Glossary of Block 4 POM Exam -- Pediatrics Lectures
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- What is oligohydramnios?
What abnormalities is it a risk factor for (3)?
- Too little amniotic fluid
Severe renal abnormalities, pulmonary hypoplasia, limb abnormalities
- Labor at how far along in gestation qualifies as preterm labor?
- Before 37 weeks gestation
- How long qualifies as prolonged rupture of membranes?
What is prolonged rupture a risk factor for (2)?
- > 24 hours
Chorioamnionitis, Neonatal infection
- Treating a mother with Mg may result in what for the fetus?
What are the signs?
CNS depression, respiratory depression, hypotonia
- What is a nuchal cord?
- Cord wrapped around the neck
- When do variable fetal decelerations occur?
What are they associated with?
- Occur and end with contraction
Assoc. w/ cord compression during contraction
- When do late fetal decelerations occur?
What are they associated with?
- Occur repetitively after a contraction
Assoc. w/ fetal hypoxia
- At what times after birth are Apgar scores calculated?
- 1 minute, 5 minutes, 10 minutes
- What does an Apgar score of 0-3 suggest?
- Breakdown of the mnemonic APGAR
- A -- appearance
P -- pulse
G -- grimace
A -- activity
R -- respiratory effort
- What is the average weight of newborns?
- 3.4 kg -- 7.5 lbs
- How long after birth should newborns return to birth weight?
- About 2 weeks
- Whay do babies lose weight the first few weeks after birth?
- Loss of excess extravascular fluid
- What is the definition of Small for Gestational Age?
What are some causes?
- Being below 10th percentile for gestational age
Maternal causes often due to decreased uterine blood flow
(HTN, diabetes, cardiac/renal disease)
Fetal causes include multiple gestation, infection, chromosomal, etc.
- What is the definition of Large for Gestational Age?
What maternal issue is it associated with?
- Being above 90th percentile for gestational age
Associated with maternal diabetes
- What is the average length of newborns?
- 50 cm -- 20 in
- What is the average head circumference of newborns?
- 35 cm -- 14 in
- What does the Dubowitz(Ballard) exam assess?
What is the optimal age for it being done?
- Gestational age of the infant
(uses physical and neuro criteria)
12 - 48 hours old
- What is the normal range for respiratory rate in newborns?
- 30 - 60 breaths/min
- What is the normal range for HR in newborns?
- 90 - 180 beats/min
(average is 120 - 160)
- What does plethoric skin in a newborn suggest?
- Possibility of polycythemia
- What is lanugo?
- Fine, soft, immature hair of scalp/brow
(often seen in premature babies)
- Comparison of skin between premies and post-date infants
- Premature -- thin, transparent skin
Post-date -- leathery, dry, cracking
- What are milia?
- White papules on nose/chin
- What is erythema toxicum neonatorum?
What does it contain?
Is it benign or malignant?
- Red splotch w/ whitish/yellow papule in center
(may last one week)
- What is transient neonatal pustular melanosis?
What group of infants is it common in?
- Vesiculopustular lesions on back, chin, neck, extremities, palms, soles
(lasts 2-3 days)
Common in African american infants
- How do salmon patches present?
- "stork bite" on nape of neck
"angel kisses" on eyelids
- What is dermal melanosis?
What groups of infants is it commmon in?
- Blue-gray pigmentation usually on lower back and buttock
(fade during 1st year)
More common in pigmented babies
- What is caput succedaneum?
What causes it?
- Boggy, edematous subcutaenous tissues
CROSSES SUTURE LINES
Results from pressure against maternal pelvic bones
- What is cephalohematoma?
How is it differentiated from caput succedaneum?
- Subperiosteal bleeding
DOES NOT CROSS SUTURE LINES
- What bone do cephalohematomas typically involve?
- Parietal bone
- What is hypertelorism?
- Increased distance between orbits
- What is leukokoria?
- Absence of the red reflex
- Dull gray tympanic membranes are a sign of what?
- Serious otitis media
- What are Epstein's pearls?
What groups of infants are they found in?
- White inclusion cysts around midline of hard palate
Found in most newborns
- What is torticollis?
- A "positioning defect"
Shortening of the SCM causes head to tilt unnaturally
- What do widely shaped nipples on a shield-shaped chest suggest?
- Turner's syndrome
- What is transient tachypnea of the newborn due to?
What factors predispose infants for this (3)?
- Due to residual amniotic fluid
Diabetic mothers, precipitous delivery, C-section
- How long after birth does the PDA murmur usually resolve?
- 1 - 2 days
- What does a small VSD sound like on chest exam?
- Harsh systolic murmur at LLSB
- What is a scaphoid abdomen?
What is it suggestive of?
- "Boat-shaped" abdomen
Suggests diaphragmatic hernia
- How many vessels does the umbilical cord normally have?
- What groups of infants are umbilical hernias common in?
- African american and low birthweight infants
NOTE: most resolve within 1 yr of birth
- What is omphalitis?
- Serious infection/cellulitis aroudn the umbilicus
NOTE: can proceed to life-threatening sepsis (treat w/ anti-biotics)
- What is the definition of gastroschisis?
- Defects lateral to the umbilicus
- Inguinal hernias are common in what type of infants?
- Preterm infants
- What is a hydrocele?
- Fluid-filled sac in scrotum
Due to remnants of proccessus vaginalis
- What is Erb-Duchenne Palsy due to?
What is the prognosis?
- Excessive lateral traction on the brachial plexus
Generally, palsy resolves spontaneously
- What is the Moro reflex?
It is absent in what condition?
- Head extension causes extension and then flexion of extremities
Absent on affected side in Erb-Duchenne palsy
- What types of infants is developmental dysplasia of the hip more common in (3)?
- Females, First-born, Breech delivery
- What is a breech delivery?
- "Butt first" pregnancy
- What is metatarsus adductus?
- In-toeing of the forefoot due to intrauterine positioning
Foot is kidney bean shaped
- What is talipes equinovarus?
- Clubfoot deformity due to contractures in utero
- What is the difference between metatarsus adductus and talipes equinovarus?
(with regards to therapy)
- Metatarsus adductus -- foot can easily be put into neutral position
Talipes equinovarus -- Foot cannot be put into a neutral position
- What is calcaneovagus?
Can this be easily repaired?
- Thin, "banana-shaped" foot
Able to fold onto anterior tibia
- What does absence of the Moro reflex imply?
- Significant CNS abnormality
- When does the root/suck reflex go away?
How about the palmar grasp?
- Root/suck -- 4-6 months
Palmar grasp -- 4 months
Moro -- 6 months
Stepping -- 2 months
- How does the infant Babinski compare to the adult?
- It is the opposite
- How many calories do infants typically need by the end of the 1st week?
- 100 - 120 kcal/kg/day
- How may calories per ounce do breast milk and formula contain?
- 20 kcal/oz.
- Describe breast milk stools
How do they compare to formula stools?
- Loose, mustard colored
Formula -- darker, firmer, smellier, less frequent
- What disease is meconium ileus assoc. w/?
- Cystic Fibrosis
- Deficiency of what enzyme causes physiologic jaundice?
- Glucuronyl transferase
- How long after birth do signs of kernicterus typically show up?
- 2 - 5 days
- How long is the lifespan of RBCs in infants?
- 70 - 90 days
- When does breast feeding jaundice occur?
- First week of life
Managed by more frequent breast feeding
- When does breast milk jaundice occur?
- Develops AFTER day 7
May persist for 2-3 weeks
- When does physiologic jaundice occur?
- Between days 3-6 of life
- What is the most common cause of hemolytic disease of the newborn?
- ABO incompatibility
Mother is usually O and infant A or B
- What type of hyperbilirubinemia is assoc. w/ kernicterus?
- UNCONJUGATED hyperbilirubinemia
- What is the most common cause of neonatal conjuctivitis?
Treated w/ ORAL erythromycin
- What is erythromycin ophthalmic ointment given for?
- Prevention of gonococcal ophthalmia neonatorum
- Why are newborns more susceptible to hemorrhage?
- Transient vitamin K deficiency
- Supplementation of which vitamin is recommended for breast-fed infants?
- Vitamin D
- Date range for term neonate?
- Neonate -- 0-28 days
Infant -- 1-12 months
Toddler -- 1-3 years
Pre-schooler -- 3-5 years
- Normal range of BP for a newborn infant
- (50-70) / (30-50)
- When is the diagnosis of failure to thrive given?
- If child's growth drops across 2 percentile curves
OR, if growth is less than 3rd percentile
- What is the classical pattern of growth "fall-off" in failure to thrive?
- First drop in percentile for weight
Then, drop in percentile for height
Finally, drop in percentile for head circumference
- What is the most common cause of failure to thrive?
- Caregiver is giving insufficient calories
- What is the best test to determine etiology of failure to thrive?
- Thorough H&P
- What are the five domains used in assessing development?
- Gross Motor
- What is global developmental delay?
- Scores at least 2 s.d's below mean in at least 2 of 5 domains
- What is Rett syndrome?
- X-linked dominant disorder of girls (boys die @ birth)
Presents as regression at age 1-2 years
- What is the best predictor of intelligence?
- Who is at more risk for speech development delays, boys or girls?
- Boys (3x higher risk)
- Most likely causes of newborn meningitis?
Of child > 4 months old?
- Newborn -- Group B strep, gram-negatives
> 4 months -- Strep pneumo, H. influenzae, N. meningitidis
- What sleeping position is thought to help prevent SIDS?
- Supine sleeping position
- Significant milestones hit by 6 months of life?
- Able to lift chest and head while on stomach
Able to sit high in a chair w/ straight back
Able to roll from back onto abdomen
Able to pick up dropped object
Beginning of teething
Starts to imitate sounds
Begins to fear strangers
- Significant milestones hit by 9 months of life?
- Is able to crawl
Can pull self to standing position
Has a pincer grip between thumb and index finger
Develops depth perception
Develops "object constancy"
Can respond to simple commands (understands "no")
- Significant milestones hit by 12 months of life?
- Nearly-closed anterior fontanel
No longer have a Babinski
Can often walk independently
Can say momma, poppa, and at least 2 other words
Experiences separation anxiety
- When do the fontanelles usually close by?
- Posterior -- often by 6 weeks of age
Anterior -- often by 18 months of age
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