CPS difficult numbers Flashcards
How much Vit K to give neonate based on weight class, and how much IM/PO?
give 0.5mg to <1500g, or 1.0mg to >1500g, or 2mg PO VIt K at birth and repeated at 2-4weeks, then 6-8 weeks
Neonate with hypoglycemia - what to do on first fail, what to do on second fail?
Give 0.5mL/kg of 40% oral dextrose gel, or feed 5mL/kg formula (should breastfeed too in both situations) , but second time is 8mL/kg, if is less than 1.8 after 1st try then should do IV
Early onset sepsis evaluation - do CBC at _ hours of life?
4 hours of life
EOS eval - what are the abnormal parameters?
- WBC<5, *ANC<1.5, WBC>30
- can watch infants with resp distress alone for up to 6 hours before deciding to do bloodwork/antibiotics
Pulse ox screening - what constitutes a borderline screen?
pulse ox screening is between 24 and 36 hours of life , 90 to 94% OR over 3 percent difference per and post is borderline. 3 or less difference is normal .
ROP screen which babies, and when?
ROP screen all babies less than or equal to *30 +6 weeks GA, or 1250 g or less, and needs to done at 31 weeks corrected or 4 weeks whichever is older
What minimum gestation to give iNO?
35 weeks
If an infant takes in ____ volume of milk, they don’t need extra Vit D
1 litre
Post splenectomy antibiotic prophylaxis - how long
post-splenectomy antibiotic prophylaxis - recommended for *2 years after splenectomy, and in all children <5 years, and ideally lifelong
*-for asplenia for other reasons - *at least until age 5, ideally lifelong
Asplenia for other reasons antibiotic prophylaxis, how long?
at least until age 5, ideally lifelong
Live vaccines can be given - __ month after high dose steroids?
1 month
Live vaccines can be given ___ month after chemo?
3 months
Live vaccines can be given ___ month after anti-b cell antibody thearpy?
6 months
Live vaccines can be given ___ month after IVIG therapy
11 months
Test mom for Zika serology AND PCR if the exposure was within _____(period of time?)
4 weeks
DDH - when should first US be? When should X ray be done?
US - 4 weeks is earliest, 4-6 months for xray as ossification happens then
NRP - what gestation should you increase FiO2?
less than 35 weeks
NRP: After ___ seconds of PPV, assessment of HR should take place.
15 seconds
NRP - reassess HR after how long of chest compressions?
60 seconds. Contrast this to BLS which is 2 minutes for reassessment after chest compressions. ECG is the preferred method to assess HR
NRP - what gestation to use plastic bags?
Less than 32 weeks
For LBW baby, how much iron to give for each weight class? For how long? if breast fed? if formula fed?
**Weight 2 to 2.5 kg - give additional iron 1 to 2 mg/kg/day for first 6 months
**Weight less than 2 kg - iron supplement 2-3 mgkgday for first year .
If they are predominantly formula fed , should give a high iron formula which should meet the requirements already (I.e. preterm formula )
Rotavirus - when should you stop; past when can you not give?
rotavirus cannot start after 15 weeks or end after 8 months of age, i.e. start at 6 weeks, first dose latest is 15 weeks, second dose latest is 8 months
Good asthma control is: ___ daytime symptoms/ Ventolin use per week?
Less than 4 times a week is good control
Mild C diff is how many stools a day?
less than 4 stools a day, if 4 or more then is moderate
Pregnant mom untreated syphillis?
LP, BCx and baby gets full course of penicillin
Mom untreated gonorrhea?
conjunctival culture and baby gets 1 dose ceftriaxone
Mom untreated chlamydia?
no testing or treatment unless symptomatic
Mom HIV? How to confirm negative or positive status?
zidovudine for 6 weeks , HIV PCR at birth. Confirming negative status needs 2 PCRs negative at* >1 month and >2 month. Confirming positive status needs either 2 positive PCR *<18 months, or positive serology past *18 months
How to define delayed puberty?
defined as no thelarche in age *12 to 13, no testicular enlargement age 13-14
Screening for complications of diabetes: Nephropathy - start at what age, what interval?
Yearly screening starting age *12, only if duration diabetes >5 years
Diabetes screening for : Retinopathy -
Yearly screening starting age 15, only if duration diabetes >5
Diabetes screening for : Neuropathy -
Yearly screening starting age 15, if duration >5 years, and poor control
Diabetes screening for : Dyslipidemia -
Screen at age 12 and 17
Diabetes screening for : Hypertension
All children, twice a year
Imaging preterm brain - what GA should infants get HUS ?
-All infants at 31+6 or less should get routine HUS
- At 32-32+6, only do HUS if risk factors for hemorrhage or ischemia
- Ex:the need for resuscitation or critical care out of keeping with the usual neonatal course for GA, a complicated monochorionic twin pregnancy, microcephaly, or a postnatal course complicated by sepsis, NEC, major surgery, or abnormal neurological signs
If you are doing screening newborn HUS, what age should the first one be? What does the first HUS look for?
DOL4-7 - hemorrhage
Do you do a 2nd screening newborn HUS? On which populations? If so, at what DOL? What does the repeat HUS look for?
**-Then do a repeat at 4-6 weeks if <=31+6, or if 32 weeker and first scan abnormal. Looks for PVHD, WMI
Who needs a term HUS?
If <26GA, or if complicated NICU course, or mod-severe abnormality on previous HUS, do repeat Term HUS. Otherwise don’t need term HUS.
Who should receive meningococcal chemoprophylaxis, and with what agent?
Rifampin for all contacts
Who should receive HiB chemoprophylaxis, and with what agent?
Rifampin for: all occupants of contact households with infants <12 months old (who have not completed the primary Hib immunization series), children <4 years old who are incompletely immunized, or immunocompromised children of any age.
Teeth : When should a baby see the dentist for the first time?
see dentist by 1 year or within 6 months of tooth eruption.
What age is youngest for fluoride supp are you allowed ?
6 months
Before age 1, how do you clean teeth?
Damp cloth
Age 1 and 2, how clean teeth?
tooth brush, tooth paste, no fluoride
What age do you start brushing with fluoride?
3 years
Mom with active HSV lesions at delivery - first episode, born vaginally after membrane rupture , what to do?
Empiric acyclovir
Swab at 24 hrs
If swab positive, full workup and treatment
If swab nevative, complete 10 days of IV acyclovir!!
Mom with active HSV lesions at delivery - first episode, born C section after membrane rupture, what to do?
Empiric acyclovir
Swab at 24 hrs
If swab positive, full workup and treatment
If swab nevative, complete 10 days of IV acyclovir!!
Mom with active HSV lesions at delivery - first episode, born C section prior to membrane rupture, what to do?
Swab at 24 hrs - if positive, full workup and treatment
Otherwise no acyclovir needed
Mom with active HSV lesions at delivery - recurrent episode , what to do?
Swab at 24 hrs - if positive, full workup and treatment
Otherwise no acyclovir needed
