Neonatology

Question 1

Low birth weight

Answer 1

< 2500g

Question 2

Very low birth weight

Answer 2

< 1500 g

Question 3

Extremely low birth weight

Answer 3

< 1000 g

Question 4

What do you need to look for in a baby with single artery in the cord?

Answer 4

Congenital anomalies
Consider renal US

Question 5

4 conditions associated with a single umbilical artery

Answer 5

Trisomy 18
Renal anomalies
Cardiac anomalies
Twins

Question 6

Conditions associated with
1. High AFP
2. Low AFP

Answer 6

1. Neural tube defects, multiple gestation
2. Trisomies 21, 13, and 18

Question 7

Symptoms of hypermagensemia
(in babies whose mothers needed Mg Sulf for pre-eclampsia

Answer 7

Resp depression
Hyporeflexia
Poor feeding
Failure to pass meconium
Lethargy
Flaccidity

Question 8

What is POTTER syndrome?

Answer 8

Pulmonary hypoplasia
Oligohydramnios
Twisted skin (wrinkly)
Twisted face (Potter facies - low set ears, posteriorly rotated ears, micro/retrognathia, hypertelorism, flattened nose)
Extremity deformities (joint contractures, club hands/feet)
Renal agenesis (bilateral)

Question 9

Causes of severe fetal bradycardia

Answer 9

Fetal hypoxia
Maternal fever
Hyperthyroidism
Maternal or fetal anemia
Drugs (atropine, hydroxyzine, ritodrine, terbutaline)
Chorioamnionitis
Fetal tachyarrhythmia
Prematurity

Question 10

Causes of fetal tachycardia

Answer 10

Prolonged cord compression
Cord prolapse
Tetanic uterine contractions
Paracervical block
Epidural and spinal anesthesia
Maternal seizures
Rapid descent in the birth canal
Vigorous vaginal examination

Question 11

APGAR scoring

Answer 11

Appearance (2=pink, 1=acro, 0=blue/pale)
Pulse (2= >100, 1=<100, 0= absent)
Grimace (2=cry/sneeze, 1=grimace, 0=nothing)
Activity (2=active, 1=flexion, 0=limp)
Respirations (2=good, crying, 1=slow, irregular, 0=absent)

Question 12

What age do you need to give
1. Antenatal steroids
2. Antenatal Mg sulf

Answer 12

1. < 34+6 (IVH, nec, lung development, mortality)
2. < 33+6 (neuroprotection)

Question 13

2 anti-epileptic medications that cause neural tube defects

Answer 13

Carbamazepine
Valproic acid

Question 14

Neonatal effects of maternal lithium

Answer 14

Ebstein anomaly
Hypothyroid
Diabetes insipidus

Question 15

What do babies born to mothers with lupus need
1. Antenatally
2. Postnatally

Answer 15

1. Fetal echo in 2nd trimester, dex if heart block is present
2. ECG at birth, echo if abnormal, repeat ECG by 12 months of age, CBC and platelets monitored until normal

Question 16

What do you need to check in babies born to mothers with hyperthyroidism

Answer 16

TSH, T3, T4 on days 3-5 of life
Should be transient and resolve in 4-6 weeks

Question 17

Do the umbilical arteries or veins close first?

Answer 17

Arteries then veins