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PEDIA > M1: Issues Unique to the Newborn > Flashcards

M1: Issues Unique to the Newborn Flashcards

0
Q

Newborn Mortality: severe immaturity

A

Preterm

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1
Q

Newborn Mortality: placental insufficiency

A

Fetal

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2
Q

Newborn Mortality: Respiratory distress syndrome

A

Preterm

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3
Q

Newborn Mortality: congenital anomalies

A

Fullterm

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4
Q

Newborn Mortality: intrauterine infection

A

Fetal

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5
Q

Newborn Mortality: severe congenital malformations

A

Fetal

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6
Q

Newborn Mortality: birth asphyxia, trauma

A

Fullterm

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7
Q

Newborn Mortality: intraventricular hemorrhage

A

Preterm

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8
Q

Newborn Mortality: Congenital anomalies

A

Preterm

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9
Q

Newborn Mortality: infection

A

Full term & Preterm

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10
Q

Newborn Mortality: umbilical cord accident

A

Fetal

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11
Q

Newborn Mortality: abruptio placenta

A

Fetal

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12
Q

Newborn Mortality: meconium aspiration pneumonia

A

Fullterm

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13
Q

Newborn Mortality: necrotinizing enterocolitis

A

Preterm

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14
Q

Newborn Mortality: persistent pulmonary hypertension

A

Fullterm

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15
Q

Newborn Mortality: bromchopulmonary dysplasia

A

Preterm

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16
Q

Newborn Mortality: hydrops fetalis

A

Fetal

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17
Q

RDS type II. Prematures or term infants. Delayed absorption of respiratory fluid. Onset is early. Tachypnea with grunting or reactions, cyanosis. Difficult to differentiate from mild RDS. Feeding withheld.

A

Transient Tachypnea of the NB

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18
Q

TTNB CXR: increase pulmonary markings, __________.

A

Overaeration

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19
Q

Tx for TTNB

A

Oxygen by mask or hood

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20
Q

Recovery period of TTNB

A

3-4 days

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21
Q

Hyaline membrane disease. Common in premature. 60-80%

A

Respiratory Distress Syndrome

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22
Q

Within minutes of birth. Peak within 3 days.

A

BS, fine rales

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23
Q

RDS CXR: ______ glass, reticulogranular, air bronchogram; appears _____ hours.

A

Ground. 6-12.

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24
Q

ABG result of RDS

A

Respiratory-metabolic acidosis, hypoxemia

25
Q

Is standard of car in women with preterm labor of up to 34weeks

A

Antenatal steroids

26
Q

For intratracheal instillation every 6-12 hrs for 2-4 doses

A

Exogenous surfactants

27
Q

Basic defect in Tx: decrease exchange of _________.

28
Q

RDS has high risk for

A

Pneumothorax

29
Q

Common complication of RDS

30
Q

10-15% of births. Stained. Term or post term. MAS in 5%. 30% mechanical ventilation, 3-5% expire. Tachypnea, retractions, grunting & cyanosis. Partial obstruction of some airways may lead to pneumothorax.

A

Meconium Aspiration

31
Q

Meconium Aspiration usually improves within

32
Q

Meconium stain CXR: patchy _______, course streaking BLF, anteroposterior diameter & ________ of diaphragm.

A

Infiltrates. Flattening.

33
Q

Prevention for Meconium aspiration

A

Careful anticipation

34
Q

Treatment for meconium stain

A

Supportive care & mgt of RDS

35
Q

Prognosis of Meconium Aspiration: depends on CNS injury from ________.

36
Q

Is observed during the first week of life in 60% term infants & 80% preterm infants. When the rate of bilirubin production exceeds the rate of elimination, the end result is an increase total serum bilirubin(TSB) _________. Accumulation of bilirubin in the skin, sclera & mucosa.

A

Jaundice. Hyperbilirubinemia.

37
Q

Risk Factor of Jaundice: a sibling with neonatal _______ or _______.

A

Jaundice. Anemia.

38
Q

Risk Factor of Jaundice: Unrecognized _______ (ABO, Rh)

39
Q

Risk Factor of Jaundice: nonoptimal ________ (bottle or breastfeeding)

40
Q

Risk Factor of Jaundice: deficiency of _______.

41
Q

Risk Factor of Jaundice: Infection. Infant of ______ mother. Immaturity.

42
Q

Risk Factor of Jaundice: __________. East asian, __________.

A

Cephalohematoma. Mediterranean.

43
Q

Jaundice is higher in populations living at

A

Higher altitudes

44
Q

Benign neonatal bilirubinemia. Nonpathologic condition due to increased bilirubin production and limited elimination. 17-18mg/dL

A

Physiologic Jaundice

45
Q

Exclusion criteria Physiologic Jaundice: jaundice persisting _______(full term)

46
Q

Occurs within 1st week of life. 12.9% incidence. Bilirubin level >12mg/dL.

A

Breastfeeding Jaundice

47
Q

Occurs after 1st week of life. 2-4% incidence. Bilirubin >10mg/dL at 3 weeks.

A

Breastmilk Jaundice

48
Q

Among the infants with jaundice appearing on day 4 & 7 of life, _________ was more common cause, occurring in 50% of cases.

A

BM jaundice

49
Q

ABO incompatibility. G6PD. Sepsis. Infants of diabetic mothers. Visible jaundice 5-7mg/dL. TSB levels >12mg/dL appear jaundiced.

A

Unconjugated Hyperbilirubinemia

50
Q

Unconjugated HyperB Dx: total ______ bilirubin

51
Q

Unconjugated HyperB Dx: blood type & ____ status

52
Q

Unconjugated HyperB Dx: ______ & differential

53
Q

Unconjugated HyperB Dx: detects antibodies bound to the surface of RBC. Usually + in hemolytic disease. Does not correlate w/ severity of jaundice. Can be obtained from the cord blood.

A

Coombs test

54
Q

Elevation suggests hemolytic disease. Can also be elevated in cases of occult or overt hemorrhage.

A

Reticulocytes

55
Q

Management of Unconjugated H with side effect of bronze baby syndrome

A

Phototherapy

56
Q

Management of Unconjugated H when the risk of kernicterus is significant

A

Exchange transfusion

57
Q

Management of Unconjugated H pharmacologic therapy. Enhances bilirubin secretion.

A

Phenobarbital

58
Q

In Unconjugated H, presence of this suggests the prognosis is bad. There is neuronal dysfunction and death.

A

Kernicterus

59
Q

Increase in polyhydramnios, preeclampsia, pyelonephritis, preterm labor & chronic HPN. Usually LGA. Mortality rate is >5%. Clinical manifestations are large & lump, puffy plethoric facies, hypoglycemia, hypocalcemia, jittery, tremulous, tachypnea, inc RDS, cardiomegaly, birth trauma & congenital anomalies.

A

Infant of Diabetic Mother

60
Q

Treatment of Infant diabetic mother: ________ within 1hr & every 6-8hrs.

A

Blood glucose

61
Q

Treatment of Infant diabetic mother: _________ feeding soonest

A

Oral or gavage

PEDIA (3 decks)

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