Fetus And newborn Flashcards
Ear form of newborn by age 24-33 weeks. <33 34-35 weeks <35 36-38 weeks <38 >39weeks
Ear cartilage by age 24-31 weeks <31 32-35 weeks <35 36-39 weeks <39 >40
Flat, shapeless
Superior incurving to start
Upper 2/3 incurving
Well defined curve
Pinna soft, folded
Cartilage scant, returns slow from fold
Thin cartilage,springs back from fold
Pinna firm, remains erect
Newborn exam sole creases
24-31 weeks 32-33 weeks 34-35 weeks 36-37 weeks 38-41 weeks >42 weeks
No anterior sole crease 1-2 ant sole crease 2-3 ant sole crease Crease over 2/3 ant sole Heel crease present Deep crease over entire sole
Leading cause of infant death in us
Congenital malformation
Which race had highest infant mortality
African Americans
Which group has highest mortality
Caucasian infants less than 500g
Most significant risk factor for prematurity
Prior preterm birth
Single umbilical artery, search for?
Congenital anomalies like cardiac and renal
If nonreassuring pattern of FHR?
List and next step.
Tacky >160. Brady <120
Saltatory variability >25 bpm
Variable decels
Late decels with variability still
Then scalp stim and pH. When stim, should inc FHR and give pH >7.25
Ominous patterns.
List and next step
Persistent late decels w no variability
NRFHT
Prolonged Brady. <80 for >3min
Sinusoidal
Tx immediate delivery
Most impt indicator of successful ppv
Increase heart rate
Optimal delivery room temp?
76F or 24 C
What is associated with
Persistent post fontanelle
Umbilical hernia
Prolonged jaundice
Congenital hypothyroidism
Leukocoria can be associated with
Chorioretinitis retinopathy of prematurity or retinoblastoma
Cataract can be associated with
Rubella
CMV
Toxo
Horners syndrome
1st thoracic nerve/low brachial plexus injury.
PAM
Ptosis. Anhydrosis. Miosis.
Neonatal conjunctivitis
<24 hours
2-5d
5-14d
Chemical. Tx erythromycin
Neiserria. Tx 3rd gen frog and erythromycin
Chlamydia. (most common). Can cause Inclusion blenorrhea @ 5-14dol
Cyanotic infant except when crying?
Choanal atresia. Try to pass NG
What is CHARGE?
Coloboma Heart Abn Atresia (choanal) Retardation growth GU Abn Ear anomalies
Congenital snuffles can be associated with?
Syphilis
Drug w/d
Trauma
What is VACTERL?
Vertebral anomalies Anal atresia Cardiac TE fistula Renal Limb anomalies
When does Moro appear and disappear
28-32 weeks
6 months
Most common congenital anomalies of IDM
VSD Neural tube defects GI atresia Situs inversus Urinary tract anomalies Spinal agenesis, Caudal regression and small left colon
Congenital syphilis early exam findings?
Gen lymphadenopathy Noninmune hydrops Jaundice HSM hemolytic anemia/ thrombocytopenia Nephrotic syndrome Hemorrhagic rhinitis (snuffles) Pseudoparalyisis of extremity due to osteochondritis/periositis Vesicular rash. Desquamation of hands/feet Uveitis/chorioretinitis
Late congenital syphilis findings?
Late findings Hutchinson teeth. Notching 8th nerve deafness Keratitis Mulberry Molars: dome 1st incisor Saddle nose Saber shins: bowing of tibia Bony prominent forehead Scaphoid scapula Thickening of sterenoclavicular third of clavicle
If In doubt, tx pen g
What is surfactant made of
Dipalmityl pjosphatidylcholine lecithin
Phsophatidylglycerol And apoproteins and cholesterol
Type 2 aveolar cells make/store lethicin
What dx?
Infant with respiratory distress, tachypnea, retractions and cyanosis after delivery.
Exam shows barrel shaped chest, distended abdomen and cxr w patchy infiltrates
Meconium aspiration syndrome
