Peds Flashcards
Major embryonic derrivatives and what they become (occurs up to 8 weeks then fetal stage begins) ectoderm, endoderm, mesoderm
Ectoderm: Epidermis, hair, nails, glands of skin, brain and spinal cord
Endoderm: Epithelial lining of glands and digestive/respiratory tract
Mesoderm: notocord, somite (vertebra and ribs), kidneys, gonads, heart and blood vessels
When babies should return to birth weight ***
by 2 weeks
weight loss of 5-10% is normal
APGAR scoring
Activity: active movement, some flexion of arms/legs, absent
Pulse: greater than 100, less than 100, absent
Grimace (reflex irritability): crying/acitve, grimace/some flexion, no response/flaccid
Appearance: pink, body pink/extrem blue, pale
Respiration: good/cry, slow/irregular, absent
Max score of 10… normal is 7-10, intubate if 0-3, 4-6 bag O2
Adverse effects of neonatal jaundice
Acute bilirubin encephalpathy
Kernicterus: unconjugated bilirubin crosses the blood-brain barrier and damages brain cells if levels above 20-25 mg/dL…s/s: poor feeding, decreased moro, tx exchange transfusion
Mechanisms of physiologic jaundice (peaks at 3 days of life)
bilirubin production is higher
bilirubin clearance by the liver is decreased
increased enterohepatic circulation
NOT physiologic if baby gets jaundice in first 24 hours (hemolysis)
Indirect Coomb’s test is a measure of…
RBC agglutination
tests the presence of blood type and antibodies in the serum
At one year of age how much should the child weigh?
triple their birth weight
Neonatal head exam (4)
Caput succedaneum: common! Crosses suture lines, normal finding
Cephalohematoma: blood collected below periosteum and DOES NOT cross suture line (usually parietal bone)
Craniosyntosis: premaute closure of sutures (usually sagittal which leads to A/P lengthening)
Craniotabes: ping pong ball feel of skull
Infant reflexes
Moro: Drop baby get symmetric abduction of extremeities, disappears in 5-6 mo’s
Grasp: finger in palm, dissapears by 2-3 mo’s
stepping: hold baby and wants to step
rooting: stroke cheek and will turn head towards, dissapears by 2-3 months
parachute: stomach in air will splay arms out, have for life
Positive babinski (toes splay) up to 1 year
4 month milestones
rolls over, laughs, orients voice, smiles
6 month milestones
sits independently, babbles, recognize faces, transfer block
9 month milestones
crawls, says mama, dada, waves bye, holds bottle
12 month milestones
walk, fine pincer grasp, a couple of words
24 month milestones
walks up and down steps, build block tower, 50 word vocabulary
3 year milestones
ride tricycle, copies circle, 250 word vocabulary with 3-word sentances
4 year milestones
hops, skips, knows colors
TORCH congenital infections
Toxoplasmosis Other (syphillis, HIV, varicella, Hepatitis) Rubella Cytomegalovirus Herpes Simplex
Congenital Toxoplasmosis triad
corioretinitis, hydrocephalus, intracranial calcifications
found in cat feces
Treat with Pyrimethamine (antiparasitic) and Sulfadizine
Childhood manifestations of congenital Syphilis
interstitial keratitis (blindness), hutchinson teeth (notched), 8th cranial nerve deafness, rash on hands and feet, snuffles (rhinitis with blood)
Tx Penicillin G
Dx IgM FTA-ABS (fluorescent treponemal antibody absorption)
Blueberry muffin rash seen in
Congenital Rubella
Congenital CMV features
Can cause deafness (sensorineural hearing loss)
most common congenital viral infection
Deletion 22q11 pertinent electrolyte abnormality
hypocalcemia
Turner syndrome features
XO
females only
webbing of neck, short stature, amenorrhea, failure of secondary sex characteristics
Klinefelter Syndrome
XXY
hypogonadism
boys with small testes and breast development, wide hips
