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Co-Exisiting Disease 2 > Neonatal > Flashcards

Neonatal Flashcards

1
Q

Organogenesis time frame?

A

1-8 wks

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2
Q

Organ function time frame?

A

2nd trimester

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3
Q

Body mass time frame?

A

3rd trimester

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4
Q

APGAR is based on infant’s condition at what times after birth?

A

1 and 5 min

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5
Q

Does APGAR score make long term prediction on child’s health?

A

NO

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6
Q

APGAR stands for?

A 
Appearance 
Pulse 
Grimace 
Activity 
Respiration
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7
Q

APGAR score of 2 for each category?

A 
A: no cyanosis
P: >100
G: cry or pull away when stimulated 
A: flexed arms and legs that resist extension 
R: strong, lusty cry
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8
Q

APGAR score above 7?

A

Normal

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9
Q

Is transient cyanosis common?

A

Yes

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10
Q

What is the purpose of the APGAR test?

A

To determine quickly whether a newborn needs immediate medical care

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11
Q

VC compared to adult?

A

Half

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12
Q

Respiratory rate compared to adult?

A

2x

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13
Q

Metabolic rate compared to adult?

A

Higher

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14
Q

Lung compliance compared to adult?

A

Decreased

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15
Q

Chest wall compliance compared to adult?

A

Greater

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16
Q

FRC compared to adult?

A

Decreased

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17
Q

Oxygenation, ventilation more effected by what 3 things?

A
  1. Opioids
  2. Barbs
  3. Gas
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18
Q

Alveoli compared to adults?

A

Not anatomically mature; reduce cross section area for gas exchange

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19
Q

What kind of breathers are neonates?

A

Diaphragmatic because poorly developed intercostal muscles

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20
Q

Do neonates desat quick?

A

YES

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21
Q

What does diaphragm look like compared to adults?

A

Flat, not domed

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22
Q

New born negative inspiratory pressures?

A

40-60 H2O (increased surface tension)

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23
Q

What 2 things are neonates prone to during anesthesia?

A
  1. Atelectasis

2. Hypoxemia

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24
Q

Use how much O2 compared to adults?

A

3x

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25
Q

Neonates have what percent increase in CO?

A

30-60%

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26
Q

Hemoglobin levels due to what?

A

High (about 17) due to fetal hemoglobin

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27
Q

CO2 response curve shift to what?

A

Right

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28
Q

Babies are those who are smaller in size than normal for the baby’s sex and gestational age, most commonly defined as a wt below the 10th percentile for the gestational age?

A

Small for gestational age (SGA)

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29
Q

When are alveolar sacs finally formed?

A

7 years of age

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30
Q

Apnea for more than how long lead to cyanosis?

A

15-20 secs

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31
Q

What bpm is considered bradycardia?

A

<80

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32
Q

When do A&B’s of prematurity markedly improves or goes away?

A

Time the baby nears his/her due date

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33
Q

CO is what dependent?

A

HR

34
Q

Ventricles of neonates?

A

Stiff and close to max contractility

35
Q

HR compared to adults?

A

Faster, can’t tolerate bradycardia

36
Q

BP compared to adults?

A

Lower BP

37
Q

3 cardiac abnormalities?

A
  1. Patent foramen ovale
  2. Patent ductus arteriosis
  3. Tetralogy of fallot
38
Q

Patent foramen ovale % close in 1st few months?

A

75%

39
Q

What % of patent foramen ovale remains open as adult?

A

25%

40
Q

Fetal hemoglobin comprises what % of infants hemoglobin?

A

50-95%

41
Q

Adult hemoglobin predominant after what age?

A

6 months

42
Q

Which has greater affinity for O2? Fetal or adult hemoglobin?

A

Fetal

43
Q

O2 saturation curve is what kind of shift?

A

Left

44
Q

Leftward shift decreases and increase what?

A

Decrease: P50
Increase: hemoglobin’s affinity for O2

45
Q

Overall leftward shirt causes what?

A

Reduce availability to the tissues

46
Q

Hepatic BF compared to adult?

A

Decreased

47
Q

Duration type with roc and what affects it?

A

Prolonged duration and P450

48
Q

Duration type of midazolam and what affects that?

A

Prolonged and CYP3A4, CYP3A5cytochromes

49
Q

PT and PTT times in healthy premature infant?

A

Prolonged

50
Q

Jaundice occurs in what % of infants?

A

60

51
Q

What therapy is used to treat newborn jaundice?

A

Phototherapy

52
Q

What 4 things does phototherapy cause?

A
  1. Brain damage (kernicterus) leading to cerebral palsy
  2. Auditory neuropathy
  3. Gaze abnormalities
  4. Dental enamel hypoplasia
53
Q

Bili lights have blue light of what nm?

A

420-470 nm

54
Q

Should infants eyes be protected when under bili lights?

A

Yes

55
Q

Glycemic levels in neonates?

A

Hypoglycemia quickly

56
Q

Why do they get hypoglycemic quickly? (2)

A

Glycogen stores are small

Gluconeogenesis is immature

57
Q

GFR compared to adults?

A

25% of adult values

58
Q

Lower esophageal sphincter formation?

A

Incompetent so increase risk of reflux; always considered full stomach

59
Q

Heat is lost when the surface dries

A

Evaporation

60
Q

Placed on a cooler surface or touching them with a cool object or hands

A

Conduction

61
Q

Heat is transferred to the air surround the infant heat loss

A

Convection

62
Q

Transfer of heat to cool objects that are no in direct contact with neonate

A

Radiation

63
Q

Heat gain/loss controlled by?

A

Hypothalamus and limbic system

64
Q

Temp sensors on what and stimulate what?

A

On posterior hypothalamus stimulate pituitary to produce T4 and adrenals to produce NoE

65
Q

Blood vessels are what to the surface?

A

Close

66
Q

Can neonates vasoconstrict?

A

No

67
Q

As infant gets cold, what happens?

A

Activates NorE release (controlled by hypothalamus) that leads to pulmonary and peripheral vasoconstriction (increased pulmonary vascular resistance)

68
Q

Non shivering thermogenesis uses what to produce heat?

A

Brown fat

69
Q

What does brown fat contain?

A

Small lipid droplets and much high number of iron containing mitochondria

70
Q

Non shivering thermogenesis is rich capillary network densely innervate by what?

A

Sympathetic nerve endings

71
Q

Non shivering thermogenesis generally disappears when after brith?

A

3-6 months

72
Q

Infant respiratory distress syndrome has a deficiency in what?

A

Surfactant

73
Q

What 4 things are used to treat respiratory distress syndrome?

A
  1. Surfactant
  2. O2
  3. CPAP
  4. PEEP
74
Q

Respiratory distress syndrome can have the chronic complication of what?

A

Broncho-pulmonary dysplasia (BPD)

75
Q

4 things to look for in volume assessment?

A
  1. Sunken (top of head and eyes)
  2. Skin turgor
  3. Cries with no tears
  4. Capillary refill
76
Q

During the 1st week reduced fluid requirements: day 1, day 3, day 5, day 7

A

Day 1: 70 ml/kg/24hr
Day 3: 80 ml/kg/24hr
Day 5: 90 ml/kg/24hr
Day 7: 120 ml/kg/24hr

77
Q

Volume of ECF is small or large?

A

Large

78
Q

7 pharmacological differences btn neonate and adults:

A
  1. Immature hepatic biotransformation
  2. Decreased protein binding
  3. Repaid rise in ET volatile agent levels
  4. Rapid induction and recovery
  5. Decreased MAC
  6. Larger volume of distribution for drugs
  7. Immature neuromuscular junction
79
Q

Maternal DM may predispose infants to what glycemic level?

A

Hypoglycemia

80
Q

Airway of neonates (5)

A
  1. Large tongue and occiput
  2. Small mouth
  3. Short neck
  4. Floppy epiglottis
  5. Weak respiratory muscles

Co-Exisiting Disease 2 (11 decks)

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