Diseases of Infancy and Childhood Quiz
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Questions and Answers

What is a key factor that differentiates malformations from disruptions in congenital anomalies?

  • Malformations never impact functional outcomes of the organs.
  • Malformations are always genetic in nature.
  • Disruptions occur due to extrinsic disturbances after initial normal development. (correct)
  • Disruptions are always hereditary in origin.

Which of the following is an example of a congenital anomaly that may not be genetically inherited?

  • Down syndrome
  • Cleft lip and palate (correct)
  • Hemophilia
  • Turner syndrome

Which of the following correctly identifies a characteristic of fetal hydrops?

  • It is related solely to tumor-like conditions.
  • It can occur due to congenital infections. (correct)
  • It is exclusively linked to genetic disorders.
  • It is always caused by inborn errors of metabolism.

What best describes the nature of primary errors of morphogenesis?

<p>They indicate a failure of normal developmental processes. (B)</p> Signup and view all the answers

Which statement about anatomic defects classified under congenital anomalies is accurate?

<p>Some may not become clinically apparent until years later. (D)</p> Signup and view all the answers

What is a common misconception regarding congenital anomalies?

<p>All congenital anomalies are inherited from parents. (C)</p> Signup and view all the answers

In what way can maternal factors contribute to the development of congenital anomalies?

<p>By causing mechanical compression during fetal development. (C)</p> Signup and view all the answers

What distinguishes polydactyly as a congenital anomaly?

<p>It represents a malformation involving extra digits. (B)</p> Signup and view all the answers

What is the term used for a complete absence of an organ and its primordium?

<p>Aplasia (D)</p> Signup and view all the answers

Which condition is primarily associated with uteroplacental insufficiency?

<p>Oligohydramnios (D)</p> Signup and view all the answers

Which of the following syndromes is NOT classified as a chromosomal syndrome?

<p>Cystic fibrosis (B)</p> Signup and view all the answers

What condition is associated with the teratogen Valproic Acid?

<p>Valproic Acid Embryopathy (A)</p> Signup and view all the answers

What does the term 'Hypoplasia' refer to?

<p>Incomplete development of an organ (C)</p> Signup and view all the answers

Which of these is a known major risk factor for prematurity?

<p>PPROM (C)</p> Signup and view all the answers

Which environmental factor has been shown to interact with genetic factors in causing certain fetal abnormalities?

<p>Maternal infections (A)</p> Signup and view all the answers

What is primarily affected by hydropic changes in fetuses?

<p>Fluid balance (C)</p> Signup and view all the answers

What developmental period is the highest peak of sensitivity for organ formation?

<p>4th to 5th week (B)</p> Signup and view all the answers

Which condition is NOT a result of maternal placental insufficiency?

<p>Cleft palate (B)</p> Signup and view all the answers

What is the most likely result of uteroplacental insufficiency on fetal development?

<p>Fetal growth restriction (D)</p> Signup and view all the answers

Which teratogen is associated with craniofacial and CNS defects due to excess dosage?

<p>All-trans-retinoic acid (B)</p> Signup and view all the answers

Which anomaly is related to the maternal disease state of diabetes mellitus (DM)?

<p>Neural tube defects (D)</p> Signup and view all the answers

What is a common outcome for neonates who survive the first 3-4 days after birth despite respiratory distress?

<p>Excellent recovery without significant sequelae (A)</p> Signup and view all the answers

Which pathogen is most commonly associated with early onset perinatal infections?

<p>Group B Streptococcus (C)</p> Signup and view all the answers

What condition results from a blood group incompatibility between mother and fetus?

<p>Kernicterus (D)</p> Signup and view all the answers

Which of the following is a sign of necrotizing enterocolitis (NEC)?

<p>Pneumatosis intestinalis on X-ray (D)</p> Signup and view all the answers

What is the most common reason for inducing fetal anemia?

<p>Twin-twin transfusion syndrome (D)</p> Signup and view all the answers

How is congenital hemolytic disease caused by blood group incompatibility primarily treated?

<p>Total exchange transfusion (D)</p> Signup and view all the answers

What condition might present as 'ground-glass opacities' in neonatal X-rays?

<p>Respiratory distress syndrome (C)</p> Signup and view all the answers

What happens during phase II of retinopathy of prematurity (ROP)?

<p>Rebound of VEGF occurs resulting in neovascularization (A)</p> Signup and view all the answers

Which type of genetic disorder is associated with phenylketonuria (PKU)?

<p>Autosomal recessive (B)</p> Signup and view all the answers

Which complication is least likely associated with bronchopulmonary dysplasia?

<p>Necrotizing enterocolitis (C)</p> Signup and view all the answers

What is the consequence of high levels of unconjugated bilirubin in a newborn?

<p>Kernicterus (B)</p> Signup and view all the answers

Which abnormal finding is associated with congenital fibrous tumors?

<p>Highly cellular spindle-shaped cells (D)</p> Signup and view all the answers

In what way does the pathogenesis of neonatal infection differ from other infections?

<p>Neonates lack immune response mechanisms (A)</p> Signup and view all the answers

What is the primary cause of disruptions in organ development?

<p>Extrinsic disturbances during development (D)</p> Signup and view all the answers

Which of the following conditions might not be purely genetic in nature?

<p>Amniotic band syndrome (A)</p> Signup and view all the answers

What is a defining feature of malformations as congenital anomalies?

<p>They are present at birth due to intrinsic developmental processes. (C)</p> Signup and view all the answers

Which of the following best describes a cascade of anomalies?

<p>A constellation of anomalies due to one initiating aberration. (D)</p> Signup and view all the answers

Which situation typically leads to the highest risk of fetal malformations due to environmental agents?

<p>First trimester exposure to teratogens (A)</p> Signup and view all the answers

How is polydactyly classified among congenital anomalies?

<p>As a malformation due to intrinsic processes (C)</p> Signup and view all the answers

What might cause secondary destruction of a previously normal organ during development?

<p>Amniotic bands leading to compression (A)</p> Signup and view all the answers

Which factor is least likely to contribute to congenital anomalies?

<p>Maternal environmental stressors (A)</p> Signup and view all the answers

What is the primary characteristic of malformation syndromes?

<p>Multiple organ defects with a cohesive pathological relationship (C)</p> Signup and view all the answers

Which of the following best describes 'agenesis' in congenital anomalies?

<p>Absence of an organ and its primordium (C)</p> Signup and view all the answers

Which factor is a known risk for preterm premature rupture of membranes (PPROM)?

<p>Poor prenatal care (A)</p> Signup and view all the answers

What developmental outcome is most directly associated with uteroplacental insufficiency?

<p>Growth retardation or injury to formed organs (B)</p> Signup and view all the answers

What is the primary consequence of maternal exposure to thalidomide during pregnancy?

<p>Limb malformations (D)</p> Signup and view all the answers

Which of the following describes the role of cyclopamine as a teratogen?

<p>Inhibits Hedgehog signaling pathway (A)</p> Signup and view all the answers

What is the primary effect of maternal smoking on fetal development?

<p>Low birth weight and growth restrictions (B)</p> Signup and view all the answers

Which factor is NOT typically associated with maternal disease states contributing to congenital anomalies?

<p>Increased maternal BMI (A)</p> Signup and view all the answers

What is the significance of the embryonic period in relation to teratogenic effects?

<p>Peak sensitivity for organ formation and defects (A)</p> Signup and view all the answers

Which condition is most likely caused by chromosomal abnormalities in the fetus?

<p>Trisomy 18 or Down syndrome (C)</p> Signup and view all the answers

What does 'dysplasia' refer to in the context of congenital abnormalities?

<p>Abnormal organization of cells (D)</p> Signup and view all the answers

Which pathogen is associated with serious maternal infections linked to congenital anomalies?

<p>Syphilis (A)</p> Signup and view all the answers

What is the expected outcome of hypoxia in the fetus during pregnancy?

<p>Potential for learning disabilities (C)</p> Signup and view all the answers

Which of the following describes the impact of maternal drug use during pregnancy on fetal development?

<p>Dependent on the type and timing of exposure (A)</p> Signup and view all the answers

What defines the term 'hypotrophy' in relation to organ development?

<p>Decreased size due to reduced cell size or number (C)</p> Signup and view all the answers

What is a common complication associated with bronchopulmonary dysplasia?

<p>Neonatal pulmonary hypertension (B), Pulmonary hemorrhage (C)</p> Signup and view all the answers

Which of the following conditions is primarily linked to maternal diabetes mellitus?

<p>Neonatal jaundice (B), Cardiovascular defects (C)</p> Signup and view all the answers

Which maternal infection is known as a likely cause for early onset neonatal sepsis?

<p>Listeria monocytogenes (B)</p> Signup and view all the answers

What is the primary treatment for severe hyperbilirubinemia in neonates?

<p>Phototherapy (C)</p> Signup and view all the answers

Which factor contributes to the pathogenesis of necrotizing enterocolitis (NEC)?

<p>Immature immune response (D)</p> Signup and view all the answers

What role does retinopathy of prematurity (ROP) typically play in the management of premature infants?

<p>It indicates the importance of regulating oxygen levels. (A)</p> Signup and view all the answers

Which histological feature is commonly associated with necrotizing enterocolitis (NEC)?

<p>Coagulative necrosis (D)</p> Signup and view all the answers

What is a probable consequence of the Rh incompatibility between a mother and her fetus?

<p>Fetal hydrops (C)</p> Signup and view all the answers

What pattern of lung development is typically observed in neonates with respiratory distress syndrome?

<p>Inadequate surfactant production (A)</p> Signup and view all the answers

Which condition involves inflammation and necrosis of the intestinal barrier, allowing for bacterial entry?

<p>Necrotizing enterocolitis (B)</p> Signup and view all the answers

Which of the following describes the typical fetal presentation of hydrops fetalis?

<p>Pallor and edema (B)</p> Signup and view all the answers

What characteristic is most commonly seen in congenital fibrous tumors?

<p>Sparse cellularity with spindle-shaped cells (A)</p> Signup and view all the answers

What complication can arise due to excessive oxygen treatment in preterm infants?

<p>Retinopathy of prematurity (C)</p> Signup and view all the answers

What typically occurs in the lungs of preterm infants who survive the first 3-4 days after birth despite respiratory distress?

<p>Increased risk for bronchopulmonary dysplasia (D)</p> Signup and view all the answers

Flashcards

Congenital Anomalies

Birth defects present at birth; some may not be apparent until later in life.

Congenital Malformations

Anatomic defects resulting from intrinsic, abnormal developmental processes.

Congenital Disruptions

Anatomic defects caused by extrinsic disturbance in developmental processes, not heritable.

Amniotic Bands

Extrinsic factors causing localized or generalized compression of the fetus by abnormal biomechanical forces.

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Prematurity

Birth before 37 weeks of gestation.

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Fetal Growth Restriction

Slowed development of a baby during pregnancy.

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Perinatal Infections

Infections affecting the baby around the time of birth.

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Inborn Errors of Metabolism

Inherited conditions affecting metabolic processes.

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Oligohydramnios

Low amniotic fluid volume during pregnancy.

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Potter Sequence

A set of birth defects caused by oligohydramnios.

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Uteroplacental Insufficiency

Reduced blood flow to the uterus and placenta.

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Bicornuate Uterus

A uterus that is abnormally shaped, with two horns.

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Genetic Malformations

Birth defects caused by genetic factors.

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Single Gene Mutations

Birth defects caused by errors in a single gene.

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Chromosomal Syndromes

Birth defects linked to issues with whole chromosomes.

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Environmental Teratogens

Harmful substances from the environment that can cause birth defects.

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Maternal Infections

Infections affecting the mother that might damage a developing fetus.

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Multifactorial Birth Defects

Birth problems arising from a mix of genes and environmental factors.

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Preterm Premature Rupture of Membranes (PPROM)

The premature rupturing of the amniotic sac before the full term.

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Intrauterine Infections

Infections affecting the fetus while in the uterus.

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Hyaline Membrane Disease (HMD)

A lung disorder in newborns, characterized by hyaline membranes forming in the lungs.

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What is ROP?

Retrolental Fibroplasia or Retinopathy of Prematurity is a condition caused by abnormal blood vessel growth in the retina of premature infants. It typically develops in infants born before 31 weeks of gestation and having low birth weight.

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What is BPD?

Bronchopulmonary dysplasia, a chronic lung disease, is characterized by underdeveloped lungs and difficulty breathing in infants, often caused by prematurity and prolonged oxygen therapy.

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What is NEC?

Necrotizing enterocolitis (NEC) is a serious intestinal disease that affects premature infants, characterized by tissue death in the intestines.

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What is Pneumatosis Intestinalis?

Pneumatosis Intestinalis is a condition characterized by air bubbles in the walls of the intestines, often occurring in premature infants with NEC.

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What is a PAF?

Platelet activating factor (PAF) is a chemical that plays a role in inflammation and may contribute to the development of NEC.

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What is TORCH?

TORCH is an acronym for a group of infections (Toxoplasmosis, Other [Syphilis, Varicella-zoster virus, etc.], Rubella, Cytomegalovirus, Herpes simplex virus) that can be passed from a mother to her baby during pregnancy.

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What is Fetal Hydrops?

Fetal Hydrops is a condition where there is an excessive accumulation of fluid in the tissues and body cavities of a fetus.

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What is Kernicterus?

Kernicterus is brain damage caused by high levels of bilirubin in the blood, often seen in newborns with Rh incompatibility.

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What is Erythroblastosis Fetalis?

Erythroblastosis Fetalis is a condition where the fetus has an excessive number of immature red blood cells, often due to Rh incompatibility.

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What is PKU?

Phenylketonuria (PKU) is an inborn error of metabolism in which the body cannot break down phenylalanine, leading to its buildup.

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What is Galactosemia?

Galactosemia is an inborn error of metabolism where the body cannot break down galactose, leading to its buildup.

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What is a Hamartoma?

A hamartoma is a noncancerous tumor-like growth made of cells that are normally found in the tissue where the tumor is located.

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What is a Choristoma?

A choristoma is a noncancerous tumor-like growth made of different types of cells that are not normally found in the tissue where the tumor is located.

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What is a Congenital Hemangioma?

A congenital hemangioma is a common birthmark consisting of a cluster of blood vessels.

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What is a Congenital Fibrosarcoma?

A congenital fibrosarcoma is a rare type of cancer that is present at birth.

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What is the effect of Oligohydramnios on the fetus?

Oligohydramnios, the low level of amniotic fluid, can lead to a set of birth defects called the Potter sequence, which includes problems with lung development, facial features, and limb deformities.

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What is the difference between Agenesis and Aplasia?

Agenesis is the complete absence of an organ and its primordium (the starting point of its development), while Aplasia is the absence of an organ due to the failure of growth of the existing primordium.

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What is a Malformation Syndrome?

A constellation of anomalies believed to be pathologically related but cannot be explained by a single, localized initiating defect. It's a group of birth defects happening together due to a single cause, often a genetic or environmental factor.

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What is the difference between Hypoplasia and Hyperplasia?

Hypoplasia is the incomplete development or decreased size of an organ due to fewer cells, while Hyperplasia is the increased size of an organ due to more cells.

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What are the main categories of congenital anomalies based on their causes?

Congenital anomalies can be caused by genetic factors (like single gene mutations or chromosomal syndromes), environmental factors (like infections, drugs, or irradiation), or a combination of both called multifactorial causes.

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What is the role of Hedgehog signaling in development?

Hedgehog signaling is a crucial pathway involved in various developmental processes, including organ formation, limb development, and brain development. Disruptions in this signaling pathway can lead to severe birth defects.

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What is Retinoic Acid Embryopathy?

Retinoic Acid Embryopathy is a group of birth defects caused by excessive exposure to retinoic acid, a form of vitamin A that is crucial for development. This can result in problems with the central nervous system, heart, and facial structures.

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What are the major risk factors for Preterm Premature Rupture of Membranes (PPROM)?

PPROM, the premature breaking of the amniotic sac, can be caused by various factors including maternal smoking, low socioeconomic status, poor maternal nutrition, and intrauterine infections.

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What are the most common organisms causing intrauterine infections?

These infections can be caused by a variety of organisms, including Ureaplasma urealyticum, Mycoplasma hominis, Gardnerella vaginalis, Trichomonas, Neisseria gonorrhea, Chlamydia, Malarial organisms, and HIV.

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What is the difference between symmetric and asymmetric fetal growth restriction (FGR)?

Symmetric FGR involves reduced growth in all parts of the fetus, while asymmetric FGR involves disproportionate growth, with head circumference relatively normal but reduced growth in the abdomen and limbs.

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What are potential causes of fetal growth restriction?

FGR can be caused by various factors like poor maternal blood supply to the fetus, fetal genetic issues, infections, or placental abnormalities.

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What is Hyaline Membrane Disease (HMD)?

HMD is a lung disorder affecting newborns, characterized by hyaline membranes forming in the lungs, hindering proper breathing. This can occur due to prematurity, lack of surfactant, or respiratory distress.

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What are Malformations?

Birth defects arising from intrinsic, abnormal developmental processes during fetal development.

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What are Disruptions?

Birth defects caused by extrinsic disturbance in developmental processes, not heritable.

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What are Amniotic Bands?

Extrinsic factors causing localized or generalized compression of the fetus by abnormal biomechanical forces.

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What are Polydactyly and Cleft Lip/Palate?

Examples of birth defects that often occur as part of a 'cascade of anomalies,' meaning a series of defects triggered by one initiating event.

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What are Inborn Errors of Metabolism?

Inherited conditions affecting metabolic processes, causing build-up of harmful substances in the body.

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What are Fetal Tumors?

Abnormal growths or masses that can develop in a fetus, either benign or malignant.

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Study Notes

Diseases of Infancy and Childhood

  • Diseases covered include congenital anomalies, prematurity, fetal growth restrictions, perinatal infections, inborn errors, SIDS, and tumors.

Congenital Anomalies

  • Congenital means "born with".
  • Some anatomic defects present at birth may not be clinically apparent for years.
  • Congenital anomalies may or may not be genetic.
  • Less severe anomalies don't always lead to stillbirths.
  • Malformations are primary errors of morphogenesis, intrinsic abnormal developmental processes, single gene defects, chromosomal defects, or multifactorial defects.
  • Ex: heart defects, anencephaly, and multiple organ defects.
  • Disruptions are secondary destruction of a previously normal organ during development due to extrinsic disturbances in morphogenesis caused by environmental agents.
  • Ex: amniotic bands
  • Deformations are cascades of anomalies triggered by a single aberration during organ development.
  • Ex: oligohydramnios (low amniotic fluid) leading to potter sequence.
  • Congenital anomalies affect 2% of newborns.

Prematurity and Fetal Growth Restrictions

  • PPROM (Preterm Premature Rupture of Membranes) occurs before 37 weeks. Risk factors include maternal smoking, low socioeconomic status, and poor nutrition.
  • Intrauterine infections by organisms (Ureaplasma, Mycoplasma, Gardnerella, Trichomonas, Neisseria, Chlamydia, Malaria, and HIV) activate TLRs, leading to deregulated prostaglandin synthesis and uterine contractions.

Fetal Growth Restriction

  • Intrinsic factors like chromosomal abnormalities, infections (TORCH, including Toxoplasmosis, Rubella, Cytomegalovirus, Herpes), and uteroplacental insufficiency lead to decreased blood supply, impacting fetal growth.
  • Symmetrical growth restriction affects the whole fetus, while asymmetrical restriction targets portions.
  • Placental issues like abruption, previa, thrombosis, chronic villitis of unknown origin, or multiple pregnancies contribute to inadequate fetal nutrition.

Intrauterine Infections

  • Infectious agents can cross the placental barrier, leading to fetal infections.

Fetal Hydrops

  • Accumulation of edema fluid in the fetus during intrauterine growth.
  • Cases can be caused by immune (blood group incompatibility) or non-immune factors.

Inborn Errors of Metabolism

  • Phenylketonuria (PKU) – Arises from a deficiency in phenylalanine hydroxylase, leading to an accumulation of phenylalanine, resulting in intellectual disability, eczema, and a mousy odor of urine.
  • Galactosemia – A deficiency in galactose-1-phosphate uridylyltransferase causes accumulation of galactose, causing failure to thrive, vomiting, jaundice, liver damage, cataracts, and mental retardation.

Cystic Fibrosis

  • A genetic disorder impacting chloride channel function (encoded by the CFTR gene on chromosome 7q31.2), resulting in thick, sticky mucus in various organs leading to pancreatic and pulmonary issues, and increased sweat chloride.
  • CFTR function varies across organs.

Sudden Infant Death Syndrome (SIDS)

  • Sudden, unexplained death of an infant under 1 year.
  • Risk factors include vulnerable infants (preterm, low birth weight, male, prior sibling SIDS), prone/side sleeping positions, sleeping with parents, and thermal stress.

Tumors and Tumor-like Conditions

  • In the context of infancy and childhood, tumors are relatively rare (2%).
  • The most prevalent tumors tend to be benign.
  • Soft tissue cancers of mesenchymal origin are frequent.
  • Tumor-like conditions, including hamartomas and choristomas, are also possible.

Benign Tumors of Childhood

  • Hemangiomas are common in infants, involving blood vessels. They can be cavernous (large, dilated vessels) or capillary (small vessels).
  • Fibrous tumors (including fibromatosis and some congenital fibrous sarcomas) also appear, with fibromatosis characterized by sparsely cellular spindle-shaped cells.

Malignant Tumors of Childhood

  • Neuroblastoma is a prevalent childhood cancer, frequently diagnosed in infants and originating from neuroblasts. (40% originate in the adrenal medulla)
  • Wilms tumor (nephroblastoma) arises from the kidney, mostly in children aged 2-5 years.

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Description

Test your knowledge on various diseases of infancy and childhood including congenital anomalies and their implications. This quiz covers key concepts such as malformations, disruptions, and deformations along with specific examples. Challenge yourself to understand the complexities of these conditions and their developmental processes.

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