General

Question 0

Seizures with in first 24h of life is most likely due to?

Answer 0

Hypoxia ischemic encephalopathy

Question 1

Chocolate brown blood is caused by?

Answer 1

Methhemoglobinemia. Excess of 1.5g/dl causes cyanosis. Cyanosis is unresponsive to oxygen in this disorder.

Question 2

Describe the Sz assoc with HIE

Answer 2

Multi focal, migratory, clonic..maybe assoc with apnea, oral-buccal-lingual movements (lip smacking), depressed consciousness, hypotonia, muscle weakness, hyperreflexia.

Question 3

Sz occurring after 1wk of life assoc with irritability, bulging fontanelle, nuchal rigidity, opisthotonos, extensors rigidity..is mostly like due to?

Answer 3

Bacterial meningitis

Question 4

Sz occurring on DOL 2/3 in an otherwise well appearing neonate is most likely due to?

Answer 4

Benign familial Sz

Question 5

What is benign familial Sz?

Answer 5

An AD syndrome of unknown cause that is self limiting usu with in 6mths of life

Question 6

In a neonate with birth asphyxiation and e/o HIE what are the long term outcomes?
*persistence of neurological abnormalities 2wk post natal indicates a poor prognosis

Answer 6

Long term outcomes are based on the Sarnat classification:
Mild: hyper-alert, no Sz, normal muscle tone (100% normal devt)
Mod: obtunded, easily controlled Sz, prox muscle hypotonia (70% normal devt)
Severe: comatose, refractory Sz, gen muscle weakness (0% normal devt)

Question 7

Which part of the abd is pneumatics is intestinalis most commonly seen and why?

Answer 7

In the RLQ @ ileo ileo-colic junction because it’s the watershed zone of the mesenteric circ and therefore most vulnerable to ischemia.

Question 8

Linear branching lucencies overlying the liver on plain radiograph in a premature infant with abd distension is due to what?

Answer 8

Pneumatosis intestinalis due to NEC. Gas has tracked into the portal venous circ. assoc with severe NEC.

Question 9

What is physiologic anemia of the NB and when does it occur and why?

Answer 9

The normal/expected drop in Hb 8-12 wk s/p birth due to incr level of O2 at birth with subsequent drop in Epo and RBC production.

Question 10

Are there any differences in how premies manifest physiologic anemia? Explain?

Answer 10

Yes, physiologic anemia of prematurity is demonstrated by an exaggerated drop in Hb compared with term infants, it occurs earlier and reaches a lower level. Depth of the physiologic nadir is related to birth wt (lower bt wts reacheing lower Nadirs first)

Question 11

What is the most common metabolic Cx of polycythemia?

Answer 11

Hypoglycemia

Question 12

What is the most common cause of neonatal polycythemia?

Answer 12

Mat diabetes. The hyperinsulinemic state coupled with inadequate glucose intake just after birth accts for hypoglycemia among these infants. Hypoglycemia among other polycythemic NB (eg due to Twin-twin xfusions) is unknown

Question 13

Features of Vit E def? What is it’s role?

Answer 13

Edema, thrombocytosis, hemolysis. It’s a lipid soluble antioxidant and protects against damage to RBC membrane

Question 14

What are the anomalies assoc with infants of diabetic mothers?

Answer 14

1. Hypertrophic cardiomyopathy(septal hypertrophy and cardiomegaly). Most are asymptomatic, may have features if obstructive left heart failure. Usu resolves within 6mths
2. Polycythemia
3. Caudal regression
4. Hypoglycemia
5. Small left colon (usu transient and resolves spontaneously)

Question 15

What are the radio graphic features of RDS vs GBS pneumonia?

Answer 15

They are indistinguishable, typical findings are: b/l diffuse reticulonodular pattern with overlying air bronchograms.

Question 16

What are the risks to the fetus with tobacco exposure?

Answer 16

IUGR, low birth wt, placental insuff, placenta previa, placental abruption, incr morbidity and mortality, SIDS, incr risk of cleft lip, incr risk for asthma, otitis media, HTN

Question 17

A neonate had a broad, depressed nasal bridge, long philthrum, hypo plastic nails, maxillary hypoplasia, anteverted nares and short nose what was he likely exposed to in utero?

Answer 17

Barbiturates

Question 18

Double bubble sign on X-ray is associated with what dx? That child would likely have what syndrome

Answer 18

Duodenal atresia. Child likely has Down’s syndrome

Question 19

Exposure to cocaine in utero is assoc with what fetal anomaly?

Answer 19

Those caused by vascular disruption (b/c cocaine causes vasoconstriction): intracranial hemm, limb reduction defects, non duodenal intestinal atresia, gastroschisis, urinary tract abnormalities

Question 20

Isolated Chorio retinitis is mostly likely due to what?

Answer 20

Congenital Toxoplasmosis, likely acquired during 3rd trimester; these pt’s have in apparent disease at birth but go on to exhibit one of the following by adolescence: visual impairment due to chorio retinitis, learning disability, MR. Those infected during 1st trimester usu dev severe disease (hepatosplenomargaly, jaundice, thrombocytopenia, hydrocephalus, microcephaly, deafness, chorio retinitis)

Question 21

What are the eye findings assoc with TORCH infxns?

Answer 21

Toxo- chorioretinitis
Rubella- cataracts
CMV- chorio retinitis
Herpes- keratitis
Syphilis- keratitis