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1. PPS Board Prep_Mar > NEONAT > Flashcards

NEONAT Flashcards

1
Q

MC cause of morbidity among preterm infants

A. IVH
B. BPD
C. Sepsis

A

B.BPD

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2
Q

Most powerful predictor of BPD is _

A. AOG
B. Maternal infection
C. Genetic make-up

A

A. age of gestation

> as AOG increases, BPD decreases

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3
Q

Define:

Extreme PT
Early
Moderate
Late

Low BW
Very low BW

A

Extreme PT: <28wks AOG
Early: <32
Moderate: 32-34
Late: 34-36

Low BW: <2500g
Very low BW: <1500g

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4
Q

Benign, slate-blue well-demarcated areas of pigmentation seen over the buttocks, back and sometimes other parts of the body

A

Mongolian spots

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5
Q

Benign small, white papules on an erythematous base 1-3 days after birth and lasts as long as 1 week, containing eosinophils

A

Erythema toxicum

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6
Q

Benign vesiculopapular lesion around the chin, neck, back, extremities, palms and soles, containing neutrophils

A

Pustular melanosis
> lasts 2-3days

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7
Q

The ff are associated with large anterior fontanel except:

A. Trisomy 21
B. Hypothyroidism
C. Congenital rubella syndrome
D. Osteogenesis imperfecta
E. None

A

E. None

All are asstd w large anterior fontanel
Table 113.1

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8
Q

Pupillary reflexes are present after _

A. 24-25 wks AOG
B. 26-27th wks AOG
C. 28th-30th wks AOG

A

C. 28th-30th wks AOG

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9
Q

Renal vein thrombosis may present as _

A. hematuria, hypotension, thrombocytosis
B. hematuria, hypertension, thrombocytopenia
C. oliguria, hypertension, thrombocytopenia
D. Anuria, hypertension, thrombocytosis

A

B. hematuria, hypertension, thrombocytopenia

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10
Q

False negative APGAR Scores (3)

A
  1. Some full term infants
  2. Maternal acidosis
  3. High fetal cathecholamines

Table 113.3

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11
Q

Mechanism of heat loss in neonates

A

Hypothermia –> Norepi release –>
activate non-shivering thermogenesis by metabolism of brown fat
> Inc muscle activity and metabolism –> O2 consumption –> hypoxemia
> Pulmonary vasoconstriction –> hypoxia
> Increase glucose utilization –> hypoglycemia

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12
Q

Methods of heat loss (4)

A

Conduction
Radiation
Convection
Evaporation

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13
Q

Most frequent bacteria to colonize the UC

A

Staph aureus

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14
Q

NRP guide: 3 questions to ask regarding the baby at birth.

A

BTT
1. Breathing or crying?
2. Tone?
3. Term?

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15
Q

4 clinical criteria for asphyxia

A

CANM
1. Cord blood pH <7.0; metab or mixed acidosis
2. APGAR 0-3 for more than 5mins
3. Neurologic sequelae in the immediate neonatal period
4. Multiorgan system dysfx in the immediate neonatal period

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15
Q

MC GI emergency in the neonate

A

NEC

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16
Q

Risk factors for NEC

A

5 Is

  1. Immaturity
  2. Infection
  3. Ischemia
  4. Immunologic
  5. Intake
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17
Q

What is the effect on the fetus is the mom has a history of Grave’s disease?

A. Neonatal hypocalcemia
B. Hypothyroidism
C. Transient neonatal thyrotoxicosis
D. Transient neonatal myasthenia

A

C. Transient neonatal thyrotoxicosis
Transplacental passage of IgG thyroid-stimulating ab

18
Q

What is the effect on the fetus is the mom has a history of endemic goiter?

A. Neonatal hypocalcemia
B. Hypothyroidism
C. Transient neonatal thyrotoxicosis
D. Transient neonatal myasthenia

A

B. Hypothyroidism
iodine deficiency

19
Q

What is the effect on the fetus is the mom has a history of hyperparathyroidism?

A. Neonatal hypocalcemia
B. Hypothyroidism
C. Transient neonatal thyrotoxicosis
D. Transient neonatal myasthenia

A

A. Neonatal hypocalcemia
Maternal Ca crosses to fetus and suppress fetal PTH gland

20
Q

What is the effect on the fetus is the mom has a history of maternal phenylketonuria?

A. Neonatal hypocalcemia
B. Hypothyroidism
C. Transient neonatal thyrotoxicosis
D. microcephaly, MR

A

D. microcephaly, MR
elevated fetal phenylalanine values

21
Q

The most serious complication of chronic oligohydramnios is:
A. Sepsis
B. Neonatal pneumonia
C. Pulmonary hypoplasia

A

C. Pulmonary hypoplasia

22
Q

Most accurate method of assigning gestational age

A. by LMP
B. by Assisted reproductive technique

A

B. by Assisted reproductive technique
with EDD after 266 days after conception

23
Q

Normal NST result?

A

Reactive= Normal
> 2 FHR accelerations
> at least 15bpm from baseline
> lasting 15 secs
> during 20mins monitoring

24
Q

First line treatment of opioid dependence in pregnancy

A. Methotrexate
B. Methadone

A

B. Methadone

25
Q

MC congenital lung lesion

A. TTNB
B. CPAM
C. PPHN
D. Atelectasis
E. Pneumothorax

A

B. CPAM (Congenital pulmonary airway malformation)
prev known as congenital cystic adenomatoid malformation

26
Q

In Twin-twin Transfusion Syndrome, who is the arterial and venous side?

A

Arterial - Donor
Venous - Recipient

The artery of the donor drains in the venous system of the recipient twin

27
Q

Recommended guideline for early enteral nutrition for preterms

A

Protein: 2g/kg in the first 24hrs after birth with a goal of supplying at least 3.5g.kg in 24-48hrs

28
Q

Volume of trophic feeds

A

Trophic feeding: Low-volume, hypocaloric feeds
> 10-20cc/kg/day

Advancing feeds:
VLBW: 20-30cc/kg/day
ELBW: 15-25cc/kg/day

29
Q

TRUE or FALSE. Not all IUGR are SGA and not SGA are IUGR

A

True

30
Q

MC fracture of the skull in neonates

A. Linear
B. Comminuted
C. Depressed fractures
D. Ping pong fracture

A

Linear fractures
> No symptoms, no treatement

Depressed fractures - ping pong ball dents
> complication of forceps delivery or fetal compression
> Some may elevate spontaneously or some require treatment
> Use of breast pump or vacuum extractor may obviate the need for neurosx interventiono

31
Q

A collection of blood beneath the aponeurosis that covers the scalp and serves as the insertion of the occipitofrontalis muscle

A. Caput
B. Cephalhematoma
C. Subgaleal hemorrhage

A

C. Subgaleal hemorrhage

32
Q

Subperiosteal hemorrhage limited to the surface of one cranial bone.

A. Caput
B. Cephalhematoma
C. Subgaleal hemorrhage

A

B. Cephalhematoma

resorbed within 2wks to 3mos

33
Q

Recommended period to perform cranial UTZ on all preterms <32wks AOG.

A. First 24-48hrs
B. First 5 days
C. 3-7 days
D. at 7 days

A

C. 3-7 days
> 75% of lesions are detected during this period
> Ffup UTZ at 36-40wks PMA

34
Q

Most sensitive imaging modality for detecting hypoxic brain injury in the neonate.

A

MRI

35
Q

Therapeutic hypothermia golden period.
Core or esophageal temp?

A

Therapeutic hypothermia should begin in the first 6 hrs and maintained for 72hr, by head or systemic cooling.
Temp of 33.5degC

36
Q

Most frequently fractured bone during labor and delivery

A

Clavicle

* no specific treatment
* immobilize the affected side for comfort
* absent Moro reflex, infant not moving that arm freely
37
Q

Appropriate therapies for mixed and obstructive apnea

A

NCPAP (nasal continuous positive airway pressure) 3-5cm H2O
HHHFNC (heated humidified high flow nasal cannula)

38
Q

Common complication of BPD

A

pulmonary hypertension

39
Q

General contraindications for indomethacin and ibuprofen treatment in PDA closure. (5)

A
  1. Thrombocytopenia <50,000plt/m3
  2. active hemorrhage (severe IVH)
  3. NEC or intestinal perforation
  4. Oliguria (UO <1cc/kg/hr)
  5. elevated plasma Crea (>1.8mg/dL)
40
Q

Most frequent sites of NEC

A

Distal ileum and proximal colon

41
Q

The ff are MAJOR risk factors for the development of severe hyperbilirubinemia EXCEPT

A. Previous sibling with jaundice
B. Previous sibling received phototherapy
C. Cephalhematoma
D. Exclusive breastfeeding

A

A. Previous sibling with jaundice
> minor risk factor
Table 123.2

42
Q
A

1. PPS Board Prep_Mar (16 decks)

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