Term
|
Definition
| Unequal pupils (benign anisocoria is a normal variant in 20% of people; pupil reacts to light normally); possible uncal herniation if in coma |
|
|
Term
|
Definition
| painless, transient monocular vision loss |
|
|
Term
|
Definition
|
|
Term
| Acute angle-closure glaucoma |
|
Definition
| Headache with dilated irregular pupil; eye PAIN will dominate the clinical picture. Also, eye will be red with cloudy cornea. |
|
|
Term
|
Definition
| Damage to SNS; Horny PAMELa: Ptosis (drooping), Anhidrosis (lack of sweating), Miosis, Enophthalmos (recession of eyeball) and Loss of ciliospinal reflex (dilation of ipsilateral pupil in response to pain to neck, face or upper trunk). |
|
|
Term
|
Definition
| Seen in MG, Miller-Fisher variant of Guillain-Barre syndrome, Botulism |
|
|
Term
|
Definition
| Seen in Horner's syndrome & Oculomotor palsy |
|
|
Term
|
Definition
|
|
Term
| Exophthalmos with periorbital edema |
|
Definition
| Bilateral in Grave's disease |
|
|
Term
|
Definition
| See white sclera upon looking down; indicates hyperthyroidism |
|
|
Term
| Lateral rectus, Superior oblique, All the rest |
|
Definition
|
|
Term
|
Definition
| deviation varies depending on gaze direction |
|
|
Term
| Non-paralytic (aka lazy eye) strabismus |
|
Definition
| Deviation is constant in all gaze directions |
|
|
Term
|
Definition
| Convergent strabismus (shorter distance between pupils) |
|
|
Term
|
Definition
| Divergent strabismus (greater distance between pupils) |
|
|
Term
|
Definition
| Abnormal eye realigns after good eye covered |
|
|
Term
|
Definition
| CN VI: longest and likeliest involved neuropathy (also caused by 1) increased intracranial pressure 2) meningeal processes, including infection and cancer) |
|
|
Term
|
Definition
| Eye is deviated inferiorly and laterally (IV and VI are intact); also see ptosis due to loss of levator m. & mydriasis |
|
|
Term
|
Definition
| Lose CN III motor fibers first |
|
|
Term
|
Definition
| Lose parasympathetic fibers first: get mydriasis |
|
|
Term
|
Definition
| affected eye is deviated superiorly and medially; pt complains of diplopia |
|
|
Term
| Intranuclear opthalmoplegia |
|
Definition
| Lesion of MLF: problem with adduction of the involved eye. Bilateral in MS. Unilateral in brainstem strokes and rarer disorders. |
|
|
Term
|
Definition
| slow drift right followed by rapid movement left. |
|
|
Term
|
Definition
| Not necessarily pathologic. Occurs in the direction you look. Can be caused by drugs of abuse and others (e.g. lithium, dilantin) |
|
|
Term
| Primary position nystagmus |
|
Definition
| Eye not fixed. Due to vestibular dz, strokes, MS |
|
|
Term
|
Definition
| Near-sighted. Cannot see distance. Retinal image focal point anterior to retina. |
|
|
Term
|
Definition
| Far-sightedness. Cannot see close. Retinal image focal point posterior to retina. |
|
|
Term
|
Definition
| involuntary eye movements during the scanning of a moving field (i.e. watching a passing train). preserved in feigned blindness. |
|
|
Term
| Complete lesion of optic nerve. |
|
Definition
| Lose both fields in one eye. |
|
|
Term
| Partial lesion of optic nerve. |
|
Definition
| Lose partial fields in one eye. |
|
|
Term
| Complete lesion of optic chiasm. |
|
Definition
| Lose lateral fields bilaterally. |
|
|
Term
|
Definition
| Lose contralateral fields in both eyes. |
|
|
Term
| Lesion of fiber tract from cortex to geniculate. |
|
Definition
| Lose contralateral fields in both eyes. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Chronic Meibomian Gland Inflammation |
|
|
Term
|
Definition
| Infected eyelash hair follicle |
|
|
Term
|
Definition
| Hyperlipidemia causes subcutaneous collection of cholesterol along medial aspect of eyelids |
|
|
Term
|
Definition
| Blood in anterior chamber |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Corneal abrasion appears green |
|
|
Term
|
Definition
| White or gray opaque ring in the corneal margin around the iris. May be present at birth and fade; may be present at <40yo and indicate hyperlipidemia; or be a normal variant in elderly. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Constriction of pupil via parasympathetics in CN III |
|
|
Term
|
Definition
| Dilation of pupil via sympathetics in CN V |
|
|
Term
|
Definition
| affected eye does not react to light directly but does constrict to light directed to the opposite eye (consensual response) |
|
|
Term
|
Definition
| Pupil finding for: narcotics, pons lesion, or cerebellum lesion with pontine compression |
|
|
Term
| Pupil midposition (5-7mm) & fixed |
|
Definition
| Pupil finding for midbrain lesion |
|
|
Term
|
Definition
| Pupil finding for: sympathomimetic such as amphetamine, LSD, cocaine |
|
|
Term
|
Definition
| Pupil finding for: lesion of medulla (brain death), drugs with anticholinergic effect |
|
|
Term
| Metabolic coma pupil finding |
|
Definition
| Coma with spared pupillary reactivity |
|
|
Term
| Pupils in coma due to endogenous toxins |
|
Definition
| Occulocephalic responses usually spared by these toxins |
|
|
Term
| Pupils in coma due to exogenous toxins |
|
Definition
| Eye movements usually paralyzed by these toxins |
|
|
Term
| Pupil & Iris bilaterally small and nonreactive to light, but will accomodate. AKA Argyll Robertson Pupil. |
|
Definition
| Pupil and iris finding due to: opiate overdose, pontine lesion, neurosyphilis |
|
|
Term
|
Definition
| Slow response to light (irregularly dilated pupil); initially unilateral, may progress to bilateral over time; delayed constriction to accomodation; reacts to instilled medications; associated with loss of deep tendon reflexes |
|
|
Term
|
Definition
| Lens opacity, various causes, common reason for inability to see the fundus |
|
|
Term
|
Definition
| Increased intraocular pressure (normal 10-21 mm Hg); symptoms: boring eye pain, headache, vision blurred with rainbow halo around lights, nausea, abdominal pain; signs: cloudy, edematous cornea, hard red eye, ciliary flush, semi-dilated fixed pupil, IOP high |
|
|
Term
|
Definition
| Mannitol IV; pupil constriction via beta-blocker or cholinergic agonist; reduced intra-ocular fluid formation with carbonic anhydrase inhibitor (Diamox) |
|
|
Term
|
Definition
| Red Eye, Discharge present, vision unaffected, pre-auricular lymph node palpable, IOP normal |
|
|
Term
|
Definition
| Red eye, some pain, blurred vision, IOP occasionally elevated |
|
|
Term
|
Definition
| Usually <50% optic disc diameter |
|
|
Term
|
Definition
| Blurred disc margins; indicates high pressure transmitted through optic nerve; due to: 1) systemic arterial pressure (malignant HTN), 2) venous pressure (central retinal vein occlusion, like an "eye DVT"), 3) high intracranial pressure (brain tumor, meninigitis) |
|
|
Term
| Hypertensive retinopathy Grade I |
|
Definition
| Mild vessel narrowing; retinal appearance normal; no papilledema |
|
|
Term
| Hypertensive retinopathy grade II |
|
Definition
| Moderate-marked narrowing (copper wiring), A-V nicking; retinal appearance normal; no papilledema |
|
|
Term
| Hypertensive retinopathy grade II |
|
Definition
| Moderate-marked narrowing (copper wiring), A-V nicking; retinal appearance normal; no papilledema |
|
|
Term
| Hypertensive retinopathy Grade III |
|
Definition
| Marked narrowing and spastic lesions (silver wiring); Retinal appearance: edema, cotton wool spots & hemorrhages; no papilledema |
|
|
Term
| Hypertensive retinopathy Grade IV |
|
Definition
| marked narrowing (copper wiring) and spastic lesions (silver wiring); A-V nicking; retina appearance: edematous with cotton wool spots & hemorrhages; Papilledema present |
|
|
Term
|
Definition
| edge of micro-retinal infarct; associated with HTN, diabetes, systemic lupus & venous infarcts |
|
|
Term
|
Definition
| Hemorrhage with a white center corresponding to a cotton wool spot (i.e. infective endocarditis & others) |
|
|
Term
| Diabetic dot and blot retinopathy |
|
Definition
| Retinal capillary microaneurysms & intra-retinal hemorrhages |
|
|
Term
|
Definition
| mass of conjunctival tissue that extends to the corneal surface. Ass'd with sunlight exposure; mostly cosmetic. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| local edema that results from the local release of histamine, which increases capillary filtration |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Morphology of skin lesions (6) |
|
Definition
| Circular, oval, annular (ring shaped), targetoid, color, size |
|
|
Term
|
Definition
primary lesion has changed.
Discoloration (hyper/hypopigmentation)
Lichenification (from rubbing, esp elbow); Scabs & crusts; Erosions (skin broken through from epi to dermis); Ulcers (possibly down to fat); Fissures
Atrophy |
|
|
Term
| Distribution/Configuration of skin lesions |
|
Definition
| Sun-exposed vs non-sun-exposed; Zosteriform (resembles herpes zoster); acral lesion (on limbs); central; geographic |
|
|
Term
| Seborrhoeic dermatitis, a common form of eczema |
|
Definition
| Erythematous, not sharp, worse in winter, itchy, papulosquamous, often on the face, scalp, trunk |
|
|
Term
| Plaque psoriasis, the most common form of psoriasis |
|
Definition
| Erythematous patches, papulosquamous, scab crusts are secondary lesions |
|
|
Term
| Subacute chronic squamous lupus erythematosus |
|
Definition
| Annular rash with scales, papulosquamous, geographic distribution |
|
|
Term
| Poison ivy (contact dermatitis) |
|
Definition
| Tense blisters, line-like |
|
|
Term
| HSV-1 with secondary impetigization |
|
Definition
| Clustered secondary lesions exhibiting honey crusting |
|
|
Term
|
Definition
| Tense grouped pustules with scabbed crust secondary lesions within a dermatome pattern |
|
|
Term
|
Definition
| Pustules, red base; open comedo; closed comedo; inflammatory pustules; post-inflammatory discoloration |
|
|
Term
| Leukocytoplastic vasculitis |
|
Definition
| Vesicular pustules; purplish base=blood leaking into skin (inflammation) |
|
|
Term
|
Definition
| Confluent (joined) small circular papules |
|
|
Term
|
Definition
| Targetoid and annular circular papules; papulosquamous; no itching; no secondary lesions |
|
|
Term
|
Definition
| Inflammation of the skin caused by a plant/perfume |
|
|
Term
|
Definition
| Epidermis, dermis, subcutaneous fat/hypodermis/superficial fascia |
|
|
Term
| Primary epidermis skin cells |
|
Definition
| Squamous cells, melanocytes, basal cells |
|
|
Term
| Primary dermis skin cells |
|
Definition
| Histiocytes, fibroblasts. Dermins also contains CT matrix of collagen. |
|
|
Term
| Color of vascular lesions |
|
Definition
|
|
Term
| Color of pigmented lesions |
|
Definition
|
|
Term
| Color of lesion squamous in origin |
|
Definition
|
|
Term
| Color of lesions derived from a deeper structure not affecting the epidermis |
|
Definition
|
|
Term
| How to tell the difference between arterial and venous vascular lesions |
|
Definition
| Arterial are brighter red/strawberry/crimson, venous are purple or violet |
|
|
Term
|
Definition
| Cherry red angiomas; Cavernous congenital angiomas; Congenital angiomas; Nevus Flammeus congenital and late occuring lesions, Nevus Flammeus Tardus; Spider Angiomas (Nevus Araneus); Pyogenic Granulomas; Telangiectasias |
|
|
Term
|
Definition
| Venous lakes; Senile Purpura; Angiokeratoma; Angiosarcoma (malignant); Kaposi Sarcoma (malignant) |
|
|
Term
| Cell most likely responsible for brown or black lesions |
|
Definition
|
|
Term
|
Definition
| Melanocytes are situated only along the dermal epidermal junction. These lesions are macular or flat. |
|
|
Term
|
Definition
| The proponderance of melanocytes are in the dermis and have migrated from the dermal epidermal junction. They may be macular or raised papular. |
|
|
Term
|
Definition
| has features of both junction and intradermal nevus |
|
|
Term
|
Definition
| A melanocytic nevus that resides deeper in the skin |
|
|
Term
| Lentigo (or multiple lentigines) |
|
Definition
| Macular or flat tan to brown lesions seen of sun exposed skin in older patients that have a very organized appearance (meaning they have symmetry, regular border, no color variation and are small in diameter). |
|
|
Term
|
Definition
| Freckles; occur more commonly in type 2 skin patients with fair skin and lighter hair/red heads. |
|
|
Term
| Congenital melanocytic nevus |
|
Definition
| pigmented mole-like skin lesion present at birth |
|
|
Term
|
Definition
| Warty or cobblestone growth that refract light and have a pasted-on like appearance. Despite being brown, they are of squamous cell origin, not melanocytes. |
|
|
Term
| Pigmented Basal Cell Carcinoma (Melanoma) |
|
Definition
| Types of melanomas: Lentigo Maligna, Superficial Spreading Malignant Melanoma, Lentigo Maligna Melanoma, Nodular Melanoma, Acralentiginous Melanoma |
|
|
Term
| Color and character of squamous cell carcinoma |
|
Definition
| Color of skin, keratin has scaly or warty texture |
|
|
Term
| Words in names of squamous cell lesions |
|
Definition
|
|
Term
|
Definition
| Verrucae vulgaris (common warts); Verrucae Plana (flat topped small warts); Verrucae Plantaris (sole of the foot); Filiform Warts (Digitate verrucae); Condyloma Accuminata (Venereal warts); Mosaic warts |
|
|
Term
|
Definition
| Pigmented Actinic (Solar =) Keratosis; Non-pigmented AK; Squamous cell carcinoma in situ (Bowens Disease); Bowenoid papulosis; Squamous cell carcinoma invasive well differentiated; Squamous cell carcinoma invasive poorly differentiated; Paget's disease usually of adenocarcinoma origin either mammary or extramammary origin; Keratoacanthoma; Lichen Planus-like Keratosis |
|
|
Term
|
Definition
| Micronodular Basal Cell Carcinoma; Ulcerating BCC; Morphea (Sclerosing) BCC; Superficial multicentric BCC; Pigmented BCC |
|
|
Term
| Lesions of fibroblastic or histiocytic origin |
|
Definition
| Hypertrophic scar; Keloid; Dermatofibroma or Histiocytoma; Dermatofibrosarcoma Protuberans; Soft fibroma (skin tags or polyps/achrochordon); Mucinosis (mucin is produced by fibroblasts) |
|
|
Term
| Lesions of deeper dermal origin |
|
Definition
| Pilar cysts (epidermoid cysts--except scalp; trichilemmal cysts--scalp); Steatocystoma Multiplex; Myxoid Cyst (variation of synovial cyst); Dermoid cyst |
|
|
Term
| Lesions of sebaceous gland origin |
|
Definition
| Tend to have waxy yellowish hue; Sebaceous Hyperplasia; Sebaceous Adenoma; Sebaceous Carcinoma; Nevus Sebaceous of Jadassohn |
|
|
Term
|
Definition
| Xanthelasma; Xanthoma; Eruptive Xanthomas |
|
|
Term
| Lesions of subcutaneous origin |
|
Definition
| Lipoma (freely movable); Angiolipoma usually appear as lipomas but are tender |
|
|
Term
| Lesions of sweat gland origin |
|
Definition
| Syringoma; Eccrine Poroma; Syringocystadenoma; Apocrine Hydrocystoma (slightly purplish and frequently on face) |
|
|
Term
|
Definition
| Neurofibroma (assymptomatic and depressible and flesh colored); Neuroma (painful) flesh colored papule; Neurofibrosarcoma |
|
|
Term
| Color of basal cell lesions |
|
Definition
| Typically pearly shiny color |
|
|
Term
| Sensory level of the nipples |
|
Definition
|
|
Term
| Sensory level of the umbilicus |
|
Definition
|
|
Term
| Sensory level of inguinal region |
|
Definition
|
|
Term
| Sensory level of plantar aspect of foot |
|
Definition
|
|
Term
| Sensory level of perianal area |
|
Definition
|
|
Term
| Describe the course of pain & temperature fibers |
|
Definition
| The spinothalamic tract crosses at the spinal level and ascends anteriorly on the contralateral side |
|
|
Term
| Describe the course of position & vibration fibers. |
|
Definition
| The posterior columns ascend ipsilaterally & cross in the lower medulla. |
|
|
Term
| Causes of spinal cord disease that may result in motor weakness |
|
Definition
| Osteophyte, anterior cord infarction, transection |
|
|
Term
| Cause of motor neuron disease (one example) |
|
Definition
|
|
Term
| Cause of demyelinating disease that may cause motor weakness (1 example) |
|
Definition
|
|
Term
| Cause of motor end-plate disease (1 example) |
|
Definition
|
|
Term
| Cause of Myopathy (1 example) |
|
Definition
|
|
Term
| An electrolyte disorder than can cause motor weakness |
|
Definition
|
|
Term
| Cause of unilateral/focal motor weakness |
|
Definition
| Carotid artery distribution cortical stroke; Traumatic injury/nerve entrapment or impingement (e.g. tumor); Lacunar stroke |
|
|
Term
| When grading motor strength, what level is given when no contraction is detected? |
|
Definition
|
|
Term
| When grading motor strength, what level is given when there is trace activity but unable to move joint? |
|
Definition
|
|
Term
| When grading motor strength, what level is given when joint can be moved, but not against gravity? |
|
Definition
|
|
Term
| When grading motor strength, what level is given when one can oppose gravity? |
|
Definition
|
|
Term
| When grading motor strength, what level is given when strength is subnormal, but can oppose some external resistance? |
|
Definition
|
|
Term
| When grading motor strength, what level is given to normal strength? |
|
Definition
|
|
Term
| Characteristics of lower motor neuron damage |
|
Definition
| Individual muscles may be affected; Atrophy pronounced (up to 80% of bulk); Flaccidity & hypotonia of affected muscles with loss of DTRs; Plantar reflex, if present, is flexor; Muscle fasciculations are present |
|
|
Term
| Characteristics of upper motor neuron damage (exhibit inhibitory effect on lower motor neurons) |
|
Definition
| Muscles affected in groups; Atrophy slight & due to disuse; Spacticity w/hyperactive DTRs (clonus seen) & extensor plantar reflex (Babinski sign) |
|
|
Term
| Resting muscle tone is decreased in |
|
Definition
| Acute spinal shock; lower MN disease/peripheral neuropathy; cerebellar disease |
|
|
Term
| Resting muscle tone is increased in |
|
Definition
| Upper motor neuron disease. Specifically, lead-pipe rigidity and cogwheel rigidity are seen in extrapyramidal disease (e.g. Parkinson's) |
|
|
Term
| Functions lost in cortical strokes |
|
Definition
| Actions of hand & face; sensory; speech/aphasia |
|
|
Term
| Functions lost in lacunar strokes |
|
Definition
| Typically purely motor or purely sensory losses (small losses of cortical neurons) |
|
|
Term
| Characteristic of CN innervation of the larynx, tongue, neck, jaw & upper face |
|
Definition
| Bilateral, such that there are no unilateral findings unless a nucleus (e.g. hypoglossal) or CN is involved. For example, Bell's palsy is unilateral lesion of CN VII with ipsilateral paralysis, whereas a UMN lesion gives contralateral paralysis of lower face only. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Occurs in posture of repose & suppressed with activity (e.g. Parkinson's, which usually disappears with activity & complete relaxation) |
|
|
Term
|
Definition
| Appears with action & worsens as goal is reached; cerebellar in etiology |
|
|
Term
| Postural (or action) tremor |
|
Definition
| Becomes evident with action & includes hyperadrenergic, physiologic, alcohol withdrawal, & essential tremor |
|
|
Term
| Benefit of normal walking assessment |
|
Definition
| Less sensitive but more specific for abnormality |
|
|
Term
| Benefit of tandem walking (heel-to-toe) assessment |
|
Definition
| More sensitive but less specific for abnormality |
|
|
Term
| Requirements of normal gait (5) |
|
Definition
| Motor strength; Vestibular system function; Position sense; Intact cerebellum; Functional basal ganglia |
|
|
Term
|
Definition
| Coordinates complex muscular activity including posture and gait; Incorporates visual & vestibular input to maintain balance; Has connections with eyes |
|
|
Term
|
Definition
| Attempted rapid alternating movements are slow, irregular or clumsy. Indicates cerebellar dysfunction. |
|
|
Term
| Affect on attempted rapid alternating movements in presence of UMN disease (e.g. cortical CVA) |
|
Definition
| Slow and deliberate movements |
|
|
Term
| Point-to-point testing in patients with cerebellar dysfunction may reveal |
|
Definition
| Intially overshooting the mark (dysmetria); Coarse intention tremor, which often worsens with approach to the target; Consistent deviation to one side (past pointing), which also indicate vestibular disease; If point-to-point is normal with eyes open but becomes abnormal with closed eyes: suggests position sense dysfunction |
|
|
Term
| Basic abnormal gait: Cerebellar ataxia |
|
Definition
| Wide-based, unsteady, lateral veering (e.g. MS, tumor) |
|
|
Term
| Basic abnormal gait: Sensory ataxia |
|
Definition
| "stamp & stick" gait. Looks at ground (e.g. B12 deficiency, tabes dorsalis) |
|
|
Term
| Basic abnormal gait: Festinating |
|
Definition
| Shuffling steps with rigidity; lower body appears to be chasing upper body (i.e. Parkinson's) |
|
|
Term
| Basic abnormal gait: Steppage or equine |
|
Definition
| Inability to dorsiflex foot (e.g. trauma to Peroneal nerve, Charcot-Marie-Tooth) |
|
|
Term
| Why is fat especially important in the newborn's diet? |
|
Definition
| Because it's required to continue myelination of their nerves |
|
|
Term
| When does the posterior fontanel normally close? |
|
Definition
| It's present at birth (1-2 cm) and closed by 2-4 months |
|
|
Term
| When does the anterior fontanel close? |
|
Definition
| It's present at birth (4-6 cm) and closed by 7-18 months. |
|
|
Term
| When do the sutures usually close? |
|
Definition
| They're closed by 2 years old. |
|
|
Term
| By what age should the eyes track together (no strabismus)? |
|
Definition
|
|
Term
| What color(s) do you want to see in the choroidal reflex and which is bad? |
|
Definition
| Want to see red or gray (in pigmented people). White could indicate retinoblastoma or congenital cataract (e.g. due to congenital rubella). Can't send baby home without seeing red reflex. |
|
|
Term
| What is remarkable about the lymph nodes in children? |
|
Definition
| They are often larger than in adults, they may enlarge, and they may never go down or only regress after 10 years old. |
|
|
Term
| What is special about nuchal rigidity in children? |
|
Definition
| It is only a useful sign of meningitis after 12 months old. |
|
|
Term
| What is the pattern of respiratory rate change with age between infants, adolescents and adults? |
|
Definition
| infants>adolescents~=adults |
|
|
Term
|
Definition
| mostly inspiratory (but can also be expiratory when severe) |
|
|
Term
|
Definition
| mostly expiratory (but can also be inspiratory when severe) |
|
|
Term
|
Definition
|
|
Term
| Describe tanner staging for pubic hair |
|
Definition
1) No hair
2) Occasional fine
3) Few coarse curly
4) Mons pubis covered
5) Down to thighs
6) Up to belly button in males |
|
|
Term
| Describe tanner staging for male genitals |
|
Definition
1) Almond-sized testicles
2) Testicles >1.5 mL
3) Penis lengthens
4) Penis widens
5) Adult |
|
|
Term
| Describe tanner staging for female breasts |
|
Definition
1) No glandular tissue
2) Breast bud
3) Breast more elevated
4) Secondary areolar mound
5) Mature breast |
|
|
Term
| What to suspect if child has hip click? |
|
Definition
| Dislocated hip, refer to pediatric orthopedics |
|
|
Term
| What to suspect if newborn has high fever +/- joint swelling |
|
Definition
| Infectious arthritis or rheumatoid arthritis |
|
|
Term
| What is the pattern of jaundice distribution in children? |
|
Definition
| Starts at the face and if worse descends down the body |
|
|
Term
| What are the 5 components of the Apgar score? |
|
Definition
| 1) Heart rate 2) Respiratory effort 3) Muscle tone 4) Reflex irritability 5) Color |
|
|
Term
| How are Apgar points assigned for heart rate? |
|
Definition
|
|
Term
| How are Apgar points assigned for respiratory effort? |
|
Definition
0=Absent
1=Slow and crying
2=Good and crying |
|
|
Term
| How are Apgar points assigned for muscle tone? |
|
Definition
| 0=Flaccid 1=Some flexion of the arms and legs 2=Active movement |
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Term
| How are Apgar points assigned for reflex irritability? |
|
Definition
| 0=No responses 1=Crying 2=Crying vigorously |
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Term
| How are Apgar points assigned for color? |
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Definition
0=Blue, pale
1=Pink body, blue extremities
2=Pink all over |
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Term
| What is the most common reason for a child to get a 9/10 Apgar score? |
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Definition
| Acrocyanosis is common since hands and feet are last to turn from blue to pink so they get 1/2 for color. |
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Term
Classify these three ranges of 1-minute Apgar scores
1) 0-4
2) 5-7
3) 8-10 |
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Definition
1) Severe depression, requiring immediate resuscitation
2) Some nervous system depression
3) Normal |
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Term
Classify these three ranges of 5-minute Apgar scores
1) 0-7
2) 9-10 |
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Definition
1) High risk for subsequent central nervous system as well as other organ system dysfunction
2) Normal |
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Term
| What is the general pattern of flexibility regarding preterm and normal term babies and what is the one exception? |
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Definition
| Preterm babies are usually MORE flexible than normal term babies (e.g. heel to ear, scarf sign), HOWEVER term babies can do hand-on-forearm at wrist flexion. |
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Term
| What are a few other things seen in preterm babies? |
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Definition
Popliteal angle: greater flexion (smaller angle)
Transverse plantar creases: fewer creases
Lanugo hair (24-32 weeks gestational age)
Thin and translucent skin |
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Term
| What is something seen in post mature infants? |
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Definition
| Peeling & cracking skin. May also release meconium in utero, which they may inhale & die. |
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Term
| What are the vitals of a normal term baby? |
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Definition
HR ~140, RR ~30-60*, BP not done routinely
*Must measure RR for full minute because breathing is irregular |
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Term
| What is the pattern in weight loss/gain for newborns? |
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Definition
| Lose weight for first few days. Should be back to birth weight by 2 weeks. |
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Term
| What is the word for large head circumference at birth? |
|
Definition
|
|
Term
| What is the word for small head circumference at birth? |
|
Definition
|
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Term
| What is the pattern for Jaundice in newborns. |
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Definition
| NOT normal at day 1. Normal on days 2,3,4,5 due to dehydration, get phototherapy to prevent brain deposits. Worse in breast-fed babies. |
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Term
| What are some normal derm findings in newborns? |
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Definition
| Sebaceous retention cysts on nose or chin; Milia (sebum/keratin-filled cysts); Mongolian spots (blue/green bruise-like patches); Erythema toxicum (baby rash/allergy to being born, eosinophilic white center), seen at day 2 or 3; Stork Marks/Angel Kisses Cutis marmorata (resolve with warmth) Forceps bruising (rare today) Capillary hemangioma |
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Term
| What is a cavernous hemangioma? |
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Definition
| A skin lesion that consists of interconnecting venules, usually full of platelets; thrombocytopenia may be a complication; should be treated |
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Term
| What is Caput succedaneum? |
|
Definition
| Scalp edema/free flowing fuid that moves when pressure is applied. Usually resolves on its own. |
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Term
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Definition
| Subperiosteal hematoma/blood trapped below the periosteum; its boundaries are defined by the bones/it won't move past the midline if pushed. Usually resolves, but may cause pain. |
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Term
| What are some things that tongue protrusion is associated with? |
|
Definition
| Hypothyroidism, small oral cavity, Down's syndrome |
|
|
Term
| What are some causes of early cyanosis (blue babies)? |
|
Definition
| The 5 Ts: Tetralogy, Transposition, Truncus, Tricuspid, TAPVR |
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|
Term
| What are some causes of late cyanosis (blue kids)? |
|
Definition
| (Different from FA): Eisenmenger's complex; Pure pulmonic stenosis; Tetralogy of Fallot; Large septal defects |
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|
Term
| How serious are umbilical hernia in newborns? |
|
Definition
| Over 90% resolve by 4-5 years; they're more common in African-Americans. |
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Term
| Contrast FAS and Down Syndrome Facies |
|
Definition
Head size: Down: short & rounded
Palpebral fissues: FAS: short, Down: upslanting
Nasal bridge: FAS: low, Down: flat
Epicanthal folds: FAS: present, Down: prominent
Ears: FAS: minor abnormalities, Down: small & low-set
Tongue: FAS: Down: relatively large
Palmar creases: Down: single transverse
Eyes: Down: Brushfield's spots
Midface: FAS: flat
Nose: FAS: short
Philtrum: FAS: indistinct
Upper lip: FAS: thin
Jaw: FAS: micrognathia |
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|
Term
| Compare infant stool between breast fed children and formula fed children. |
|
Definition
Breast fed: more like pea soup
Formula fed: darker, with more consistency |
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|
Term
| What is the normal gestational age? |
|
Definition
| Full term is 37-42 weeks. Preterm is <37. Postterm is >42. |
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Term
|
Definition
| The cheesy white material of sebum and desquamated cells on newborns, especially in the labial folds. |
|
|
Term
| When would you notice CHF in a newborn? |
|
Definition
| It manifests as dyspnea on exertion. It may be noticed as tiredness during feeding. |
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|
Term
|
Definition
| Abnormally placed urethral opening in males. |
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|
Term
| What GI findings do you need to see before sending a newborn home? |
|
Definition
| Perforate anus and passage of stool. Also chech for myelomeningocele (spina bifida) while you're back there. |
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Term
| Weakness, fatigue, ptosis, diplopia, nasal speech and dysphagia are classic signs of what? |
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Definition
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Term
| Ipsilateral ptosis, miosis and anhidrosis are symptoms of what? |
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Definition
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Term
| Fixed dilated pupil, ptosis and lateral eye deviation are symptoms of what? |
|
Definition
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|
Term
| Horner's syndrome is caused by what? |
|
Definition
| Pathologic involvement of sympathetic chain. E.g. cancer, spinal cord disease, neck tumro, vascular aneurysm/dissection |
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Term
| Finger nail pitting is associated with what diseases (2)? |
|
Definition
| Psoriasis and Iron Deficiency Anemia (although the latter is ass'd with Koilonychia/"spooning of finger nails" in case it is different) |
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Term
| What deficit(s) are present in Syringomyelia? |
|
Definition
| Pain and temperature sense lost; posterior columns remain intact. |
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Term
| These findings are characteristic of what disorder that is present in the far east(?): mouth aphthous ulccers; genital ulcers; cutaneous lesions; uveitis; joint pain; vasculitis, phlebitis & meningoencephalitis; pulm. a. rupture a cause of death; GI bleeding from ulceration. |
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Definition
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|
Term
| What disorder has these characteristics(?): Recurrent fractures, usually before puberty; triangular-shaped face; blue sclera; hearing loss; scoliosis; loose joints; brittle teeth |
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Definition
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