Shared Flashcard Set

Details

ICM 3 Test 2 (UKCOM)
Eyes, Derm, Neuro, Peds, Newborn
223
Medical
Professional
01/30/2011

Additional Medical Flashcards

 


 

Cards

Term
Anisocoria
Definition
Unequal pupils (benign anisocoria is a normal variant in 20% of people; pupil reacts to light normally); possible uncal herniation if in coma
Term
Amarosis fugax
Definition
painless, transient monocular vision loss
Term
See anisocoria, do what
Definition
Order head CT
Term
Acute angle-closure glaucoma
Definition
Headache with dilated irregular pupil; eye PAIN will dominate the clinical picture. Also, eye will be red with cloudy cornea.
Term
Horner's syndrome
Definition
Damage to SNS; Horny PAMELa: Ptosis (drooping), Anhidrosis (lack of sweating), Miosis, Enophthalmos (recession of eyeball) and Loss of ciliospinal reflex (dilation of ipsilateral pupil in response to pain to neck, face or upper trunk).
Term
Bilateral ptosis
Definition
Seen in MG, Miller-Fisher variant of Guillain-Barre syndrome, Botulism
Term
Unilateral ptosis
Definition
Seen in Horner's syndrome & Oculomotor palsy
Term
Endopthalmos
Definition
Trauma
Term
Exophthalmos with periorbital edema
Definition
Bilateral in Grave's disease
Term
Lidlag
Definition
See white sclera upon looking down; indicates hyperthyroidism
Term
Lateral rectus, Superior oblique, All the rest
Definition
LR6 SO4 AR3
Term
Paralytic stabismus
Definition
deviation varies depending on gaze direction
Term
Non-paralytic (aka lazy eye) strabismus
Definition
Deviation is constant in all gaze directions
Term
Esotropia
Definition
Convergent strabismus (shorter distance between pupils)
Term
Exotropia
Definition
Divergent strabismus (greater distance between pupils)
Term
Cover/uncover test
Definition
Abnormal eye realigns after good eye covered
Term
Diabetes CN involvement
Definition
CN VI: longest and likeliest involved neuropathy (also caused by 1) increased intracranial pressure 2) meningeal processes, including infection and cancer)
Term
CN III palsy
Definition
Eye is deviated inferiorly and laterally (IV and VI are intact); also see ptosis due to loss of levator m. & mydriasis
Term
CN III infarction
Definition
Lose CN III motor fibers first
Term
Pressure on CN III
Definition
Lose parasympathetic fibers first: get mydriasis
Term
CN IV palsy
Definition
affected eye is deviated superiorly and medially; pt complains of diplopia
Term
Intranuclear opthalmoplegia
Definition
Lesion of MLF: problem with adduction of the involved eye. Bilateral in MS. Unilateral in brainstem strokes and rarer disorders.
Term
Left nystagmus
Definition
slow drift right followed by rapid movement left.
Term
End point nystagmus
Definition
Not necessarily pathologic. Occurs in the direction you look. Can be caused by drugs of abuse and others (e.g. lithium, dilantin)
Term
Primary position nystagmus
Definition
Eye not fixed. Due to vestibular dz, strokes, MS
Term
Myopia
Definition
Near-sighted. Cannot see distance. Retinal image focal point anterior to retina.
Term
Hypermetropia
Definition
Far-sightedness. Cannot see close. Retinal image focal point posterior to retina.
Term
Opticokinetic nystagmus
Definition
involuntary eye movements during the scanning of a moving field (i.e. watching a passing train). preserved in feigned blindness.
Term
Complete lesion of optic nerve.
Definition
Lose both fields in one eye.
Term
Partial lesion of optic nerve.
Definition
Lose partial fields in one eye.
Term
Complete lesion of optic chiasm.
Definition
Lose lateral fields bilaterally.
Term
Damage to optic tract.
Definition
Lose contralateral fields in both eyes.
Term
Lesion of fiber tract from cortex to geniculate.
Definition
Lose contralateral fields in both eyes.
Term
Blepharitis
Definition
Inflammation of eyelid
Term
Chalazion
Definition
Chronic Meibomian Gland Inflammation
Term
Hordeolum (sty)
Definition
Infected eyelash hair follicle
Term
Xanthelasma
Definition
Hyperlipidemia causes subcutaneous collection of cholesterol along medial aspect of eyelids
Term
Hyphema
Definition
Blood in anterior chamber
Term
Hypopyon
Definition
Pus in anterior chamber
Term
Fluorescein exam
Definition
Corneal abrasion appears green
Term
Arcus senilis
Definition
White or gray opaque ring in the corneal margin around the iris. May be present at birth and fade; may be present at <40yo and indicate hyperlipidemia; or be a normal variant in elderly.
Term
Glaucoma
Definition
Cloudy/steamy cornea
Term
Miosis
Definition
Constriction of pupil via parasympathetics in CN III
Term
Mydriasis
Definition
Dilation of pupil via sympathetics in CN V
Term
Marcus Gunn Pupil
Definition
affected eye does not react to light directly but does constrict to light directed to the opposite eye (consensual response)
Term
Pupil pinpoint <1mm
Definition
Pupil finding for: narcotics, pons lesion, or cerebellum lesion with pontine compression
Term
Pupil midposition (5-7mm) & fixed
Definition
Pupil finding for midbrain lesion
Term
Pupil dilated & reactive
Definition
Pupil finding for: sympathomimetic such as amphetamine, LSD, cocaine
Term
Pupil dilated & fixed
Definition
Pupil finding for: lesion of medulla (brain death), drugs with anticholinergic effect
Term
Metabolic coma pupil finding
Definition
Coma with spared pupillary reactivity
Term
Pupils in coma due to endogenous toxins
Definition
Occulocephalic responses usually spared by these toxins
Term
Pupils in coma due to exogenous toxins
Definition
Eye movements usually paralyzed by these toxins
Term
Pupil & Iris bilaterally small and nonreactive to light, but will accomodate. AKA Argyll Robertson Pupil.
Definition
Pupil and iris finding due to: opiate overdose, pontine lesion, neurosyphilis
Term
Holmes-Adie Syndrome
Definition
Slow response to light (irregularly dilated pupil); initially unilateral, may progress to bilateral over time; delayed constriction to accomodation; reacts to instilled medications; associated with loss of deep tendon reflexes
Term
Cataract
Definition
Lens opacity, various causes, common reason for inability to see the fundus
Term
Glaucoma
Definition
Increased intraocular pressure (normal 10-21 mm Hg); symptoms: boring eye pain, headache, vision blurred with rainbow halo around lights, nausea, abdominal pain; signs: cloudy, edematous cornea, hard red eye, ciliary flush, semi-dilated fixed pupil, IOP high
Term
Treatment of glaucoma
Definition
Mannitol IV; pupil constriction via beta-blocker or cholinergic agonist; reduced intra-ocular fluid formation with carbonic anhydrase inhibitor (Diamox)
Term
Conjunctivitis
Definition
Red Eye, Discharge present, vision unaffected, pre-auricular lymph node palpable, IOP normal
Term
Anterior uveitis
Definition
Red eye, some pain, blurred vision, IOP occasionally elevated
Term
Optic cup
Definition
Usually <50% optic disc diameter
Term
Papilledema
Definition
Blurred disc margins; indicates high pressure transmitted through optic nerve; due to: 1) systemic arterial pressure (malignant HTN), 2) venous pressure (central retinal vein occlusion, like an "eye DVT"), 3) high intracranial pressure (brain tumor, meninigitis)
Term
Hypertensive retinopathy Grade I
Definition
Mild vessel narrowing; retinal appearance normal; no papilledema
Term
Hypertensive retinopathy grade II
Definition
Moderate-marked narrowing (copper wiring), A-V nicking; retinal appearance normal; no papilledema
Term
Hypertensive retinopathy grade II
Definition
Moderate-marked narrowing (copper wiring), A-V nicking; retinal appearance normal; no papilledema
Term
Hypertensive retinopathy Grade III
Definition
Marked narrowing and spastic lesions (silver wiring); Retinal appearance: edema, cotton wool spots & hemorrhages; no papilledema
Term
Hypertensive retinopathy Grade IV
Definition
marked narrowing (copper wiring) and spastic lesions (silver wiring); A-V nicking; retina appearance: edematous with cotton wool spots & hemorrhages; Papilledema present
Term
Cotton wool spots
Definition
edge of micro-retinal infarct; associated with HTN, diabetes, systemic lupus & venous infarcts
Term
Roth's spots
Definition
Hemorrhage with a white center corresponding to a cotton wool spot (i.e. infective endocarditis & others)
Term
Diabetic dot and blot retinopathy
Definition
Retinal capillary microaneurysms & intra-retinal hemorrhages
Term
Pterygium
Definition
mass of conjunctival tissue that extends to the corneal surface. Ass'd with sunlight exposure; mostly cosmetic.
Term
Papulosquamous
Definition
A bump with scales
Term
Papule
Definition
bump without scales
Term
Vesicle
Definition
blister
Term
Wheals/welts
Definition
local edema that results from the local release of histamine, which increases capillary filtration
Term
Pustule
Definition
blister with pus
Term
Macule
Definition
flat colored spot
Term
Morphology of skin lesions (6)
Definition
Circular, oval, annular (ring shaped), targetoid, color, size
Term
Secondary skin lesion
Definition
primary lesion has changed.
Discoloration (hyper/hypopigmentation)
Lichenification (from rubbing, esp elbow); Scabs & crusts; Erosions (skin broken through from epi to dermis); Ulcers (possibly down to fat); Fissures
Atrophy
Term
Distribution/Configuration of skin lesions
Definition
Sun-exposed vs non-sun-exposed; Zosteriform (resembles herpes zoster); acral lesion (on limbs); central; geographic
Term
Seborrhoeic dermatitis, a common form of eczema
Definition
Erythematous, not sharp, worse in winter, itchy, papulosquamous, often on the face, scalp, trunk
Term
Plaque psoriasis, the most common form of psoriasis
Definition
Erythematous patches, papulosquamous, scab crusts are secondary lesions
Term
Subacute chronic squamous lupus erythematosus
Definition
Annular rash with scales, papulosquamous, geographic distribution
Term
Poison ivy (contact dermatitis)
Definition
Tense blisters, line-like
Term
HSV-1 with secondary impetigization
Definition
Clustered secondary lesions exhibiting honey crusting
Term
Herpes varicella zoster
Definition
Tense grouped pustules with scabbed crust secondary lesions within a dermatome pattern
Term
Acne
Definition
Pustules, red base; open comedo; closed comedo; inflammatory pustules; post-inflammatory discoloration
Term
Leukocytoplastic vasculitis
Definition
Vesicular pustules; purplish base=blood leaking into skin (inflammation)
Term
Drug allergy
Definition
Confluent (joined) small circular papules
Term
Erythema multiforme
Definition
Targetoid and annular circular papules; papulosquamous; no itching; no secondary lesions
Term
Phytodermatitis
Definition
Inflammation of the skin caused by a plant/perfume
Term
Skin is composed of
Definition
Epidermis, dermis, subcutaneous fat/hypodermis/superficial fascia
Term
Primary epidermis skin cells
Definition
Squamous cells, melanocytes, basal cells
Term
Primary dermis skin cells
Definition
Histiocytes, fibroblasts. Dermins also contains CT matrix of collagen.
Term
Color of vascular lesions
Definition
Red or purple
Term
Color of pigmented lesions
Definition
Brown or black
Term
Color of lesion squamous in origin
Definition
White
Term
Color of lesions derived from a deeper structure not affecting the epidermis
Definition
Skin color
Term
How to tell the difference between arterial and venous vascular lesions
Definition
Arterial are brighter red/strawberry/crimson, venous are purple or violet
Term
Red vascular lesions
Definition
Cherry red angiomas; Cavernous congenital angiomas; Congenital angiomas; Nevus Flammeus congenital and late occuring lesions, Nevus Flammeus Tardus; Spider Angiomas (Nevus Araneus); Pyogenic Granulomas; Telangiectasias
Term
Purple vascular lesions
Definition
Venous lakes; Senile Purpura; Angiokeratoma; Angiosarcoma (malignant); Kaposi Sarcoma (malignant)
Term
Cell most likely responsible for brown or black lesions
Definition
Melanocyte
Term
Junctional nevus
Definition
Melanocytes are situated only along the dermal epidermal junction. These lesions are macular or flat.
Term
Intradermal nevus
Definition
The proponderance of melanocytes are in the dermis and have migrated from the dermal epidermal junction. They may be macular or raised papular.
Term
Compound nevus
Definition
has features of both junction and intradermal nevus
Term
Blue nevus
Definition
A melanocytic nevus that resides deeper in the skin
Term
Lentigo (or multiple lentigines)
Definition
Macular or flat tan to brown lesions seen of sun exposed skin in older patients that have a very organized appearance (meaning they have symmetry, regular border, no color variation and are small in diameter).
Term
Ephelids
Definition
Freckles; occur more commonly in type 2 skin patients with fair skin and lighter hair/red heads.
Term
Congenital melanocytic nevus
Definition
pigmented mole-like skin lesion present at birth
Term
Seborrheic Keratosis
Definition
Warty or cobblestone growth that refract light and have a pasted-on like appearance. Despite being brown, they are of squamous cell origin, not melanocytes.
Term
Pigmented Basal Cell Carcinoma (Melanoma)
Definition
Types of melanomas: Lentigo Maligna, Superficial Spreading Malignant Melanoma, Lentigo Maligna Melanoma, Nodular Melanoma, Acralentiginous Melanoma
Term
Color and character of squamous cell carcinoma
Definition
Color of skin, keratin has scaly or warty texture
Term
Words in names of squamous cell lesions
Definition
Keratosis, acanthoma
Term
Types of verrucae/warts
Definition
Verrucae vulgaris (common warts); Verrucae Plana (flat topped small warts); Verrucae Plantaris (sole of the foot); Filiform Warts (Digitate verrucae); Condyloma Accuminata (Venereal warts); Mosaic warts
Term
Squamous cell lesions
Definition
Pigmented Actinic (Solar =) Keratosis; Non-pigmented AK; Squamous cell carcinoma in situ (Bowens Disease); Bowenoid papulosis; Squamous cell carcinoma invasive well differentiated; Squamous cell carcinoma invasive poorly differentiated; Paget's disease usually of adenocarcinoma origin either mammary or extramammary origin; Keratoacanthoma; Lichen Planus-like Keratosis
Term
Basal Cell lesions
Definition
Micronodular Basal Cell Carcinoma; Ulcerating BCC; Morphea (Sclerosing) BCC; Superficial multicentric BCC; Pigmented BCC
Term
Lesions of fibroblastic or histiocytic origin
Definition
Hypertrophic scar; Keloid; Dermatofibroma or Histiocytoma; Dermatofibrosarcoma Protuberans; Soft fibroma (skin tags or polyps/achrochordon); Mucinosis (mucin is produced by fibroblasts)
Term
Lesions of deeper dermal origin
Definition
Pilar cysts (epidermoid cysts--except scalp; trichilemmal cysts--scalp); Steatocystoma Multiplex; Myxoid Cyst (variation of synovial cyst); Dermoid cyst
Term
Lesions of sebaceous gland origin
Definition
Tend to have waxy yellowish hue; Sebaceous Hyperplasia; Sebaceous Adenoma; Sebaceous Carcinoma; Nevus Sebaceous of Jadassohn
Term
Lesions of deposition
Definition
Xanthelasma; Xanthoma; Eruptive Xanthomas
Term
Lesions of subcutaneous origin
Definition
Lipoma (freely movable); Angiolipoma usually appear as lipomas but are tender
Term
Lesions of sweat gland origin
Definition
Syringoma; Eccrine Poroma; Syringocystadenoma; Apocrine Hydrocystoma (slightly purplish and frequently on face)
Term
Lesions of Neural origin
Definition
Neurofibroma (assymptomatic and depressible and flesh colored); Neuroma (painful) flesh colored papule; Neurofibrosarcoma
Term
Color of basal cell lesions
Definition
Typically pearly shiny color
Term
Sensory level of the nipples
Definition
T4
Term
Sensory level of the umbilicus
Definition
T10
Term
Sensory level of inguinal region
Definition
L1
Term
Sensory level of plantar aspect of foot
Definition
L5
Term
Sensory level of perianal area
Definition
S5
Term
Describe the course of pain & temperature fibers
Definition
The spinothalamic tract crosses at the spinal level and ascends anteriorly on the contralateral side
Term
Describe the course of position & vibration fibers.
Definition
The posterior columns ascend ipsilaterally & cross in the lower medulla.
Term
Causes of spinal cord disease that may result in motor weakness
Definition
Osteophyte, anterior cord infarction, transection
Term
Cause of motor neuron disease (one example)
Definition
ALS
Term
Cause of demyelinating disease that may cause motor weakness (1 example)
Definition
Guillian-Barre
Term
Cause of motor end-plate disease (1 example)
Definition
Myasthenia
Term
Cause of Myopathy (1 example)
Definition
Polymyositis
Term
An electrolyte disorder than can cause motor weakness
Definition
Hypokalemia
Term
Cause of unilateral/focal motor weakness
Definition
Carotid artery distribution cortical stroke; Traumatic injury/nerve entrapment or impingement (e.g. tumor); Lacunar stroke
Term
When grading motor strength, what level is given when no contraction is detected?
Definition
0/5 muscle strength
Term
When grading motor strength, what level is given when there is trace activity but unable to move joint?
Definition
1/5 muscle strength
Term
When grading motor strength, what level is given when joint can be moved, but not against gravity?
Definition
2/5 muscle strength
Term
When grading motor strength, what level is given when one can oppose gravity?
Definition
3/5 muscle strength
Term
When grading motor strength, what level is given when strength is subnormal, but can oppose some external resistance?
Definition
4/5 muscle strength
Term
When grading motor strength, what level is given to normal strength?
Definition
5/5 muscle strength
Term
Characteristics of lower motor neuron damage
Definition
Individual muscles may be affected; Atrophy pronounced (up to 80% of bulk); Flaccidity & hypotonia of affected muscles with loss of DTRs; Plantar reflex, if present, is flexor; Muscle fasciculations are present
Term
Characteristics of upper motor neuron damage (exhibit inhibitory effect on lower motor neurons)
Definition
Muscles affected in groups; Atrophy slight & due to disuse; Spacticity w/hyperactive DTRs (clonus seen) & extensor plantar reflex (Babinski sign)
Term
Resting muscle tone is decreased in
Definition
Acute spinal shock; lower MN disease/peripheral neuropathy; cerebellar disease
Term
Resting muscle tone is increased in
Definition
Upper motor neuron disease. Specifically, lead-pipe rigidity and cogwheel rigidity are seen in extrapyramidal disease (e.g. Parkinson's)
Term
Functions lost in cortical strokes
Definition
Actions of hand & face; sensory; speech/aphasia
Term
Functions lost in lacunar strokes
Definition
Typically purely motor or purely sensory losses (small losses of cortical neurons)
Term
Characteristic of CN innervation of the larynx, tongue, neck, jaw & upper face
Definition
Bilateral, such that there are no unilateral findings unless a nucleus (e.g. hypoglossal) or CN is involved. For example, Bell's palsy is unilateral lesion of CN VII with ipsilateral paralysis, whereas a UMN lesion gives contralateral paralysis of lower face only.
Term
Definition of TIA
Definition
Resolves within 24 hours
Term
Resting tremor
Definition
Occurs in posture of repose & suppressed with activity (e.g. Parkinson's, which usually disappears with activity & complete relaxation)
Term
Intention tremor
Definition
Appears with action & worsens as goal is reached; cerebellar in etiology
Term
Postural (or action) tremor
Definition
Becomes evident with action & includes hyperadrenergic, physiologic, alcohol withdrawal, & essential tremor
Term
Benefit of normal walking assessment
Definition
Less sensitive but more specific for abnormality
Term
Benefit of tandem walking (heel-to-toe) assessment
Definition
More sensitive but less specific for abnormality
Term
Requirements of normal gait (5)
Definition
Motor strength; Vestibular system function; Position sense; Intact cerebellum; Functional basal ganglia
Term
Cerebellar functions
Definition
Coordinates complex muscular activity including posture and gait; Incorporates visual & vestibular input to maintain balance; Has connections with eyes
Term
Dysdiadochokinesis
Definition
Attempted rapid alternating movements are slow, irregular or clumsy. Indicates cerebellar dysfunction.
Term
Affect on attempted rapid alternating movements in presence of UMN disease (e.g. cortical CVA)
Definition
Slow and deliberate movements
Term
Point-to-point testing in patients with cerebellar dysfunction may reveal
Definition
Intially overshooting the mark (dysmetria); Coarse intention tremor, which often worsens with approach to the target; Consistent deviation to one side (past pointing), which also indicate vestibular disease; If point-to-point is normal with eyes open but becomes abnormal with closed eyes: suggests position sense dysfunction
Term
Basic abnormal gait: Cerebellar ataxia
Definition
Wide-based, unsteady, lateral veering (e.g. MS, tumor)
Term
Basic abnormal gait: Sensory ataxia
Definition
"stamp & stick" gait. Looks at ground (e.g. B12 deficiency, tabes dorsalis)
Term
Basic abnormal gait: Festinating
Definition
Shuffling steps with rigidity; lower body appears to be chasing upper body (i.e. Parkinson's)
Term
Basic abnormal gait: Steppage or equine
Definition
Inability to dorsiflex foot (e.g. trauma to Peroneal nerve, Charcot-Marie-Tooth)
Term
Why is fat especially important in the newborn's diet?
Definition
Because it's required to continue myelination of their nerves
Term
When does the posterior fontanel normally close?
Definition
It's present at birth (1-2 cm) and closed by 2-4 months
Term
When does the anterior fontanel close?
Definition
It's present at birth (4-6 cm) and closed by 7-18 months.
Term
When do the sutures usually close?
Definition
They're closed by 2 years old.
Term
By what age should the eyes track together (no strabismus)?
Definition
By 4-6 months old
Term
What color(s) do you want to see in the choroidal reflex and which is bad?
Definition
Want to see red or gray (in pigmented people). White could indicate retinoblastoma or congenital cataract (e.g. due to congenital rubella). Can't send baby home without seeing red reflex.
Term
What is remarkable about the lymph nodes in children?
Definition
They are often larger than in adults, they may enlarge, and they may never go down or only regress after 10 years old.
Term
What is special about nuchal rigidity in children?
Definition
It is only a useful sign of meningitis after 12 months old.
Term
What is the pattern of respiratory rate change with age between infants, adolescents and adults?
Definition
infants>adolescents~=adults
Term
Describe stridor
Definition
mostly inspiratory (but can also be expiratory when severe)
Term
Describe wheezing
Definition
mostly expiratory (but can also be inspiratory when severe)
Term
Describe rales
Definition
crackles
Term
Describe tanner staging for pubic hair
Definition
1) No hair
2) Occasional fine
3) Few coarse curly
4) Mons pubis covered
5) Down to thighs
6) Up to belly button in males
Term
Describe tanner staging for male genitals
Definition
1) Almond-sized testicles
2) Testicles >1.5 mL
3) Penis lengthens
4) Penis widens
5) Adult
Term
Describe tanner staging for female breasts
Definition
1) No glandular tissue
2) Breast bud
3) Breast more elevated
4) Secondary areolar mound
5) Mature breast
Term
What to suspect if child has hip click?
Definition
Dislocated hip, refer to pediatric orthopedics
Term
What to suspect if newborn has high fever +/- joint swelling
Definition
Infectious arthritis or rheumatoid arthritis
Term
What is the pattern of jaundice distribution in children?
Definition
Starts at the face and if worse descends down the body
Term
What are the 5 components of the Apgar score?
Definition
1) Heart rate 2) Respiratory effort 3) Muscle tone 4) Reflex irritability 5) Color
Term
How are Apgar points assigned for heart rate?
Definition
0=Absent 1=<100 2=>100
Term
How are Apgar points assigned for respiratory effort?
Definition

0=Absent 1=Slow and crying 2=Good and crying

Term
How are Apgar points assigned for muscle tone?
Definition
0=Flaccid 1=Some flexion of the arms and legs 2=Active movement
Term
How are Apgar points assigned for reflex irritability?
Definition
0=No responses 1=Crying 2=Crying vigorously
Term
How are Apgar points assigned for color?
Definition
0=Blue, pale
1=Pink body, blue extremities
2=Pink all over
Term
What is the most common reason for a child to get a 9/10 Apgar score?
Definition
Acrocyanosis is common since hands and feet are last to turn from blue to pink so they get 1/2 for color.
Term
Classify these three ranges of 1-minute Apgar scores
1) 0-4
2) 5-7
3) 8-10
Definition
1) Severe depression, requiring immediate resuscitation
2) Some nervous system depression
3) Normal
Term
Classify these three ranges of 5-minute Apgar scores
1) 0-7
2) 9-10
Definition
1) High risk for subsequent central nervous system as well as other organ system dysfunction
2) Normal
Term
What is the general pattern of flexibility regarding preterm and normal term babies and what is the one exception?
Definition
Preterm babies are usually MORE flexible than normal term babies (e.g. heel to ear, scarf sign), HOWEVER term babies can do hand-on-forearm at wrist flexion.
Term
What are a few other things seen in preterm babies?
Definition
Popliteal angle: greater flexion (smaller angle)
Transverse plantar creases: fewer creases
Lanugo hair (24-32 weeks gestational age)
Thin and translucent skin
Term
What is something seen in post mature infants?
Definition
Peeling & cracking skin. May also release meconium in utero, which they may inhale & die.
Term
What are the vitals of a normal term baby?
Definition
HR ~140, RR ~30-60*, BP not done routinely
*Must measure RR for full minute because breathing is irregular
Term
What is the pattern in weight loss/gain for newborns?
Definition
Lose weight for first few days. Should be back to birth weight by 2 weeks.
Term
What is the word for large head circumference at birth?
Definition
Hydrocephalus
Term
What is the word for small head circumference at birth?
Definition
Craniosynostosis
Term
What is the pattern for Jaundice in newborns.
Definition
NOT normal at day 1. Normal on days 2,3,4,5 due to dehydration, get phototherapy to prevent brain deposits. Worse in breast-fed babies.
Term
What are some normal derm findings in newborns?
Definition
Sebaceous retention cysts on nose or chin; Milia (sebum/keratin-filled cysts); Mongolian spots (blue/green bruise-like patches); Erythema toxicum (baby rash/allergy to being born, eosinophilic white center), seen at day 2 or 3; Stork Marks/Angel Kisses Cutis marmorata (resolve with warmth) Forceps bruising (rare today) Capillary hemangioma
Term
What is a cavernous hemangioma?
Definition
A skin lesion that consists of interconnecting venules, usually full of platelets; thrombocytopenia may be a complication; should be treated
Term
What is Caput succedaneum?
Definition
Scalp edema/free flowing fuid that moves when pressure is applied. Usually resolves on its own.
Term
What is Cephalhematoma?
Definition
Subperiosteal hematoma/blood trapped below the periosteum; its boundaries are defined by the bones/it won't move past the midline if pushed. Usually resolves, but may cause pain.
Term
What are some things that tongue protrusion is associated with?
Definition
Hypothyroidism, small oral cavity, Down's syndrome
Term
What are some causes of early cyanosis (blue babies)?
Definition
The 5 Ts: Tetralogy, Transposition, Truncus, Tricuspid, TAPVR
Term
What are some causes of late cyanosis (blue kids)?
Definition
(Different from FA): Eisenmenger's complex; Pure pulmonic stenosis; Tetralogy of Fallot; Large septal defects
Term
How serious are umbilical hernia in newborns?
Definition
Over 90% resolve by 4-5 years; they're more common in African-Americans.
Term
Contrast FAS and Down Syndrome Facies
Definition
Head size: Down: short & rounded
Palpebral fissues: FAS: short, Down: upslanting
Nasal bridge: FAS: low, Down: flat
Epicanthal folds: FAS: present, Down: prominent
Ears: FAS: minor abnormalities, Down: small & low-set
Tongue: FAS: Down: relatively large
Palmar creases: Down: single transverse
Eyes: Down: Brushfield's spots
Midface: FAS: flat
Nose: FAS: short
Philtrum: FAS: indistinct
Upper lip: FAS: thin
Jaw: FAS: micrognathia
Term
Compare infant stool between breast fed children and formula fed children.
Definition
Breast fed: more like pea soup
Formula fed: darker, with more consistency
Term
What is the normal gestational age?
Definition
Full term is 37-42 weeks. Preterm is <37. Postterm is >42.
Term
What is vernix?
Definition
The cheesy white material of sebum and desquamated cells on newborns, especially in the labial folds.
Term
When would you notice CHF in a newborn?
Definition
It manifests as dyspnea on exertion. It may be noticed as tiredness during feeding.
Term
What is hypospadias?
Definition
Abnormally placed urethral opening in males.
Term
What GI findings do you need to see before sending a newborn home?
Definition
Perforate anus and passage of stool. Also chech for myelomeningocele (spina bifida) while you're back there.
Term
Weakness, fatigue, ptosis, diplopia, nasal speech and dysphagia are classic signs of what?
Definition
Myasthenia Gravis
Term
Ipsilateral ptosis, miosis and anhidrosis are symptoms of what?
Definition
Horner's syndrome
Term
Fixed dilated pupil, ptosis and lateral eye deviation are symptoms of what?
Definition
CN III palsy
Term
Horner's syndrome is caused by what?
Definition
Pathologic involvement of sympathetic chain. E.g. cancer, spinal cord disease, neck tumro, vascular aneurysm/dissection
Term
Finger nail pitting is associated with what diseases (2)?
Definition
Psoriasis and Iron Deficiency Anemia (although the latter is ass'd with Koilonychia/"spooning of finger nails" in case it is different)
Term
What deficit(s) are present in Syringomyelia?
Definition
Pain and temperature sense lost; posterior columns remain intact.
Term
These findings are characteristic of what disorder that is present in the far east(?): mouth aphthous ulccers; genital ulcers; cutaneous lesions; uveitis; joint pain; vasculitis, phlebitis & meningoencephalitis; pulm. a. rupture a cause of death; GI bleeding from ulceration.
Definition
Behcet's Disease
Term
What disorder has these characteristics(?): Recurrent fractures, usually before puberty; triangular-shaped face; blue sclera; hearing loss; scoliosis; loose joints; brittle teeth
Definition
Osteogenesis Imperfecta
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