NEONATOLOGY Flashcards by Bao Truong

Seen this in a newborn

What is the finding? What is the cause?

Erb-Duchenne palsy

(upper brachial plexus palsy involving C5-C7)

How well did you know this?

Not at all

Perfectly

Seen this in a newborn

What is the finding? What is the cause?

Klumpke palsy

(lower brachial plexus palsy involving C8-T1)

How well did you know this?

Not at all

Perfectly

Gross hematuria, a new mass palpable in flank of a newborn

What is going on?

Renal vein thrombosis (RVT)

How well did you know this?

Not at all

Perfectly

When does physiologic jaundice start to become apparent? (earlier jaundice would likely be pathologic)

48-72 hours

How well did you know this?

Not at all

Perfectly

Most common causes of neonatal sepsis? (3)

1 - E.coli
2 - Listeria
3 - GBS

How well did you know this?

Not at all

Perfectly

An newborn refuses to move arm, with XR shows extensive bone destruction in the diaphyses and solid periosteal new bone formation

What is going on? What is the underlying cause?

Pseudoparalysis

Caused by congenitial syphillis

How well did you know this?

Not at all

Perfectly

What is this finding? What is it associated with?

Scaphoid abdomen

Associated with congenital diaphragmatic hernia (CDH)

How well did you know this?

Not at all

Perfectly

Displaced apical impulse, respiratory distress, bowel sounds over chest

What is going on?

CDH

How well did you know this?

Not at all

Perfectly

What are long term risks for neonate with IUGR? (2)

1 - Metabolic syndrome
2 - Hypertension

How well did you know this?

Not at all

Perfectly

Non-blanching, non-tender, bluish, flacutuant swelling lateral to midline of lower mouth, might displace tongue slightly to left

What is it? Cause?

Ranula

Pseudocyst associated with sublingual & submandibular glands

How well did you know this?

Not at all

Perfectly

Short palpebral fissures, ptosis, long and smooth philtrum, thin upper lip

What is going on? What is the common associated heart disorder?

Fetal alcohol syndrome

Septal defects (ASD, VSD)

How well did you know this?

Not at all

Perfectly

Which birth weight is associated with increased risk of neonatal hypoglycemia?

< 2500g

How well did you know this?

Not at all

Perfectly

What gestational age is associated with increased risk of neonatal hypoglycemia?

< 37 wks GA

How well did you know this?

Not at all

Perfectly

What is Galeazzi sign? How is it helpful?

Asymmetry in hieght of knees due to shortening of thigh on affected side

Used to detect dysplasia of hip in patients > 3mo

How well did you know this?

Not at all

Perfectly

When Barlow & Ortolani tests no longer helpful?

3 months of age

How well did you know this?

Not at all

Perfectly

What are risk factors for dysplasia of hip (DDH) in infants? (3)

1 - Girl
2 - Breech
3 - Family history of DDH

How well did you know this?

Not at all

Perfectly

When weight loss in first 2 weeks of life is too much?

> 10%

How well did you know this?

Not at all

Perfectly

Fleshy-color smooth surface lesion noted to protrude from inferior portion of the vagina of the newborn

What is it? Management?

Hymental tag

Reassurance

How well did you know this?

Not at all

Perfectly

Fleshy-color smooth surface lesion noted to protrude from inferior portion of the vagina of the newborn

What is it? Management?

Hymental tag

Reassurance

How well did you know this?

Not at all

Perfectly

What is this finding? Which syndrome is it associated with ?

“Mitten hand”
Syndactyly of the 2nd, 3rd, and 4th fingers and toes

Associated with Apert syndrome

How well did you know this?

Not at all

Perfectly

When does lanugo disappear from face in fetus?

between week 33 and 37

How well did you know this?

Not at all

Perfectly

When does hair becomes fine and wooly in fetus?

between 28 and 36 weeks

How well did you know this?

Not at all

Perfectly

When rugae begins to develop on scrotum in fetus?

between 28 and 35 weeks

How well did you know this?

Not at all

Perfectly

When vernix starts decrease in fetus?

~38 weeks

How well did you know this?

Not at all

Perfectly

Duodenal treasia and endocardial cushion defect Which syndrome?

Trisomy 21

Clenched hands, cystic hygroma, horseshoe kidney Which syndrome?

Trisomy 18

Severe midline facial abnormalities, polydactyly Which syndrome?

Trisomy 13

Fetal hydrops, coarctation What is going on?

Turner syndrome

Limb defects (missing arms/legs), or ear malformation in newborn Maternal exposure to what drug ?

Thalidomide

Limb defects (missing arms/legs), or ear malformation in newborn Maternal exposure to what drug ?

Thalidomide

What are newborn defects seen in maternal exposure to warfarin during pregnancy? (2)

1 - Nasal hypoplasia 2- Stippled epiphyses

What are components of WAGR syndrome?

1- Wilm's tumor 2- Aniridia 3 - GU malformations 4 - Reduced intellectual capacity

Mass located anterior to the SCM muscle in a child What is it?

Brachial cleft cyst

Indurated, reddish nodules and plaques on lower back and buttocks of an infant with history of traumatic birth? What are they? What is the potential risk?

Subcutaneous fat necrosis Risk of **hypercalcemia**

What are 5 components of APGAR score?

1 - Breathing 2 - Heart beat 3 - Muscle tone 4 - Grimace 5 - Skin color

Which reflex can be elicited in healthy 1-yo

Parachute reflex

Which type of medications can cause oligohydramnios of fetus?

ACEi

Color differences in half part of the body, quickly returns to normal (within several minutes) with reposition, in first couple weeks of life. What is it? Management?

Harlequin color change Nothing (benign).

Scant ear cartilage with pinna returns slowly from folding What is estimated gestational age?

32-35 weeks

Thin cartilage, pinna springs back from folding What is estimated gestational age?

36 - 39 weeks

Areola first raised, but breast tissue not yet palpable What is the estimated gestational age?

34 - 35 weeks

What is recommended delivery room temperature?

22 - 26 C

Newborn with bilious vomiting - contrast enema shows small-diameter sigmoid and descending colon with dilated air-filled loops of small bowel What is going on? What is the associated disorder?

Meconium ileus Associated with **cystic fibrosis** (in fact 80-90% of neonate with meconium ileus has CF)

Neonate with mom who is HBsAg-positive. What is the management?

Give BOTH HepB vaccine and HBIG

Long, wide, protruding ears Associated with which syndrome?

Fragile X syndrome

Hypoplastic testes in a male neonate? What is the associated syndrome?

Klinefelter

What is this finding? Which are 2 congenital conditions it is associated with?

Arachnodactyly 1 - Neonatal Marfan syndrome 2 - Congenital contractural arachnodactyly syndrome

Hypothermia, vomiting, frequent stools, feeding difficulties, excessive crying in a newborn What is the drug that mother was on that can cause these?

SSRI

Aplasia or hypoplasia of abdominal muscles Which syndrome? What are 4 associated problems?

Prune belly syndrome 1 - Bilateral undescended testes 2 - GU tract and renal anomalies 3 - Pulmonary atresia 4 - Cardiac abnormalities 5 - MSK abnormalities

What syndrome caused by CHD7 gene? What are the components of syndrome?

CHARGE syndrome 1 - Coloboma 2 - Heart defect 3 - Atresia choanae 4 - Restricted growth and development 5 - Genital anomalies 6 - Ear anomalies

Which factor in a case of supernumerary digits on a hand would warrant orthopedic consultation

A bony articulation of the digit

Soft, painless, compressible, nonpusatile mass on lateral neck that transluminates well, not involving underying tissue. What is it? What causes it? What types of condition this finding is associated with ?

Cystic hygroma Abnormal development of the lymphatic system -> obstruction of normal lymphatic flow and sequestration of lymphatic fluid **Karyotypic abnormalities** (up to 70%) - trisomies, Turner, Klinfelter

Neonate with myelomeningocele and heart issues What antihypertensive medication in mother causes this? When was she exposed?

ACEi exposed in 1st trimester

Which illicit drug by mother can cause gastroschisis?

Cocaine (vasoconstriction)

Bilious emesis, abdominal distension, "soap bubble" appearance of portions of intestinal contents What is going on? Likely underlying diagnosis?

Meconium ileus Cystic fibrosis

Neonate with flattened dimpled buttocks, small pelvis, absence of sacrum What is going on? What are conditions this finding is associated?

Caudal regression syndrome Associated with 1 - Diabetic mother 2 - VACTERL

Which antiepileptic might cause neural tube defect?

Valproate

What are 3 clinical features of Wiscott-Aldrich syndrome? (WAS)

1 - Eczema 2 - Immunodeficiency 3 - Thrombocytopenia (eXit) (X = X-linked)

What is the hematologic complication in neonate whose mom was on phenytoin?

Vitamin K deficiency bleeding

What is the classic triad of neonatal renal vein thrombosis?

1 - Hematuria 2 - Flank mass 3 - Thrombocytopenia

Short and upturned nose, stubby digits, hypoplastic nails What is the maternal drug exposure?

Phenytoin

Prevention of GBS in newborn for mom who is GBS positive

Penicilline (or ampicillin) every 4 hours until delivery

What is anicosiria?

Unequal pupils (might be caused by miosis in one pupil)

What are 3 components of Horner's syndrome? If seen in a newborn, what is it associated with?

1 - Miosis 2 - Ptosis 3 - Anhidrosis Associated with **lower brachial plexus injury that involves T1**

Treatment of Criggler-Nijjar syndrome type II

Phenobarbital (doesn't work for type I where there is no UGT enzyme production at all)

Macules with central pustules on erythematous base in neonate What is it? When will they resolve?

Erythema toxicum neonatorum Resolves within first week of life

What are these? Treatment?

Milia Nothing - benign

What is this ? Treatment ?

Epstein pearl (like milia, but in mouth) Nothing - benign

What is management of newborn whose mom is positive for HbsAg?

HBIG at birth Hep B at birth, 1, 2 and 6 months Test for HbsAg and anti-Hbs-Ag at 9-12 months (after completing the vaccine series)

Inclusion bodies seen in cells of ocular discharge What is going on? Treatment?

Chlamydial conjunctivitis Oral erythromycin / azithromycin

Descending colon with abrupt caliber transition at the splenic flexture, small sigmoid, normal rectum - seen in a newborn What is going on? What is the associated maternal condition?

**Small left colon syndrome** Associared with **maternal diabetes**

Apnea, decreased bowel sound in all quadrants in a newborn What is going on? What does the mother have?

Hypermagnesemia ! (mother has pre-eclampsia, got Mg)

Management of CDH with respiratory distress? (3)

1 - Intubation 2 - Mechanical ventilation after intubation (do NOT bag mask) 3 - Passing an NG/Repogle to decompress abdominal contents

Which maternal medication associated with persistent pulmonary hypertension in a newborn?

SSRIs