Pediatrics Unit 3 UPDATED Exam
Questions and CORECT Answers
Neonatal Hypocalcemia:
- Can be divided into early and late. What are the time frames? - CORRECT ANSWER Early
- if it occurs within the first 72 hrs of life Late - if it occurs After 72 hours
Early neonatal hypocalcemia focuses on? - CORRECT ANSWER 1. Maternal illness such as
diabetes or HPT
2. Complications during birth such as asphyxia and toxemia
Late neonatal hypocalcemia focuses on? - CORRECT ANSWER 1. Dietary phosphate intake
(both formula and IV fluids)
2. Family hx of calcium abnormalities
3. Possible Maternal Vitamin D Deficiency (prenatal vitamin D intake, exposure to sun)
Clinical Features of neonatal Hypocalcemia? - CORRECT ANSWER • Mild can remain
asymptomatic
• Severe: seizures, inspiratory stridor, tetany, and life-threatening arrhythmias.
What are the Physical Findings for neonatal Hypocalcemia? - CORRECT ANSWER 1. Facial
dysmorphia or other somatic abnormalities
2. Clinical signs: positive Chvostek and positive Trousseau sign
3. Presence of Rachitic Rosary, craniotabes, widening of wrists and bowing of knees indicative
of rickets
4. Presence of vitiligo or neuromas of oral mucosa in child or adolescent
What is Rachitic Rosary? - CORRECT ANSWER Prominent knobs of bone at the
costochondral joints of rickets patients are known as a rachitic rosary or beading of the ribs.
, What are Craniotabes? - CORRECT ANSWER Craniotabes is the finding of a softening or
thinning of the skull, which may be normally present in newborns.
*Seen in patients with rickets.
Diagnosis for neonatal Hypocalcemia? - CORRECT ANSWER 1. Vitamin D
deficiency/rickets must be suspected in infants exclusively breastfed who do not receive vitamin
D supplementation
2. Differential - congenital hypoparathyroidsim (various like DiGeorge)
Labs for neonatal hypocalcemia? - CORRECT ANSWER 1. Serum calcium, phosphate,
alkaline phos (ALP), intact PTH, 25-OH vitamin D and urine calcium excretion
2. Micro chromosome deletion 22q11.2 on FISH for DiGeorge Syndrome.
What is DiGeorge Syndrome? - CORRECT ANSWER DiGeorge syndrome (22q11.2 deletion
syndrome), a disorder caused by a defect in chromosome 22, results in the poor development of
several body systems.
-include heart defects, poor immune system function, a cleft palate, complications related to low
levels of calcium in the blood and behavioral disorders.
What is found on ECG for pts with neonatal hypocalcemia? - CORRECT
ANSWER Prolonged QT
Neonatal Hypocalcemia:
Radiology:
Chest X-Ray Findings: - CORRECT ANSWER 1. Absence of Thymus in neonate suggestive
of DiGeorge
2. Rachitic rosary is indicative of rickets
Neonatal Hypocalcemia:
Radiology:
Wrists: - CORRECT ANSWER •Metaphyseal widening w/cupping is indicative of rickets
Questions and CORECT Answers
Neonatal Hypocalcemia:
- Can be divided into early and late. What are the time frames? - CORRECT ANSWER Early
- if it occurs within the first 72 hrs of life Late - if it occurs After 72 hours
Early neonatal hypocalcemia focuses on? - CORRECT ANSWER 1. Maternal illness such as
diabetes or HPT
2. Complications during birth such as asphyxia and toxemia
Late neonatal hypocalcemia focuses on? - CORRECT ANSWER 1. Dietary phosphate intake
(both formula and IV fluids)
2. Family hx of calcium abnormalities
3. Possible Maternal Vitamin D Deficiency (prenatal vitamin D intake, exposure to sun)
Clinical Features of neonatal Hypocalcemia? - CORRECT ANSWER • Mild can remain
asymptomatic
• Severe: seizures, inspiratory stridor, tetany, and life-threatening arrhythmias.
What are the Physical Findings for neonatal Hypocalcemia? - CORRECT ANSWER 1. Facial
dysmorphia or other somatic abnormalities
2. Clinical signs: positive Chvostek and positive Trousseau sign
3. Presence of Rachitic Rosary, craniotabes, widening of wrists and bowing of knees indicative
of rickets
4. Presence of vitiligo or neuromas of oral mucosa in child or adolescent
What is Rachitic Rosary? - CORRECT ANSWER Prominent knobs of bone at the
costochondral joints of rickets patients are known as a rachitic rosary or beading of the ribs.
, What are Craniotabes? - CORRECT ANSWER Craniotabes is the finding of a softening or
thinning of the skull, which may be normally present in newborns.
*Seen in patients with rickets.
Diagnosis for neonatal Hypocalcemia? - CORRECT ANSWER 1. Vitamin D
deficiency/rickets must be suspected in infants exclusively breastfed who do not receive vitamin
D supplementation
2. Differential - congenital hypoparathyroidsim (various like DiGeorge)
Labs for neonatal hypocalcemia? - CORRECT ANSWER 1. Serum calcium, phosphate,
alkaline phos (ALP), intact PTH, 25-OH vitamin D and urine calcium excretion
2. Micro chromosome deletion 22q11.2 on FISH for DiGeorge Syndrome.
What is DiGeorge Syndrome? - CORRECT ANSWER DiGeorge syndrome (22q11.2 deletion
syndrome), a disorder caused by a defect in chromosome 22, results in the poor development of
several body systems.
-include heart defects, poor immune system function, a cleft palate, complications related to low
levels of calcium in the blood and behavioral disorders.
What is found on ECG for pts with neonatal hypocalcemia? - CORRECT
ANSWER Prolonged QT
Neonatal Hypocalcemia:
Radiology:
Chest X-Ray Findings: - CORRECT ANSWER 1. Absence of Thymus in neonate suggestive
of DiGeorge
2. Rachitic rosary is indicative of rickets
Neonatal Hypocalcemia:
Radiology:
Wrists: - CORRECT ANSWER •Metaphyseal widening w/cupping is indicative of rickets
