Fetus and the Newborn

Question 0

Risk Factors for Severe Bronchiolitis

Answer 0

FHx of Asthma 
School age kids at home 
No breast feeding 
Multiple Births 
Smokers 
Low Birthweight

Question 1

Triple screen interpretation

Answer 1

AFP. HCG. E3

NTD. up. — —

Trisomy 21. Dn. up. Dn

Trisomy 18. Dn. Dn. Dn

Question 2

Signs of Severe Brochiolitis

Answer 2

• O2 sat < 95%
• PO2 < 65%
• PCO2 > 40%
• CXR showing atelectasis
• RR> 70bpm

Question 3

Lab/clinical Findings Consistent with CF

Answer 3

• FTT
• Decreased albumin
• anemia
• Hyponatremia
• recurrent pna
• steatorrhea
• Hypochloremic alkalosis

Question 4

VOCAL CORD PARALYSIS

Answer 4

A baby with a hoarse cry

• difficulty on INSPIRATION
• normal puse ox with no response to Beta agonist
• blunted inpiratory loop on spirometry
• associated with Uri, Chemical exposure, GERD

Question 5

When to Start Long acting Beta agonist on kids 0-4yrs

Answer 5

• at least 4 episodes of wheezing lasting longer than a day, that interferes with sleep and has a POSITIVE ASTHMA PREDICTIVE INDEX
• 2 or more exacerbation in the last 6 mo requiring oral CS

ASTHMA PREDICTIVE INDEX ( 1 major or 2 minor)

Major: MINOR
PARENTAL HX OF ASTHMA POS SKIN TEST
MD DX ATOPIC DERM EOSINOPHILIA > 4%
Wheezing without URI

Question 6

Diagnosis of EXERCISE INDUCED ASTHMA

Answer 6

Consistent with a 15% decrease in PEFR or FEV1 during exercise challenge

Question 7

RISK FACTORS FOR PERSISTENT ASTHMA

Answer 7

• Onset before age 3yr
• increased IgE
• Maternal HX of asthma
• eosinophilia
• Eczema or AR
• tobacco exposure
• obesity

Question 8

ABPA

Answer 8

Colonization of the airways with hypersensitivity to mold

-TYPE I and TYPE III RXN

CLINICALLY

sputum eosinophilia
Increased serum IgE
Antibodies to A fumigates
RAST positive

Question 9

BPD CLINICAL MANIFESTATION

Answer 9

Chronic Lung dz in infants
O2 Dependency beyond 28 DOL

CLINICAL 
Tachypnea 
SOB
Tracheomalacia 
Cyonotic spells 
FTT
Pulmonary HTN 
GERD 
Feeding problems

Question 10

BETA 2 Adrenergic effects on NEONATES

Answer 10

Ex. Terbutaline (tocolytic)

Hyperinsulinism–» hypoglycemia

Question 11

IVH GRADING

Answer 11

GRADE I – Germinal Matrix

GRADE II –IVH WITHOUT DILATATION

GRADE III – IVH WITH DILATATION

GRADE IV – EVERYTHING PLUS PARENCHYMAL INVOLVEMENT

Question 12

Metabolic Derangements associated withIVH

Answer 12

Hyperglycemia
Thrombocytopenia
Hyponatremia
Acedemia

Occurs within 96 hrs of life

Question 13

Metabolic Associations with Polycythemia

Answer 13

Hyperbilirubinemia

Thrombocytopenia

Hypoglycemia

Question 14

Arterial blood gas values in normal NEONATES

Answer 14

PO2 60-90

PCO2 35-45

Question 15

DISTINGUISHING RDS FROM GBS PNA IN A PREEMIE

Answer 15

Band:Neutrophil

If > or equal to 0.2 sepsis or PNA more likely

Question 16

Breast Milk Content

GREATER IN

Answer 16

• protein
• Na
• lactoferrin
• LCFA
• IGA

Question 17

Premature Breast Milk low in

Answer 17

• protein
• calcium
• VITAMIN D
• iron
• phosphate

Question 18

Factors that reduce the incidence of Neonatal Jaundice

Answer 18

• maternal heroine
• smoking
• alcohol
• phenobarbital
• phenytoin

Question 19

Estimate of Preemie BP

Answer 19

Mean arterial BP should not be < than corrected GA in weeks

Question 20

Factors that impact the prognosis of preemies

Answer 20

GA
Morbidity in the NICU
INTRACRANIAL HEMORRHAGE

Question 21

SE of MgSO4 on the NB

Answer 21

• delayed stooling
• thrombocytopenia
• neutropenia

Question 22

Complications of Exchange Transfusion

Answer 22

Transfusion Impact No!!

Potassium high
Calcium low
Thrombocytopenia
Volume NO (hypovolemia)

Question 23

Common Causes of Hemorrhagic dz of the NEW BORN

Answer 23

• maternal use of drugs
  - anticonvulsants
  - anticoagulants
  - quinolones
  - cephalosporins
  - TB drugs

Question 24

APT TEST

Answer 24

Tests for the presence of maternal blood in a neonates gastric aspirates