NEONAT Flashcards
Anemia in a newborn is defined as:
a. Hbg below normal values in healthy individuals
b. RBC below normal values in healthy individuals
c. Platelets below normal values in healthy individuals
d. RBC as well and destruction of WBC
Hbg below normal values in healthy individuals
When does physiologic anemia of infancy occur?
6-8 weeks
What is the manifestation of anemia in the newborn period?
Pallor
In patient with anemia, at what hemoglobin level do clinical findings become apparent?
<7
Patient is lethargic, anorexic and systolic murmur. Most likely the hemoglobin levels dropped to what level?
5
What is the condition in which a patient compulsively eats items that have no nutritional value seen in patients with iron deficiency anemia (IDA)?
pica
Louie, who has iron deficiency anemia, is irritable and has poor appetite, his Pediatrician gave iron oral supplements, when will his condition improve?
12-24 hours
What is the normal survival time of red blood cells?
110-120 days
Which of the following best describe as an early onset of neonatal infection?
a. Occurs in the first week of life
b. Organism acquired in the hospital
c. Present with candidemia
d. Manifest with malignant hyperthermia
Occurs in the first week of life
Which of the following best describe as an late onset of neonatal infection?
a. Occurs around 6 weeks of hospital stay
b. Occurs in the organism acquired in the post natal period
c. Included organism acquired transplacentally
d. Infection can be acquired from maternal UTI
Occurs in the organism acquired in the post natal period
What are considered sensitive indications of sepsis tend to be late findings?
Poor perfusion and hypotension
Most effective prevent strategy for prevention of NEC.
Human Milk
Which is diagnostic radiologic finding for NEC?
Pneumatosis intestinalis
A 3 day old infant was transferred and room in with the mother from NICU after observation for TTN. Her condition improved and now for room in with the mother. The pediatrician now requests direct breastfeeding as shown below. How will you assess the attachment?
Poor attachment
A Filipino newborn baby boy 38 weeks neonatal age delivered via CS from an uncontrolled diabetic mother. He weighs 4000g, length of 52cm and head circumference of 40, has ____. (Plot the anthropometric measurements to the chart)
Large for gestational age
Correct positioning of breastfeeding will be:
a. Ear, shoulder and hip will be straight line
b. Baby’s head facing mothers arm
c. Tummy of mother touches with chest of baby
d. Mothers breast is well supported
Ear, shoulder and hip will be straight line
Newborn baby born from a low risk mother. What should be the appropriate procedure to performfirst health worker /physicians do after birth.
Put the baby on mother’s chest and dry the baby
According to EINC program when is the best time to cut or clamp the umbilical cord of the newborn without complications?
when cord pulsation stops
All of the following are early cues for early feeding, EXCEPT
a. Stirring
b. Rooting
c. Mouth opening
Stirring
A senior medical clerk attended a delivery of full term neonate due to cephalopelvic disproportion. After immediate and thorough drying. What will be the next step in EINC guidelines?
Cord clamping
Baby girl c born in an uncontrolled diabetic mother. What are the laboratory parameters monitored with infant with diabetic mother.
Capillary blood glucose
Route of administration of BCG Vaccine
Intradermal
An intern assisted the resident pediatrician in receiving a normal spontaneous vaginal delivery. The mother had no maternal illnesses and comorbidities. The newborn neonate had a good cry but was noted to have tachypnea and subcostal retraction shortly after birth. The ballard score was at 32 weeks AOG. What was the cause of the respiratory distress of the neonate?
RDS
Where is the most ideal site to administer the Hepatitis B vaccine in newborns?
anterolateral aspect of the vastus lateralis muscle
Term infant birthweight 2000g
Low for gestational age
When should a health care provider give the vit K. injection and other immunizations based on the EINC guidelines.
After the first full term breast feeding
Burnt sugar smell of urine
Maple Syrup urine disease
Branched chain ketoacid dehydrogenase deficiency.
MSUD
Patient was noted to have jaundice. The newborn screening exam results were positive but the mother cannot recall the results. During PE it was noted that patient had hepatomegaly, vomiting, hypoglycemia with cataract. Blood culture for sepsis was ordered and E.coli was noticed. What is the inborn error of metabolism?
Galactose-1-phosphate uridyl transferase
Which substance has the potential to cause hemolysis?
naphthol/naphthalene
KMC except
a. all mothers with small babies must do the KMC
b. If the mother is willing to lactate and breastfeed
c. if the baby is less than 2500g
d. the neonate can be handled with or without
feeding
all mothers with small babies must do the KMC
How BCG is given?
intradermal
The palmar grasp is fully developed at 32 weeks and will last until ______ postnatally
2-3 months
A newborn infant was born via forceps extraction. On the examination of the skull, there was a note of fine tense mass with palpable rim on the right parietal area, the infants most probably have
Cephalhematoma
5-day old newborn, hyperemia on conjunctivae, best treatment?
No treatment
Preterm infants who are prone to have IVH. When is the best time to do CT Scan?
3-7 days
A newborn was delivered via CS. During delivery, the baby was limp and bradycardic. Resuscitation was done still no response to stimuli. No moro reflex, pupils were irregular and poor reaction to light, decebrate seizure. What stage of Hypoxic-Ischemic Encephalopathy?
Stage 3
Among the patients with HIE with poor outcome, what is the expected complication
Hypoxia
A 3-day-old infant with macrosomia and have difficulty in extracting via normal delivery noted adducted left arm and internally rotated with pronation forearm. Moro reflex is absent on the left arm. On palpation, you noted crepitus sound in the clavicular area. What is the type of injury?
Erb-duchenne paralysis
Transient Tachypnea of the Newborn (TTN) is associated with:
Ineffective expression or activity of ENaC and Na~, K+-ATPase
What is the appropriate initial management of respiratory distress syndrome (RDS) ?
Nasal continuous positive airway pressure (nCPAP)
Which of the following mechanism is responsible for the signs and symptoms in patients with Meconium Aspiration Syndrome (MAS) ?
Airway obstruction
Josie, a 3 day old infant is diagnosed with meconium aspiration syndrome. What will be the expected chest x ray findings?
Coarse streaking of both lung fields
In the case of PPHN, the most potent pulmonary vasodilator is?
Oxygen
Shiela, a newborn baby is treated with neonatal pneumonia due to tachypnea and chest retractions but with adequate oxygenation. What is the appropriate management for her?
IV antibiotics
Baby Girl B was born 38 weeks by amenorrhea to a 30-year-old primigravida with no known comorbidities during pregnancy and adequate prenatal care. She had an unremarkable perinatal course and was able to breastfeed well. On the 3rd day of life, she was noted to have jaundice over the face. What type jaundice does Baby B have?
Physiologic jaundice
At 3 days old Baby D presents with jaundice up to soles and icteric sclerae. When is the best time to start phototherapy?
Wait serum bilirubin before starting phototherapy
Breastfeeding jaundice occurs in the first few days of an infant’s life. It takes a few days to establish an adequate amount of breastmilk, thus, breastfed infants receive lesser amounts of calories during this period. What will increase in decreased caloric intake in affected infants.
Enterohepatic circulation of the bilirubin
Prevent increase bilirubin
Early and frequent feeding
Most common clinical manifestation of Late onset Group B streptococcus infection.
Meningitis
Which organism causes transplacental transmission within the 1st and 3rd week period / trimester?
Toxoplasmosis
Intraventricular hemorrhage occur to preterm infants due to
Cerebral blood flow is decreased
A 12 hour old roomed in male infant present with bilateral conjunctivitis.The next best step in the management is to?
Begin systemic antibiotic therapy with ceftriaxone
Which of the following immunoglobulin crosses the placenta?
IgG
A 2-week-old infant was rushed to the hospital due to a fever. A lumbar puncture was performed and the CSF examination came back with a WBC Differential of 50,000 cells/mm3. What is the most likely cause of the disease?
E. coli
A 2-day-old infant presents with erythema, foul-smelling discharge, and swelling of the umbilical cord. What is the diagnosis?
Omphalitis
2-month-old girl had Ileal atresia and ——. Now she has a Hemangioma on her left shin that’s rapidly growing. What other condition is associated with this?
Anemia
Which of the following is LEAST likely related to polycythemia?
a. Thrombocytpenia
b. Hypoglycemia
c. Hypocalcemia
d. Hypoxia
Hypocalcemia
Classic hemorrhagic disease of the newborn is characterized by which of the ff?
a. Inadequate Vitamin K stores and intake
b. More common in girls than boys
c. More common during the colder months
d. Asymptomatic unless the infant undergoes an invasive procedure
Inadequate Vitamin K stores and intake
Which of the following is the most common hemoglobinopathy?
a. Alpha Thalassemia
b. Beta Thalassemia
c. Hemoglobin E
d. Hereditary spherocytosis
Hemoglobin E
The most likely mechanism involved in physiologic jaundice is decreased ___.
Bilirubin conjugate
Which of the following LEAST likely limit the efficacy of Phototherapy?
a. Blue-green spectrum (note: not the exact sentence)
b. Distance between the light and infant(note: not the exact sentence)
c. Rate of hemolysis(note: not the exact sentence)
d. Surface area of the exposed skin(note: not the exact sentence)
Blue-green spectrum
The most likely laboratory results in infant with vitamin K deficiency are:
Normal platelet, Inc PT, Normal PTT
Most common heart failure symptom in newborn
Feeding difficulty
Which of the following findings in the skin is considered abnormal in the newborn?
a. Acrocyanosis
b. Harleyquin color change
c. Mongolian spot
d. Amniotic band
Amniotic band
A female newborn baby diagnosed with down-syndrome was born prematurely. What inborn error of metabolism is associated with this condition?
Congenital Hypothyroidism
What mechanism is responsible for the signs and symptoms of meconium aspiration syndrome?
Bronchial constriction
A newborn female was diagnosed with Down Syndrome delivered preterm. What most common inborn errors of metabolism is involved?
Congenital Hypothyroidism
According to Neonatal Resuscitation guidelines, who among the following requires extensive suctioning of the mouth and nose of new born
Meconium stained amniotic in a non-vigorous baby
4 year old male admitted because of jaundice up to abdomen. It work up is done, which is likely to help with the diagnosis
Ballard score
4 year old male admitted because of jaundice up to
abdomen. It work up is done, which is likely to
help with the diagnosis. What is the treatment of choice?
Double phototherapy
Should the mother withhold the breast feeding?
No
Greatest risk in indirect hyperbilirubinemia
Bilirubin induced neurologic dysfunction
Boy, delivered 39 weeks AOG, CS, secondary to cervical dilation. Noted nasal flaring and grunting 30 mins after birth with progressive tachypnea. Xray finding of this condition. (TTN)
Fluid in fissure
39-week AOG, grunting, APGAR 1, 5 mins, 7 or 9 respectively.
Transient tachypnea
Term neonate, cyanosis, nasal flaring and retractions soon after birth. Upon inspection, increased chest wall diameter, and scaphoid abdomen. Auscultation of the chest shows heart sounds at the right side of the chest.
Congenital diaphragmatic hernia
Which is most likely the cause of excessive high pulmonary vascular resistance after birth?
Right to Left shunt
What is the least likely to seen in newborn
a. heart rate of 80 bpm
b. irregular abdominal respiration in between 30-60
c. present Moro reflex
d. uneven head size
heart rate of 80 bpm
Physiologic Jaundice in Newborn Infant is considered?
A bilirubin level of 5 mg/dl or less and visible on the 2nd to 3rd day of life
1 year old term infant with superficial swelling at the parietotemporal region that DO NOT CROSS the sutures?
Cephalohematoma
Which of the following is the risk factor for RDS?
a. Cesarean section
b. Antenatal corticosteroid
c. Term birth
Cesarean section
A term baby girl 4.4 Kg, GA 41, Meconium stained, grunting, retractions, RR (80 but not sure) Temp 37.2.
Meconium aspiration Pneumonia
Which of the following will present with direct hyperbilirubinemia.
a. Rh incompatibility
b. Twin to twin transfusion
c. G6PD deficiency
d. Galactosemia
Galactosemia
Spooning of the nails is an indication that the patient might have which of the following
IDA
What is the most recognizable feature of iron deficiency anemia?
PALLOR
A neonate w/ worsening erythema in the umbilicus for 2 days came in for consult. The mother kept the area clean and dry. However, the newborn appears less active and has temperature instability. There was a purulent discharge from the umbilical cord and skin eythema surrounding the cord. What is the dx of this infant?
Omphalitis
Baby boy C was born 35 weeks by amenorrhea to a severly pre-eclampic mother. His borthweight is 1500grams. He was placed on NPO for 24 hrs due to polycythemia. On the 2nd day of life, he presented with jaundice up to the lower extremities. What risk factors for severe hyperbilirubinemia are present in Baby C?
Small for gestational age
Shiela, a newborn baby is treated with neonatal pneumonia because of tachypnea and chest retractions but adequate oxygenation. What is the appropriate management for Shiela’s condition?
IV ampicilin and gentamycin
Respiratory distress syndrome (RDS) is secondary to:
Decreased production and secretion of surfactant
Noe delivered prematurely from a hypertensive mother. Upon delivery she was noted to cry vigorously, with active movement of extremities and cyanotic sols. Her HR ranges from 150-160/min. What will be the APGAR Score at 1 min?
9
