1 - Neonatology Flashcards
EINC
• Immediate drying
• Uninterrupted skin-to-skin contact
• Delayed cord clamping
• Non-separation of mother and baby
Target temperature for newborns
36.5-37.5°C
Room temperature at birth
25-28°C
Low birth weight
<2,500g
Very low birth weight
<1,500g
Extremely low birth weight
<1,000g
Estimated birth anthropometrics (Lt, Wt, HC)
Lt: 50cm
Wt: 3.5kg
HC: 33-35cm
Small for gestational age
BW <3rd percentile for calculated gestational age
Large for gestational age
BW >90th percentile for gestational age
APGAR
• Activity
• Pulse
• Grimace (reflex irritability)
• Appearance
• Respiration
APGAR interpretation
0-3 severely depressed
4-6 moderately depressed
7-10 excellent condition
APGAR score that is a valid predictor of neonatal mortality
5-minute score
Newborn screening ideally when for term
48 hours of life
Newborn screening ideally when for preterm
5-7 days
Expanded NBS covers how many diseases
28
Most common cause of congenital hypothyroidism
Thyroid dysgenesis
Most common enzyme deficiency in congenital adrenal hyperplasia
21-hydroxylase
Physiologic weight loss in during first 10 days for term and 2 weeks for preterm
5-10%
Vaguely demarcated pitting edema that extend across sutures; maximal size at birth; resolves in 48-72 hours
Caput succedaneum
Blood collection with distinct margins and does not cross suture lines; increases size after birth for 12-24 hours; resolves over 2-3 weeks
Cephalhematoma
Firm to fluctuant blood collection with ill-defined borders located beneath the epicranial aponeurosis; progressive after birth; resolution over 2-3 weeks; may be massive if there is associated coagulopathy
Subgaleal hemorrhage
Most common Tracheoesophageal Fistula (TEF)
Type C
(Esophageal Atresia (EA) with distal TEF)
Most common type of congenital diaphragmatic hernia
Bochdalek hernia
Extrusion of abdominal viscera covered with sac
Omphalocele
Extrusion of abdominal viscera without sac
Gastroschisis
Triad of Necrotizing Enterocolitis (NEC) pathophysiology
Intestinal ischemia
Enteral nutrition
Pathologic organisms
Single bubble sign
Hypertrophic pyloric stenosis
Pyloric atresia
Double bubble sign
Duodenal atresia
Annular pancreas
Malrotation
Triple bubble sign
Jejunal atresia
Paroxysms of crampy abdominal pain
Currant jelly stools
Intussusception
Target/doughnut sign
Pseudokidney sign
Intussusception
Apnea is cessation of breathing for
Longer than 20 seconds or any duration if accompanied by cyanosis and bradycardia
Most common cause of apnea
Idiopathic apnea of prematurity
Ground glass appearance (+) air bronchograms
Respiratory Distress Syndrome
Prominent pulmonary vascular markings
Fluid lines in fissure
Transient Tachypnea of the Newborn
“Bubbly lungs”
Bronchopulmonary Dysplasia
Coarse streaking granular pattern
Meconium Aspiration Syndrome
Perihilar streaking
Neonatal pneumonia
Jaundice visible on 2nd-3rd day, peaks at 5-6 mg/dl on the 2nd- 4th day and decrease to below 2 mg/dl between 5-7 days of life
Physiologic jaundice
Jaundice that appears on the first 24-36 hours of life, rises faster than 5mg/dl/24 hours, persists after 10-14 days
Pathologic jaundice
Most common cause of hemolytic disease of the newborn
ABO incompatibility
Congenital infection presenting as vesicular lesions on the face and mouth
HSV
Congenital infection presenting as purpuric hemorrhagic lesions all over the body and IUGR
Rubella
Congenital infection presenting as maculopapular rash, IUGR, bone periostitis
Syphilis
Congenital infection presenting as chorioretinitis, IUGR, periventricular calcifications
CMV
Congenital infection presenting as chorioretinitis, IUGR, microcephaly, hepatosplenomegaly, intracerebral calcifications
Toxoplasmosis
Congenital infection presenting as cutaneous scars, IUGR, cortical atrophy
Varicella
Undescended testes should be treated surgically not later than
9-15 months old
