Neonatal

Question 1

Meconium aspiration can result in…

tx?

Answer 1

systemic hypoxia and pulmonary hypertension

Tx: intubation + tracheal suction + O2 mask

Question 2

Transient tachypnea of the newborn (TTN):
dx?
tx?

Answer 2

achypnea, grunting, possible cyanosis in a c/s infant due to retained fetal lung fluid

dx = CXR shows pulmonary vascular markings

Tx = 100% O2 (will resolve in 3 days)

Question 3

TTN vs. RDS:

Answer 3

TTN improves w/ O2, RDS persists despite O2

Question 4

Neonatal bloody stool: management?

Answer 4

first get Apt test to differentiate maternal from fetal bleed, then further tests only if blood is fetal

Question 5

Neonatal hypothermia is a/w incr risk of…

Answer 5

hypoglycemia

Question 6

Management of neonatal hypoglycemia?

Answer 6

increase feedings if glucose <20

Question 7

SGA = incr risk of…

Answer 7

congenital malformations, hypoglycemia (low glycogen/fat stores), future growth retardation

Question 8

Tx hyperviscosity syndrome?

Answer 8

partial exchange transfusion

Question 9

Duodenal atresia:

presentation?

Answer 9

bilious vomiting and polyhydramnios

Question 10

Cause of intestinal atresia?

KUB shows…

Answer 10

vascular accidents in utero

“triple bubble”

Question 11

Neonatal hypothyroidism :
cause?
cause of umb hernia?

Answer 11

thyroid dysgenesis → lack of T4/T3 synthesis

hypothy = constipation → distended abdomen →umbilical hernia

Question 12

Neonatal thyrotoxicosis: tx?

Answer 12

propylthiouracil (PTU) for 2-4 months until mom’s ab disappear

Question 13

cranial bruits + high-output CHF =

Answer 13

AVM of great vein of Galen

Question 14

Tx NEC?

Answer 14

NPO/IVF/abx if unperforated, surgery if perforated

Question 15

Congenital toxoplasmosis: management?

Answer 15

pyrimethamine + sulfadiazine

Question 16

Tx congenital Rubella?

Answer 16

supportive

Question 17

MC sequelae of congenital CMV?

CMV inclusion disease =
tx?

Answer 17

sensorineural hearing loss (usually asymptomatic

“blueberry muffin” rash, HSM/jaundice, thrombocytopenia, periventricular calcifications
tx = IV GCV + supportive care

Question 18

Neonatal HSV

tx?

Answer 18

vesicular rash, HSV pneumonitis, temporal lobe encephalitis (focal seizures)

Tx: IV ACV + vidarabine if disseminated/systemic

Question 19

Early congenital syphilis =
dx?
tx?

Answer 19

maculopapular peeling rash, snuffles (rhinitis w/ serous, purulent, or bloody discharge), HSM, jaundice, generalized LAD

Dx screen w/ RPR/VDRL, confirm w/ TPPA or FTA- ABS

Tx PCN + supportive care

Question 20

Late congenital syphilis =
dx?
tx?

Answer 20

deafness, saber shins, mulberry molars, Hutchinson teeth, saddle nose

Dx screen w/ RPR/VDRL, confirm w/ TPPA or FTA- ABS

Tx PCN + supportive care

Question 21

Congenital varicella syndrome?

tx?

Answer 21

limb hypoplasia, clear vesicles → cutaneous scars, chorioretinitis, cortical atrophy

Tx VZIG if mom has chickenpox from 5 days prior to 2 days after delivery, otherwise reassurance

Question 22

Cephalohematoma?

Answer 22

bleeding between periosteum and skull → “squishy” feel to scalp that doesn’t cross midline

Question 23

Caput succedaneum?

Answer 23

soft-tissue swelling of scalp where baby was delivered, crosses midline

Question 24

Subgaleal hemorrhage?

Answer 24

bleeding under galeal aponeurosis → “squishy” feel to rapidly expanding scalp that crosses midline;

*Tx NICU admit for possible hemorrhagic shock