Pediatric COMAT final update Questions and
Answers With 100% Verified Solutions
Newborn vital signs (HR, RR, BP)
HR: 120-160
RR: 40-60 Br/min
BP: 65/50 mmHg
APGAR score components
Appearance: pink all over = 2
Pulse: > 100 bpm = 2, < 60 = 0
Grimace: sneeze, cough, loud cry = 2
Activity: active movement = 2
Respiration: strength, not rate
APGAR score interpretation
0-3: requires resuscitation
4-6: likely requires resuscitation
7-10: normal
Does a low APGAR score predict cerebral palsy?
No
Causative agents of eye irritation/infection in newborns
0-2 days: chemical
3-7 days: N. gonorrhoeae
8-21 days: C. trachomatis
> 21 days: HSV
Eye irritation / infection: 0-2 days
Chemical irritation
More likely to be seen in developing countries d/t silver nitrate drops
Care is supportive, no intervention necessary
Eye irritation / infection: 3-7 days
N. gonorrheae - gonococcal neonatorum
Prevented with prophylactic erythromycin & tetracycline drops
Treated with ceftriaxone or cefotaxime IM or IV
Can become disseminated gonococcal disease if not treated
Eye irritation / infection: 8-21 days
C. trachomatis
Discharge is watery at first, then mucopurulent
Not prevented with prophylactic erythromycin & tetracycline drops
Treated with oral erythromycin
Eye irritation / infection: > 21 days
HSV
Watery discharge
Treated with systemic acyclovir and topical vidarabine
(T/F) Erythromycin drops provided at birth protect against gonorrhea, but not
chlamydia
,True
What prophylactic treatments are used to prevent eye disease in newborns?
Erythromycin & tetracycline drops / ointment prevent N. gonorrhea
Vitamin K is required for activation of which clotting factors?
2, 7, 9, 10, Protein C, protein S
How is hemorrhagic disease of the newborn prevented?
Prophylactic vitamin K IM
PO vitamin K is ineffective
Most states mandate screening for which 7 disorders?
PKU
Congenital adrenal hyperplasia
Biotinidase
Beta-thalassemia
Galactosemia
Hypothyroidism
Homocysteinuria
Some also test for G6PD deficiency and hearing
Epo levels in primary vs secondary polycythemia
1: normal or low [Epo]
2: high [Epo]
Risk factors for polycythemia of the newborn (3)
Small for gestational age
Large for gestational age
Maternal diabetes
Transient polycythemia of the newborn is most commonly dt
cord clamping --> hypoxia --> increased epo
Normalizes when baby starts to breathe
Risk factors for transient tachypnea of the newborn (2)
Term or post-term
Delivered via c-section
Management of transient tachypnea of the newborn
Oxygen
Antibiotic prophylaxis
Observation
Workup with CBC and CXR for sepsis
Transient hyperbilirubinemia is (indirect / direct)
indirect (unconjugated)
Transient hyperbilirubinemia peaks at ___ days
2-3 days
In preterm infants, transient hyperbilirubinemia is _(more/less)_ common and
lasts _(longer/shorter)
In preterm infants, transient hyperbilirubinemia is more common and lasts longer
Transient hyperbilirubinemia is due to (2)
Increased RBC breakdown d/t no longer needing cells that contain HbF
Decreased unconjugated bilirubin uptake by the liver
, When does hyperbilirubinemia warrant extensive workup?
< 24 hours of life
Conjugated
Caput succedaneum (does / does not) cross suture lines
Caput succedaneum does cross suture lines
Is a swelling of the scalp
Cephalohematoma (does / does not) cross suture lines
Cephalohematoma does not cross suture lines
Is a swelling of the bone
Facial nerve palsy management
Will resolve on its own
Erb's palsy is d/t damage of which nerve roots?
C5-6
Erb's palsy results in what position?
"Waiter's tip" - adduction and internal rotation of the arm
C5 & 6 supply which upper extremity nerves?
Suprascapular nerve
Musculocutaneous nerve (supination)
Axillary nerve (abduction)
Klumpke paralysis is d/t damage of which nerve roots?
C7-T1
Klumpke paralysis results in what position?
Claw hand deformity +/- Horner syndrome
Horner syndrome
Unilateral miosis, ptosis, anhydrosis
C7-T1 supply which upper extremity nerves?
Ulnar (hand extensors)
Management of clavicular fracture in newborn
Immobilization
Early neonatal sepsis time frame
< 7 days
Usually < 72 hours
Early neonatal sepsis causative agents (3)
GBS
E. Coli
Listeria
Late neonatal sepsis causative agents (3)
Staphylococci
E. Coli
GBS
Management of neonatal sepsis
IV fluids
Cultures
Ampicillin + gentamicin, cefotaxime
Toxoplasmosis - presentation (3)
Answers With 100% Verified Solutions
Newborn vital signs (HR, RR, BP)
HR: 120-160
RR: 40-60 Br/min
BP: 65/50 mmHg
APGAR score components
Appearance: pink all over = 2
Pulse: > 100 bpm = 2, < 60 = 0
Grimace: sneeze, cough, loud cry = 2
Activity: active movement = 2
Respiration: strength, not rate
APGAR score interpretation
0-3: requires resuscitation
4-6: likely requires resuscitation
7-10: normal
Does a low APGAR score predict cerebral palsy?
No
Causative agents of eye irritation/infection in newborns
0-2 days: chemical
3-7 days: N. gonorrhoeae
8-21 days: C. trachomatis
> 21 days: HSV
Eye irritation / infection: 0-2 days
Chemical irritation
More likely to be seen in developing countries d/t silver nitrate drops
Care is supportive, no intervention necessary
Eye irritation / infection: 3-7 days
N. gonorrheae - gonococcal neonatorum
Prevented with prophylactic erythromycin & tetracycline drops
Treated with ceftriaxone or cefotaxime IM or IV
Can become disseminated gonococcal disease if not treated
Eye irritation / infection: 8-21 days
C. trachomatis
Discharge is watery at first, then mucopurulent
Not prevented with prophylactic erythromycin & tetracycline drops
Treated with oral erythromycin
Eye irritation / infection: > 21 days
HSV
Watery discharge
Treated with systemic acyclovir and topical vidarabine
(T/F) Erythromycin drops provided at birth protect against gonorrhea, but not
chlamydia
,True
What prophylactic treatments are used to prevent eye disease in newborns?
Erythromycin & tetracycline drops / ointment prevent N. gonorrhea
Vitamin K is required for activation of which clotting factors?
2, 7, 9, 10, Protein C, protein S
How is hemorrhagic disease of the newborn prevented?
Prophylactic vitamin K IM
PO vitamin K is ineffective
Most states mandate screening for which 7 disorders?
PKU
Congenital adrenal hyperplasia
Biotinidase
Beta-thalassemia
Galactosemia
Hypothyroidism
Homocysteinuria
Some also test for G6PD deficiency and hearing
Epo levels in primary vs secondary polycythemia
1: normal or low [Epo]
2: high [Epo]
Risk factors for polycythemia of the newborn (3)
Small for gestational age
Large for gestational age
Maternal diabetes
Transient polycythemia of the newborn is most commonly dt
cord clamping --> hypoxia --> increased epo
Normalizes when baby starts to breathe
Risk factors for transient tachypnea of the newborn (2)
Term or post-term
Delivered via c-section
Management of transient tachypnea of the newborn
Oxygen
Antibiotic prophylaxis
Observation
Workup with CBC and CXR for sepsis
Transient hyperbilirubinemia is (indirect / direct)
indirect (unconjugated)
Transient hyperbilirubinemia peaks at ___ days
2-3 days
In preterm infants, transient hyperbilirubinemia is _(more/less)_ common and
lasts _(longer/shorter)
In preterm infants, transient hyperbilirubinemia is more common and lasts longer
Transient hyperbilirubinemia is due to (2)
Increased RBC breakdown d/t no longer needing cells that contain HbF
Decreased unconjugated bilirubin uptake by the liver
, When does hyperbilirubinemia warrant extensive workup?
< 24 hours of life
Conjugated
Caput succedaneum (does / does not) cross suture lines
Caput succedaneum does cross suture lines
Is a swelling of the scalp
Cephalohematoma (does / does not) cross suture lines
Cephalohematoma does not cross suture lines
Is a swelling of the bone
Facial nerve palsy management
Will resolve on its own
Erb's palsy is d/t damage of which nerve roots?
C5-6
Erb's palsy results in what position?
"Waiter's tip" - adduction and internal rotation of the arm
C5 & 6 supply which upper extremity nerves?
Suprascapular nerve
Musculocutaneous nerve (supination)
Axillary nerve (abduction)
Klumpke paralysis is d/t damage of which nerve roots?
C7-T1
Klumpke paralysis results in what position?
Claw hand deformity +/- Horner syndrome
Horner syndrome
Unilateral miosis, ptosis, anhydrosis
C7-T1 supply which upper extremity nerves?
Ulnar (hand extensors)
Management of clavicular fracture in newborn
Immobilization
Early neonatal sepsis time frame
< 7 days
Usually < 72 hours
Early neonatal sepsis causative agents (3)
GBS
E. Coli
Listeria
Late neonatal sepsis causative agents (3)
Staphylococci
E. Coli
GBS
Management of neonatal sepsis
IV fluids
Cultures
Ampicillin + gentamicin, cefotaxime
Toxoplasmosis - presentation (3)
