Unit 1 Flashcards by Robbie Fugiel

Transient mottling when infant is exposed to decreased temperature

Cutis Marmorata

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cyanosis of hand and feet in response to cold

acrocyanosis (underlying cardiac defect should be expected if more intense in feet)

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Whitish, moist, cheeselike substance - mixture of sebum and skin cells on newborn

Vernix Caseosa (protective)

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Fine, silky hair covering newborn

Lanugo (shed within 10-14 days)

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Flat, deep pink, localized areas usually seen in back of neck

Telangiectactic nevi (stork bites)

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Irregular areas of blue/blue-gray pigmentation usually in sacral and gluteal regions (predominantly in african, native american, asian, or latin descent)

Dermal Melanocytosis (Mongolian spots)

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Pink papular rash with vesicles superimposed

Erythema toxicum (may apear 24-48 hours after birth)

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Hyperbilirubinemia risk factors

breast feeding, hemoltyic disease, infection, cephalhematoma, cutaneous or subcutaneous bleeds

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preferred treatment for hyperbiligubinemia

Bili lam and bili blanket

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Present in 50% of newborns and appears to be an inability of the liver to conjugate bilirubin present in the bloood

physiologic jaundice

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if jaundice is present in the first 24 hours or it is intense and persistent it is considered

pathological

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What does tenting indicate

dehydration and malnutrition

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What is schamroth technique

Placing nail surfaces of corresponding fingers together: normal - diamond shaped, Clubbed - angle between distal tips increases

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Small, white, discrete papules on the face and bridge of the nose - common during the first 2-3 months

Milia (plugged sebaceous glands)

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Caused by occlusion of sweat ducts during periods of heat and high humidity

Milaria (heat rash)

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Scalp lesions that are scaling, adherent, thick, yellow, and crusted

Seborrheic dermatitis (cradle crap)

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Honey colored crusts caused by staph or strep

Impetigo

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Tuft of hair overlying the spinal column usually lumbosacral area

Faun Tail Nevus (spina bifida occulta)

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Evenly pigmented patches present at birth or shortly after

Cafe au lait spots (suspect neruofibromatosis if >5 patches >1cm diameter in children under 5)

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What is axillary freckling or inguinal freckling associated with

neurofibromatosis

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periodic cessation of breathing during sleep do to airflow obstruction

Obstructive sleep apnea

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Which lymph nodes is it NEVER normal to be enlarged in children

Supraclavicular

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Initial symptoms: pharyngitis, fever, fatigue, malaise. Exam findings: enlarged anterior and posterior cervical chains, splenomegaly, hepatomegaly

Infectious Mononucleosis (eptstein-barr virus)

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Initial symptoms: sore throat and runny nose, headache, fatigue, and abdominal pains

Strep Pharyngitis (throat culture needed to confirm)

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Subcutaneous edema, crosses suture lines, MC occiput, soft, poorly defined margins

Caput Succedaneum

Subperosteal bleed, does not cross sutures, MC parietal, firm, well-defined edges

Cephalhematoma

Premature union of cranial sutures - small head circumference, rigid sutures, misshapen skull

craniosynostosis (usually not accompanied by mental retardation)

No ridging, ear on flat side migrates forward, forehead protrudes, bald spot on side flattening

Positional head deformity

Palpaple ridge, ears even or ear on flat side appears to be more posterior, forehead does not protrude, no bald spot or central bald spot

Craniosynostosis

At what months do the anterior and posterior fontanels close

Posterior about 2 mos. | Anterior about 24 mos.

What condition results from a hematoma that can be palpated shortly after birth and becomes a fibrous mass 2-3 weeks later

torticollis (wry neck)

which condition elicits setting sun sign (sclera visible above the iris)

hydrocephalus (enlarged head, bossing, widening of sutures and fontanels)

Softening of the skull, demonstrated by pressing the bone along the suture line

craniotabes - associated with rickets and hydrocelphalus

Asymmetry of facial features

Bell's Palsy

Depressed nasal bridge, epicanthal folds, mongolian slant of eyes, low set ears, large tongue

down syndrome

Smooth philtrum, widespread eyes, hirsute forehead, short nose, thin upper lip

Fetal Alcohol Syndrome

Widely spaced eyes - may be associated with mental retardation

Hypertelorism

Loss of functional pupil, often associated with other congenital abnormalities

coloboma "keyhole pupil"

White specks in a linear pattern around the circumference of the iris

Brushfield spots (suggests down syndrome)

Congenital non-progressive horizontal opthalmoplegia primarily affecting the abducens nucleus and nerve and lateral recuts muscle

Duane syndrome

Eye chart used for children usually about 3 years old

Snellen E chart

What might a 2 line difference (20/50 and 20/30) indicate

Amblyopia

At what age is 20/20 vision expected. At what age is it 20/50

6 yo | 3 yo

Congenital malignant tumor initially recognized from a white reflex

retinoblastoma

What should the tip of the auricle cross in an infant

imaginary line between outer canthus of eye and the prominent portion of EOP

What are poorly shaped auricles associated with

renal disorders and congenital abnormalities

Itching of ear canal, intense pain with movement of pinna, discharge may be watery at first, then purulent and thick mixed with pus and epithelial cells, conductive hearing loss

Otitis externa

Infection of the middle ear, fever, feeling of blockage, deep-seated earache, discharge if tympanum ruptures, conductive hearing loss

Bacterial Otitis Media

Collection of liquid in the middle ear, cracking sound when yawning, pain is uncommon, feeling of fullness, discharge is uncommon, conductive hearing loss

Otitis media with effusion

Congenital nasal obstruction of the posterior nares

Choanal atresia (will breathe when crying)

Which sinuses are developed at birth

maxillary and ethmoidal (sphenoid not till puberty, frontal sinus not until 7-8 yo)

appear along buccal of the gums, pearl-like cysts, disappear in 1-2 months

Retention cysts (epstein pearls)

Multiple brown caries on upper and lower incisors

Baby bottle syndrome (bedtime bottle of juice/milk)

Enamel dysplasia

Mottled or pitted teeth (d/t tetracycline treatment during tooth development)

unconscious grinding of the teeth

bruxism

Caused by haemophilus influenzae type B, most common in 3-7 yo, croupy cough, sore throat, appears anxious, tripod position

epiglottitis

autosomal recessive exocrine glands, frequent pulmonary infections, sticky foul stool, tastes salty

cystic fibrosis

Cartilage of larynx is floppy, larynx closes in response to varying pressures of inspiration and expiration resulting in noisy breathing

Laryngomalacia

RSV, MC

bronchiolitis

Parainfluenza virus, very young, boys > girls, often begins in evening after child has gone to sleep, harsh stridorous cough (bark of seal)

croup

COPD characterized by airway inflammation, mucosal edema, increased secretions, bronchoconstriction

athsma

inflammatory response of the bronchioles and alveolar space to an infective agent, exudates lead to consolidation

Pneumonia

inflammation of the mucus of the bronchial tube with fever and chest pain

acute bronchitis

In fetal circualation blood travels directly from R to L atrium through this

foramen ovale

In fetal circulation RV pumps blood through thIS

ductus arteriosus

Leads to increased workload for RV and increased pressure in the pulmonary circulation, Machinery murmur (harsh, loud, continuous murmur, 1-3rd intercostal space,

Patent Ductus Arteriosus

Apical impulse location in infant and age it reaches adult position

3rd-5th intercostal, age 7

MC on left side, shifts heart to the right

diaphragmatic hernia

If consistently above this percentile in BP it is considered severe and could be renal disease, renal artery disease, or coarctation of aorta

95th

Narrowing in a portion of the aorta, MC descending arch near origin of left sublcavian artery

coarcation of the aorta

Oxygenated blood leaks from the LA to the RA

atrial septal defect

Allows oxygenated blood to leak from left ventricle into the right (holosystolic murmur)

ventricular septal defect

Pulmonary valve stenosis, RV hypertrophy, overriding aorta, VSD

tetralogy of fallot

What are "tet spells"

central cyanosis, paraxysmal dyspnea with loss of conciousness

Complication of strep, pharangitis, CT disease, may result in cardiac mitral or aortic valve involvement

Acute rheumatic fever (5-15)

fever, conjunctivitis, rash, strawberry tongue MC

kawasaki disease

midline separation of recuts abdominis usually resolves by 6 yo

Diastasis recti

MC intraabdominal tumor in childhood, malignant,

Nephroblastoma

Absence of parasympathetic ganglion cells in a segment of the colon... no peristalsis

Hirschprung Diseease (congenital aganglionic megacolon)

Sausage, shaped mass in left or right upper quadrant, MC 3-12 mos, etiology unknown

intussusception (ABCDEF)

Olive-shaped mass in upper RQ immediately after the infant vomits

pyloric stenosis

hypertrophy of the circular pylorus or obstruction of the pyloric sphincter, projectile vomiting, feeding irregularly

Pyloric Stenosis

relaxation or incompetence of the lower esophagus persisting beyond the newborn period, regurgitation and vomiting, weight loss, failure to thrive, repsiratory problems

Gastroesophageal reflux

Congenital obstruction or absence of some or all of the bile duct system, jaundice, hepatomegaly, abdominal distention

biliary atresia

Thickening and hardenin gof meconium in lower intestine - intestinal obstruction, failure to pass meconium 1st 24 hours after birth must consider cystic fibrosis

meconium ileus

Outpouching of the ileum, MC congenital anomaly of the GI tract

Meckel diverticulum

Unit 1 Flashcards

(86 cards)