Peds Aquifer Cases -2023 Latest Questions With Correct
Answers Already Passed!!
Management for fever without a source
CBC and empiric treatment with antibiotics are generally NOT necessary.
-vast majority will not have bacteremia or SBI
-even immunized, immunocompetent 3- to 36-month-old children
A 30-minute-old infant is evaluated in the nursery for tachypnea. He was born at
30 5/7 weeks gestation by vaginal delivery. Labor was induced due to severe
maternal pre-eclampsia. Mother received no prenatal care. Apgars were 6 and 7 at
1 and 5 minutes, respectively. One dose of betamethasone was given prior to
delivery. A chest x-ray reveals decreased lung expansion. Likely dx?
Respiratory distress syndrome (RDS)
-Preterm
-Mom got betamethasone = risk for RDS
-Insufficient surfactant.
-CXR and PE shows RDS: reticulogranular or "ground-glass" appearance and
bronchograms
Tobacco affect on newborn?
Low birth weight
Fetal alcohol syndrome
1. Facial abnormalities
2. Growth deficiency
3. Evidence of CNS dysfunction
Maternal heroin use association
1. Risk of fetal growth restriction
2. placental abruption
3. fetal death
4. preterm labor
5. intrauterine passage of meconium
Infant who has uncoordinated sucking reflexes, poor feeding, irritability, and
high-pitched cry likely has?
Neonatal abstinence syndrome
-mothers who use opioids
Cocaine and other stimulant effect on new born?
Causes vasoconstriction:
-placental insufficiency
-low birth weight
Up to 70% of SGA infants are small simply due to ...
constitutional factors determined by maternal ethnicity, parity, weight or height
When is prophylactic antibiotics indicated for GBS?
Gestational age <38 e.g. 35 weeks
TORCHZ infection
Toxoplasmosis
Other-varicella
, Other - syphillis
Rubella
CMV
HSV
Zika*
Components of the Apgar score:
Appearance (skin color)
Pulse (heart rate)
Grimace (reflex irritability)
Activity (muscle tone)
Respiration
-0, 1, or 2 for each component
-Final score range: 0 - 10.
-Reported at 1 minute and 5 minutes after birth
Pulse determination for apgar?
Palpation of umbilical cord shows heart rate
Term pregnancy
Born at >37 weeks gestation
Rooting reflex
Newborn turns his head toward your finger when you touch his cheek
Startle - moro reflex?
Support the newborn's head with one hand and buttocks with the other. With the head in
a midline position, the hand supporting it is quickly dropped to a position approximately
10 cm below its original supporting position, and the head is caught in its new position.
In response, the newborn will flex his thighs and knees, fan and then clench his fingers,
with arms first thrown outward and then brought together as though embracing
something.
Absent red reflex underlying causes?
1. Cataract
2. Opacified cornea (mucopolysaccharidosis)
3. Inflammation (anterior chamber)
4. Developmental anomalies
5. Retinoblastoma, a potentially lethal malignancy (white, irregular mass within the
globe).
Key clinical findings about the present illness
Term
SGA
Normal vital signs
Normal physical exam
Normocephaly
Developmental screening for peds should performed at what times?
9-month
18-month
30-month
autism screening - 18-months and 24-months
developmental surveillance recommended at every health maintenance visit
Answers Already Passed!!
Management for fever without a source
CBC and empiric treatment with antibiotics are generally NOT necessary.
-vast majority will not have bacteremia or SBI
-even immunized, immunocompetent 3- to 36-month-old children
A 30-minute-old infant is evaluated in the nursery for tachypnea. He was born at
30 5/7 weeks gestation by vaginal delivery. Labor was induced due to severe
maternal pre-eclampsia. Mother received no prenatal care. Apgars were 6 and 7 at
1 and 5 minutes, respectively. One dose of betamethasone was given prior to
delivery. A chest x-ray reveals decreased lung expansion. Likely dx?
Respiratory distress syndrome (RDS)
-Preterm
-Mom got betamethasone = risk for RDS
-Insufficient surfactant.
-CXR and PE shows RDS: reticulogranular or "ground-glass" appearance and
bronchograms
Tobacco affect on newborn?
Low birth weight
Fetal alcohol syndrome
1. Facial abnormalities
2. Growth deficiency
3. Evidence of CNS dysfunction
Maternal heroin use association
1. Risk of fetal growth restriction
2. placental abruption
3. fetal death
4. preterm labor
5. intrauterine passage of meconium
Infant who has uncoordinated sucking reflexes, poor feeding, irritability, and
high-pitched cry likely has?
Neonatal abstinence syndrome
-mothers who use opioids
Cocaine and other stimulant effect on new born?
Causes vasoconstriction:
-placental insufficiency
-low birth weight
Up to 70% of SGA infants are small simply due to ...
constitutional factors determined by maternal ethnicity, parity, weight or height
When is prophylactic antibiotics indicated for GBS?
Gestational age <38 e.g. 35 weeks
TORCHZ infection
Toxoplasmosis
Other-varicella
, Other - syphillis
Rubella
CMV
HSV
Zika*
Components of the Apgar score:
Appearance (skin color)
Pulse (heart rate)
Grimace (reflex irritability)
Activity (muscle tone)
Respiration
-0, 1, or 2 for each component
-Final score range: 0 - 10.
-Reported at 1 minute and 5 minutes after birth
Pulse determination for apgar?
Palpation of umbilical cord shows heart rate
Term pregnancy
Born at >37 weeks gestation
Rooting reflex
Newborn turns his head toward your finger when you touch his cheek
Startle - moro reflex?
Support the newborn's head with one hand and buttocks with the other. With the head in
a midline position, the hand supporting it is quickly dropped to a position approximately
10 cm below its original supporting position, and the head is caught in its new position.
In response, the newborn will flex his thighs and knees, fan and then clench his fingers,
with arms first thrown outward and then brought together as though embracing
something.
Absent red reflex underlying causes?
1. Cataract
2. Opacified cornea (mucopolysaccharidosis)
3. Inflammation (anterior chamber)
4. Developmental anomalies
5. Retinoblastoma, a potentially lethal malignancy (white, irregular mass within the
globe).
Key clinical findings about the present illness
Term
SGA
Normal vital signs
Normal physical exam
Normocephaly
Developmental screening for peds should performed at what times?
9-month
18-month
30-month
autism screening - 18-months and 24-months
developmental surveillance recommended at every health maintenance visit
