CLIPP 1

Question 1

maternal heroin use associated with increased risk of what in fetus

Answer 1

fetal growth restriction, 
placental abruption, 
fetal death
preterm labor
intrauterine passage of meconium.

Question 2

neonatal abstinence syndrome symptoms

Answer 2

uncoordinated sucking reflexes leading to poor feeding, irritability,
high-pitched cry

Question 3

cocaine during pregnancy

Answer 3

vasoconstriction leading to placental insufficiency and low birth weight.

deficits in cognitive performance, information processing, and attention

Question 4

maternal etiologies of SGA at birth

Answer 4

Both young and advanced maternal age
Maternal prepregnancy short stature and thinness
Poor maternal weight gain during the latter third of pregnancy
Nulliparity
Failure to obtain normal medical care during pregnancy
Cigarette smoking, cocaine use, other substance abuse
Lower socioeconomic status
African-American ethnicity (in the U.S.)
Uterine and placental abnormalities (see below)
Polyhydramnios

Question 5

fetal etiologies of SGA at birth

Answer 5

Chromosomal abnormalities (e.g., trisomies) and syndromes
Metabolic disorders
Congenital infections (e.g., "TORCH" infections, zika)

Question 6

measuring what is an estimate of gestational age.

Answer 6

measuring fundal height (done by palpating the superior aspect of the enlarged uterus).

Question 7

intrapartum antimicrobial prophylaxis against Group B streptococcal disease (GBS) should be administered if one of the following is present and the mother is in labor with ruptured membranes:

Answer 7

Previous infant with invasive GBS disease
GBS bacteriuria during any trimester of the current pregnancy
Positive GBS vaginal-rectal screening culture in late gestation during current pregnancy
Unknown GBS status at the onset of labor (culture not done, incomplete, or results unknown) and any of the following:

Delivery at < 37 weeks’ gestation
Amniotic membrane rupture ≥ 18 hours
Intrapartum temperature ≥ 38°C (100.4°F)
Intrapartum NAAT positive for GBS

Question 8

what pregnant of women have vaginal or rectal colonization of GBS.

Answer 8

30%

Question 9

what happens if nontreated GBS in newborn?

Answer 9

sepsis

Question 10

newborn rescusitation

Answer 10

Warm and dry the infant and remove any wet linens immediately. Infants have a large surface area relative to their body weight and can thus experience significant hypothermia from evaporation.
Stimulate the infant to elicit a vigorous cry. This helps clear the lungs and mobilize secretions.
Suction amniotic fluid from the infant’s nose and mouth. This helps clear the upper airway.
Initiate further resuscitation if required. This may include using blow-by oxygen, positive pressure (bag-valve mask) ventilation with oxygen, chest compressions, and medications.

Question 11

APGAR stands for

Answer 11

Appearance (skin color)
Pulse (heart rate)
Grimace (reflex irritability)
Activity (muscle tone)
Respiration

Question 12

when is apgar done

Answer 12

he score is reported at 1 minute and 5 minutes after birth for all infants.

if score <7 at 5 minutes –> resuscitation, with re-assessment every 5 minutes, up to 20 minutes, until a score of 7 is achieved.

Question 13

Ballard Gestational Age Assessment Tool

Answer 13

uses signs of physical and neuromuscular maturity to estimate gestational age.

useful when gestational age unknown

Question 14

Symmetric vs Asymmetric IUGR

Answer 14

symmetric includes small head

asymmentric normocephalic

Question 15

risks for SGA newborns

Answer 15

hypoglycemic
hypothermia
polycthemic

Question 16

causes of absent red reflex

Answer 16

A cataract
An opacified cornea (such as in mucopolysaccharidosis)
Inflammation of the anterior chamber
Developmental anomalies of the eye
Retinoblastoma,

Question 17

Which medications are routinely given to newborns

Answer 17

vit K
hep B vaccine
erythromycin

Question 18

early VKDB

Answer 18

0-24 hrs

Severe
Mainly found in infants whose mothers used medications (e.g antiepileptic drugs or isoniazid) that interfere with how the body uses vitamin K

Question 19

classical VKDB

Answer 19

1-7 days

Bruising
Bleeding from the umbilical cord

Question 20

late VKDB

Answer 20

2-12 weeks after birth is typical, but can occur up to 6 months

30-60% of infants have bleeding within the brain
Tends to occur in breastfed only babies who have not received the vitamin K shot
Warning bleeds are rare

Question 21

ophthalmia neonatorum

Answer 21

caused by neisseria gonnorrhea –> blindness

treated by erythromycin at birth

Question 22

Chlamydia trachomatis conjunctivitis

Answer 22

more common than gonorrhea

but occurs at 7-14 days after birth, and neonatal prophylaxis does little to prevent it

Question 23

Discharge teaching should include the following:

Answer 23

Reasons to seek immediate medical care, including fever, signs of poor feeding, worsening jaundice
Expectations for normal feeding, stooling, urine output
Safety issues (including placing the newborn on his back to sleep, proper infant auto restraint, avoiding cigarette smoke exposure.)
Plan for physician outpatient followup in 48-72 hours
Social Services follow up plan
24 hour emergency contact information

Question 24

anticolvulsants effect on fetus

Answer 24

cardiac defects, dysmorphic craniofacial features, hypoplastic nails and distal phalanges, IUGR, and microcephaly. Mental retardation may be seen. A rare neonatal side effect is methemoglobinuria.

Question 25

PKU symptoms

Answer 25

vomiting, hypotonia, musty odor, developmental delay, and decreased pigmentation of the hair and eyes.