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Phase 2 PEDs > Neonate > Flashcards

Neonate Flashcards

1
Q

TORCH definition

A 
Pregnacy Hx/Congenital Infections
Toxoplasmosis
Other
Rubella
CMV
HSV

Other - GBS, HIV, HVB, B19, GC TB

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2
Q

Definition of perinatal/neonatal mortaility

A

Fetal death 20w EGA - 28D post delivery

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3
Q

Definition of premature birth

A

Birth <38wk (pre-term infant)

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4
Q

MC factors to Perinatal mortality

A

Congenital anomalies and prematurity

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5
Q

Reasons for fetal demise (in utero)

A

Intrauterine asphyxia
Multiple gestation
Intrauterine infection
Placental insufficiency

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6
Q

Preterm - perinatal mortality reasons

A

RDS
Immaturity
Intraventricular hemorrhage
Necrotizing enterocolitis

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7
Q

Term infant - perinatal mortality

A

Birth asphyxia
Congenital anomalies
Infection

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8
Q

RFs for low birth weights?

A

Black - (doubles risk)
<16 or >35yo
Common sense items

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9
Q

Causes of neonatal asphyxia

A

D/O of respiratory drive
CNS depression
Occlusions of up/low AW
Extreme prematurity

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10
Q

During AW positioning ensure not to?

A

Hyperextend neck too much

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11
Q

Neonatal Intubation intervention if?

A

No chest rise w/ BVM
No IV route of Rx admin established
Preferred if transporting

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12
Q

3 methods of O2 administration

A

Blow by
BVM (PPV)
Intubation

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13
Q

2 techniques of Chest compressions? Preferred method?

A

Two thumb - preferred

Two fingers

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14
Q

Purpose of Ductus arteriosus? And how it works?

A

Blood bypasses lungs via R-vent to descending aorta

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15
Q

Is PDA patent at birth?

A

Yes

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16
Q

When does the PDA typically close?

A

24-48hrs

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17
Q

What patient population typically has a PDA that fails to close?

A

Preterm infants

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18
Q

What can occur if PDA remains patent and nev er closes?

A

Heart failure

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19
Q

In what situation would a HCP leave a PDA open?

A

Cyanotic heart disease

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20
Q

Neonatal resuscitation medications

A

O2
IV fluids
Epinephrine
Narcan (PRN)

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21
Q

Neonatal resuscitation - epinephrine Route/dosing/purpose.

A

1:10k IV or Inhaled ETT for Asystole or bradycardia

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22
Q

When is F-hgb fully replaced by adult Hgb?

A

3-6mo

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23
Q

Which has a higher affinity for O2 - F-hgb vs Adult Hgb?

A

F-Hgb

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24
Q

NL Neonatal physiological shunts

A

Ductus Venosus
Ductus Arteriosus
Foramen Ovale

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25
Q

Purpose of Ductus Venosus?

A

Shunts fresh O2 from Placenta to IVC bypassing Liver

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26
Q

Bypasses what?
Ductus Venosus
Ductus Arteriosus
Foramen Ovale

A

Ductus Venosus - past liver
Ductus Arteriosus - past lungs 85%
Foramen Ovale - past lungs

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27
Q

Closes when?
Ductus Venosus
Ductus Arteriosus
Foramen Ovale

A

Ductus Venosus - Mins after birth
Ductus Arteriosus - w/in 1-2D
Foramen Ovale - 1st fetal breath

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28
Q

How can you prevent GC conjunctivitis w/ a newborn in a nursery setting?

A

Erythromycin - Ophthalmic ointment (Better than AgNO3)

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29
Q

What are screenings/shots/labs of newborn in nursery setting?

A

Hearing
HVB
Genetic/metabolic - PKU/TSH/CF/SCA
Vit K

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30
Q

Purpose of vitamin K?

A

PVT Vit K deficiency (Hemorrhagic disease of the newborn (HDN)).

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31
Q

Appearance of HDN (S/S)?

A

Generalized ecchymosis
GI bleeding
Bleeding from umibilical stump or circumcision

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32
Q

What two supplementations are required if breast feeding?

A

Iron and Vit D

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33
Q

When is Iron supplementation required for breast feeding infants?

A

At 4 months (until child is eating sufficent iron in diet)

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34
Q

IF giving formula for diet what must you supplement with?

A

Vit D (Iron is added to formula)

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35
Q

What is the dosage/day for Vit D and iron?

A

Vit D - 400IU/day

Iron - 1mg/kg/day (Max 15mg)

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36
Q

Severe Vit D deficiency will result in?

A

Rickets

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37
Q

Childhood Rickets presents as?

A 
Thickening at wrist and ankles
Rachitic Rosary
Enlarged anterior fontanelle
Bow legs or knocked knees
Craniotabes
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38
Q

How can you estimate gestational age?

A

Using the Ballard score (Physical and neurological characteristics score added)

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39
Q

Purpose of Ballard score is to?

A

Identify abnormal growth patterns
Predict neonatal complications
Estimate GA

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40
Q

Small for EGA is what percentile?

A

<10%

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41
Q

Large for EGA is what percentile?

A

> 90%

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42
Q

SGA is also known as?

A

Intrauterine growth restriction

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43
Q

SGA is associated w/?

A

Increased risk of…

  • temperature instability
  • perinatal asphyxia
  • hypoglycemia
  • polycythemia
  • pulmonary hemorrhage
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44
Q

LGA is associated with?

A

Maternal DM

Neonatal hypoglycemia

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45
Q

Post-term delivery is also known as how many weeks?

A

> 42

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46
Q

Ballard score maturity rating? Baseline? Increments?

A

40=40 baseline

Every 5 point change = 2wk change

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47
Q

Scaphoid abdomen may indicate?

A

Diaphragmatic hernia

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48
Q

NL umbilical cord anatomy?

A

3 vessels ( 2 arteries and 1 venous)

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49
Q

Barlows maneuver checks for? Performed how

A

Congenital hip dysplasia-

Adduct w/ Downward force to dislocate hip

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50
Q

Ortalani maneuver checks for? Performed how?

A

Congenital hip dysplasia - clunks when hip relocates back into acetabulum

ABduct with lateral pressure over greater trochanter

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51
Q

Barlows/Ortalini reqs what to indicate congenital hip dysplasia?

A

Multiple F/U visits that have reproducible clunks

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52
Q

Congenital hip dysplasia can lead to?

A

Pathological changes

  • Flattening acetabulum
  • Muscle contractures limiting motion
  • Joint Capsule tightening
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53
Q

Congenital hip dysplasia MCs?

A

Left hip 3x

Female 9x

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54
Q

Congenital hip dysplasia risk factors?

A

Breech presentation
1st born child
Oligohydraminos
Tight swaddling

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55
Q

Positive Barlows/ortalini reflex to?

A

Ultrasound of hips for congenital hip dysplasia after 6wks of age to avoid NL laxity confusion.

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56
Q

Congenital hip dysplasia TXT?

A 
Refer to PEDs ortho - 
Pavlics Harness (up to 6mo)
Abduction orthosis
Closed reduction w/ hip spica cast
Open reduction
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57
Q

Newborn Back ABNL findings?

A

Lumbosacral hair tuft = spina bifida

Gluteal fold dimples (sacral dimples)

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58
Q

Rooting reflex is gone by?

A

4-6mo

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59
Q

Fencer reflex is gone by?

A

3mo

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60
Q

Moro reflex is gone by?

A

6mo

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61
Q

Grasp reflex is gone by?

A

6mo

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62
Q

Placing reflex is gone by?

A

4-6mo

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63
Q

Galant reflex is gone by?

A

4mo

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64
Q

Babinski reflex is gone by?

A

12-18mo

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65
Q

Which reflex is a “true reflex”

A

Sucking reflex

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66
Q

Umbilical cord w/ 2 vessels should cause you to…?

A

Perform a more detailed exam

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67
Q

Enlarged anterior fontanelle >5cm may suggests?

A

Hypothyroidism

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68
Q

Closed sutures/fontanelles is also known as?

A

Carniosynostosis

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69
Q

ABNL red reflex that is white is AKA?

A

White reflex (Leukokoria)

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70
Q

White eye reflex is associated w/?

A

Cataracts
Ocular tumors
Severe chorioretinitis
Immature retinas

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71
Q

Neck cysts per location will indicate?
Anterior midline on neck?
Anterior SCM?
Posterior SCM?

A

Anterior midline on neck? - Thyroid disorder
Anterior SCM? - Brachial cleft cysts
Posterior SCM? - Cystic hygroma

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72
Q

Will murmurs be initially heard upon newborn exam auscultation?

A

Maybe - (Maybe not!)

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73
Q

Single second heart sound may indicate?

A

Cyanotic heart disease

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74
Q

What are the pathological Murmurs?

A

Holosystolic, continuous harsh murmur
Grade 3 or higher
All diastolic murmurs

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75
Q

Hepatomegaly may indicate?

A

Left sided heart failure

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76
Q

When does the umbilical cord typically fall off?

A

At 3-4weeks post delivery

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77
Q

Is jaundice abnormal or normal w/in the 1st 24hr?

A

Abnormal

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78
Q

Overriding sutures are?

A

When sutures overlap creating a ridge palpable on exam

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79
Q

NL eye alignment of a infant usually occurs at?

A

4mo

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80
Q

Strabismus is?

A

Eyes not aligned properly - ABNL light reflex

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81
Q

Pseudostrabismus is?

A

Eyes aligned - NL light reflex, +- epicanthal folds

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82
Q

Epicanthal folds are notable w/ what population?

A

Asians and downs

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83
Q

Newborn gum/palate NL 2 benign findings? Resolves w/in?

A

Epstein pearls and Bohn nodules - Resolves w/in 1st few wks

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84
Q

Epstein Pearls are?

A

Gum/palate - Keratin cysts (Benign) (looks like teeth)

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85
Q

Bohn Nodules are?

A

Salivary tissue (Benign) (looks like teeth)

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86
Q

Desquamation of newborn epithelial occurs when?

A

24-48hrs

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87
Q

Vernix Caseosa is?

A

Chalky-white to gray mix of Epithelial, Sebum, Keratin common in preterm infants

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88
Q

Milia is?

A

<2mm White smooth papules on face and scalp from trapped keratin occluding pores that resolves 1st few wks

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89
Q

Milia Rubra is?

A
  • Overheating/febrile infants that present w/ Erythematous 1-3mm papules
  • “heat rash”
  • does not involve follicles
90
Q

Monglolian spots are?

A

Blue to black pigmented maclues that fade over several years of life.

91
Q

Cafe-Au-Lait spots are?

A

Light to dark sharply defined macules.

92
Q

When does Cafe-Au-Lait spots require further eval?

A

> = 6 spots
5mm diameter
Not confined to a segmental region

93
Q

What are Cafe-au-Lait spots ass/w?

A

Neurofibromatosis

94
Q

Nevus Simplex is AKA?

A

Salmon Patch

95
Q

Nevus Simplex locations?

A

Stork Bite - Nape of neck

Forehead or eyelids - Angel kiss

96
Q

Is nevus simplex Benign or concerning?

A

Benign

97
Q

Nevus Fameus is AKA?

A

Port Wine Stain

98
Q

Nevus Fameus pathogenesis?

A

Malformation of capillary bed

99
Q

Nevus Fameus is ass/w?

A

Sturge-Weber Syndrome on face in the trigeminal nerve distribution.

100
Q

Difference between Nevus Fameus/simplex

A

Simplex - Transient and Benign (symmetrical) light pigmentation
Fameus - Persistent through life (Asymmetrical) darker pigmentation

101
Q

Erythema Toxicum Neonatorum is?

A

Pustules w/ erythematous base located on trunk/back that contain EOS

102
Q

When does Erythema Toxium Neonatorum Begin/Resolve?

A

Starts 24-48hrs of life

Resolves w/in 14d

103
Q

Neonatal acne pathogenesis?

A

Exposure to maternal estrogen

104
Q

Neonatal acne is?

A

Self limiting pustules appearing w/in birth to 1st few weeks of life found on cheecks and scalp.

105
Q

Cutis Marmorata AKA?

A

Mottling

106
Q

Cutis Marmorata pathogenesis?

A

Physiologic response to cold

107
Q

Cutis Marmorata resolves when?

A

As neonate ages or exposed to warmth

108
Q

Persistent Cutis Marmorata may be ass/w?

A

Hypothyroidism,
Vascular malformation,
Congenital conditions

109
Q

Cradle Cap is AKA?

A

Seborrheic Dermatitis

110
Q

Cradle cap may be first sign of?

A

Atopic Dermatitis

111
Q

TXT for severe cradle cap?

A

Mineral oil
Emollient (white petrolatum)
Medicated shampoo w/ soft brush to remove scales.

112
Q

Cradle cap can take how long to resolve?

A

Months

113
Q

Umbilical Granuloma is? And TXT how?

A

Friable red papule - TXT w/ silver nitrate

114
Q

DDx to consider w/ umbilical granuloma?

A

Urachus - (W/ intermittent urinary discharge)
Meckles diverticulum
Persistent Vitelline duct - (Malodorous discharge)
Umbilical polyp - (W/ sticky surface due to mucus)
Talc Granulomas _ ( Use of talc on umbilical)

115
Q

Metatarsus adductus is?

A

Medial deviation of mid and forefoot

116
Q

To Dx metatarsus adductus?

A

Mid line heel bisector - line goes between 2 and 3 toes

V-finger test - should not gap at 5th Metatarsal

117
Q

Txt of Metatarsus adductus?

A

Conservative management or if severe serial casting

118
Q

Clubfoot is AKA?

A

Talipes equinovarus

119
Q

Clubfoot is classified as either?

A

Extrinsic (supple)

Intrinsic (rigid)

120
Q

Clubfoot anatomical position is?

A

Inversion, adduction, plantar flexion

121
Q

Extrinsic clubfoot is due to?

A

Uterine molding

122
Q

Intrinsic clubfoot is due to?

A

Idiopathic abnormal bone structure

123
Q

Key differences between intrinsic vs extrinsic clubfoot?

A

Extrinsic - able to reduce

Intrinsic - not able to reduce

124
Q

TXT for clubfoot

A

Serial casting - if intrinsic many need surgery to correct bone ABNLs

125
Q

Spina bifida is AKA?

A

Cleft Spine

126
Q

Spina bifida is?

A

Lumbosacral neural tube defect of spinal cord or meninges

127
Q

DX for spina bifida usually occurs when? And how?

A

2nd trimester

Fetal U/S and Alpha fetoprotein

128
Q

Alpha fetoprotein is?

A

Protein secreted from fetal yolk sac, GI tract, and liver into mothers serum.

129
Q

Low vs High results of Alpha fetoprotein indicate?

A

High - neural tube defects (Spina bifida)

Low - Aneuloploidy (Trisomy’s 18, 13 and downs)

130
Q

Quad test components?

A

Alpha fetoprotein
Unconjugated Estriol
Inhibin A
HCG

131
Q

Spina bifida occulta is def? AKA?

A

Rachischisis - minor defect (hair tuft) w/out neuro S/S

132
Q

Spina bifida occulta requires a eval for? to avoid what?

A

A connecting sinus - to avoid meningitis.

133
Q

Meningo-cele def?

A

Meninges herniates (w/out spinal cord protrusion)

134
Q

Meningo-myelocele def?

A

Meninges and spinal cord herniates

135
Q

Myeloschisis def?

A

Open skin w/ exposed spinal cord

136
Q

Spina bifida TXT is?

A

Neurosurgery

137
Q

Neuro tube defect prevention in pregnancy?

A

Folate

138
Q

Delivery w/ physicians forceps may result in what condition?

A

Facial nerve palsy (CN VII)

139
Q

Erb-Duchenne palsy affects what spinal cord level?

A

C5-6 (phrenic nerve lesions w/in brachial plexus)

140
Q

Erb-Duchenne palsy may be due to?

A

Shoulder dystocia

141
Q

Erb-Duchenne palsy is AKA?

A

Waiters tip palsy

142
Q

Erb-Duchenne palsy affects what reflexes?

A

Grasp reflex - present

Biceps reflex - absent

143
Q

Erb-Duchenne palsy TXT?

A

PT and close observation > SL resolves

144
Q

Brachial plexus lesions?

A

Erb-Duchenne Palsy (MC - 90%) or Klumpke Palsy (<1%)

145
Q

Klumpke Palsy affects what spinal cord level?

A

C8-T1

146
Q

Klumpke Palsy is AKA?

A

Claw hand

147
Q

Klumpke Palsy affects what reflexes?

A

Grasp reflex -

Bicep reflex -

148
Q

Klumpke Palsy is ass/w what other condition?

A

Horners syndrome ipsilaterally

149
Q

Differences between Klumpke Palsy VS Erb-Duchenne palsy

A

Klumpke “Claw hand” - (C8-T1, Reflex Grasp - absent/bicep present)
VS
Erb-Duchenne “ Waiter-tip” - (C5-6, Reflex Grasp - present/bicep absent)

150
Q

Hydrocephalus def?

A

Increased CSF volume

151
Q

Types of Hydrocephalus?

A
  1. Communicating (w/ subarachnoid)

2. Non-communicating (Obstructed)

152
Q

TXT for hydrocephalus?

A

Ventriculoperitoneal shunt

153
Q

Key hydrocephalus S/S presentations?

A

Papilledema
Setting Sun Gaze
Lower extremity Spasticity
Bulging fontanelle

154
Q

Highest incidence of neonatal sepsis? Term vs Preterm?

A

Preterm 1:250

155
Q

Biggest RFs of neonatal sepsis?

A

Prematurity x6
Prolonged ruptured membranes >24hrs
GBS

156
Q

Classifications of neonatal sepsis? Timeframe?

A

Early (0-7d) and Late onset (8-28d)

157
Q

S/S of “early” onset neonatal sepsis

A

Rapid onset of - Fever, Hypothermia, Hypotonia, Resp distress(pneumonia)

158
Q

S/S of “late” onset neonatal sepsis

A

Insidious onset of - Fever, lethargy, seizure, increased direct bili, bulging fontanelle, poor muscle tone.

159
Q

Which classification is more likely associated w/ late onset neonatal sepsis?

A

Late onset neonatal sepsis

160
Q

Organisms associated w/ EARLY onset neonatal sepsis?

A 
#1 - GBS
E. Coli
Klebsiella
L. Mono
Salmonella
Mycoplasmas
161
Q

Organisms associated w/ LATE onset neonatal sepsis?

A 
H. Influenzae
Staph
HSV, CMV
Enterovirus
S. Pneumoniae 
N. Meningitidis
162
Q

Eval components for Neonatal sepsis evaluation?

A 
CBC
Bld Cx X2
UA/Cx
Blood glucose
CXR
CSF
163
Q

Neonatal Sepsis Rx TXT? If + Meningitis? If + HSV?

A 
IV Ampicillin AND Gentamicin
OR
IV Ampicillin AND Cefotaxime
as soon as labs are drawn and continue until...
NEG Cxs
(+- Vancomycin if meningitis present)
(Acyclovir if HSV present)
164
Q

How long does Rx TXT go on for Neonatal sepsis and if meningitis is associated?

A

Sepsis only -14D

Sepsis w/ Meningitis - 21D (+- Add Vancomycin)

165
Q

TXT HSV w/ what Rx?

A

Acyclovir

166
Q

GBS positive mother requirements per what 3 steps?

A
  1. Neonate S/S of sepsis/infection? Empiricly TXT/Eval
  2. <35wks EGA? 48hr hold/limited eval
  3. Did mom receive 2 doses of ABX?
    - - Y-48h observe w/out txt - No-48h hold/limited eval
167
Q

At a minimum how long do you hold a baby born to GBS positive mother?

A

48h

168
Q

What is a sign of neonatal respiratory distress?

A

Grunting or subtle soft meowing

169
Q

Respiratory distress syndrome is AKA?

A

Hyaline membrane disease

170
Q

RDS pathophys?

A

Insufficient surfactant synth by type II pneumatocytes.

171
Q

EGA cutoff RDS is commonly seen?

A

<34w

172
Q

What is the physiological outcome to lungs from RDS?

A

End-Expiration atelectasis

173
Q

RDS CXR will appear?

A

Bilateral, Ground glass appearance

174
Q

Prior to birth what will help prevent RDS occuring in neonate?

A

CCS given to mom 32-34wks

175
Q

TXT for RDS after birth?

A

Intubate - vent w/ artificial surfactant via ET tube.

176
Q

Complications of RDS?

A

Persistent PDA
PTX
Bronchopulm dysplasia
Retinopathy of prematurity

177
Q

What is PDA typically noticed?

A

2-4d of life

178
Q

PDA can lead to what complications?

A

Pulmonary edema and hepatomegaly

179
Q

TXT of PDA?

A

Restrict fluids
Diuretics (lessen burden)
Indomethacin or Ibuprofen - closes PDA

180
Q

Symptomatic pneumothorax TXT?

A

Chest tube

181
Q

Bronchopulm dysplasia pathophys?

A

Damage to lungs caused by mechanical ventilation and long-term oxygen (O2 toxicity/barotrauma)

182
Q

Retinopathy of prematurity pathophys?

A

O2 toxicity on developing retinal blood vessels

183
Q

Apnea of prematurity causes?

A

MC - Central - Phrenic nerve not stimulated by Medulla/Pons

Periph - Malformation/positioning causes AW obstruct

184
Q

TXT of Apnea of prematurity?

A

o2,
Stimulants - caffeine or theophylline
Transfusions for anemia

185
Q

Tracheomalacia pathophys? Worse w/?

A

Weak/floppy cartilage or tracheal wall causing collapse of trachea.
Worse w/ coughing, crying, feeding, URI

186
Q

Breath sounds ass/w Tracheomalacia?

A

+- high pitched rattling/noisy breath sound

187
Q

What is Meconium aspiration syndrome?

A

Respiratory distress
Pneumonia/Pneumonitis
Pneumothorax

188
Q

Nonvigorous child w/ suspected meconium aspiration requires what TXT?

A

Intubation and suction (if this fails)

BVM w/ PPV

189
Q

How does Meconium aspiration syndrome occur?

A

Meconium is mixed w/in amniotic fluid

190
Q

CXR of Meconium aspiration syndrome neonates look like?

A

Coarse irregular infilitrates

191
Q

Transient tachy-P is defined as?

A

Retained amniotic fluid causes mild hypoxia then tachy-P shortly after birth.

192
Q

When does Transient tachy-P of neonate resolve typically?

A

In 24h

193
Q

CXR of a neonate w/ Transient tachy-P appears?

A

Fluid in fissures (distinct linear marking between lobes)

194
Q

Transient tachy-P occurs in what kind of neonates MCLY? Why these neonates?

A

C- Section or LGA (large gestational age).

- Due to the lack of squeeze during delivery to force fluid out of lungs

195
Q

MC cause of a serious neonatal anemia?

A

Hemolytic Dz of newborn (ABO/Rh/antigen incompatibilities)

196
Q

Why do all newborns have Jaundice?

A

Elevated bilirubin from

  • Increased RBC mass turnover
  • Insufficient hepatic clearance
  • Decreased gut motility/excretion
197
Q

Hyperbilirubinemia is defined as what lab result?

A

> 5mg/dL

198
Q

MC cause of neonatal jaundice is?

A

Hemolytic dz of newborn

199
Q

Normal physiologic causes of neonatal jaundice?

A

Breastfeeding jaundice

Breast milk jaundice

200
Q

Difference between Breastfeeding jaundice vs Breast milk jaundice?

A
  • Breastfeeding jaundice - 1st wk of life - Insufficent milk synth by mom/intake by baby > Baby retains bilirubin due to decreased gut motility
  • Breast milk jaundice - After 1st wk of life lasting 1-2w - Milk has a factor or enzyme that inhibits bilirubin conjugation or causes increases bilirubin absorption on intestines.
201
Q

How does jaundice begin and progress?

A

Mucosa/sclera of head then skin head > toe

202
Q

What physical evidence suggests concern that jaundice is bad?

A

Yellow skin at/below umbilicus

203
Q

NL bilirubin levels for a full term infant? Breastfed infant?

A

Bili <13 on day 3
or
Up to 17 if breastfed

204
Q

NL bilirubin levels for a pre-term infant?

A

Bili <15 on day 5

205
Q

Pathologic bilirubin lab values?

A

> 13 on 1st day of life in term infant
Bilirubin rate rises >0.5/h OR >5/d
Jaundice starts w/in 24h of life

206
Q

Severe signs of neonatal jaundice?

A

Hepatosplenomegaly AND anemia

207
Q

Jaundice on 1st day of life is NL physiologic or pathologic?

A

Always pathologic

208
Q

Breast feeding jaundice typically occurs in what type of moms?

A

1st baby Moms

209
Q

Breastmilk jaundice physiology?

A

Fatty acids from milk displaces Bili from ALB = unconjugated w/out hemolysis

210
Q

1st > 2nd place jaundice will show on the body

A

1st - Under tongue

2nd - Sclera

211
Q

Coomb’s test in the eval of neonatal jaundice will detect?

A

ABO incompatiability due to ABs attached to fetal RBCs

212
Q

Kernicterus is AKA?

A

Bilirubin Encephalopathy

213
Q

Pathophys of Kernicterus?

A

Lipid soluble unconjugated (indirect) Bili deposits in brain cells and is toxic to CNS

214
Q

Kernicterus will occur if bili value is?

A

Bili > 20-25 or less if comorbid conditions are present

215
Q

Early S/S of Kernicterus?

A

Lethargy, Hypotonia, poor Moro’s, vomiting, high-pitched cry.

216
Q

Early S/S of Kernicterus typically occur when?

A

4th day of life

217
Q

Late S/S of Kernicterus

A

Fontanelle bulge
Opisthotonic posture (arched back)
Fever, seizure
Upward gaze is paralyzed in position

218
Q

TXT of (mild,mod,severe) neonatal Jaundice

A

Mild - lifestyle (sun exposure, increase/improve feeding)
Mod - Phototherapy
Severe - Transfuse

219
Q

Transfusion of neonate w/ severe jaundice occurs if?

A

Indirect bili =20 or more for infants w/ hemolysis and >2kg

Indirect bili >25 in asymptomatic infants w/ physiologic jaundice

220
Q

SEs of phototherapy?

A

Diarrhea/gas, temperature instability, bonding w/ mom
Asthma - long term
DM1 - long term

221
Q

Follow up times post discharge of neonate w/ jaundice?

A

Discharge before 24hr life - F/U in 3d
Discharge between 24-48h of life - F/U in 4d
Discharge between 48-72h of life - F/U in 5d

Phase 2 PEDs (23 decks)

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