnios, anemia, hypovolemia w/ shock
recipient = polyhydramnios, LGA, hyperbilirubinemia, resp distress, hypocalcemia, convulsions, renal vein thrombosis
What anomalies assocaited w/ oligohydramnios?
renal agenesis or obstruction
What anomalies associated with polyhydramnios?
duodenal atresia, TE fistula, anencephaly
What is erb duchenne?
C5/C6
arm cannot be abducted or externally rotated, forearm cannot be supinated
What is klumpke?
C7/C8
palsy of hand + horners syndrome
What is next step in subgaleal hemorrhage?
send to ICU for monitoring, risk of hypovolemic shock from blood loss
What is next step if simple post-axial polydactylyl?
surgically remove after birth
What are risks of baby drinking goats milk?
inadequate folate and iron –> prone to anemia
What are apneic episodes in infant?
normal in preemie (not full term)
in preemie: 2/2 incompletely developed resp center, have periodic breathing = 3-10 sec pauses
in term: suspect sepsis, GE reflux, CHD, seizure, RSV, hypoglycemia, obstruction
What is transient tachypnea of newborn? CXR?
see after C section due to retained fetal lung fluid
CXR = prominent pulm vascular marks + hyperexpansion
resolves in 3 days w/ supportive
