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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
Erb’s Palsy
C5-7 injury Excessive lateral neck flexion Phrenic nerve paralysis Waiter’s tip
26
Klumpke palsy
C8-T1 injury Horner syndrome Anisocoria Claw hand
27
SGA definition
Lower 10th percentile < 2500g
28
LGA definition
Above 90th percentile > 3900g
29
Risk factors for SGA
IUGR Mothers with chronic illness Teenage mothers
30
Complications of SGA
Higher morbidity and mortality Temperature instability Polycythemia Hypoglycemia
31
Causes of Symmetric IUGR (proportional head and body)
Early pregnancy Infections Genetic abnormalities Chronic alcohol/tobacco use
32
Causes of asymmetric IUGR (Head larger than body)
Later pregnancy Placental issues Hypertension Preeclampsia
33
Characteristics of posterm infants (>42 wk GA)
Peeling dry skin Long fingernails Decreased lanugo on the back Ears with strong recoil
34
Most common cause of fetal demise
Chromosomal abnormalities Congenital malformations
35
MAP in preemie
No less than corrected GA in weeks
36
Factors which impact prognosis in VLBW (<1500g)
Gestational age (most important) Morbidity while in NICU intracranial hemorrhage
37
Symptoms of meconium aspiration
Barrel chest Rales/tho chi on auscultation
38
CXR for meconium aspiration
Patchy areas of atelectasis alternating with areas is hyperinflation
39
Most likely complication of meconium aspiration
Persistent pulmonary hypertension
40
Causes of delayed passing of meconium (no stool in first 48 hrs)
Meconium plug syndrome Hirschsprung’s disease Imperforate anus
41
Risk factors for NEC
Hypoxia Bacterial infection
42
Objective data for NEC
Positive blood culture Pneumotosis intestinalis Air in biliary tree Pneumoperitoneum
43
Long term complication of NEC
Intestinal strictures
44
Causes of indirect hyperbilirubinemia
Gilbert disease Hypothyroid, hypopituitary Obstruction, pyloric stenosis Meconium ileus, ileus, Hirschsprung Lucy Driscoll syndrome Hemolysis Galactossemia, Tyrosinosis, CF Hemorrhage/hematomas
45
Physiologic jaundice
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
Abnormal Bili level in newborn
Elevated level during first 24 hours (>13) Bilirubin level of 17 after 120 hours
47
Contraindications for phototherapy
Conjugated (direct) bilirubin (bronze baby syndrome) Family h/o light sensitivity porphyria
48
Breastfeeding jaundice
Unconjugated hyperbilirubinemia (most common cause) First days of life Decreased caloric intake (increased enterohepatic circulation) or delayed passage of meconium
49
Human milk jaundice
Inherent human milk factors 6-14 days after birth Persist 1-3 months
50
Management for hypoglycemia (BG < 40) in newborn
2-3 ml/kg D10 bolus Increased enteral feeds or dextrose fluids Maintain good body temperature
51
Complications of infants of diabetic mothers
LGA Hypoglycemia Polycythemia RDS Cardiac abnormalities Colon abnormalities Caudal regression syndrome Dr Dr Sx
52
Anemia nadir
Term: 2-3 mo Preterm: 1-2 mo
53
Polycythemia of newborn Management
Central venous HCT of > 65 Associated with hypoglycemia Tx: partial exchange transfusion (if Sx)
54
Risk factors for hyperviscosity syndrome
Twin-twin transfusion Delayed cord clamping Down syndrome IDM
55
Omphalocele
Protrusion of bowel and other organs through base of umbilical cord Bowel contents cover with membrane
56
Risk factors for omphalocele
Large babies Chromosomal defects Beckwith Wiedemann
57
Gastroschisis
Germination of bowel through defect in abdominal musculature to right of umbilicus. Limited to intestinal contents Not covered with membrane
58
Risk factors for gastroschisis
Small (IUGR) infants Vascular accidents Vasoactive medications/drugs
59
Scaphoid abdomen Decreased breath sounds on Left Heart sounds on right
Diaphragmatic hernia
60
Most likely cause of neonatal seizure within 24 hours of birth
Birth asphyxia
61
Typical characteristics of neonatal seizures
Staring spells Decreased motor activity Lip smacking Abnormal facial movements
62
Most frequent cause of neonatal seizures in full term infant
Neonatal encephalopathy HIE
63
Management of neonatal seizures
Phenobarbital
64
Grading Intraventricular hemorrhage
Grade 1 - germinal matrix Grade 2 - IVH without dilation Grade 3 - IVH with dilation Grade 4 - above + parenchyma involvement
65
Risk factors for hypoglycemia in newborn
IDM (insulin) Polycythemia (Hct > 65) Tocolytics Beta adrenergics (terbutaline) Maternal alcohol use Prematurity (< 37 wk GA) Sepsis Hypothermia
66
Respiratory depression Apnea Generalized hypotonia GI hypomobility Meconium plug syndrome Mother treated for preeclampsia
Neonatal hypermagnesemia
67
Colonic obstruction involving a significant caliber reduction in the sigmoid and descending colon
Small left colon syndrome Associated with maternal diabetes
68
Microcephaly Hypertonia Arthrogryposis
Zika virus
69
Teratogenic effects of ACEi
Septal defects PDA neural tube defects Renal anomalies/failure IUGR Oligohydramnios Pulmonary hypoplasia Limb anomalies
70
Nasal hypoplasia Stippled epiphyses
Fetal warfarin syndrome
71
Abnormal development of lymphatic system leading to obstruction of normal lymphatic flow and sequestration of lymphatic fluid Lateral neck. Transilluminates
Cystic hygroma
72
Asymmetry of gluteal folds Asymmetry in knee height (Galeazzi sign) Diagnosis
Developmental dysplasia is the Hip (DDH) Hip US in infants < 4 mo
73
Complication of twin-to-twin transfusion syndrome
Hydrops details in both infants
74
Well-circumscribed Nontender Nonfluctuant Reddish-purple nodules Hypercalcemia
Subcutaneous fat necrosis of the newborn Self-limited
75
Gross hematuria Flank mass Thrombocytopenia
Renal vein thrombosis

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