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NICU > ID and Endo > Flashcards

ID and Endo Flashcards

1
Q

MCC of EOS and LOS in term? EOS in VLBW?

A
  • EOS: GBS, E. Coli, strep
  • LOS: CONS, E. Coli, staph
  • VLBW: E. Coli
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2
Q

Chocolate like amniotic fluid?
What does placenta have?
What other associated physical findings?

A

Listeriosis
micro-abscesses
discoloration/jaundice around umbilicus, granulomatosis infantisepticum

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3
Q

What is the rubella triad?
Late manifestations of rubella?
bones and eyes?

A
  • cataracts, hearing loss, and CHD (PPS or PDA)
  • thyroid disease, DM, and immunodeficiency
  • celery stalking of bones and salt and pepper retinopathy
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4
Q

Classic triad for toxo?
Transmission during pregnancy?
When do they present?
Treatment?

A
  • chorioretinitis, intracranial calcifications, and hydrocephalus
  • Risk of transmission greatest in later pregnancy, but disease is worse if transmitted early
  • preterm infants at ~3 months, term later
  • pyrimethamine and sulfadiazine AND folate x1 year
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5
Q

Treatment for omphalitis?

A

vancomycin and cefotaxime

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6
Q

When does T4 synthesis begin in fetus?

A

14 weeks (T4 14)

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7
Q

When does the fetal thyroid begin to take up iodine?

A

10 weeks (10dine)

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8
Q

What is the most common system involved with hypothyrodism?

A

cardiac

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9
Q

About what % of infants affected with toxo will have visual/learning disabilities?

A

80%

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10
Q

When is C-section indicated for HIV+ mom?

A

viral load >1000

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11
Q

When does TSH peak?

A

30 minutes after birth?

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12
Q

Primary thyroid hormone in fetus?

A

rT3

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13
Q

When does PTH peak?

A

48 hours (follows calcium decrease after delivery, nadirs at 24 hours of life)

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14
Q

Which 2 adrenal hormones are not produced by the fetus?

A

3B-HSD and aromatase are produced by the placenta

    • limited cortisol production before 30 weeks
    • if placenta is deficient in aromatase and fetus is female, they have ambiguous genitalia d/t too much testosterone –> mother gets hirsuitism
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15
Q

Which of the following is NOT used to monitor hydrocort/fludrocort dosing in CAH?
- blood pressure, linear growth, bone age, hand/wrist X-rays, renin, aldosterone, ACTH, andostenedione

A

ACTH

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16
Q

What two lesions will culture negative

A

Chlamydia and SSSS

17
Q

In what infectious condition do you give steroids as an adjunct for meningitis treatment?

A

TB

18
Q

electrolyte abnormality with ampho B?

A

hypomagnesemia (think of it if you start ampho B after SIP and see seizures)

19
Q

What are 4 causes of undervirilized male? 4 causes of overvirilized female?

A

male: 3 beta, 5 alpha, 17 (both alpha and beta), AIS
female: 3 beta, 11 beta, 21 alpha, aromatase deficiency

20
Q

What viruses are dsDNA? ssDNA?

A

dsDNA: CMV, HBV, HSV, VZV
ssDNA: parvo

everything else is ssRNA

21
Q

Which of the following is increased in preterm compared to term: T4, T3, TBG, thyroglobulin?

A

thyroglobulin

22
Q
  • What stimulates Wolffian duct differentiation?
  • What stimulates Mullerian duct regression?
  • What stimulates formation of scrotum and penis in 1st trimester?
  • What stimulates phallic enlargement and testicular descent in 2nd trimester?
A
  • Testosterone (formed by leydig cells and driven by placental hcg)
  • MIS
  • hCG (1st trimester)
  • LH (2nd trimester)
23
Q

Which one of the following is NOT used to evaluate an undervirilized male:
MIS, testosterone, DHT, LH, FSH, renin

A

renin (use in CAH)

24
Q

Where does the wolffian duct come from?

Where does the mullerian duct come from?

A

Wolf: mesonephros
Muller: paramesonephric duct

25
Q

MCC of conjunctivitis in the first month of life?

A

chlamydia

26
Q

Between gonorrhea and chlamydia:

  • which one is prevented with erythro ppx?
  • which one presents earlier?
  • how to treat each?
A
  • gonorrhea is prevented with erythro
  • gonorrhea at 2-5 days, chlamydia 5-14 days
  • gonorrhea: CTX IV
    chlamydia: erythromycin PO
27
Q

gram pos/neg cocci/rod?

  • clostridium
  • TB
  • GBS
  • Listeria
  • pseudomonas
A
  • clostridium: gram positive rod
  • TB: acid-fast rod
  • GBS: gram positive diplococci
  • Listeria: gram positive rod
  • pseudomonas: gram negative rod
28
Q

what radiographs do you do for vitamin D deficiency?

A

anterior knee less than three

hand/wrist if >4 years

29
Q

25 hydroxy vs. 1,25 dihydroxy - what is low in vitamin D deficiency?

A

25 hydroxy

30
Q

syphilis tests

A

Non-treponemal tests: RPR/VDRL

    • Sensitive not specific
    • Need to be confirmed with treponemal tests
    • Quantitative - assess activity, medications response

Treponemal tests - MHA-TP, FTS-ABS

    • Confirmatory: identify spirochete in skin lesions, placenta, umbilical cord, snuffles at autopsy
    • Qualitative - once+ always+
    • Presumptive dx - CSF+ VDRL, RPR/VDRL > 4 times maternal titer, IgM+, clinical symptoms
31
Q

why do DiGeorge infants have hypocalcemia?

A

they have absent parathyroid glands –> low PTH –> low calcium

32
Q

How is the RAA pathway stimulated?

A

decreased blood volume –> decreased blood flow to kidney –> juxtaglomerular cells sense decrease –> increase in renin

33
Q

What are calcium, phos, and 1,25OH levels in MBD?

A

normal Ca/Phos, elevated 1,25OH

34
Q

What is most threatening symptom of enterovirus

A

myocarditis

35
Q

Liver hemangioma can cause what?

A

consumptive hypothyroidism (converts T3 back to rT3)

36
Q

Hyperinsulinism treatment?

A

Diazoxide (monitor for pulm edema and neutropenia)

37
Q

HSV:

  • what L&D intervention increases risk?
  • What type is most common, less common, least common?
  • When does each present?
A

Fetal scalp monitor increases risk

Disseminated 7-10 days (least common)
SEM presents 5-14 days (most common)
CNS 15-21 days (less common)

CNS has retinitis and encephalitis

38
Q

Testosterone is made in ______, stimulated by these two things

A

made in leydig cells, stimulated by hcg and LH

39
Q

Rubella, syphilis, toxo infectious patterns?

A

Rubella: U-shaped (worse at beginning and at end)

Toxo and syphilis: worse if acquired at beginning, more common to be acquired at the end

NICU (16 decks)

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