Tozragore Curriculum Integration Aquifer Pediatrics can be used by third-year medical students, Physician Assistant students, and Nurse Practitioner students as a complement to a clerkship or course on pediatrics. Exam Aquifer is excited to announce that the multiple-choice exams which accompany our Aquifer Family Medicine, Aquifer Pediatrics, and Aquifer Radiology courses will be transitioning from their current summative format into a new, innovative formative assessment tool. Aquifer offers an online, validated summative exam included with your Aquifer Pediatrics course subscription. Aquifer is excited to announce that the multiple-choice exams which accompany our Aquifer Family Medicine, Aquifer Pediatrics, and Aquifer Radiology courses will be transitioning from their current summative format into a new, innovative formative assessment tool. With realistic case scenarios that demonstrate best practices, our course builds a bridge from content to practice for our students. It can be used to replace or enhance an existing comprehensive assessment or to remediate students.
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Immediate assessment at birth: Examine neonate immediately after birth to determine general condition of cardiorespiratory, neurologic, gastrointestinal systems and to detect congenital abnormalities. An Apgar score is assessed at one and five minutes following delivery.
Ballard exam: This method is helpful if there is no early prenatal ultrasound to help confirm dates, or if the gestational age is in question because of uncertain maternal dates.
Symptoms include poor feeding and listlessness, but also commonly asymptomatic. Hypothermia due to cold stress, decreased subcutaneous insulation. Philadelphia, Pennsylvania: Lippincott Williams and Wilkins, Observation: Note tone, movement, alertness.
Look at shape of face, skull. Observe for dysmorphic features. Palpate fontanelles and sutures. Cardiovascular: Listen for rate, rhythm, presence of murmur. Feel for pulses. Respiratory: Auscultate lungs. Look for signs of retractions, nasal flaring, grunting. Abdomen: Palpate for masses. Extremities: The hips should have full range of motion.
The Ortolani and Barlow examinations should demonstrate no instability of the hips, and no "clicks" or "clunks" are heard or palpated. Neurological: Check reflexes: Rooting, Moro, palmar and plantar grasps, tonic neck response, stepping response.
Observe eyes for presence of red reflex. Symptoms of CMV, if present, are most likely to include signs involving the skin, CNS and hepatobiliary system jaundice, chorioretinitis, hearing loss, intracranial calcifications. Additional testing is often needed to distinguish among these infections. Fetal alcohol syndrome: Rash and hepatosplenomegaly are not commonly seen with ethanol exposure in utero. Chromosomal abnormality: May result in an infant who is SGA.
Prenatal tobacco exposure: Can cause placental insufficiency and an infant to be small for gestational age. Newborn hearing test: As explained further below, may be normal in a newborn. Hearing loss may progress over time. CT scan of the head: Abnormalities of congenital cytomegalovirus may include microcephaly, intracranial calcifications, enlarged ventricles, and abnormal gyri and a thickened cortex a condition known as lissencephaly or agyria-pachygyria.
Ophthalmologic examination: Review for evidence of chorioretinitis. Mother: The following are a few of the commonly performed prenatal labs: Rapid HIV antibody test: A negative result allows mother to proceed with breastfeeding. Presence or absence of maternal hepatitis B core antibody does not predict risk for vertical hepatitis B transmission.
Rubella IgG: Positive result is evidence of protection against the virus either through past infection or immunization. In many infected infants onset of hearing loss may be after the newborn period i. An infant infected with CMV may develop hearing loss and progress to severe-to-profound bilateral hearing loss during the first year of life. Microcephaly and intracranial calcifications are factors associated with increased risk of CNS sequelae of congenital CMV infection.
Regular ophthalmologic examinations to monitor for chorioretinitis Hepatosplenomegaly and rash, the non-neurological neonatal clinical abnormalities of CMV infection, can be expected to resolve spontaneously within weeks. Currently, antiviral treatment for CMV is indicated only for immunocompromised hosts. Routine medications given to newborns in U. Neonatal prophylaxis does little to prevent conjunctivitis from chlamydia, which typically occurs days after birth.
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