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Questions and Answers
What is the most common acquired paralysis in a previously healthy child?
What is the most common acquired paralysis in a previously healthy child?
Guillain Barre syndrome
What is the most important electrolyte to replace in a dehydrated 4 week old infant with gastric outlet obstruction?
What is the most important electrolyte to replace in a dehydrated 4 week old infant with gastric outlet obstruction?
Potassium
A child has a midline cyst in the neck that moves with swallowing. What is the most likely diagnosis?
A child has a midline cyst in the neck that moves with swallowing. What is the most likely diagnosis?
Thyroglossal duct cysts
How much time does a full term neonate spend in a waking state?
How much time does a full term neonate spend in a waking state?
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What is the appropriate initial bolus dose of an isotonic crystalloid solution for a 16 month old in hypovolemic shock?
What is the appropriate initial bolus dose of an isotonic crystalloid solution for a 16 month old in hypovolemic shock?
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What procedure is most commonly done to correct hydrocephalus in a newborn with a meningomyelocele?
What procedure is most commonly done to correct hydrocephalus in a newborn with a meningomyelocele?
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What is the most likely diagnosis for an infant with hypotonia, upslanting palpebral fissures, and a single transverse palmar crease?
What is the most likely diagnosis for an infant with hypotonia, upslanting palpebral fissures, and a single transverse palmar crease?
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What is another name for Trisomy 21?
What is another name for Trisomy 21?
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What is a common cause of deaths in infants?
What is a common cause of deaths in infants?
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What antibiotic is the best treatment for a 4 week-old infant with fever and right otitis media?
What antibiotic is the best treatment for a 4 week-old infant with fever and right otitis media?
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What is the most likely diagnosis for an infant with agenesis of the forearm and cardiac anomalies?
What is the most likely diagnosis for an infant with agenesis of the forearm and cardiac anomalies?
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Which is the most effective and practical method to prevent the spread of infection?
Which is the most effective and practical method to prevent the spread of infection?
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What is the best intervention for a child having difficulty maintaining lip seal with a bottle and nipple?
What is the best intervention for a child having difficulty maintaining lip seal with a bottle and nipple?
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What is the most appropriate next course of action for a newborn with low heart rate after a traumatic birth?
What is the most appropriate next course of action for a newborn with low heart rate after a traumatic birth?
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What are initial respiratory signs and symptoms of septic shock?
What are initial respiratory signs and symptoms of septic shock?
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What is the most likely cause of a reducible swelling of the scrotum in a newborn?
What is the most likely cause of a reducible swelling of the scrotum in a newborn?
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What is the best initial management for an infant with noisy breathing that gets worse when coughing or feeding?
What is the best initial management for an infant with noisy breathing that gets worse when coughing or feeding?
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What is this a sign of in a 1 week old infant with noisy breathing?
What is this a sign of in a 1 week old infant with noisy breathing?
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What is the most common childhood abdominal malignancy?
What is the most common childhood abdominal malignancy?
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What capillary refill time in neonates would suggest decreased intravascular volume?
What capillary refill time in neonates would suggest decreased intravascular volume?
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What test would be most helpful in making the diagnosis for a lethargic infant with poor feeding?
What test would be most helpful in making the diagnosis for a lethargic infant with poor feeding?
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What is the rate of hearing loss associated with Pierre Robin syndrome?
What is the rate of hearing loss associated with Pierre Robin syndrome?
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From age 4 years old until puberty, what is the average growth per year?
From age 4 years old until puberty, what is the average growth per year?
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With what condition will gastrografin enema NOT be therapeutically helpful?
With what condition will gastrografin enema NOT be therapeutically helpful?
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What is the normal systolic BP of a newborn?
What is the normal systolic BP of a newborn?
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What equipment should be requested at the bedside for an 18 month old with pneumonia who becomes hypoxic?
What equipment should be requested at the bedside for an 18 month old with pneumonia who becomes hypoxic?
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What is the most important variable in assuring bonding between the father and child?
What is the most important variable in assuring bonding between the father and child?
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With what is Klumpke paralysis mainly associated?
With what is Klumpke paralysis mainly associated?
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When should the second dose of hepatitis B vaccine be given to an infant born of an HBsAg-positive mother?
When should the second dose of hepatitis B vaccine be given to an infant born of an HBsAg-positive mother?
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What is the general term for the performance of an unlawful act?
What is the general term for the performance of an unlawful act?
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What study is the most appropriate initial radiographic study for an infant with abdominal pain and bilious emesis?
What study is the most appropriate initial radiographic study for an infant with abdominal pain and bilious emesis?
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Which location is most commonly involved in compartment syndrome?
Which location is most commonly involved in compartment syndrome?
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What area of the brain is least likely to be affected by kernicterus?
What area of the brain is least likely to be affected by kernicterus?
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Hyperbilirubinemia in neonates can result in?
Hyperbilirubinemia in neonates can result in?
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What is the diagnosis for a newborn with an abnormal left arm after a difficult delivery?
What is the diagnosis for a newborn with an abnormal left arm after a difficult delivery?
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What is due to paralysis of the upper brachial plexus and is most common during childbirth?
What is due to paralysis of the upper brachial plexus and is most common during childbirth?
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Where is an intraosseous line usually inserted?
Where is an intraosseous line usually inserted?
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In comparison to the vocal cords, where is the LMA usually placed?
In comparison to the vocal cords, where is the LMA usually placed?
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What is the most ominous significance of leukocoria?
What is the most ominous significance of leukocoria?
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Which condition is treated with fresh frozen plasma and platelets?
Which condition is treated with fresh frozen plasma and platelets?
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What weight defines fetal macrosomia in a term infant?
What weight defines fetal macrosomia in a term infant?
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What condition is characterized by opaque peripheral lungs on CXR in a neonate one day after birth?
What condition is characterized by opaque peripheral lungs on CXR in a neonate one day after birth?
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The left umbilical vein communicates directly with the:
The left umbilical vein communicates directly with the:
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What will most likely result from an injury to the middle meningeal artery?
What will most likely result from an injury to the middle meningeal artery?
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Most neonates pass meconium within how long after birth?
Most neonates pass meconium within how long after birth?
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During ventilation of an infant with congenital diaphragmatic hernia, what precaution should be exercised?
During ventilation of an infant with congenital diaphragmatic hernia, what precaution should be exercised?
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What treatment should be considered for a patient with Crigler-Najjar syndrome who develops kernicterus?
What treatment should be considered for a patient with Crigler-Najjar syndrome who develops kernicterus?
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Where is the most common defect of myelomeningocele?
Where is the most common defect of myelomeningocele?
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What is the most common origin of arterial anomaly of origin in tetralogy of Fallot?
What is the most common origin of arterial anomaly of origin in tetralogy of Fallot?
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What is the most likely etiologic agent for a 2 week old female with cough and conjunctivitis?
What is the most likely etiologic agent for a 2 week old female with cough and conjunctivitis?
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What is the drug of choice for chlamydia?
What is the drug of choice for chlamydia?
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What is most useful if employing the E-C clamp technique?
What is most useful if employing the E-C clamp technique?
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What chromosome most likely expresses an abnormality for a 2 month old without a red reflex?
What chromosome most likely expresses an abnormality for a 2 month old without a red reflex?
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This neonate has macrocephaly with a head circumference of 39 cm. What condition does this indicate?
This neonate has macrocephaly with a head circumference of 39 cm. What condition does this indicate?
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A normal head circumference in a neonate is _____?
A normal head circumference in a neonate is _____?
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What device will best assist you in the care of a 2 year old brought in cardiac arrest?
What device will best assist you in the care of a 2 year old brought in cardiac arrest?
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What is the major occupation of preschool children?
What is the major occupation of preschool children?
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Growth assessment should be done every _____?
Growth assessment should be done every _____?
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What is the best investigation that should be done for a 3 week old male presenting with vomiting?
What is the best investigation that should be done for a 3 week old male presenting with vomiting?
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What is the best method of opening the airway in a patient who is unconscious and vomiting?
What is the best method of opening the airway in a patient who is unconscious and vomiting?
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What is the most common presentation of Wilms Tumor?
What is the most common presentation of Wilms Tumor?
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What is the proposed mechanism for imperforate anus associated with rectovesical fistula in males?
What is the proposed mechanism for imperforate anus associated with rectovesical fistula in males?
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How should an infant with low APGAR scores be managed?
How should an infant with low APGAR scores be managed?
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What should be the first treatment of an infant born at 28 weeks?
What should be the first treatment of an infant born at 28 weeks?
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What is the most likely causative agent for an infant with signs of congenital infection?
What is the most likely causative agent for an infant with signs of congenital infection?
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What is the most probable diagnosis for an infant who returns with stridor and wheezing after a tracheoesophageal fistula?
What is the most probable diagnosis for an infant who returns with stridor and wheezing after a tracheoesophageal fistula?
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What is the APGAR score of a newborn with a HR of 60 and a normal physical exam?
What is the APGAR score of a newborn with a HR of 60 and a normal physical exam?
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What test should be ordered for a non-gaining weight 3 month old with fatty stools?
What test should be ordered for a non-gaining weight 3 month old with fatty stools?
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Following traumatic skull fracture, what is the most common cause of meningitis?
Following traumatic skull fracture, what is the most common cause of meningitis?
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By what means is a child whose parents are not present treated?
By what means is a child whose parents are not present treated?
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What is the most common cardiac malformation?
What is the most common cardiac malformation?
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This is a typical presentation of which disorder in an infant who is normal at birth but appears jaundiced at 6 weeks?
This is a typical presentation of which disorder in an infant who is normal at birth but appears jaundiced at 6 weeks?
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At what age does the moro reflex disappear?
At what age does the moro reflex disappear?
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What complication is associated with fetal growth restriction?
What complication is associated with fetal growth restriction?
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What does a week old baby not having had a bowel movement suggest?
What does a week old baby not having had a bowel movement suggest?
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What causes Kehr sign?
What causes Kehr sign?
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What occurs when there is pain at the tip of the shoulder secondary to irritants under the diaphragm?
What occurs when there is pain at the tip of the shoulder secondary to irritants under the diaphragm?
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What is the cause of cardiogenic shock?
What is the cause of cardiogenic shock?
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At what age should circumcision be performed for a neonate with hypospadias?
At what age should circumcision be performed for a neonate with hypospadias?
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When do neonatal SAH induced seizures usually appear?
When do neonatal SAH induced seizures usually appear?
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Study Notes
Guillain Barre Syndrome
- Most common acquired paralysis in previously healthy children.
Potassium
- Vital electrolyte to replace in a dehydrated 4-week-old infant with gastric outlet obstruction.
Thyroglossal Duct Cysts
- Characterized by a midline neck cyst that moves with swallowing.
Neonate Wake Time
- A full-term neonate spends approximately 30% of their time in a waking state.
Isotonic Crystalloid Solution Bolus
- Initial bolus for a 16-month-old child in hypovolemic shock: 20ml/kg over 5-20 minutes, may repeat.
Ventriculoperitoneal Shunt
- Most common procedure for correcting hydrocephalus in newborns post-meningomyelocele surgery.
Trisomy 21 Symptoms
- Infant with hypotonia, upslanting palpebral fissures, bilateral epicanthal folds, macroglossia, and single transverse palmar crease likely has Down syndrome.
Down Syndrome
- Another name for Trisomy 21.
SIDS
- Sudden Infant Death Syndrome is a common cause of death in infants.
Antibiotic Treatment
- In a 4-week-old with fever and right otitis media, appropriate treatment includes Ampicillin and Ceftriaxone.
Holt-Oram Syndrome
- Diagnosed when an infant shows agenesis of the forearm, cardiac anomalies, and a bifid thumb.
Infection Prevention
- Hand washing with soap is the most effective method to prevent infection spread.
Lip Seal Difficulty
- Best intervention for maintaining lip seal with a bottle and nipple involves applying pressure under the jaw.
Therapeutic Hypothermia
- Recommended if a term infant shows lethargy, overactive reflexes, and had significant metabolic acidosis after resuscitation.
Septic Shock Respiratory Signs
- Initial signs include hyperventilation.
Scrotum Swelling Cause
- A reducible scrotal swelling in a newborn is likely due to failure of the processus vaginalis to involute.
Infant Breathing Noises
- Reassurance and supportive therapy are the best initial management for respiratory noises in a 1-week-old.
Tracheomalacia
- Characterized by high-pitched noisy breathing which improves during sleep in infants.
Wilms Tumor
- Most common abdominal malignancy in children.
Capillary Refill Time
- A capillary refill time of 4-5 seconds in neonates indicates potential decreased intravascular volume.
Botulinum Toxins Test
- Stool testing for botulinum toxins is helpful in diagnosing lethargy, weak cry, and poor feeding in infants.
Pierre Robin Syndrome Hearing Loss
- Associated with a hearing loss rate of 60%.
Child Growth Rate
- Average growth from age 4 years until puberty is 5 cm per year.
Hirschsprung Disease Treatment
- Gastrografin enema is not therapeutically helpful in this condition.
Normal Newborn Blood Pressure
- Normal systolic blood pressure for a newborn is around 70 mmHg.
Patient Equipment for Pneumonia
- Large bore needle and chest tube setup should be prepared for an 18-month-old with pneumonia.
Father-Child Bonding
- Presence of the father in the delivery room is crucial for bonding.
Klumpke Paralysis
- Associated with traction lesions of the C8 and T1 spinal nerves.
Hep B Vaccine Timing
- Second dose for infants born to HBsAg-positive mothers is given at 1 month.
Malfeasance
- General term for performing an unlawful act.
Upper GI Study
- Recommended initial radiographic study for a 2-week-old with abdominal pain and bilious emesis.
Compartment Syndrome Location
- Anterior compartment of the lower leg is commonly involved.
Kernicterus
- Result of hyperbilirubinemia in neonates.
Erb Duchenne Palsy
- Diagnosed in a newborn with an abnormal left arm appearing paralyzed and rotated.
Brachial Plexus Injury
- Erb palsy due to paralysis of the upper brachial plexus from difficult childbirth.
IO Line Insertion Site
- Commonly inserted one finger breadth below the tibial tuberosity.
LMA Positioning
- Laryngeal Mask Airway is placed superior to the vocal cords.
Retinoblastoma
- Ominous significance of leukocoria can indicate retinoblastoma.
DIC Treatment
- Disseminated intravascular coagulation is treated with fresh frozen plasma and platelets.
Fetal Macrosomia
- Defined by a birth weight of 4500 grams in term infants.
Neonatal CXR Findings
- Opaque lung periphery on day after birth is considered normal; alveoli may not fully expand.
Ductus Venosus Communication
- Left umbilical vein communicates directly with the ductus venosus.
Epidural Hemorrhage
- Resulting injury from a middle meningeal artery blowout.
Neonates and Meconium
- Most neonates pass meconium within 24 hours after birth.
Congenital Diaphragmatic Hernia Ventilation
- Lower ventilatory pressure is crucial to avoid complications.
Crigler-Najjar Syndrome
- Plasma exchange is a consideration for treatment after kernicterus.
Myelomeningocele Defect Location
- Most commonly occurs in the lumbar region.
Tetralogy of Fallot Anomaly
- Most common arterial anomaly of origin is the LAD from RCA.
Chlamydia in Infants
- Likely cause of symptoms in a 2-week-old female with cough and conjunctivitis is Chlamydia.
Erythromycin Use
- Drug of choice for treating Chlamydia infections.
BVM Device Techniques
- Employing the E-C clamp technique enhances effectiveness.
Chromosome Abnormality
- A lack of red reflex correlates with potential abnormalities on chromosome 13.
Macrocephaly Measurement
- Head circumference of 39 cm defines macrocephaly in a full-term infant.
Normal Head Circumference Range
- Normal head circumference in neonates is 34-35 cm.
Pediatric Emergency Tape
- Essential tool for managing cardiac arrest in children.
Preschool Children Activities
- Major occupation for preschool children is play.
Growth Assessment Frequency
- Should be performed every 4-6 months for monitoring development.
Abdominal US Indication
- Best investigation for a 3-week-old with post-feeding vomiting and poor weight gain is an abdominal ultrasound.
Airway Management in Unconscious Patients
- Placing unconscious patients in the recovery position opens the airway effectively.
Wilms Tumor Presentation
- Most common presentation is an abdominal mass.
Imperforate Anus Mechanism
- Associated with failure of the urorectal septum.
APGAR Scores Management
- Infants with low APGAR scores (2 and 4) at 1 and 5 minutes require immediate management such as intubation.
Neonatal Care at 28 Weeks
- Initial treatment for infants at 28 weeks includes placing them in a radiant warmer.
Cytomegalovirus Symptoms
- Signs such as chorioretinitis and intracranial calcifications indicate potential CMV infection in infants.
Tracheoesophageal Fistula Complications
- Expiratory stridor and wheezing in infants can signify tracheomalacia.
APGAR Score Calculation
- A newborn with a HR of 60 and a normal physical examination would likely receive an APGAR score of 9.
Cystic Fibrosis Diagnosis
- DNA testing for cystic fibrosis transmembrane regulator mutations is recommended for diagnosing CF when sweat tests are inconclusive.
Post-Traumatic Meningitis
- Streptococcus pneumoniae is the leading cause of meningitis following a traumatic skull fracture.
Implied Consent
- In the absence of parents, a child is treated under implied consent provisions.
Most Common Cardiac Malformation
- Ventricular septal defect is recognized as the most common cardiac defect.
Biliary Atresia Symptoms
- Typical presentation of this condition includes jaundice appearing 6 weeks after birth.
Moro Reflex Timeline
- Moro reflex typically disappears by 4 months of age.
Fetal Growth Restriction Complication
- Complication associated with fetal growth restriction is hypoxia.
Neonate with Imperforate Anus
- Suspected condition in a week-old baby not yet having a bowel movement is imperforate anus.
Kehr Sign
- Indicative of splenic trauma, characterized by referred pain to the shoulder.
Kehr Sign Explanation
- Occurs when irritation such as blood under the diaphragm causes shoulder pain.
Cardiogenic Shock Cause
- Primary cause of cardiogenic shock is pump failure.
Hypospadias Circumcision Timing
- Circumcision should be performed after specifically 2 years of age if hypospadias is present.
Neonatal SAH Seizure Timing
- Seizures induced by neonatal subarachnoid hemorrhage typically appear within the first hour of life.
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