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1
Q

Normal RR for a newborn

HR

A

40-60 BPM

120-160

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2
Q

What does the 1 min apgar evaluate?

5 min?

A

Labor and delivery

Response to resuscitative efforts

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3
Q

What are the 5 apgar criteria?

A 
Appearance
Pulse
Grimace
Activity
Respiration
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4
Q

What is the most likely cause of eye redness on day 1?
Day 2-7?
>7 days?
>3 weeks?

A

Chemical irritation
Gonorrhea
Chlamydia
HSV

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5
Q

What 2 Abx are given babies to prevent eye issues?

A

Erythromycin or tetracycline ointment

silver nitrate solution

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6
Q

What are 8+1 screenings that occur prior to discharge for newborns?

A 
PKU: treat w special diet
CAH: replace steroid deficiencies, repair genitalia
Biotinidase 
Beta thalassemia
Galactosemia: eliminate lactose
Hypothyroidism
Homocysteinuria 
CF: initial sweat Cl, accurate CFTR genetic test
Hearing test
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7
Q

What children get the HepB vaccine?

What kids get the HepB IG?

A

Every newborn

HbSAg + mothers

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8
Q

What is transient polycythemia of the newborn?

A

Hypoxia during delivery stimulates EPO to increase RBCs

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9
Q

What is transient tachypnea of the newborn?

A

C section babies who have fluid in their lungs but should only last less than 4 hours

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10
Q

Why does transient hyperbili occur in newborns?

A

Infant spleen removes express RBCs carrying HbF

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11
Q

What are the 3 types of skull fracture in newborns?

A

Linear (common)
Depressed
Basilar (fatal)

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12
Q

What are the 2 scalp injuries and their difference

A

Caput Succedaneum: crosses suture lines

Cephalohematoma: sub periosteal bleeding that does not cross

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13
Q

What are the 2 types of diaphragmatic hernias?

A

Morgagni: retrosternal or parasternal
Bochdalek: more common –> posterolateral on left side

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14
Q

What screening is associated with omphalocele?

What genetic disease is highly associated?

A 
elevated AFP (most common cause is incorrect dating)
T18
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15
Q

WAGR syndrome=?

A 
Cr11
Wilms
Aniridia
GU malformations
Retardation
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16
Q

What is the initial test for Wilms tumor?

Accurate?

A

U/S

Contrast CT

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17
Q

What is a hydrocele within?

Does it resolve?

A

Remnant of tunica vaginalis

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18
Q

What is the most common cyanotic heart defect in kids?
What are the characteristics?
What is the chromosome assn?
What is the murmur?

A

Tetralogy of fallot
Pulmonary stenosis > VSD > RVH > overriding aorta
Cr22 deletion
Holosystolic at LLSB

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19
Q

What is the most common congenital defect in T21?

A

Endocardial cushion defect of the AV canal

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20
Q

What are the only 3 causes of holosystolic murmurs?

A

mitral regurg
Tricuspid regurg
VSD

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21
Q

What is the most common cyanotic lesion in neonates?
What murmur is heard?
What is seen on CXR?
What is the treatment?

A

TOGV
Single S2
Egg on a string
PGE1 to keep DA open –> surgery (only 25% survive)

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22
Q

What is pulses alternans?
Bigeminus?
Bisferiens?
Tardus et parvus?

A

LV systolic dysfunction
HOCM
Aortic regurg
AS

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23
Q

What are the Sx of TA and when do they occur?

Why do you want to operate early?

A

Severe dyspnea + respiratory infections

Prevent pulm HTN

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24
Q

Define Eisenmenger Syndrome and when it occurs

A

LtoR shunt caused by VSD reverses to RtoL because of hypertrophic RV

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25
What are the 3 types of ASD? What is the Sx? What are 2 tests?
Primum (mitral V issues also), Secundum (common), Sinus venosus (rare) Fixed wide S2 Cath vs ECHO
26
Where do mitral lesions radiate? Tricuspid and pulmonary? Aortic?
Axilla Back Neck
27
What does a pear shaped CXR mean? Boot shaped? Jug handle? 3 appearance or rib nothing?
Pericardial effusion Tetralogy of fallot Primary pulm HTN Coarctation
28
What are 3 signs of long QT
Family hx of sudden death Hearing loss Syncope
29
What are 5 signs of pathological hyperbili?
``` Appears on 1st day of life Rises over 5mg/dl/day Rises over 19.5 in term child Direct rises above 2 at any time Persists in 2nd week of life ```
30
What is kernicterus? | Sx?
Bilirubin in the basal ganglia | Hypotonia/seizures/choreoathetosis/hearing loss
31
When do you consider a transfusion (what bili level)?
20-25
32
After delivery what are the next steps?
Mouth/nose suctioned Clamp/cut cord Newborn dried/wrapped/warmed
33
What electrolyte issue would you expect to see with pyloric stenosis?
HypoCl, HypoK, MetAlk (low K made worse by increasing aldosterone to maintain fluid)
34
What is the initial test for pyloric stenosis? Accurate? Tx?
U/S Upper GI series Myotomy
35
What is the CHARGE syndrome of congenital defects?
``` Coloboma of eye, CNS anomalies Heart defects Atresia of choanae Retardation of growth/development GU defects Ear issues **commonly these come together! ```
36
How does a child with choanal atresia present? | How do you diagnose?
Blue with feeding and pink with crying | CT scan
37
How is Hirschprung Disease diagnosed?
Full thickness biopsy showing lack of submucosal ganglionic cells
38
What comprises VACTERL?
``` Vertebral anomalies Anal atresia Cardiovascular issues TEF EA Renal anomalies Limb anomalies ```
39
What is DA often due to?
Lack or absence of apoptosis causes improper canalization of the duodenal lumen
40
Where does a volvulus most commonly occur? | What is the best initial therapy?
Ileum | Endoscopic decompression
41
What is the initial test for intussusception? What is the most accurate test for intussusception? When do you not do that test? How do you treat?
U/S Barium enema Peritonitis/shock/perforation Barium enema
42
What is the classic Meckel presentation? | What is the most accurate test?
Painless rectal bleeding | Tech99 scan
43
What 3 Abx should be used in suspected NEC? | When does NEC occur?
Vanc/Gent/Metronidazole | Premature infants
44
What is the major disorder in CAH 21? 17? 11?
21=hypoTN 17=ambiguous genitalia boys 11=HTN + ambiguous genitalia girls
45
What is rickets due to? (3)
Lack of VitD Inability to convert 25OH to 1,25OH2 XL hypoP: inability to retain P
46
What children should get a VitD supplament? | When does it start?
Exclusively breastfed | 2 months
47
What are the most common causes of neonatal sepsis? (2) What are the most common organisms? (4) What are diagnostic tests? (3) What are the treatments? (2)
Pneumonia, meningitis GBS, Ecoli, Saureus, Listeria Blood culture, urine culture, CXR Amp + Gent
48
How does Toxo present? Initial test? Accurate? Tx?
Chorio retinitis + ring enhancing lesions IgM PCR Pyrimethamine + Sulfadiazine
49
How does rubella present? Initial test? Treatment?
PDA, cataracts, deaf, blueberry muffin rash, hyperbili maternal IgM Supportive
50
How does CMV present? Initial test? Accurate? Treatment?
Peri ventricular Ca, microcephaly, chorio, hearing loss Urine or saliva titers Urine or saliva PCR Ganciclovir
51
HSV presentation in a neonate?
Week 1: shock + DIC 2: vesicular lesions 3: encephalitis
52
What is the Pentad of scarlet fever?
``` Fever Pharyngitis Sandpaper rash on trunk and extremities Strawberry tongue Cervical lymphadenopathy ```
53
What are the top 2 causes of croup? How is mild croup treated? How is moderate to severe croup treated?
Parainfluenza 1 and 2 > RSV Steroids Racemic epinephrine
54
What is the treatment for epiglottis?
Intubate in OR Administer Ceftriaxone for 7-10 days Rifampin for all close contacts
55
What are the 3 stages of whooping cough?
Catarrhal stage: 14 days=severe congestion Paroxysmal stage: 14-30 days=severe cough/whoop Convalescent stage:14 days=decreasing cough
56
How is whooping cough treated?
Erythromycin or azythromicin in Catarrhal stage only
57
How is strep pharyngitis diagnosed? | Treated?
Rapid DNAse antigen test | Oral penicillin x10 days or macrolide
58
How is diphtheria diagnosed? | Treated?
Culture of membrane (no scraping!) | Antitoxin (Abx do not work!)
59
How is congenital hip dysplasia treated?
Pavlik harness
60
What ages is Legg Calve Perthes? | How is treated?
2-8 | Surgery on both hips
61
How does a SCFE present? | What is the treatment?
Externally rotated leg | Internal fixation and pinning
62
VitA deficiency | Toxicity
Poor night vision, hypoPTH | Pseudotumor cerebri, HyperPTH
63
B1 low | High
Beriberi, wernickes | -
64
B2 low | High
Angular chelosis, stomatitis, glossitis | -
65
B3 low | High
Pellagra (diarrhea/dementia/dermatitis/death) | -
66
B5 low | High
Burning feet | -
67
B6 low | High
Peripheral neuropathy --> prevent by giving with INH | -
68
B9 low | High
Megaloblastic anemia
69
B12 low | High
Megaloblastic anemia, peripheral neuropathy from DC | -
70
VitC low | High
Scurvy | -
71
VitD low | High
Rickets in kids | HyperCa, polyuria, polydipsia
72
VitK low | High
Increased PT/INR, bleeding | Rare

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