Gee....I
On Exam
Patient's bracelet
Other organs
Potpourri
100
Is it Gastroschisis or Omphalocele? Arises within the umbilical ring as a central defect.
What is omphalocele (arises within the umbilical ring as a central defect, while a gastroschisis involves the base of the umbilical stalk)
100
5 day old presents with soft tissue swelling on their occipital area. Swelling crosses suture line. Patient born at 41 weeks gestation through C-Sect secondary to failed vacum delivery. Good birth weight and apgars. At birth, scalp swelling crossed the midline on skull radiograph. The most likeley diagnosis is.
What is Caput seccedaneum
100
With early congenital syphillus (Before 2 years of age). Name some findings on exam (need 6 for credit)
What is Hepatosplenomegaly- diffuse inflammation, scarring Jaundice – due to hepatitis Generalized lymphadenopathy –epitrochclear nodes Coombs – hemolytic anemia, thromobocytopenia, leukopenia, leukocytosis Hydrops fetalis Mucocutaneous: rhinitis (highly infectious), “snuffles”, mucous patches Macuolpapular rash Desquamation Pemphigus syphiliticus (vesicular bullous eruptions of palms and soles) Petechial lesions Bony lesions, osteochondritis, periostitis, pseudoparalysis Syphilitc leptomeningitis Chorioretinitis,salt and pepper fundus, glaucoma Pancreatitis Early manifestations are varied, with multi-system Involvement Papulosquamous Plaques Broken vesicles, desquamation Condylomata around anus Infiltration, desquamation and rhinitis Rhinitis (snuffles), mucous patches, damage to palate(late) Bullae and vesicular rash on soles Eroded papular lesions Lone Bone Radiographs show Osteochondritis of distal radius and ulna Osteochondritis of femur and tibia metaphysis
100
Most common type of tracheoesophageal fistula
What is Type A (90%) Esophageal Atresiawith distal TE Fistula.
100
Consider that your daily double Get it correct, double your points (For a full 200). Newborn following difficult delivery with hand held in a "clawed" position. Grasp is also poor on this hand. However, proximal portion of both upper extremities are ok. The problem most likely here.
What is damage to C7 & C8 This is different than waiter's tip (Erb's palsy. You know C5, C6, some texts say C7 injury)
200
Is it Gastroschisis or Omphalocele. Usually covered by a translucent membrane
What is Omphalocele
200
Difference between Erb's Palsy Vs. Klumpke's palsy A. Begin with Where in the brachial plexus the injury is (specifically what roots). B. Tell if arm can move and if fingers can move. C. What do you see on exam
What is Erb’s palsy is a weakness of the upper arm due to a brachial plexus birth injury (spinal roots C5-C7). A baby diagnosed with Erb’s palsy may be unable to move their arm, but may be able to move their fingers. The arm hangs at the side with the elbow extended and the forearm pronated; the so-called waiter's tip Klumpke’s Palsy Weakness or paralysis caused by an injury to the lower part of the brachial plexus. Damage to the seventh and eighth cervical and first thoracic nerve cause Klumpke’s Palsy. Symptoms include fingers that do not move and a limp wrist and hand. In this injury the elbow becomes flexed and the forearm supinated (opened up, palm-upwards) with a characteristic clawlike deformity of the hand. Sensation in the palm of the hand is diminished
200
Whith syphillus infection and treatment Which is the only test that will always be positive for life of patient (Be it treated patient or not)
What is Treponemal antibody titers (become positive soon After initial infection and usually remain positive For life, even with adequate therapy)
200
Name some (at least 3 for credit) conditions associated with Polyhydramnios during perinatal assesment.
What is Anencephaly, duodenal atresia, gastroschisis, TE fistula, congenital diaphragmatic hernia, and maternal diabetes mellitus.
200
Leading cause of infant death
What is Congenital malformation
300
Most common affected sites (TWO) of bowel in NEONATAL NECROTIZING ENTEROCOLITIS (NEC)
What is terminal ileum and ascending colon
300
Newborn on day one of life is examined and it is unclear if newborn is male or female. Which is the most improtant test to run on a stable patient.
What is Karyotype. Other test to run : Barr Body analysis, 17OH Progesterone, Electrolytes, Head US.
300
Infant with congenital syphillus treated with Penicillin G. On follow up testing there is a 4 fold increase titer after treatment suggests what?
What is reinfection or relapse Note: A sustained 4 fold decrease in titer of nontreponemal test after treatment demonstrates adequate therapy
300
If seizure occurs within the first 24 hours following birth, it is likely secondary to.......(Hint don't think electrolytes)
What is Birth asphyxia
300
Any infant with persistent hyperbilirubinemia, poor weight gain since birth, umbilical hernia, decreased tone, and open wide anterior fontanel. On the top of your differential is.....
What is Hypothyrodism
400
Is it Gastroschisis or Omphalocele? Defect is lateral to the umbilicus
What is gastroschisis
400
60 seconds after the birth of the infant, heart rate is taken to read 110 bpm, while resp rate is 44 bpm, and movement spontaneous to both arms and legs. Skin color was all pink except for the hands and feet which were a purple to blue like color. Patient made a contorted facial expression and moved head away during bulb suction of nares.What is APGAR score at 1 minute
What is 9
400
Neonatal herpes (Skin manifestations-vesicles) are most likeley seen at what day of life.
What is day 8 of life
400
If patient born to Hep C positive mom, at what age would serologic testing for antibody to Hep C be a good idea, as mom's antibody sufficently cleared.
What is 2 years (some text's say 18 months)
400
10 day old male brought into ED unresponsive. No medical records are available as patient was born across the boarder in an area with no medical access. Mom reports patient did well soley breastfeeding untill 3 days ago when was given antibiotics from neighbor who said this would settle the patient down as patient had a shaking episode that lasted for a c ouple of minutes. On exam patient with retinal hemorrhage. CT and skeletal series are negative. Besides begining ABC of resusitation what other therapy (med) should be given.
What is Vitamin K Patient with hemorrhagic disease of newborn
500
9 day old pretern infant (32 weeks gestational age)who had umbilical artery catheterization done at birth and recent (within 96 hours) large volume nasogastric feeding. At check out yesterday from previous resident had abdominal distension and GI bleeding (confirmed by guiac) and hypotension. Which xray finding on this patient would be associated with a 50% chance of survival?
What is Fixed dilated loop of intestine, or Portal vein gas, or Pneumoperitoneum
500
Patient jaundice at 2 weeks of age. You ordered an indirect bili which was normal. When you checked the direct (conjugated) hyperbili is was high. What is your differential. (Need at least 4 for credit)
What is Galastosemia, Biliary atresia, choledochal cyst, total parenteral nutrition administration, TORCH infections, alpha 1 antitrypsin deficiency, pancreatitis, and Drug induced cholestasis.
500
What percent of women who just delivered to an infant that develops herpes simplex virus, were asymptomatic during delivery OR have no history of herpes at any time in past. Wow, so they deliver a baby that gets herpes infection soon after birth (within a few weeks) yet no personal history or no exam findings upon delivery.
What is 60-80% That's a lot
500
Leading cause of infant death
What is congenital malformations
500
If patient with single umbilical artery, what should you be concered about.
What are congenital anomalies
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