Meds High Yield

Question 1

What does the APGAR tell you?

Answer 1

General info about how the newborn tolerated labor (1min) and the newborn’s response to resuscitation (5min)

Question 2

What does the APGAR not tell you?

Answer 2

What to do next (does not guide therapy)How the baby will turn out (does NOT predict neurologic outcome)

Question 3

And on physical exam you find: When assessing Moro on an LGA newborn, the right arm remains extended and medially rotated.

Answer 3

Erb-DuchenneC5-C6.
(Klumpke is C7-C8 + T1)
Refer if not better by 3-6mo for neuroplasty

Question 4

When palpating the clavicles on a LGA newborn, you feel crepitus and discontinuity on the left.

Answer 4

Clavicular Fracture.

Will form a callus in 1wk. No tx needed. Can use figure of 8 splint.

Question 5

Caput succedaneum

Answer 5

“Edema.Crosses suture lines.”

Question 6

Cephalo-hematoma

Answer 6

“Fluctuance. Doesn’t cross suture lines.”

Question 7

Description and treatment of Nevus Sebaceous

Answer 7

Described as “an area of alopecia with orange colored nodular skin”.
What to do? Remove before adolescence b/c it can undergo malignant degeneration.

Question 8

Description and treatment of Seborrheic Dermatitis

Answer 8

Described as “thick, yellow/white oily scale on an inflammatory base”.
What to do? Gently clean w/ mild shampoo

Question 9

Two disorders screened for in every state because they are disastrous if not caught early (and happen to be a contraindication to breast feeding…)

Answer 9

Phenylketonuria.

Galactosemia.

Question 10

Pathogenesis, symptoms, signs, and treatment for Phenylketonuria?

Answer 10

Deficient Phehydrolxalase.

• Sxs= MR, vomiting, athetosis, seizures, developmental delay over 1stfew mos
• Signs = fair hair, eyes, skin, musty smell.
• Low Phediet.

Question 11

Pathogenesis, symptoms, signs, and treatment for Galactosemia?

Answer 11

• Deficient G1p-uridyl-transferase. G1p accumto damage kidney, liver, brain.
• Sxs= MR direct hyperbili& jaundice, ↓glc, cataracts, seizures.
• Predisposed to E. coli sepsis.
• No lactose for life.

Question 12

Yellow baby: 3 days old, bili @ 10, direct is 0.5. Eating & pooping well.

Answer 12

Physiologic Jaundice. Gone by 5thDOL.

Liver conjugation not yet mature.

Question 13

Yellow baby: 7 days old, bili @ 12, direct is 0.5. dry mucous membranes, not gaining weight.

Answer 13

Breast feeding Jaundice. ↓feeding = dehydration = retain meconium & re-absorb deconjugated bili.

Question 14

Yellow baby: 14 days old, bili @ 12, direct is 0.5. Baby regained birth weight, otherwise healthy.

Answer 14

Breast milk Jaundice. Breast milk has glucuronidase and de-conj bili.

Question 15

Yellow baby: 1 day old, bili @ 14, direct is 0.5.

Answer 15

Pathologic Jaundice = on 1stDOL, bili >12, d-bili >2, rate of rise >5/day.

Question 16

Pathologic Jaundice Next best test?

Answer 16

Coombs

Question 17

Pathologic Jaundice If coombs positive?

Answer 17

Means Rh or ABO incompatability

Question 18

Pathologic Jaundice If coombs negative?

Answer 18

Means twin/twin or mom/fetus transfusion, IDM, spherocytosis, G6p-DH deficiency, etc.