WGUD119PediatricPrimaryCare 1dayoldbilirubin14,direct0.5?-✅✅-PathologicJaundice(>12,direct>2, dayoflife1,fastrateofrise>5/day).NextbesttestisaCoombstest(+ meansRhorABOincompatibility;-indicatedmaternalfetaltransfusion, twin/twintrasfusion,IDM,spherocytosis 1weekoldbabywithcyanosiswhenfeedingbutpinksupwhencrying?- ✅✅-ChoanalAtresia-Restrictednasalpassages(choana).Associatedwith CHARGEsyndrome(Coloboma,Heartdefects,Atresiachoanal,Growth retardation,Earanomalies) 14dayold,bilirubin12,direct0.5.Hasregainedbirthweight.-✅✅-Breast MilkJaundice(milkcontainsglucuronidaseandde-conjugatesbilirubin) 3dayoldwithbilirubin10,direct0.5,eating/poopingwell?-✅✅-Physiologic Jaundice-goneby5thdayoflife(immatureliver)bilirubinusuallydoesn'tgo above15 5causesofdirecthyperbilirubinemia-✅✅-r/oSEPSIS,galactosemia, hypothyroidism,choledochalcyst,cysticfibrosis
5minuteAPGARscoreisanindicationof:
a.howthenewborntoleratedlabor b.howthemothertoleratedlabor c.howsuccessfulresuscitationeffortswere d.howthenewbornwilldooverthenext24hours e.howthenewbornwilldooverthenext28days-✅✅-c.Identifieshow successfulresuscitationeffortswere
7dayoldwithdarkurine,palestool.Bilirubin12,direct8,LFT'selevated:-
✅✅-BiliaryAtresia-can'tdrainbile,leadstoliverfailure,requiressurgical intervention 7dayold,bilirubin12,direct0.5,drymucousmembranes,notgainingweight?-✅✅-BreastfeedingJaundice(orlackofbreastfeeding).Babyisdehydrated, canbelatchingproblemsornotfeedinglongoroftenenough.Ageinfantcango6-12hourswithoutfeeding-✅✅-6Months 1 / 2
Agethatinfant:
-rollsfromsupinetoprone -steadilysitsforupto10minutes -walksholding1hand-✅✅-4-6months 9months 12months APGAR-✅✅-Appearance(allpink,pinkandblue,blue(pale) Pulse(>100,<100,absent) Grimace(cough,grimace,noresponse) Activity(flexed,flaccid,limp) Respirations(strongcry,weakcry,absent)
APGAR:NewbornCrying,Acrocyanotic,MovingAllExtremities,HR130,
GrimacestoStimulation-✅✅-Score=8(loses1ptforcolorand1ptfor irritability) Areaofalopeciawithorangecolorednodularskin(Newborn)?-✅✅-Nevus Sebaceous Removebeforeadolescenceb/citcanundergomalignantdegeneration.Atwhatagedoesachildhave20/30vision?hearingmaturity?a.4years b.Toddler c.8years d.Adolescent e.School-Age-✅✅-Toddler(vision)4years(Hearing) Blue/slategraymaculeonbackorthigh?-✅✅-Mongolianspots(Arrested Melanocytes) Firmwhitepapulesonanewborn'sfacefilledwithkeratin?-✅✅-Milia(Day oflife1)-nottobeconfusedwithneonatalacne(Weekoflife1-2) Fontanelleclosuretimeframe(AnteriorandPosterior)-✅✅-Posterior(back) closesby2months Anterior(front)fontanelleclosedby18months Inheritedcausesofdirectbilirubinemia?-✅✅-Dubin-Johnson-blackliver
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