B

Question 1

fetal abnormalities in fetal alcohol syndrome

Answer 1

growth retardation, short palpebral fissures, smooth philtrum, thin smooth upper vermillion border

Question 2

which drug can cause ebstein anomaly or tricuspid valve

Answer 2

lithium

Question 3

fetal hydantois syndrome

Answer 3

phenytoin

broad nasal bridge, cleft lip/palate, microcephaly, mental retardation

Question 4

retinoic acid can affect fetus how

Answer 4

otic anomalies, thymic aplasia, anomalies of heart or aorta

Question 5

valproic acid affects fetus how

Answer 5

spina bifida, facial anomalies

Question 6

componenets of APGAR scoring

Answer 6

HR, RR, color, muscle tone and reflex irritability

Question 7

Respiratory distress syndrome

Answer 7

hyaline membrane disease

deficiency of surfactant from type II pneumocyte cells

Question 8

chest radiograph findings in respiratory distress syndroe

Answer 8

ground glass or diffuse retinculonodular pattern

Question 9

how to prevent RDS

Answer 9

give glucocorticoids to mom 48 hours before delivery

Question 10

transient tachypnea in the newborn

Answer 10

retained fetal lung liquid syndrome

Question 11

most common neonatal infection

Answer 11

pneumonia

Question 12

most common pathogens neonatal pneumonia

Answer 12

group B strep, E coli and klebsiella

Question 13

Tx if suspect neonatal pneumonia

Answer 13

IV ampicllin and gentanycin

Question 14

early onset neonatal sepsis

Answer 14

birth - 5 or so days

Question 15

late onset sepsis

Answer 15

first several days - 1 month

Question 16

most common pathogen neonatal sepsis

Answer 16

GBS

Question 17

risk fators for neonatal sepsis

Answer 17

premature or prolonged rupture of the membranes, chorioamnionitis, maternal intrapartum fever or leukocytosis and preterm birth

Question 18

early signs of sepsis

Answer 18

cyanosis, pallor, petechiae, vomiting, abdominal distension, respiratory distress, hypotension

Question 19

Tx eraly onset sepsis

Answer 19

ampicillin and gentamicin for 10-14 days

Question 20

Tx if meningitis with sepsis

Answer 20

add cephalosporin

Question 21

physiologic jaundice

Answer 21

indirect hyperbilirubinemia from problems with bilirubin metabolism
peaks day 3 or 5 and normalize by 14-21 days

Question 22

breast milk jaundice

Answer 22

bilirubin peak higher and remain elevated longer than physiologic jaundice
increase in enterohepatic circulation from unknown maternal factor in breast milk

Question 23

most comomn cause non physiologic unconj hyperbilirubinemia is what

Answer 23

ABO incompatability

Question 24

causes conj hyperbilirubinemia

Answer 24

biliary atresia, neonatal hepatitis, congenital infections, alpha1 antitrypsin deficiency and galactosemia

Question 25

Direct Coombs

Answer 25

detects maternal Ab on surface of neonatal RBC | will be positive in infants with ABO incompatability

Question 26

When is rhogam administered

Answer 26

28 weeks gestation

Question 27

what leads to kernicterus

Answer 27

unconj hyperbilirubinemia because binds albumin in blood and excess can cross bbb, goes to brainstem and basal ganglia

Question 28

infant has elevated uncong bilirubin and negative coombs test, now what

Answer 28

get hematocrit if elevated- polycythemia if normal or low- evaluate reticulocyte count and blood smear

Question 29

clinical features kernicterus

Answer 29

lethargy, irritability, progressing to hypotonia, opisthotonos, seizuresc

Question 30

cleft palates common in what population

Answer 30

those with chromosomal abnormalities

Question 31

when is cleft palate repaired

Answer 31

9-12 mo

Question 32

cleft lip repaired

Answer 32

shortly after birth

Question 33

esophageal atresia at higher risk for

Answer 33

tracheoesophgeal fistula

Question 34

VACTERL syndrome

Answer 34

vertebral, anal, cardiac, tracheal, esophgeal, renal and limb anomalies

Question 35

duodenal atresisa

Answer 35

failure of lumen to recanalize during 8th and 10th weeks

Question 36

duodenal atresia common in what disorder

Answer 36

trisomy 21

Question 37

double bubble

Answer 37

duodenal atresia

Question 38

bochdalek hernia

Answer 38

diaphragmatic hernia commonly in left side

Question 39

omphalocele

Answer 39

abdominal viscera herniate through umbilical and supraumbilical portions of abdominal wall covered by peritoneum and amniotic membrane

Question 40

omphalocele, macroglossia, gigantism, hyperinsulin and hypoglycemia

Answer 40

beckwith wiedemann syndrome

Question 41

gastroschisis

Answer 41

herniation of intestine lateral to umbliicus with no covering og peritoneal membrane

Question 42

biliary atresia

Answer 42

absence common bile duct | earliest finding is conj hyperbilirubinemia

Question 43

clay colored stool

Answer 43

biliary atresia

Question 44

Dx biliary atresia

Answer 44

nuclear med using tec 99 confirms absence of bile flow

Question 45

what is screened from newborn blood in hospitals

Answer 45

phenylketonuria, sickle cell, congenital adrenal hyperplasia, hypothyroidism

Question 46

weight gain in neonates

Answer 46

actually lose 5-7% in first few days then gain back by 14 days