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Laughing Your Way > Neonatology > Flashcards

Neonatology Flashcards

1
Q

Most common reason for elevated AFP

A

Inaccurate dating of pregnancy

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2
Q

Causes of increased AFP

A

Renal (nephrosis, renal agenesis, PKD)
Abdominal wall defects
Increased # of fetuses/Incorrect dates
Neuro (anencephaly, spina bifida)

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3
Q

Causes of decreased AFP

A

Trisomy 21
Trisomy 18

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4
Q

Management of apnea of prematurity

A

Caffeine
Theophylline

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5
Q

Pressure required to inflate lungs for first breath

A

60 mmHg

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6
Q

Cause of Transient Tachypnea of Newborn (TTN)

A

Retained fetal fluid

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7
Q

Xray findings for TTN

A

Fluid in interlobar fissures
Increased interstitial markings

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8
Q

Cause of RDS (Hyaline Membrane Disease)

A

Surfactant deficiency (< 36 wk GA)

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9
Q

CXR finding for RDS

A

Ground glass appearance
Granular opacifications
Air bronchograms

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10
Q

Increases risk for RDS

A

Infancy of diabetic mothers
C-section
Birth asphyxia

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11
Q

Decreases risk for RDS

A

Prolonged rupture of membrane
Prenatally administered steroids

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12
Q

Criteria for ECMO

A

> 34 wk GA
2 kg
Reversible lung disease < 10-14 days duration
Refractory to other treatment

No hemorrhage
No CHD

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13
Q

Arrest of normal lung development in premature infants

Management

A

Bronchopulmonary disease (BPD)

Tx: Diuretics

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14
Q

CXR for BPD

A

Diffuse opacities
Cystic areas with streaky infiltrates
Ground glass appearance

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15
Q

Most common causes of coma and lethargy in infants

A

Sepsis
Metabolic disturbances
Asphyxia

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16
Q

Empiric treatment for sepsis in newborn

A

Ampicillin + gentamicin

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17
Q

Early GBS

A

First 7 days
Sepsis or pneumonia

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18
Q

Late GBS

A

First month of life to 90 days
Bacteremia or meningitis

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19
Q

Late-Late GBS

A

Up to 6 months of age
Preterm infants

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20
Q

Antenatal screening for GBS

A

36 0/7 to 37 6/7 weeks GA

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21
Q

Treatment for GBS

A

Penicillin G

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22
Q

Caput succadaneum

A

Crosses suture lines
Soft, boggy pitting

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23
Q

Cephalohematoma

Cause

A

Cannot cross suture lines
Firm

Caused by prolonged labor or instrument-assisted delivery. Or underlying skull fractures

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24
Q

Subalgeal hematoma

A

Vacuum-assisted deliveries
Bleed between epicranial aponeurosis and skull periosteum

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25
Q

Erb’s Palsy

A

C5-7 injury
Excessive lateral neck flexion
Phrenic nerve paralysis
Waiter’s tip

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26
Q

Klumpke palsy

A

C8-T1 injury
Horner syndrome
Anisocoria
Claw hand

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27
Q

SGA definition

A

Lower 10th percentile
< 2500g

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28
Q

LGA definition

A

Above 90th percentile
> 3900g

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29
Q

Risk factors for SGA

A

IUGR
Mothers with chronic illness
Teenage mothers

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30
Q

Complications of SGA

A

Higher morbidity and mortality
Temperature instability
Polycythemia
Hypoglycemia

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31
Q

Causes of Symmetric IUGR
(proportional head and body)

A

Early pregnancy
Infections
Genetic abnormalities
Chronic alcohol/tobacco use

32
Q

Causes of asymmetric IUGR
(Head larger than body)

A

Later pregnancy
Placental issues
Hypertension
Preeclampsia

33
Q

Characteristics of posterm infants (>42 wk GA)

A

Peeling dry skin
Long fingernails
Decreased lanugo on the back
Ears with strong recoil

34
Q

Most common cause of fetal demise

A

Chromosomal abnormalities
Congenital malformations

35
Q

MAP in preemie

A

No less than corrected GA in weeks

36
Q

Factors which impact prognosis in VLBW (<1500g)

A

Gestational age (most important)
Morbidity while in NICU
intracranial hemorrhage

37
Q

Symptoms of meconium aspiration

A

Barrel chest
Rales/tho chi on auscultation

38
Q

CXR for meconium aspiration

A

Patchy areas of atelectasis alternating with areas is hyperinflation

39
Q

Most likely complication of meconium aspiration

A

Persistent pulmonary hypertension

40
Q

Causes of delayed passing of meconium (no stool in first 48 hrs)

A

Meconium plug syndrome
Hirschsprung’s disease
Imperforate anus

41
Q

Risk factors for NEC

A

Hypoxia
Bacterial infection

42
Q

Objective data for NEC

A

Positive blood culture
Pneumotosis intestinalis
Air in biliary tree
Pneumoperitoneum

43
Q

Long term complication of NEC

A

Intestinal strictures

44
Q

Causes of indirect hyperbilirubinemia

A

Gilbert disease
Hypothyroid, hypopituitary
Obstruction, pyloric stenosis
Meconium ileus, ileus, Hirschsprung
Lucy Driscoll syndrome
Hemolysis
Galactossemia, Tyrosinosis, CF
Hemorrhage/hematomas

45
Q

Physiologic jaundice

A

Unconjugated hyperbilirubinemia
Occurs day 2-5
Last 1 week
Healthy infant
Increased rate of bilirubin production (shorter lifespan of fetal RBC)
Diminished bilirubin excretion

Reaches max values of 5-9 mg/dL between 72 and 96 hrs of age in full term

46
Q

Abnormal Bili level in newborn

A

Elevated level during first 24 hours (>13)

Bilirubin level of 17 after 120 hours

47
Q

Contraindications for phototherapy

A

Conjugated (direct) bilirubin (bronze baby syndrome)
Family h/o light sensitivity porphyria

48
Q

Breastfeeding jaundice

A

Unconjugated hyperbilirubinemia (most common cause)
First days of life
Decreased caloric intake (increased enterohepatic circulation) or delayed passage of meconium

49
Q

Human milk jaundice

A

Inherent human milk factors
6-14 days after birth
Persist 1-3 months

50
Q

Management for hypoglycemia (BG < 40) in newborn

A

2-3 ml/kg D10 bolus
Increased enteral feeds or dextrose fluids
Maintain good body temperature

51
Q

Complications of infants of diabetic mothers

A

LGA
Hypoglycemia
Polycythemia
RDS

Cardiac abnormalities
Colon abnormalities
Caudal regression syndrome Dr Dr Sx

52
Q

Anemia nadir

A

Term: 2-3 mo

Preterm: 1-2 mo

53
Q

Polycythemia of newborn

Management

A

Central venous HCT of > 65
Associated with hypoglycemia

Tx: partial exchange transfusion (if Sx)

54
Q

Risk factors for hyperviscosity syndrome

A

Twin-twin transfusion
Delayed cord clamping
Down syndrome
IDM

55
Q

Omphalocele

A

Protrusion of bowel and other organs through base of umbilical cord

Bowel contents cover with membrane

56
Q

Risk factors for omphalocele

A

Large babies
Chromosomal defects
Beckwith Wiedemann

57
Q

Gastroschisis

A

Germination of bowel through defect in abdominal musculature to right of umbilicus.
Limited to intestinal contents
Not covered with membrane

58
Q

Risk factors for gastroschisis

A

Small (IUGR) infants
Vascular accidents
Vasoactive medications/drugs

59
Q

Scaphoid abdomen
Decreased breath sounds on Left
Heart sounds on right

A

Diaphragmatic hernia

60
Q

Most likely cause of neonatal seizure within 24 hours of birth

A

Birth asphyxia

61
Q

Typical characteristics of neonatal seizures

A

Staring spells
Decreased motor activity
Lip smacking
Abnormal facial movements

62
Q

Most frequent cause of neonatal seizures in full term infant

A

Neonatal encephalopathy
HIE

63
Q

Management of neonatal seizures

A

Phenobarbital

64
Q

Grading Intraventricular hemorrhage

A

Grade 1 - germinal matrix
Grade 2 - IVH without dilation
Grade 3 - IVH with dilation
Grade 4 - above + parenchyma involvement

65
Q

Risk factors for hypoglycemia in newborn

A

IDM (insulin)
Polycythemia (Hct > 65)
Tocolytics
Beta adrenergics (terbutaline)
Maternal alcohol use
Prematurity (< 37 wk GA)
Sepsis
Hypothermia

66
Q

Respiratory depression
Apnea
Generalized hypotonia
GI hypomobility
Meconium plug syndrome
Mother treated for preeclampsia

A

Neonatal hypermagnesemia

67
Q

Colonic obstruction involving a significant caliber reduction in the sigmoid and descending colon

A

Small left colon syndrome

Associated with maternal diabetes

68
Q

Microcephaly
Hypertonia
Arthrogryposis

A

Zika virus

69
Q

Teratogenic effects of ACEi

A

Septal defects
PDA
neural tube defects
Renal anomalies/failure
IUGR
Oligohydramnios
Pulmonary hypoplasia
Limb anomalies

70
Q

Nasal hypoplasia
Stippled epiphyses

A

Fetal warfarin syndrome

71
Q

Abnormal development of lymphatic system leading to obstruction of normal lymphatic flow and sequestration of lymphatic fluid

Lateral neck.
Transilluminates

A

Cystic hygroma

72
Q

Asymmetry of gluteal folds
Asymmetry in knee height (Galeazzi sign)

Diagnosis

A

Developmental dysplasia is the Hip (DDH)

Hip US in infants < 4 mo

73
Q

Complication of twin-to-twin transfusion syndrome

A

Hydrops details in both infants

74
Q

Well-circumscribed
Nontender
Nonfluctuant
Reddish-purple nodules
Hypercalcemia

A

Subcutaneous fat necrosis of the newborn

Self-limited

75
Q

Gross hematuria
Flank mass
Thrombocytopenia

A

Renal vein thrombosis

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