Neonatology Flashcards
APGAR
APGAR (0, 1, 2 in each category)
Appearance (blue/pale, pink trunk, all pink)
Pulse (0, 100)
Grimace with stimulation (0, grimace, grimace and cough)
Activity (limp, some, active)
Respiratory effort (0, irregular, regular)
APGAR Scores
Scores of 8–10: Typically reflect good cardiopulmonary adaptation.
Scores of 4–7: Indicate the possible need for resuscitation. Infants should be observed, stimulated, and possibly given ventilatory support.
Scores of 0–3: Indicate the need for immediate resuscitation.
A complication of unconjugated hyperbilirubinemia that results from irreversible bilirubin deposition in the basal ganglia, pons, and cerebellum. It typically occurs at levels of > 25–30 mg/dL and can be fatal
Kernicterus
Treatment of unconjugated hyperbilirubinemia versus conjugated hyperbilirubinemia and can lead to skin bronzing.
Treat unconjugated hyperbilirubinemia with phototherapy (for mild elevations) or exchange transfusion (for severe elevations > 20 mg/dL). Start phototherapy earlier (10–15 mg/dL) for preterm infants. Phototherapy is not indicated for conjugated hyperbilirubinemia and can lead to skin bronzing.
The most common cause of respiratory failure in preterm infants
Respiratory distress syndrome
- “Ground-glass” appearance, diffuse atelectasis, and air bronchograms on CXR.
- Retained amniotic fluid results in prominent perihilar streaking in interlobular fissures. Resolves with O₂ administration.
- RDS
2. TTN
- Coarse, irregular infiltrates; hyperexpansion and pneumothoraces.
- Nonspecific patchy infiltrates; neutropenia, tracheal aspirate, and Gram stain suggest the diagnosis.
- Meconium aspiration
2. Pneumonia
An Lecithin to Sphingomyelin ratio ____ indicates a need for maternal glucocorticoid administration.
Hernia tin of the intestine through an abdominal defect next to the umbilicus usually on the right (no sac)
Gastrochisis
Hernia toon of the abdominal viscera at the umbilicus
Omphalocoele
Double bubble sign
Bilous Emesis after the first feeding
Duodenal atresia
Not present until 72 hours after birth
Physiologic jaundice
ESSENTIAL INTRAPARTUM NEWBORN CARE
- Immediate and thorough Drying
- Early Skin to skin contact
- Properly-timed cord clamping
- Non-separation of mother and baby
Newborn Screening Tests include (6)
Congenital hypothyroidism CAH Galactosemia g6PD MSUD phenylketonuria
Normal birth wt and length Delayed development Sluggish Feeding difficulties Hypothermia Prolonged physiologic jaundice Edema of genitals
Congenital hypothyroidism
Enzyme deficiency in congenital adrenal hyperplasia
21-hydroxylase enzyme = cortisol deficiency
Vomiting, failure to thrivePseudohermaphroditism
Low serum Ma Co cortisol
High K
Increased 17-hydroxyprogesterone
Congenital Adrenal Hyperplasia
Symptoms develop 1-2 days after exposure to oxidant properties Exposure causes hemolysis Jaundice Anemia Acute renal failure Heinz bodies
G6PD
Substances with oxidant properties
Sulfonamide Nalidixc acid Nitro duration Chloramphenicol Antimalarials Vitamins K analogs ASA Benzene Naphthalene
Enzyme deficiency in phenylketonuria
Phenylalanine hydroxylase
Vomiting Hypertonic Hyperactive DTRs Seizures Athetoid Unpleasant misty odor
Phenylketonuria
Accumulation of branched chain ketoacid due to defective branched chain alpha ketoacid dehydrogenase complex
Irritability Poor feeding Maple syrup odor Encephalopathy Central respiratory failure
MSUD
Essential Amino acids for removal in MSUD
Valine
Isoleucine
Leucine
Subperiosteum bleed due to birth trauma
Does not cross suture lines
Cephalhematoma
Diaphragmatic hernia posterolateral portion of the diaphragm
Bochdalek form
Scaphoid abdomen and increased chest wall diameter
Diaphragmatic hernia
Accumulation of fluid in tunica vaginalis
Hydrocele
- Lateral to Epigastric vessels and projects through Inguinal ring
- Medial to Epigastric vessels and projects through the abdominal wall
- Indirect Inguinal hernia
2. Direct Inguinal hernia
If testes has not descended by ____ months it will remain undescended
4 months
Most common cause of PPHN
Meconium Aspiration Syndrome
DIRECT COOMBS positive Spherocytes in blood smear Increased retic count Increased B1 Jaundice Mild hepatosplenomegaly
ABO incompatibility
