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Flashcards in Pediatric Diseases Deck (66)
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1

A 17-year-old primigravida gives birth at 34 weeks’ gestation to a male infant of low birth weight. The infant is given exogenous surfactant and does not develop respiratory distress. On the third day of life, physical examination reveals hypotension, abdominal distention, and absent bowel sounds, and there is bloody stool in the diaper. A radiograph shows pneumatosis intestinalis and abdominal free air. What do you think of the diagnosis?

Necrotizing enterocolitis

2

An 18-year-old woman gives birth to a term infant after an uncomplicated pregnancy and delivery. Over the first 2 days of life, the infant becomes mildly icteric. On physical examination, there are no morphologic abnormalities. Laboratory studies show a neonatal bilirubin concentration of 4.9 mg/dL. The direct Coombs test of the infant’s RBCs yields a positive result. The infant’s blood type is A negative, and the mother’s blood type is O positive. What type of bilirubin is present in child's blood?

Unconjugated

3

Amniotic Band Syndrome is a congenital birth defect believed to be caused by entrapment of fetal parts (usually a limb or digits) in________________ while in utero

fibrous amniotic bands

4

Potter sequence: typical physical appearance and is associated with_______________(1) of a neonate as a direct result of ____________(2) and compression while in utero

1. pulmonary hypoplasia 2. oligohydramnios

5

Oligohydramnios (decreased amniotic fluid) is caused by___________ and ___________

Renal Agenesis, Amniotic leak

6

The position of delivery of the child in potters is_____________

Breech Presentation

7

An infant born prematurely at 28 weeks gestation is immediately noticed to be tachypneic and cyanotic following birth. A presumptive diagnosis of NRDS is made based on the clinical picture and chest CT, and treatment is initiated. Which of the following organelles and cell types are involved in this clinical picture? 

1.  Lamellar bodies - type I pneumocytes  2.  Mitochondria - type II pneumocytes  3.  Lamellar bodies - type II pneumocytes  4.  Endoplasmic reticulum - type I pneumocytes  5.  Plasma membrane - type II pneumocytes 

Lamellar bodies - type II pneumocytes 

8

A P2G1 diabetic woman is at risk of delivering at 29 weeks gestation. Her obstetrician counsels her that there is a risk the baby could have significant pulmonary distress after it is born. However, she states she will give the mother corticosteroids, which will help prevent this from occurring. Additionally, the obstetrician states she will perform a test on the amniotic fluid which will indicate the likelihood of the infant being affected by this syndrome. Which of the following ratios would be most predictive of the infant having pulmonary distress?  

Lecithin: sphingomyelin ratio

Lecithin: sphingomyelin ratio < 1.5 

9

A cyanotic neonate. Following is the blood gas following 100% oxygen therapy. Before: PO2=30% After: PO2=35%

What is the likely explanation of this finding?

 

Hyalin membrane disease/diffusion defect 

10

A cyanotic neonate. Following is the blood gas following 100% oxygen therapy.  Before: PO2=30% After: PO2=50%

X-Ray chest attached. 

What is the likely explanation of this finding?

Pulmonary stenosis/perfusion defect likely

11

1.Retrolental fibroplasia is due to___________________

(high concentration of O2   produces free radicals)

12

Necrotizing enterocolitis (NEC), which typically occurs in the __________week of life in ___________, _________-fed infants.

second to the third Week
premature
formula

13

NEC, The Underlying pathology is_______

intestinal ischemia

14

In NEC septic and shock is caused by_______

1.Platelet-activating factor (PAF) → by promoting enterocyte apoptosis → sepsis and shock

15

NEC: 

Gangrene of the intestine

Involves________ (parts of GIT)

terminal ileum, cecum and right colon

16

Fetal hydrops refers to the accumulation____________in the

fetus during intrauterine growth.

accumulation of edema fluid (transudate)

17

Fetal Hemolysis: Mother forms _____ antibodies which cross the placenta and destroy fetal RBCs (______ hypersensitivity)

IgG

Type 2


 

18

A 19-year-old woman is G2 P1. Her previous gestation resulted in a normal term birth at home. Her current pregnancy results in the birth of a 2990 gm baby at 35 weeks. At birth, the infant appears hydropic and icteric, but no congenital anomalies are present. The baby's hemoglobin is 8.5 g/dL. The placenta is also hydropic, but microscopic examination of the placenta shows no inflammation of either fetal membranes or placental villi, and there is no meconium staining. 
 

Which of the following mechanisms is the most likely explanation for these events? 

A Maternal rubella infection in the first trimester 

B A maternal chromosomal abnormality 

C Maternal antibodies crossing the placenta 

D Elevated maternal serum glucose 

E Increased maternal phenylalanine levels

C Maternal antibodies crossing the placenta 
 

19

Cystic hygromas are characteristically seen, but not limited to, constitutional chromosomal anomalies such as ------------karyotypes

45,X0

20

Anemia →  ------------------ → increased hydrostatic pressure → edema and anasarca, →hydrops fetalis

high output Cardiac failures

21

Anemia → --------------- →  decreased plasma oncotic pressure → edema and anasarca, →hydrops fetalis

Liver hypoxia

22

CF=The carrier frequency in the United States is -----------among Caucasians but significantly lower in African Americans, Asians, and Hispanics.

1 in 20

23

Even heterozygote carriers (__________) have a higher incidence of respiratory and pancreatic diseases

 

mention %

2-4%

24

CYSTIC FIBROSIS IN SKIN: Chloride channel defect in the sweat duct causes increased _____________________concentration in sweat

chloride and sodium

25

In the airway, cystic fibrosis patients have__________chloride secretion and __________sodium and water reabsorption leading to _______ of the mucus layer coating epithelial cells

 decreased

increased

DEHYDRATION

26

 CF= Bronchiectasis •Infection commonly caused by ------

Pseudomonas

27

CF PANCREAS: 

-_________ of ducts leads to cystic dilatation, AND ___________ of exocrine pancreas acini.

Mucous plugging

Atrophy

28

Pancreatic insufficiency, a feature of classic cystic fibrosis, is virtually always present when there are CFTR mutations with abnormal ______________conductance.

bicarbonate

29

Deficiency of fat-soluble vitamins A would lead to__________

Sq metaplasia
decreased night vision

30

Deficiency of fat-soluble vitamins D would lead to__________

osteomalacia

fracture