34 - Evaluation and care of the newborn infant

Question 1

Term = born after ____ weeks gestation

Answer 1

37

Question 2

What are the TORCHES infections?

Answer 2

• Toxoplasmosis
• Other (HIV, HBV, parvo, syphilis)
• Rubella
• Cytomegalovirus
• HSV2

Question 3

What are the sequelae of congenital CMV?

Answer 3

• Hearing loss
• Microcephaly
• Intracranial calcifications
• Hepatosplenomegaly
• Rash

Question 4

What are the brain imaging findings in congenital CMV?

Answer 4

• Intracranial calcifications
• diminished number of gyri and abnormally thick cortex (lisencephaly or agyria-pachygyria)
• enlarged ventricles

Question 5

what is the leading cause of congenital infection in the US?

Answer 5

CMV

Question 6

what are the routine newborn medications?

Answer 6

• vitamin K
• hepatitis B vaccine
• erythromycin (also tetracycline or silver nitrate)

Question 7

erythromycin / tetracycline / silver nitrate is used to prophylactically treat what condition in the newborn?

Answer 7

gonococcal conjunctivitis

Question 8

which is more common in the neonate: gonococcal or chlamydial conjunctivitis? which is treated prophylactically? why?

Answer 8

• chlamydial
• gonococcal
• chlamydial conjunctivitis typically occurs 7-14 days after birth, and neonatal prophylaxis does little to prevent it

Question 9

progression of hearing loss can be diminished in congenital CMV infection if treated with _____________ or _____________

Answer 9

parenteral ganciclovir or oral valganciclovir

Question 10

treatment of symptomatic congenital CMV with CNS involvement for 6 months is accepted practice to improve hearing and developmental outcomes if treatment can be started within what time frame?

Answer 10

within 1 month

Question 11

follow up audiometry for congenital CMV infection should be performed with _____ and at what time points?

Answer 11

• ABR or OAE

- 3, 6, 9, 12, 18, 24, 30, 36 months then annually