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Test #1 Flashcards

(58 cards)

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1
Q

APGAR Scoring System

A

Activity: Absent (0), Arms&legs flexed (1), Active motion (2)

Pulse: Absent (0), <100 bpm (1), >100 bpm (2)

Grimace (facial reflex): flaccid, grimace, Cry

Appearance: blue/pale, body pink/extremities blue, all pink

Respiration: absent, slow/irregular, vigorous cry

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2
Q

APGAR Value Indications

A

0-3 = Severely depressed

4-6 = Moderately depressed

7-10 = Excellent condition

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3
Q

Embryonic Period

A

First 8 weeks

All major organs formed during this period (organogenesis)

Particularly vulnerable during weeks 3 and 4

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4
Q

Fetal Period

A

Remaining 30 weeks

Organs get larger and more complex

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5
Q

Ductus Venosus

A

Connects umbilical vein to inferior IVC

Oxygenated blood from mom bypasses liver, goes directly to heart

Sensitive to [O2] of blood - increase in oxygenation after birth causes vasoconstriction/closure

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6
Q

Ductus Arteriosus

A

Channel between main pulmonary artery and aorta

Bypasses pulmonary vasculature to get blood directly to systemic

Disappears w/in 2 weeks after birth, becomes ligamentum venosum

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7
Q

Kernicterus

A

Chronic/permanent BIND

Indirect bilirubin > 20-25 mg/dL in newborn

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8
Q

Acute Bilirubin Encephalopathy

A

Early symptoms

Hypotonia, seizures

Reversable BIND

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9
Q

Estimating bilirubin levels in newborns

A

Jaundice progresses from head to toe

Head = TSB 5

Upper Chest = 10

Abdomen = 12

Palms/Soles = >15

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10
Q

Pathological Jaundice

A

Appears w/in 1st 24 hours of birth

Jaundice in newborn older than 2 weeks

Direct bilirubin >1mg/dL with TSB < 5 OR >20% TSB is direct

Increase in bilirubin >0.5 mg/dL/hr

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11
Q

Mottled skin

A

Cutis Marmorata

Will disappear at birth

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12
Q

White/Waxy covering of skin

A

Vernix Caseosa

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13
Q

Downy hair

A

Lanugo

More common with prematurity

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14
Q

Benign erythematous rash with papules/pustules

A

Erythema Toxicum

Appears in 1-14 days, resolves in weeks

Eosinophils in the pustules

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15
Q

Benign flat red markings

On upper eyelids or back of neck

A

Nevus Flammeus/Vascular Nevi/Salmon patches

Upper eyelids = crows nest

Back of neck = stork bites

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16
Q

Permanent discoloration

Arteriovenous malformation

A

Port-wine stain

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17
Q

Small yellow papules

A

Sebaceous gland hyperplasia

Disappear spontaneously

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18
Q

Smaller, white papules

A

Milia

Disappears in weeks

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19
Q

Acne from maternal hormones

A

Acne Neonatorum

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20
Q

Bluish-black lesion over lumbosacral area

A

Mongolian Spots

Common in Native American, Blacks, and Asians

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21
Q

Elevated collection of capillaries

A

Strawberry/Capillary hemangiomas

Worrisome skin findings

Grow for 3-7 months, stabilize, then usually involute by 5 years old

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22
Q

Cavernous hemangioma

A

Less predictable collection of large blood vessels

May be associated with thrombocytopenia

May resolve on own or need steroids/radiation

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23
Q

Neonate

A

First 30 days of life

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24
Q

Infant

Study These Flashcards
A

1 month to 1 year old

25
Child
1-12 years old
26
Adolescent
12-18 years old
27
Most common pediatric overdose drugs
Iron supplements (vitamins) Acetaminophen
28
Drugs to avoid in peds
Propylene glycol - hyperosmolality (IV drugs) Benzyl alcohol - metabolic acidosis and neuro damage (IV fluids) Fluoroquinolones Tetracyclines
29
Acetaminophen dosing in pediatrics
Tylenol 10-15 mg/kg q4-6h
30
Ibuprofen dosing in pediatrics
Motrin for \>6 months old 5-10 mg/kg q6h
31
1 tsp = \_\_mL
5 cc = 5 mL = 1 tsp
32
TORCH
Toxoplasmosis Other (HEP-VHS) - HIV, Enterovirus, Parvovirus B-19, Varicella, Hepatitis, Syphilis Rubella Cytomegalovirus Herpes simplex
33
Other from TORCH
HIV Enterovirus Parvovirus B-19 Varicella Hepatitis Syphilis
34
Toxoplasmosis triad and treatment
Triad: Chorioretinitis, Hydrocephalus, Intracranial calcifications Tx: pyrimethamine & sulfadiazine or Spiramycin Dx: IgM = acute infection, IgG = previous infection Safe to treat during pregnancy
35
Leading cause of sensorineural hearing loss?
Cytomegalovirus
36
5 T's of congenital cyanotic heart disease
Tetralogy of Fallot (TOF) Transposition of great arteries Tricuspid atresia Truncus arteriosus Total anomalous pulmonary return
37
Corresponding murmurs for the following: VSD ASD PDA Aorta coarctation TOF
VSD: loud, pansystolic murmur ASD: soft, systolic ejection murmur w/ fixed split S2 PDA: continuous machine-like murmur Aorta coarctation: systolic murmur upper left chest TOF: loud, harsh systolic ejection murmur with Tet spells
38
Marfan's Syndrome mutation, treatment, and typical death
FBN1 gene mutation (fibrillin protein) Beta blockers (1st line), Losartan (ARB) Typically die from aneurysm rupture
39
ADHD Treatment
Stimulants are 1st line -BBW: sudden death w/ CV problem, dependency 2nd line: Atomoxetine 3rd line: Wellbutrin, Tofranil, Norpramin, Catapres, Tenex
40
ADHD Stimulants
Methylphenidate (Ritalin, Methylin) Dextroamphetamine (Adderall) Start on short-acting, titrate up doses
41
Depression Treatment
SSRI (selective serotonin reuptake inhibitors) Fluoxetine (Prozac) - 8-17 yo Escitalopram (Lexapro) - 12-17 yo BBW: Increased suicidal risk \<24 yo
42
Pediatric Leukemia
Bone pain, anemia, fatigue, fever, infection, petechiae ALL and AML (auer rods) Down's Syndrome increases risk of AML
43
Hodgkin's Lymphoma
painless lymphadenopathy, mediastinal mass, constitutional symptoms B symptoms diagnostic: weight loss, night sweats, FUO \> days
44
Non-Hodgkin's Lymphoma
B symptoms are not prognostic Treatment depends on exact type Looks like HL with emergent presentation common Overall survival is high
45
Wilm's Tumor
Big belly, not sick Tumor spill (biopsy) will upstage it to 3 -\> requires radiation
46
Most common malignant brain cancer
Medulloblastoma
47
Bilious vomiting DDx in newborns
Partial/Complete bowel obstruction
48
Nonbilious vomiting DDx in newborns
GERD -\> most common Milk protein intolerance Pyloric stenosis Gastritis
49
Abdominal pain DDx Newborn Infants
Newborn: GERD, Necrotizing colitis, Volvulus Infant-2yo: Intussusception, Meckel's diverticulum, Bacterial enteritis
50
Colic rule of 3's
Greater than 3 hours crying per day More than 3 days a week Lasts for more than 3 weeks Infants less than 3 months
51
Chronic Diarrhea DDx
Bloody: Irritable bowel disease, milk protein intolerance Non-bloody: Inflammatory bowel syndrome, cystic fibrosis/malabsorption, Immunodeficiency, lactose intolerance
52
Acute Diarrhea DDx
Tender abdomen/mass: Appendicitis, intussusception, toxic megacolon Non-tender: bacterial enteritis, parasites
53
Enuresis temporary treatment
Desmopressin acetate Suppresses ADH Only works when taken, no longer term effects
54
Tanner Sexual Maturity Scale
Stage 1: Pubic hair, breast, penis, testes all preadolescent Stage 2: sparse downy hair; breast bud; penis/testes enlarge Stage 3: increased pigment, curly hair; enlarged breast/areola w/o contour; increased length and size testes Stage 4: adult hair but less; areola forms secondary mound; glans enlarge, testes darken Stage 5: adult hair distribution; nipple elevation; adult size penis and testes
55
Delayed Puberty DDx Primary and Secondary
Primary: Hypogonadism or membrane receptor defect on gonadal cells Secondary: gonads intact; hormonal secretion issue (LH, FSH, GnRH) - hypopituitarism, hypothyroidism, hyperprolactinemia
56
Russell's sign
Erosions on inside of front teeth from vomiting
57
Sleep Disturbance Screening
BEARS Bedtime issues Excessive daytime sleepiness Night awakenings Regularity and duration of sleep Snoring
58
Infant vision development
Visual fixation shortly after birth -\> 20/400 Follow an object by 3 months old Stereopsis and binocular vision by 6 months old 20/20 vision by 3-5 years old

Pediatrics (6 decks)

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