WGU D119 Pediatric Primary Care
1 day old bilirubin 14, direct 0.5? - ✅✅ -Pathologic Jaundice (>12, direct >2,
day of life 1, fast rate of rise >5/day). Next best test is a Coombs test (+
means Rh or ABO incompatibility; - indicated maternal fetal transfusion,
twin/twin trasfusion, IDM, spherocytosis
✅✅
1 week old baby with cyanosis when feeding but pinks up when crying? -
-Choanal Atresia - Restricted nasal passages (choana). Associated with
CHARGE syndrome (Coloboma, Heart defects, Atresia choanal, Growth
retardation, Ear anomalies)
14 day old, bilirubin 12, direct 0.5. Has regained birth weight. - ✅✅
-Breast
Milk Jaundice (milk contains glucuronidase and de-conjugates bilirubin)
3 day old with bilirubin 10, direct 0.5, eating/pooping well? - ✅✅ -Physiologic
Jaundice - gone by 5th day of life (immature liver) bilirubin usually doesn't go
above 15
5 causes of direct hyperbilirubinemia - ✅✅-r/o SEPSIS, galactosemia,
hypothyroidism, choledochal cyst, cystic fibrosis
5 minute APGAR score is an indication of:
a. how the newborn tolerated labor
b. how the mother tolerated labor
c. how successful resuscitation efforts were
✅✅-c. Identifies how
d. how the newborn will do over the next 24 hours
e. how the newborn will do over the next 28 days -
successful resuscitation efforts were
✅✅
7 day old with dark urine, pale stool. Bilirubin 12, direct 8, LFT's elevated: -
-Biliary Atresia - can't drain bile, leads to liver failure, requires surgical
intervention
✅✅
7 day old, bilirubin 12, direct 0.5, dry mucous membranes, not gaining weight?
- -Breastfeeding Jaundice (or lack of breastfeeding). Baby is dehydrated,
can be latching problems or not feeding long or often enough.
Age infant can go 6-12 hours without feeding - ✅✅-6 Months
, Age that infant:
-rolls from supine to prone
✅✅
-steadily sits for up to 10 minutes
-walks holding 1 hand - -4-6 months
9 months
12 months
APGAR - ✅✅ -Appearance (all pink, pink and blue, blue (pale)
Pulse (>100, <100, absent)
Grimace (cough, grimace, no response)
Activity (flexed, flaccid, limp)
Respirations (strong cry, weak cry, absent)
✅✅
APGAR: Newborn Crying, Acrocyanotic, Moving All Extremities, HR 130,
Grimaces to Stimulation - -Score = 8 (loses 1 pt for color and 1pt for
irritability)
Area of alopecia with orange colored nodular skin (Newborn)? - ✅✅-Nevus
Sebaceous
Remove before adolescence b/c it can undergo malignant degeneration.
At what age does a child have 20/30 vision? hearing maturity?
a. 4 years
b. Toddler
c. 8 years
✅✅
d. Adolescent
e. School-Age - -Toddler (vision) 4 years (Hearing)
Blue/slate gray macule on back or thigh? - ✅✅-Mongolian spots (Arrested
Melanocytes)
Firm white papules on a newborn's face filled with keratin? - ✅✅ -Milia (Day
of life 1) - not to be confused with neonatal acne (Week of life 1-2)
Fontanelle closure timeframe (Anterior and Posterior) - ✅✅-Posterior (back)
closes by 2 months
Anterior (front) fontanelle closed by 18 months
Inherited causes of direct bilirubinemia? - ✅✅-Dubin-Johnson - black liver
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