MTB 1 Flashcards
Causes of conjunctivitis in newborns day 1?
Chemical irritation
Causes of conjunctivitis in newborns days 2-7?
Neisseria Gonorrhea
Causes of conjunctivitis in newborns 7-20 days?
Chlamydia trachomatis
Causes of conjunctivitis in newborns more than 21 days?
HSV
How does HSV Keratitis present?
Pain photophobia decreased vision dendritic ulcer Minute clear vesicles in corneal epithelium
What is the tx for Neisseria G. conjunctivitis in NB?
IV/IM Cefrtiaxone or Cefoxamine
Complication that arises from Neisseria conjunctivitis in NB?
Corneal perforation
Permanent blindness
What is the tx for chlamidya trachomatis conjunctivitis?
Oral Erythromycin
What is the cause of worldwide blindness?
Trachoma
-Serotypes A-C
4 YO immigrant boy presents w conjunctivitis
Trachoma
Tx for trachoma
topical tetracycline
oral azithromycin
What do you see in trachoma in the active phase?
Follicular conjunctivitis
Pannus (neovascularization) in cornea
How does a neonate with Vit K deficiency present?
Bleeding from GI tract, belly button, urinary tract
Hemorrhagic dz of NB
What is Ppx tx for Vit K Def?
1 IM dose of Vit K
What is the most common test for PKU?
- Blood for Phenylalanine
2. Guthrie test - qualitative test (coloration)
What does the Guthrie test detect?
Presence of metabolic products of phenylalanine in urine
When do we vaccinate pre term babies? CA or GA?
Chronological Age Unless wt is < 2 kg - Can’t do Hep B
Which children get Hep B vaccine?
All
Which children get Hep B Ig (HBIG)?
Children w HBsAg-positive mothers
When will we see increased circulating RBCs in NB?
Transient polycythemia of NB
- Hypoxia during delivery stimulates EPO -> Increased RBCs
How does NB’s Hb normalize after transient hypoxia?
NB’s first breath increases O2, dropping EPO, normalizing
Is splenomegaly pathologic in NBs?
No. It is normal
What aids in removing fluid from lungs during delivery?
Compression of rib cage when passing thru mother’s vaginal canal.
C-section NBs may have excess fluid and be hypoxic
When is tachypnea considered sepsis in NB?
When it lasts more than 4 hours
Sepsis in NB workup
Blood and urine cultures
When is vaginal spotting/bleeding in female infant normal? Why does it occur?
Less than 3 months b/c of maternal estrogen crosses placenta, entering fetal circulation before birth causing a pubertal effect in NB. Disappears once hormone has been cleared
Why do we see transient hyperbilirubinemia in NB?
Infant’s spleen removing excess RBCs that carry HbF
Excess breakdown of RBCs -> physiological release of Hb -> rise in BR
Caput succedaneum
Swelling of soft tissues of scalp that do cross suture lines
Cephalohematoma
Subperiosteal hemorrhage that do NOT cross suture lines
MC skull fx in NB?
Linear
Most fatal skull fx in NB?
Basilar
What is shoulder dystocia of NB?
After delivery of fetal head, anterior shoulder gets stuck behind pubic bone
How does Erb Duchenne Palsy present?
Unable to abduct shoulder or externally rotate or supinate arm
What part of brachial plexus does Erb Duchene affect?
C5-C6
Tx for Erb Duchenne?
Immobilization
What is Klumpke paralysis? How does it present?
C7-C8/T1 injury
Claw hand - lack of grasp reflex
Paralyzed hand w/Horners
Tx for Klumpkes?
Immobilization
Best Dx test for Clavicular Fx in NB?
Xray
Tx for Clavicular Fx in NB?
Immobilization
Splinting
PT
Tx for Clavicular Fx in preterm breast fed NB?
First 6 mos = supplement w Vit D and Iron until 1 yoa
What palsy is ass’d with forceps delivery?
Facial N palsy
How much of amniotic fluid is made by mom? By baby?
80% mothers plasma
20% baby swallows, absorbs, filters, urinates
What are causes of polyhydramnios?
Neuro: Werdnig-Hoffman = infant unable to swallow
GI: Intestinal Atresi
What are causes of oligohydramnios?
Prune belly = lack of abdominal muscles, can’t bear down and urinate
Renal agenesis = Potter syndrome
Flat facies due to high atmospheric pressure = compresses fetus
What is the tx of prune belly?
Serial Foley catheter
Risk of UTI
How does oligohydramnios present
No vertical pocket of amniotic fluid
> 2 cm or AFI <5cm
Risk factor for oligohydramnios
How do we monitor
Prolonged pregnancy > 42 wks
Monitor with US 2x/week
Bowel sounds heard in the back of NB?
Diaphragmatic hernia
What is a Diaphragmatic hernia?
Hole in the diaphragm that allows abdominal contents to move into the thorax
What does CXR show in Diaphragmatic hernia?
Air fluid levels
Two types of Diaphragmatic hernia?
Midline: Morgagni
Bochdalek: Bilateral
