Fetal/newborn

Question 1

What prenatal exposure causes broad, low nasal bridge, epicanthal folds, wide spaced eyes, cardio abnormalities, distal digital hypoplasia?

Answer 1

Phenytoin exposure

Question 2

What prenatal exposure can cause neural tube defects, as well as cardia, limb, and renal abnormalities with characteristics facies?

Answer 2

Prenatal exposure with valproic acid

Question 3

Fetal warfarin syndrome

Answer 3

Nasal hypoplasia and depressed nasal bridge0P

Question 4

Litium exposure in utero

Answer 4

Ebstein anomaly
Risk is only 1-5%
Also can cause congenital goiter, nephrogenic DI

Cannot breastfeed

Question 5

When should you give antenatal steroids?

Answer 5

Between 24-34 weeks gestation who are at risk of delivering within 7 days

Question 6

APGAR score

Answer 6

Appearance
Pulse
Reflex irritability
Activity (flexion)
Respiratory effort

Question 7

Normal ABG in newborns

Answer 7

pO2 60-90

PCO2 35-45

Question 8

Effect of cocaine

Answer 8

CNS stimulant
Vasoconstrictve Effie’s which contribute to placental insufficiency, infection, and/or abruption
Preterm birth, low BW, SGA

Long term can cause attention and behavioral self regulation deficits

Question 9

Physiologic nadir for full term vs premies

Answer 9

Hgb as low as 11.4 for FT

As low at 8 at 8 weeks for premies

Question 10

Infraorbital creases can be associated with which syndrome (2)

Answer 10

Beck with Wiedemann syndrome

Fetal valproate syndrome

Question 11

X-ray: fluid in fissure, congestion, and perihilar streaking

Answer 11

TTN aka retained fetal lung fluids

Question 12

X-ray: ground glass appearance or air bronchograms

Answer 12

RDS or GBS pneumonia

Question 13

Risk factors for hyperbili

Answer 13

Major risk factors:

• high risk at D.C.
• jaundice within first 24 hours
• Late preterm 34-36wks
• sibling needing PTX
• cephalohematoma

Minor risk factor:

• Having intermediate risk at dc
• male sex
• sibling with jaundice

Question 14

When do you start pharm treatment for NAS?

Answer 14

Finnegans scores 8 or higher

Question 15

Auditory brain stem response

Answer 15

Assesses brains responses to auditory stimulus
Tests auditory nerve, cochlea, brain stem
Detects sensorineural hearing loss, but cant distinguish from conductive

Question 16

Otoacoustic emission

Answer 16

Assesses function of peripheral nervous system
Unable to screen for neural or brainstem dysfunction
Measures sensory loss
False positives: ambient noise, canal obstruction, structural abnormalities of outer ear