Fetus and Newborn Flashcards
baby with meconium aspiration and respiratory distress?
meconium plug - may cause pneumothorax
besides hypoglycemia, what other electrolyte abnormalites can be present in a infant of a diabetic mother?
hypocalcemia (tremors, twitches, seizures, also can lead to prolonged QT) and hypomagnesemia
persistent posterior fontanelle, umbilical hernia, jaundice
hypothyroidism
what are some compliations of exchange transfusion?
thrombocytopenia, portal vein thrombosis, NEC, electrolyte imbalances, GVHD, infection
protruding tongue with small mouth +/- cleft palate
pierre robin syndrome
what should concern you more - pre-axial (thumb/toe) or post-axial (pinky) polydactyly?
pre-axial
what is the underlying injury in Horner Syndrome?
damage to sympathetic fibers of T1
ptosis, miosis, enophthalmos, delayed pigmentation of iris
what is considered abnormal penile length in term neonate?
when after needle decompression do you consider a chest tube?
pneumothorax still >20% or still having hypoxia or distress
what are the xray findings of intersitial pulmonary fibrosis in an infant?
early on, bilateral reticular infiltrates occurs with development of multi-cystic lesions
occur in premies with no history of RDS/HMD
what are craniotabes?
soft areas of the skull away from the fontanelle - associated with syphillis, hydrocephalus, and rickets
management options for PPHN?
mechanical ventilation
hyperventilation (lowers CO2)
pressors (to reverse shunting)
sedation
iNO
ECMO
what are the chronic signs of kernicterus(>1 yr)
hypotonia, active DTRs, obligatory tonic neck reflexes, delayed motor skills
what is RDS also known as?
hyaline membrane disease
would hypoxemia due to pulmonary hypertension be improved with oxygen?
nope.
who should be screened for developmental hip dysplasia?
breech presentation, daughters of mother’s with DDH
what congential defects are common in infants of diabetic mothers?
VSD
caudal regression syndrome
neural tube defects
GI atresia
microcolon (small left colon syndrome) - will have normal bowel function in future
GU malformations
what radiologic finding may you see in a baby with meconium peritonitis
intraabdominal calcifications
what should you look for if a newborn has jaundice within first 24 hours?
infection!
are infants of mothers with gestational diabetes at risk for congenital heart disease?
no, just babies of mother’s with type 1 or type 2 diabetes
where are thryoglossal duct cysts?
midline, most with swallowing and tongue protrusion
if a fetus/newborn has a single umbilical artery, what should you do?
look for other congenital anomalies
what are the acute signs of kernicterus?
poor sucking, stupor, hypotonia, seizures
hypertonia of extensor muscles, pisthotonus, retrocollis, fever
hypertonia
which could have other related congential anomalies - omphalocele or gastroschisis?
omphalocele
what is picture B
Klumpke paralysis
lower part of brachial plexus (C8 and T1 parts)
claw like posturing of the hand
mostly seen in breech delivery
less likely to improve but may with PT
what is the cutoff for hypoglycemia in a newborn?
what syndromes are associated with multiple areas of craniosynostosis?
Crouzon or Alperts
large protruding tongue
hypothyroidism, Down syndrome, Beckwidth-Wiedemann, hemangioma, isolated macroglossia
physical exam findings with patent ductus arteriosis?
continuous machine like murmur
bounding pulses
wide pulse pressure
hyperdynamic precordium
worsening respiratory status
is it okay to use indomethacin if a baby has an IVH?
yes
don’t use with poor kidney function, NEC, decreased UOP, low platelets, or bleeding issues
what is picture A
Erb palsy - damange to upper part of brachial plexus (5th and 6th cervical roots)
“waiter’s tip” position
resolves spontaneously
palpate for ipsilateral clavicle fractures
what is a complication of iNO?
methemoglobinemia
what should you think of in a coughing newborn?
viral pneumonia
in what cells is surfactant stored in?
type 2 alveolar cells
what ratio is measured to indicate fetal lung maturity?
lecithin-sphingomyelin ration
lecithin is much higher than sphingomyeline in mature lungs
(equal in immature lungs)
