Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Laughing Pedi > neonatal > Flashcards

neonatal Flashcards

0
Q

adeq gbs px?

A

1 dose more than 4 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

abx for mom if pcn allergy

A

clinda, vanc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

normal fetal growth?

A

5g / day at 16 wk

35 g/ day at 35 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

testes descend at what GA

A

33-34wk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

no matter what if mom had chorio?

A

treat baby!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

well appearing infant, mom adequate treatment.

?

A

discharge as early as 24 hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

< 37 wks, > 18 hr ROM, but otherwise well appearing baby?

A

eval, but don’t need to tx right away

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Def of SGA?

A

< 10th percentile, and < 2500g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

IUGR?

A

rate of growth less than potential (a change)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

fetal hb curve?

A

to the left, incr O2 binding affinity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

htn causes what kind of IUgR?

A

asymmetric, late

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

fetal blood flow preferentially where?

A

placenta, brain, adrenals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

higher MCA blood flow in fetus, sign of what?

A

late asymmetric IUGR (spares head)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

symmetric growth restriction, when was insult?

A

early: chromosomal, torch…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

common issue in IUGR?

A

hypoglycemia, incr mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

LGA:

A

2 SD above the mean
>3900g
upper 10% for wt for GA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

creases in soles of feet, all the way vs 1st 3rd

A

full, < 36wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

% premature births in US?

A

12.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Prematurity defined?

A

<37 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

calculate chronological age of baby:

ex: 8 month old, former 28 wks

A

correct to 40 wks!

5 mos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

biggest risk factor for premature baby?

A

previous preemie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

high fetal fibronectin/

A

incr prematurity risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

prenatal corticosteroids

-effective when

A

24-48 hrs –> 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

steroids prenatally does what w/ lung stuff

A

decr RDS, but no change in ventilatory/BPS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

doses of dexameth vs beta for prenatal steroids?

A

4 doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

post term def?

A

> 42 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

meds that decr vit K level in baby?

A

AEDs! (esp early bleeding < 48h)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

vit K less in what population of baby?

A

breast fed vs formula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

cleft lip, neural tube defects in what teratogen

A

AED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

prolonged PT in what

A

vit K def

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

vit K dosing

A

1mg IM at birth, preemies 1/2mg IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Treatment of chlamydia in newborn (conjunctivitis…)

A

PO erythromycin 2 wks! (pna + conjunctivitis), often at 2 wks of age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

total body water

A

highest at newborn, extracellular until 3mos, then intracellular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

newborn caloric requirement

A

90-100cal/kg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

carbo, fat, protein, fa req percentages for enteral feeding

A

30-60% total calories
55% fat
20% protein, 2-5% essential fatty acids (lineloaic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

carbo3.4
protein4
fat 9
cal/gram of each?

A

nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

glucose rate

A

6-8mg/kg/min,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

D5 vs D10

A

D10 100mg/mL

D5: 50mg/ML

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

why intralipids 20% in newborn

A

3g/kg/day requirement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

essential fatty acid deficiency? whats missing, what do you see?

A

linelaic and omega 3 fatty acids

see very scaly skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

protein req

A

2.5-3.5g/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

1kg baby, what fluids needed?

A

100ml/kg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

how does fetus get glucose in utero

A

facilitated diffusion of glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

lowest glucose timing for baby

A

30-90 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what glucose should be treated in newborn

A

<40, feed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

who is hyperinsulinemic?

A

Beckwith biedemann

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

why is IUGR hypoglycemic

A

not enough glycogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

big baby with relative microcephaly?

A

Beckwith weidemann

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

2mL D10? how much glucose

A

200mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

max glucose infusion in piv?

A

12.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

desired hct?

A

55

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

RPR + mom?, how do you know if baby has it?

A

4x greater titer than mom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

confirmatory syphilis test

A

FTA- stays pos for life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

only acceptable tx of syphilis for mom?

A

PCN 4 wks before delivery, needs 4 fold decr in titers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

successful tx of syphilis

A

FTA pos, RPR neg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

peeling of hands, feet in baby?

A

syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

snuffles in baby?

A

syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

test pku when

A

after feed 48-72hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

essential AA in PKU?

A

tyrosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

if mom has inappropriate pku tx?

A

teratogenic- miscarriage, SGA, iugr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

cause for very high tsh in newborn

A

surge in first 24 hours… normal

61
Q

hospital hearing screen?

A

ABR: quick, early, detects auditory dysynchrony at 35 decibels

62
Q

what % of infants get referred for formal hearing test?

A

5%

63
Q

percent that fail hearing test that have actual hearing loss?

A

80% are fine,

64
Q

discharge criteria for newborn

A

1 stool 48 hr
1 urine 24 hr
VS nl 12 hr
>7% wt loss in first 48 hrs

65
Q

drug causing jaundice in baby b/c disrupts albumin: bili ratio?

A

ceftriaxone

66
Q

% newborns w/ jaundice

A

25%

67
Q

breast milk jaundice

A

2 wks with very high bili… BUT not, “breast not feeding jaundice”

68
Q

shrill cry

A

kernicterus

69
Q

acquired hearing loss baby

A

kernicterus, meningitis

70
Q

lungs are filled with what during intrauterine life

A

fetal lung fluid

71
Q

delayed clearance of fetal lung fluid in baby born by C/S

Dx and Tx

A

TTN, give supplemental O2, monitoring…

72
Q

RDS CXR finding?

A

fine reticulogranular pattern, ground glass, air bronchograms, granular opacifications, symmetric

73
Q

TTN lung findings on CXR

A

perihilar streaking, no air bronchograms
fluid in fissures
good lung volumes
incr interstitial markings

74
Q

peak severity of RDS?

A

24-72hrs

75
Q

amniotic fluid test for lung maturity?

What is the other ratio test and why don’t we use it?

A

phosphatidylglycerol (late appearing surfactant component)
LS ratio: Lecithin : Sphingomyelin ratio, >2:1 indicates lung maturity (Lecithin increases throughout gestation, while sphingomyelin stays constant) Problem is can’t trust if there is blood or mec…

76
Q

complication of surfactant admin?

A

pulm hemorrhage

77
Q

CXR finding in mec aspiration

A

coarse, patchy infiltrates, hyperinflation

78
Q

best way to eval PPHN?

A

echo

79
Q

pre / post ductal splitting may or may not be present in what condition (change in SaO2 >10%)

A

mec aspiration (may just have cardiac shunting, not ductal…)

80
Q

the missed bacterial sepsis in early onset neonatal sepsis after GBS, Ecoli, Listeria? (2)

A

Strep viridans

non typeable H flu

81
Q

Common causes of late onset neonatal sepsis ((4)

A

coag neg staph, s. aureus, GNRs, Candida

82
Q

Sepsis in baby previously discharged from hospital?

A

GBS, listeria, Ecoli, Salmonella

83
Q

late onset sepsis in high risk newborns (NICU babies)

A

coag neg staph (48%), GNR (20%), S aureus, Candida, enterococci (2%)

84
Q

Most common clinical features of early onset GBS

A

apnea and pna

85
Q

which has higher mortality? early or late GBS?

A

Early has higher mortality (risk of septic shock higher, often premature)

86
Q

dx if granulomatosis infantisepticum (red rash w/ 1-2mm pale nodules on skin, pharynx - path granuloma)

A

Listeria

87
Q

I:T ratio?

A

Immature > total >0.2 –> sepsis

88
Q

When shouldn’t you use amp/gent as first line in neonatal sepsis?

A

ONLY Late onset:
VLBW infants in NICU might need oxacillin/Vanc + gent or 3rd gen in late onset sepsis OR
community acquired - amp / 3rd gen cephalosporin

89
Q

duration and type of treatment for neonatal meningitis (GNR)

A

3 weeks. Start w/ amp/gent as empiric, then can do cefotax + gent

90
Q

bug likely to cause brain abscess and GN meningitis?

A

Citrobacter koseri (diversus)&raquo_space; Enterobacter, Serratia marcescens

91
Q

preferred drug for mother if PCN allergy for GBS

A

Cefazolin

92
Q

Is Prophylaxis of GBS needed if c/s before labor?

A

NO

93
Q

Does neonate with HIV look like sepsis?

A

No

94
Q

risk of HSV trm in primary infx vs recurrent?

A

50% vs 5%

95
Q

Tx of neonatal HSV? Duration

A

IV ACyclovir only
14 d for mucosal/skin/eyes dz only
21 d for disseminated / CNS

96
Q

Most common congenital infx, most common presentation, most common sx

A

1% of all infants CMV,
most common presentation is asx (90%)
Commonest sx: TCP/petechiae, jaundice

97
Q

risk of chorioretinitis w/ CMV infx

A

10%

98
Q

most significant sequelae of CMV in neonates that are asx at birth?

A

deafness

99
Q

blueberry muffin, microcephaly, b/l cataracts.

Most likely CHD?

A

Rubella.

PDA, also pulmonic stenosis

100
Q

Salt and pepper retinopathy in TORCH is what instead of what

A

rubella/syphilis instead of toxo/CMV which is focal retinitis

101
Q

Congenital toxo causes what even if asx at birth

A

neurological and visual problems by adulthood:(

102
Q

Y ou need a maternal PRIMARY infx for congenital what?

How do mom’s get it?

A

Congenital Toxo… need primary infx. from raw beef or cat feces

103
Q

intraparenchymal calcifications vs perventricular

A

intraparenchymal: toxo
periventricular: CMV

104
Q

Tx of toxo?

Mom and baby

A

mom: spiramycin to decr transmission, pyramethamine and sulfadiazine if infx after 17 wks
baby: pyrimethamine and sulfadiazine for 1 yr

105
Q

very common and unique manifestation of congenital syphilis besides snuffles (bloody mucus), rash, HSM, LAD?

A

periostitis: lots of bone issues - osteomyelitis, periostitis, osteochondritis

106
Q

Neonate w/ hydrops, most common infx?

A

parvo B19 (from severe anemia and HOCF)

165
Q

normal fetal / placental weight ratio should be what

A

6.5-7 at term (or if less, decreased fetal growth)

166
Q

when should preemie growth be “caught up”

A

by yr 2

167
Q

Caloric requirement for preemie

A

120cal/kg/day

168
Q

optimal whey/casein ratio for preemies
lipid source
extra of what
cal/oz

A

60/40 Whey/Casein
MCTs
higher Ca and phos
24 / oz

169
Q

long term complication of NEC

A

intestinal strictures

170
Q

bad things that actually DECrease jaundice in neonate

A

maternal heroin, smoking, alcohol, Phenytoin/PB

171
Q

What is Lucy Driscoll Syndrome

A 
transient neonatal uncong hyperbili
Uenzyme defect (metabolic)
172
Q

exchange transfusion s/es?

A

Hi K
low Ca
low volume
tcp

173
Q

Hypoglycemia management?

A

3mL/kg D10 bolus

176
Q

mechanism of late hypocalcemia in infant?

A

cows milk given by accident causing major phosphate load and hypocalcemia results

177
Q

Full term anemia def

Test to do?

A

HB < 13

Due Kleihauer Betke test to look for fetal cells in mom’s blood

178
Q

TReatment for what HCT that is too high/

Sx? (3)

A

70

causes hyperbili, hypoglycemia, TCP

179
Q

immediate irritability tremors, tachycardia/SVT dx?

A

in the immediate newborn period, its neonatal thyrotoxicosis

180
Q

firm and tense bulge of blood in newborn

A

cephalohematoma

181
Q

soft, boggy, pitting, swelling of head crossing suture

A

caput succedaneum

182
Q

Three syndromes assoc w/ cleft lip/palate

A

Crouzon, Apert, Treacher/collins

183
Q

neonate with alcohol withdrawal presents how

A

hyperactive, irritable, hypoglycemia

184
Q

neonate w/ cocaine w/d?

A

NO SX

185
Q

Neonate w/ amphetamine w/d?

A

drug effects decline over several days, but NO w/d

186
Q

Neonate w/ barbiturate w/d?

A

hyperactive, hyperphagia, irritability, crying, poor suck/swallow

187
Q

Neonate w/ opioid w/d and its tx?

A

hyperirritability, tremor, jitters, hypertonia, loose stools, emesis, feeding difficulty
Sz
Tx w/ methadone, oral morphine

196
Q

what does low calcium do to ekg?

A

prolonged QT

201
Q

define hypocalcemia

A

ical < 4.5
total cal < 8.5
(bound is 50%)

237
Q

causes of high AFP

A 
BADRAIN: Bladder extrophy/Anencephaly/Defects *NTD
Renal: agenesis, polycystic kids
Abd wall defects
Incorrect dates / multIPle pregnancy
Neuro: NTD
238
Q

BPP includes what

A 
Fetal Movement
Reactive HR
Breathing
Tone
Volume of amniotic fluid
239
Q

Non stress test measures what

A 
spontaneous fetal movement
HR activity (autonomic nervous system integrity)
240
Q

Contraction stress test measures what

Bad sign?

A

fetal HR w/ contraction: uteroplacental insufficiency and labor tolerance

Bad sign would be late decels after 50% of contractions

241
Q 
Risk for RDS increased in (3)
Decreased in (2)
A

Increased RDS: DM moms, C-section, birth asphyxia

Decreased RDS: PROM, prenatal steroids

242
Q

LS ratio? problem with it

A

Lecithin: Sphingomyelin > 2 is low RDS risk

but maternal DM interferes

243
Q

when do you need mechanical ventilation for RDS?

A

pH 60

Tx goal: PO2 50-70

244
Q

Changes in lungs with small cystic changes and fine lacy infiltrates without hx of prolonged O2 exposure/ventilation or RDS?

A

Wilson Mikity syndrome

245
Q

Types of early GBS infx?

A

PNA, meningitis, sepsis

246
Q

late onset GBS
assoc w/ prematurity
most common infx

A

w/in 1 mo, usu meningitis

NOT assoc w/ preemies

247
Q

The deal w/ TOXO and timing of pregnancy infx / outcomes

Mom sx?

A

Early exposure: lower fetal infx chance, but severe if does
Late exposure: hi fetal infx, but less severe
Infx in mom may just be LAD

248
Q

Sx of TOXOplasmosis in neonate at birth and later

A 
GONDII: 
Greatly small head: microceph
On the brain is water
Nothing - asx neonate
Diffuse calcific
I=eyes/chorioretinitis
Icterus/HSM

Longterm: deafness, vision, seizures, cognition

249
Q

MRI signs of toxo?

A

ring enhancing lesions in encephalitis

diffuse calcifications

250
Q

Dx and Tx of toxo

A

Dx: IFA
Tx: pyrimethamine, sulfadiazine, folinic acid

251
Q

palsies to look for in clavicular frx and their sx

when does callus heal/recede

A

Erb’s palsy - high C5-C7: Waiter’s tip but they can grab money
Phrenic nerve palsy - resp distress
2 yrs for callus to recede

252
Q

Klumpke paralysis: where / sx

Possible assoc?

A

C8-T1: claw hand (born grabbing Klump of sand, but then can’t grasp later)
May be assoc w/ Horner’s (SNS near T1)

253
Q

test to do in setting of 1 umbilical artery

A

renal US

254
Q

Umbilical cath complications

A

NEO CATH:
Necrosis, Emboliz of liver, Ompalitis, Compromised fetal pulse, Accidental hemorr, Traumatic perf renal artery/aorta, hepatic dysfunction
(infx, punctures, ischemia/hemorrhage, liver)

255
Q

Low umbilical vs high umbilical

A

Low: L3-L5

High (x2): T6-T10

256
Q

normal P02 and PCO2

A

P02 60-90
PCO2 35-45
Normal scalp pH >7.25

257
Q

silver nitrate vs emycin eye ointment/drops

A

silver does NOT prevent chlamydia only gonorrhea

Emycin does both

Laughing Pedi (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions