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Peds ⛄️ > Neonatology > Flashcards

Neonatology Flashcards

1
Q

RDS is ___ deficiency

A

Surfactant

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2
Q

Age at risk for RDS?

A

Preterm

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3
Q

Age at risk for TTN

A

Usually term

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4
Q

How does TTN happen?

A

Delayed resorption of fetal lung fluid

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5
Q

TTN CXR

A

Wet silhouette, fluid in fissures

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6
Q

Risk factor for TTN

A

Short labour, Elective CS

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7
Q

CXR in RDS

A

Homogenous infiltrates, Air bronchogram, Groundglass appearance

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8
Q

RDS prevention?

A

Corticosteroids prenatally

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9
Q

RDS treatment

A

Surfactant

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10
Q

MAS treatment

A

inhaled NO

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11
Q

MAS CXR

A

Patchy atelectasis

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12
Q

What ratio indicates lung maturity?

A

Lecithin/Sphinngomyelin ratio > 2:1

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13
Q

Fluid in fissures appears in

A

TTN

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14
Q

Complication of MAS

A

Pneumothorax

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15
Q

BRUE is >1 of:

A

1-Cyanosis
2-Change of tone
3-Absent/irregular breathing
4-Altered level of responsiveness

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16
Q

Red flags of BRUE

A 
1- <60 days
2-Unwell upon exam
3->1 episode
4->1min
5-Born<32weeks
6-FH SIDS
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17
Q

BRUE low risk management

A

Observe 1-4 hrs, Pertussis PCR, outpatient visit

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18
Q

Physiologic Jaundice appears on __ day, and disappears on __ day

A

2-3, 7th

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19
Q

Physiologic Jaundice’s peak is __ mg/dL

A

<13 mg/dL (if term)

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20
Q

Physiologic Jaundice’s rate of bilirubin’s rise is __ mg/dL/d

A

<5 mg/dL/d

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21
Q

Pathological Jaundice’s rate of bilirubin’s rise is __ mg/dL/d

A

> 5 mg/dL/d

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22
Q

Pathological Jaundice appears in ___ day

A

First 24 hrs of life

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23
Q

Unconjugated bilirubin features:

A

Lipid soluble, crosses BBB

No urine excretion, Kernicterus

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24
Q

Conjugated bilirubin features:

A

Water soluble, Doesn’t cross BBB,

No kernicterus, + urinary excretion

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25
Q

Where does unconjugated bilirubin accumulate causing kernicterus?

A

Basal ganglia and brain stem nuclei

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26
Q

Kernicterus leads to _____

A

Sensorineural hearing loss

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27
Q

If jaundice was indirect, what do we think ?

A

Coombs + or -

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28
Q

Breastfeeding jaundice

A
  • Feeding inadequate, baby dehydrated
  • First time mothers
  • First week of life
  • Tx is breastfeeding education
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29
Q

Breast milk jaundice

A
  • Problem in the MILK
  • Feeding is adequate
  • Second week of life, resolve by 2-3m
  • Tx is phototherapy
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30
Q

How to deliver glucose concentration of > 12.5% in neonate with hypoglycemia?

A

Via central line

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31
Q

Biliary atresia initial test

A

RUQ US

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32
Q

Biliary atresia initial management

A

Kasai

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33
Q

Biliary atresia definitive management

A

Liver transplant

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34
Q

Type of jaundice in Biliary atresia?

A

Direct hyperbilirubinemia

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35
Q

Biliary atresia pathogenisis

A

Extrahepatic bile duct fibrosis

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36
Q

US of biliary atresia shows:

A

Absent/abnormal gallbladder and CBD

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37
Q

Cow milk deficient in

A

Iron, Copper, Vit C

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38
Q

Human milk deficient in

A

Vit D and Riboflavin

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39
Q

Caput Succedeum

A

Crosses suture lines
Disappears in a few days
Maximum size at birth

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40
Q

Cephalhematoma

A

Doesn’t cross suture lines
Resolves in 2 wks
Maximum size 1d after birth

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41
Q

Coloboma association

A

CHARGE

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42
Q

Early introduction of cow’s milk leads to

A

Iron deficiency anemia

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43
Q

When do breastfed infants need iron?

A

> 4 m

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44
Q

Newborn growth rate in grams

A

30 g/day

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45
Q

Which Ig present in colostrum?

A

IgA

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46
Q

Do not brrastfeed

Do not give expressed milk

A 
1- Mother has HIV
2- Mother has Ebola 
3- Mother has Human T-lymphotropic virus
4- Mother uses illicit drugs
5- Child has Galactosemia
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47
Q

Do not brrastfeed
Do not give expressed milk
(Temporarily)

A

Mother has untreated Brucellosis
Mother has HSV w/ lesions on breast
Mother is taking certain meds

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48
Q

Temporarily do not breastfeed, expressed is okay

A

Untreated active TB

Varicella (developed bw 5 days prior to delivery and 2 days following delivery)

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49
Q

Human milk stays in freezer for

A

6m

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50
Q

Human milk stays in fridge

A

4 d if fresh

1 d if previously frozen

51
Q

Human milk stays in counter for

A

4 hrs if fresh

1 hr if previously frozen

52
Q

Parenteral nutrition options for <3wks

A

Peripheral line

Central line

53
Q

Parenteral nutrition options for >3wks

A

Peripheral dwell line

Central tunneled line

54
Q

Hirschsprung disease associated with

A

Down Syndrome

55
Q

Squirt sign present in

A

Hirschsprung

56
Q

Hirschprung disease Tx

A

First stage: diverting colostomy to relieve the dilated bowel.

  • Second stage: Resection of the aganglionic segment & anastomoses
57
Q

Meconium ileus Tx

A

Enema with a contrast agent

58
Q

Meconium ileus associated with

A

Cystic Fibrosis

59
Q

Patient with Meconium plug, what to do next?

A

Rectal biopsy

60
Q

Patient w\ Meconium ileus, what to do next?

A

Sweat chloride test

61
Q

Triple bubble seen with

A

Jejunal atresia

62
Q

Double bubble seen with

A

Duodenal atresia

63
Q

Intussusception px

A

Currant jelly stool
Intermittent abx pain
Sausage shaped abdx mass

64
Q

Intussusception Tx

A

Air/Saline enema

Surgery

65
Q

Intussusception Dx

A

Target sign on US

66
Q

When is surgical reduction done in Intussusception?

A

When a pathological lead sign is suspected

67
Q

Treatment of choice for Intussusception?

A

Nonoperative reduction using hydrostatic or pneumatic pressure by enema

68
Q

Most common cause of acute abdomen in premature infants.

A

NEC

69
Q

NEC risk factors

A

Prematurity

Enteral feeding

70
Q

NEC X-Ray findings

A

Pneumatosis intestinalis
Portal venous gas
Pneumoperitoneum

71
Q

NEC Tx

A

Bowel rest
Abx
+/- surgery

72
Q

NEC Indication of surgery:

A

perforation (Pneumoperitoneum), peritonitis and/or clinical worsening despite medical therapy

73
Q

Cyanosis that is relieved after crying

A

Bilateral choanal atresia

74
Q

Bilateral choanal atresia Dx

A

inability to pass NG tube

75
Q

Bilateral choanal atresia Tx

A

Urgent insertion of an oropharyngeal airway as a temporary airway until surgery

76
Q

asymmetrical moro reflex (absent in on side) →

A

Clavicular fracture (it causes Erb palsy)

77
Q

Absent moro reflex →

A

Cerebral palsy

78
Q

Total plexuses palsy (upper limb)

A

C5-C8 and sometime T1

79
Q

Intermediate plexus palsy:

A

C7-C8

80
Q

Extended upper plexus palsy:

A

C5-C7

81
Q

Upper plexus palsy (Erb palsy):

A

C5-C6 – “Bad shoulder, good hand”

82
Q

Lower plexus palsy (Klumpke palsy):

A

C8-T1 – “Good shoulder, bad hand”

83
Q

Brachial plexuses injury risk factor

A

Shoulder dystocia

84
Q

Which conjunctivitis presents within 2-5d of life?

A

N Gonorrhea

85
Q

N Gonorrhea conjunctivitis Tx and prophylaxis

A

IM Ceftriaxone, prophylaxis is erythromycin

86
Q

Which conjunctivitis presents within 7-14 d of life?

A

Chlamydia Trachomatis

87
Q

Chlamydia Trachomatis conjunctivitis Tx and prophylaxis

A

Tx is oral erythromycin

No effective prophylaxis

88
Q

Chemical conjunctivitis cause and Tx

A

Silver nitrate irritation, Tx is lubrication

89
Q

Target sign is seen in

A

Pyloric stenosis & Intussusception

90
Q

Pyloric stenosis clinical features

A

Projectile, non bilious vomiting
Immediate postprandial vomiting
Hungry between feeds

91
Q

Pyloric stenosis management

A

Treat electrolyte imbalance, pyloromyotomy

92
Q

Pyloric stenosis electrolyte imbalance

A

Hypochloremic hypokalemic metabolic alkalosis

93
Q

Gastroschisis is abdominal defect ____ to umbilicus

A

LATERAL

94
Q

Omphalocele is failure of intestines to return to abdominal cavity with gut ____ umbilicus

A

through

95
Q

Omphalocele/Gastroschisis Tx

A

Surgical silo
Nasogastric suction
IVF
Surgery

96
Q

Neonatal Polycythemia Hct

A

> 65%

97
Q

Olive shaped abdx mass

A

Pyloric Stenosis

98
Q

SIDS risk factor

A

Prematurity and prone sleeping

99
Q

SIDS prevention

A

Pacifier and sleeping on the back

100
Q

Epiglottitis pathogen

A

Haemophilus influenza

101
Q

Bronchiolitis pathogen

A

RSV

102
Q

Laryngotracheitis pathogen

A

Para influenza virus (croup)

103
Q

Barky cough is usually with 

A

Croup

104
Q

Focally diminished breath sounds

A

Foreign body

105
Q

Stridor improves when prone

A

 Laryngomalacia

106
Q

Laryngomalacia Dx

A

Laryngoscopy

107
Q

Croup Tx

A

Mild: steroids and humidified air
Severe: Steroids and racemic epinephrine

108
Q

How do you tell if croup is severe

A

Stridor at rest

109
Q

Epiglottitis features

A

Extremely sore throat
Drooling
High fever
Sniffing position

110
Q

Best initial test for epiglottitis

A

Laryngoscopy

111
Q

Most accurate test for epiglottitis

A

Culture from tracheal aspirate

112
Q

Most accurate test for croup

A

PCR of virus

113
Q

Best initial test for croup

A

Clinical dx

114
Q

Bronchiolitis vaccine

A

Palivizumab

115
Q

Palivizumab for bronchiolitis is given to:

A

Chronic lung disease of prematurity
Hemodynamically significant congenital heart disease
Less than 29 weeks of gestation

116
Q

Apgar score is evaluate it based on

A

Heart rate, respiration, color, tone, reflex irritability

117
Q

Small for gestational age is defined

A

2 SD < mean weight for GA/<10 percentile

118
Q

Most common type of skull fracture during delivery

A

Linear and no treatment needed

119
Q

Jaundice occurs with cephalhematoma or caput?

A

cephalhematoma

120
Q

Breast milk predominant protein:

A

Whey

121
Q

Human milk vs cow milk, which has more of what?

A

Human: Lactose
Cow: Protein

122
Q

Most common diaphragmatic hernia?

A

Bochdalek hernias

123
Q

Most common diaphragmatic hernia?

A

Bochdalek hernias

124
Q

Kcal of 1 ml of human milk vs cow

A

70 in human’s milk

67 in cow’s milk

Peds ⛄️ (12 decks)

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