Peds Aquifer Cases -2019 updated to pass

Peds Aquifer Cases -2019Management 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