Rash
Respiratory
Cardiology
NRP
GI
100
A healthy term newborn develops these erythematous papules with central pustules on their trunk and face on day 2 of life. Palms and soles are spared. What is diagnosis?
Erythema toxic neonatorum
100
Neonate born at 36w 5d via scheduled c-section 20 min after deliver develops tachypnea, retractions, desaturations requiring initiation of LFNC --> CPAP over the next hour to maintain sats. This is CXR obtained, what is diagnosis and next best step?
Respiratory distress syndrome, administer surfactant
CXR= air bronchograms, ground glass opacity in a late preterm baby
100
5 day old infant develops acute onset poor feeding, tachypnea, weak femoral pulses and shock. What is most likely diagnosis?
Coarctation of aorta
Systemic hypo-perfusion when ductal flow decreases
100
Do you suction mouth or nose first in resuscitation?
Mouth (then nose)
100
A 3 week old infant has progressively worsening projectile, non-bilious vomiting after feeds. Infant remains hungry and roots after vomiting. Labs reveal hypochloremic metabolic alkalosis. What is the diagnosis?
Hypertrophic pyloric stenosis
200
A 1 day old neonate develops these diffuse clusters of vesicles that include palms and soles. What is diagnosis?
Neonatal HSV
200
2 hour old neonate born at 41 wga via c-section for failure to progress develops respiratory distress. This is CXR- what is diagnosis?
Transient tachypnea of newborn
CXR= hyperinflation, increased vascular markings, interfissural fluids
200
What congenital heart condition do you suspect based on this x-ray?
"Egg on a string" x-ray
Transposition of the great arteries
200
What is the pre ductal SpO2 normal range for neonate at 5 minutes of life?
80-85%
200
A newborn has excessive drooling, choking, and cyanosis during the first feeding. An OG tube is placed and CXR shown below. What is diagnosis?
Esophageal atresia with tracheoesophageal fistula
300
A 2 day old infant develops this rash of pustules that rupture, leaving hyper pigmented macule. What is diagnosis?
Transient neonatal pustular melanosis
300
2 hour old neonate born 41 wga born via c-section for failure to progress develops respiratory distress. This is CXR- what is diagnosis?
Meconium aspiration syndrome
CXR= diffuse coarse, patchy consolidations bilaterally
300
What congenital heart condition do you suspect based on this x-ray?
Tetralogy of fallot
"boot shaped heart"
300
You are at the resuscitation of a newborn who is gasping and has HR of 60 bpm after initial warm/ dry/ stimulation, what should next step be?
Positive pressure ventilation
300
A newborn fails to pass meconium within 48 hours and develops abdominal distention with bilious vomiting. Rectal exam results in explosive passage of stool. What is diagnosis?
Hirschprung Disease
400
What is diagnosis?
Milia
400
3 day old neonate born at 32 wga admitted to NICU for RDS with increasing respiratory support requirement, this is CXR- what is diagnosis?
Pneumothorax and pneumomediastinum
Spinnaker sign= "lifting" of thymus in pneumomediastinum
400
Newborn develops cyanosis in first several hours of life. Exam shows central cyanosis and a single second heart sound. EKG shows this- what is diagnosis?
Tricuspid atresia
EKG shows left axis deviation and left ventricular dominance
400
What is the APGAR?
HR 101, cyanotic trunk and extremities, slow and irregular cry to stimulation, minimal response to stimulation holding arms/ legs flexed
5
0 points for appearance (color)
2 for HR (>100)
1 for grimace (minimal response)
1 for activity (holds in flexion)
1 for respiration (slow and irregular)
400
4 week old infant presents with persistent jaundice, dark urine, pale stools, hepatomegaly. Total bilirubin is 8 mg/ dL, direct bilirubin is 5 mg/ dL. What is diagnosis and treatment?
Biliary atresia
Treatment: kasai procedure ideally within first few weeks of life
500
Rash present at birth. What is diagnosis?
Sebaceous hyperplasia
Separate from neonatal acne which presents later (2-4 weeks of age) and are associated with faint surrounding erythema
500
Full term neonate with shortness of breath shortly after birth, this is CXR- what is diagnosis?
Congenital diaphragmatic hernia
CXR= opacification of L lung, shift of mediastinum to contralateral side, yellow arrow is bowel gas
500
What congenital heart anomaly do you suspect based on this X-ray?
Total anomalous pulmonary venous return "snowman" sign
500
Neonate requiring bag mask ventilation at birth, PPV not successfully getting chest rise. What steps can you take to correct? (acronym, list all)
M- mask adjustment
R- reposition head/ airway to sniffing position
S- suction
O- open mouth
P- increase pressure
A- alternative airway
500
A 2 week old infant lab workup shows elevated direct bilirubin level. On physical exam, pt has a systolic murmur consistent with peripheral pulmonary artery stenosis, butterfly vertebrae, and these facial features. What is diagnosis?
Alagille Syndrome