Neonatology

Question 1

Steps in EINC

Answer 1

immediate drying
uninterrupted skin to skin contact
delayed cord clamping –> 1 to 3 mins
non-separation of mother and baby

Question 2

Most importance component of APGAR

Answer 2

Respiration

Question 3

Ventilation corrective steps in Newborn resuscitation

Answer 3

MR. SOPA
mask adjustment
reposition airway
suction mouth and nose
Open mouth
Pressure increase
Airway alternative

Question 4

6 NBS

Answer 4

Congenital Hypothyroidism
Congenital Adrenal hyperplasia
Galactosemia
MSUD
PKU
G6PD

done: 24-48 hrs
RA 9288

Question 5

MCC of Congenital Hypothyroidism

Answer 5

Thyroid Dysgenesis
dx: thyroid utz

Question 6

Lab findings in CAH

Answer 6

Hyponatremia, Hyperkalemia, Hypoglycemia
AR, deficiency in 21-hydroxylase enzyme

Question 7

MC deficiency in CAH

Answer 7

21-hydroxylase enzyme 90%

Question 8

Classic form of Galactosemia

Answer 8

Galactosemia 1 phosphate uridyltransferase deficiency

Question 9

MCC of anemia in child

Answer 9

G6PD deficiency
impt in HMP shunt (reduces NADP – NADPH –> reduced gluta —- counteract oxidative stress)

Question 10

developmental delay, unpleasant MUSTY ODOR
Infant: severe vomiting, hypertonic DTR seizure
Older: Hyperactive with purposeless movement, rhythmic rocking and athetosis

Answer 10

PKU
deficiency: Phenyalaline hydroxylase

Question 11

purplish reticulated pattern on the skin of a neonate when exposed to COLD
Cobblestone, lacy appearance

Answer 11

Cutis marmorata

Question 12

patient with Galactosemia is increased risk for

Answer 12

E. coli neonatal sepsis
Tx: Lactose free milk

Question 13

Slate blue, well demarcated areas of
pigmentation over the buttocks and back

Answer 13

Mongolian spots

Question 14

Small, white occasionally vesiculopustular papules on an erythematous base develop after 1-3 days
Eosinophils.

Answer 14

Erythema toxicum

Question 15

Vesiculopustular eruption over a dark macular base around the chin, neck,
back, and soles
Neutrophils

Answer 15

Pustular melanosis

Question 16

CYST appearing on the HARD PALATE which is composed of accumulations of
epithelial cells

Answer 16

Epstein pearl

Question 17

Pearly WHITE PAPULES seen mostly on the CHIN and around the cheeks

Answer 17

Mila

Question 18

Open and closed COMEDONES or inflammatory pustules and papules on the CHEEKS of the baby usually after a week from delivery

Answer 18

Neonatal ance

Question 19

PINK MACULAR lesions on the nape, glabella, upper eyelids, or nasolabial region

Answer 19

Nevus simplex

Question 20

HAIR that covers the skin of preterm infants.
Seen on term infants around the shoulders.

Answer 20

Lanugo

Question 21

Thick, white creamy material usually absent in post term infants

Answer 21

Vernix caseosa
for thermoregulation

Question 22

imbalance of cutaneous blood vessel tone due to immature hypothalamus
transient HALF of the body is reddish

Answer 22

Harley Quinn Change

Question 23

Chorioretinitis + Periventricular calcification

Answer 23

CMV

Question 24

Chorioretinitis
Microcephaly
Hepatosplenomegaly
INTRACEREBRAL CLACIFICATION

Answer 24

Toxoplasmosis

Question 25

TRIAD of NEC

Answer 25

intestinal ischemia Enteral nutrition Pathologic organism (E.coli, Klebsiella, Proteus, Pseudomonas)

Question 26

preterm, toxic abd distention with abdominal erythema cries when touched + pneumatosis intestinalis

Answer 26

NEC histo: Coagulation necrosis

Question 27

accumulation of fluid in tunica vaginalis

Answer 27

Hydrocele majority are non communicating resolve by 1 y/o

Question 28

MCC of Apnea

Answer 28

Idiopathic apnea of prematurity apnea - cessation of breathing longer than 20 sec, accompanied with cyanosis and bradycardia

Question 29

test used to detect antibodies that are bound tp the surface of the RBc

Answer 29

Direct Coombs Test Indirect Coombs test - detects antibodies against RBCs that are present unbound to the patient’s serum

Question 30

MCC of hemolytic disease of the newborn

Answer 30

ABO incompatibility 20-25% in pregnancy, 10% develops in the offspring mild, jaundice, mild hepatosplenomegaly

Question 31

+ direct coombs spherocytes hemoglobin is usually normal, but may be low as 10-12g/dl inc reticulocyte increase B1

Answer 31

ABO incompatibility

Question 32

Direct Coombs test is + Anemia Increased reticulocyte count B1 rises rapidly in the 1st 6 hours of life B2 may also be elevated

Answer 32

RH Incompatibility Injection of anti-D gamma globulin (RhoGAM) into the mother immediately after the delivery of each Rh+ infant reduces Rh hemolytic disease

Question 33

breast milk storage duration when put in Refrigerator 4 degree

Answer 33

8 days freezer 1 door - 2 weeks freezer 2 door - 3 months deep freezer (-20) - 6 months

Question 34

breast milk storage duration when put in room temp < 25 degree

Answer 34

4 hours RT >25 degree - 1hr

Question 35

general softening of the bones Craniotabes or softening of the cranial bones Rachitic rosary, PIgeon chest Harrison groove bowlegs or knock knees

Answer 35

Rickets - def in Vit D tx: Stoss therapy --> vitamin D 300,000-600,000 IU or IM as 2-4 doses over 1 days

Question 36

Scorbutic rosary at the costochondral junction & depression of the sternum Bluish, purple spongy swellings of the mucous membranes corkscrew hair” poor wound & fracture healing white line on the end of shafts

Answer 36

Scurvy - Vit C deficiency tx: Daily intake of 3-4 oz of orange or tomato juice or Vitamin C supplements of 100-200 mg orally

Question 37

which among the micronutrients are affected by maternal sattus

Answer 37

Vitamin D and Iodine

Question 38

infants born full term, have sufficient stores of these nutrients that are ENOUGH for 6 mos of life

Answer 38

Iron and ZInc

Question 39

pellagra Casal necklase pellagarous glove and boots

Answer 39

Niacin - Vit B3 deficiency

Question 40

irritability, pruritus, painful extremities brawny swelling, coarse hair, dry skin, seborrhea increased ICP

Answer 40

Hypervitaminosis A

Question 41

Malnourished child when fed with excessive carbohydrates will cause

Answer 41

Hypokalemia, Hypomagnesemia, Hypophosphatemia refeeding syndrome HM: severe hypophosphatemia

Question 42

goal of the management of obesity

Answer 42

weight maintenance

Question 43

neonate with prolonged jaundice >14days, suspect

Answer 43

Congenital Hypothyroidism