Current diagnosis and treatment in
pediatrics chap 2 (pp supplement)
Major congenital anomalies - ANS1.5% live births
20-25% of perinatal/neonatal deaths
2 vessel cord - ANSOnly slightly increases risk of associated defects
Small placenta - ANSAlways associated w/sm infant
Erythroblastosis featalis - ANSMost severe form if rh isoimmunization
Life threatening anemia
Generalized edema
Fetal or neonatal heart failure
Death without trearment
Irregular irregular hr - ANSusually associated w/PACs and resolves first days of life
Minor anomalies that require no special investigation - ANSpreauricular pits
shallow sacral dimple w/no other associated cutaneous abn w/in 2.5 cm of anus
3 or less cafe au lait spots in white infant
5 or less cafe au lait spots in AA infant
Visible jaundice first 24h life - ANSnever normal
hemolytic anemia
congenital hepatitis
Benign skin eruptions in newborn - ANSmilia
miliaria
erythema toxicum
pustular melanosis
cephalohematoma versus caput succendaneum - ANSCaphalohematoma - swelling over one or
both pariental bones that does not cross the suture line - may have an associated skull fx
Caput Succendaneum swelling over the presenting part that crosses the suture line
Subgaleal hemorrhage - ANShemorrhage beneath the scalp
, can cause extensive blood loss resulting in hypovolemic shock
Presence of a third fontanelle - ANSbony defect, sometimes assoc w/syndromes such as
trisomy 21
Craniosynostosis - ANSprematurely fused suture line
causes abn cranial shape
Brushfield spots - ANSspeckling of the iris seen in trisomy 21
Snuffles - ANSpurulent nasal drainage at birty - congenital syphilis
Epithelial (Epstein) pearls - ANSbenign retention cysts along gum margins and at the junction of
the hard and soft palates
Pierre Robin Syndrome - ANSsm mandible and retraction of the tongue with a cleft palate
assoc w/resp difficulty such as the tongue occluding the airway
Prominent tongue - ANSTrisomy 21
Beckwith-Wiedemann syndrome
Barrell chest - ANSseen in aspiration syndromes
pneumomediastinum - ANSmuffled heart sounds
Decreased breath sounds - ANSpneumothorax
space occupying lesion
Hyaline membrane dz - ANSexpiratory grunting and decreased air entry
Cardiac murmurs in the first few hours of life - ANSusually benign
Severe congenital heart dz in newborns may present w/no murmur at all.
Two most common presentations of heart dz in newbord - ANScyanosis
congestive heart failure w/abn pulses and perfusion
hypoplastic l heart and critical aortic stenosis - ANSpulses decreased at all sites
aortic coarctation and interrupted aortic arch - ANSpulses decreased in lower extremities only
Most abd passes in infants - ANSassociated w/renal d/o
pediatrics chap 2 (pp supplement)
Major congenital anomalies - ANS1.5% live births
20-25% of perinatal/neonatal deaths
2 vessel cord - ANSOnly slightly increases risk of associated defects
Small placenta - ANSAlways associated w/sm infant
Erythroblastosis featalis - ANSMost severe form if rh isoimmunization
Life threatening anemia
Generalized edema
Fetal or neonatal heart failure
Death without trearment
Irregular irregular hr - ANSusually associated w/PACs and resolves first days of life
Minor anomalies that require no special investigation - ANSpreauricular pits
shallow sacral dimple w/no other associated cutaneous abn w/in 2.5 cm of anus
3 or less cafe au lait spots in white infant
5 or less cafe au lait spots in AA infant
Visible jaundice first 24h life - ANSnever normal
hemolytic anemia
congenital hepatitis
Benign skin eruptions in newborn - ANSmilia
miliaria
erythema toxicum
pustular melanosis
cephalohematoma versus caput succendaneum - ANSCaphalohematoma - swelling over one or
both pariental bones that does not cross the suture line - may have an associated skull fx
Caput Succendaneum swelling over the presenting part that crosses the suture line
Subgaleal hemorrhage - ANShemorrhage beneath the scalp
, can cause extensive blood loss resulting in hypovolemic shock
Presence of a third fontanelle - ANSbony defect, sometimes assoc w/syndromes such as
trisomy 21
Craniosynostosis - ANSprematurely fused suture line
causes abn cranial shape
Brushfield spots - ANSspeckling of the iris seen in trisomy 21
Snuffles - ANSpurulent nasal drainage at birty - congenital syphilis
Epithelial (Epstein) pearls - ANSbenign retention cysts along gum margins and at the junction of
the hard and soft palates
Pierre Robin Syndrome - ANSsm mandible and retraction of the tongue with a cleft palate
assoc w/resp difficulty such as the tongue occluding the airway
Prominent tongue - ANSTrisomy 21
Beckwith-Wiedemann syndrome
Barrell chest - ANSseen in aspiration syndromes
pneumomediastinum - ANSmuffled heart sounds
Decreased breath sounds - ANSpneumothorax
space occupying lesion
Hyaline membrane dz - ANSexpiratory grunting and decreased air entry
Cardiac murmurs in the first few hours of life - ANSusually benign
Severe congenital heart dz in newborns may present w/no murmur at all.
Two most common presentations of heart dz in newbord - ANScyanosis
congestive heart failure w/abn pulses and perfusion
hypoplastic l heart and critical aortic stenosis - ANSpulses decreased at all sites
aortic coarctation and interrupted aortic arch - ANSpulses decreased in lower extremities only
Most abd passes in infants - ANSassociated w/renal d/o
