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Peds 1 > Neonatology > Flashcards

Neonatology Flashcards

1
Q

two principal phases of fetal growth

A
  • embryonic (1st trimester)

- fetal (2/3 trimesters), rapid growth and elongation of function

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2
Q

when does heart begin to beat

A
  • around 4 weeks of dev

- attains final form b/w 8 and 12 weeks

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3
Q

what is the first blood forming center?

A

connective tissue

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4
Q

when does surfactant production begin?

A

22-24 weeks

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5
Q

at what point are lungs mature enough for survival?

A

27-28 weeks

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6
Q

when does meconium form?

A

16 weeks

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7
Q

when does weak active suckling and swallowing begin?

A

28-29 weeks

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8
Q

when does the neural tube develop?

A

4 weeks

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9
Q

when does the moro response begin?

A

25 weeks

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10
Q

things we want to know from a history before pt gets pregnant?

A

We want to know advanced maternal (down’s syndrome) and paternal age (achondroplasia, neurofibromatosis, marfan’s, hemophilia, muscular dystrophy, autism, schizo)

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11
Q

how does diabetes in other increase risk for baby?

A

Diabetes in mother increases risk for neural tube defects, and congenital heart defects from oxidative stress which inhibits pax 3 gene

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12
Q

maternal obesity increases risks for…

A

Obesity increases risk for neural tube defects, CV abnormalities, cleft lip/palate, anorectal atresia, hydrocephalus

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13
Q

maternal smoking increases risk for….

A

Smoking increases risk for ADHD, atrioseptal/ventriculoseptal defects, psychotic diseases, fertility of male offspring

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14
Q

If acetaminophen is used >1 p/week, what can happen?

A

decreases fetal testosterone leading to undescended testicles

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15
Q

how long is normal labor

A

24 hours

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16
Q

precipitous labor

A

baby comes out very quickly-problem bc the head expands too quickly and can cause meningeal tears

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17
Q

when is APGAR done?

A

1 min and 5 min after delivery

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18
Q

APGAR

A 
Appearance
Pulse
Grimace (response to  nasal canula)
Activity (muscle tone)
Respirations
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19
Q

appearance score

A

0-blue to pale
1-body pink, extremity blue
2-all pink

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20
Q

pulse score

A

0-absent
1-<100, irregular
2->100
normal is 140-60

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21
Q

grimace score (response to nasal canula)

A

0-none
1-grimace
2-sneeze/cough

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22
Q

activity (muscle tone) score

A

0-limp
1-some tone
2-active motion

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23
Q

respirations

A

0-absent
1-slow grasping
2-good crying
normal is 40-60

24
Q

normal umbilicus has how many vessels?

A

3
2 umbilical arteries and 1 umbilical vein
if one umbilical artery, possible malformations in CVS, CNS, GI

25
Q

Skin lesions over the spinal cord can be a problem, derives from the

A

ectoderm

26
Q

Premature babies have no
small for gestation age has
large for gestational age is very bad bc

A
  • flexion
  • flexion but is smaller
  • his blood glucose drops sharply
27
Q

normal bowel movement frequency

A
  • range from 8x/day to once a week

- yellow mustard colored

28
Q

Feed the baby on demand (when they are hungry) every

A

2-2.5 hours, one 6 hour period where they sleep

29
Q

house temperature

A

68 during day and 65 at night

30
Q

Baby with a fever <1 month old w/101 fever, 2 month w/102, 3 month w/103 is ( ) until proven otherwise

A

sepsis

31
Q

direct vs indirect billirubin

A

elevated direct is BAD

32
Q

clinical course of jaundice in term infants?

preterm?

A
  • begins by day 2 or 3 and gone by day 7
  • begins by day 4 or 5 and gone by day 14
  • worry if billirubin rises >5 mg a day
33
Q

do all babies get jaundice?

A

yes, they are born with too much blood

34
Q

why are billirubin levels increased in infants?

A
  • increased production
  • impaired handling
  • increased absorption from intestine
35
Q

if indirect billirubin is high, check….

A

coombs

36
Q

if coombs is negative, check….

A

Hg

37
Q

if Hg is normal, check

A

reticulocyte

38
Q

if reticulocyte is elevated the MCC is

A

spherocytosis

39
Q

if reticulocyte is normal it is possibly

A

enclosed hemorrhage, infrequent stool ,bowel obstruction

40
Q

transplacental bacterial infections are rare except for

A

syphilus

41
Q

what happens if mom has a bacterial infection?

A

she produces cytokines and IL-2, which do cross the placenta which can cause periventriculur leukomalacia

42
Q

PROM

A

> 12 hours risk for infection, >24 hours is sepsis until proven otherwise (CBC and blood culture)

43
Q

MCC sepsis

A

Group B strep

44
Q

sepsis may present as

A

pneumonia

45
Q

how to dx sepsis

A

clinical suspicion, then do a CSF, CBC, and blood cultures

46
Q

how to treat sepsis?

A

gentamycin or ampicillin

47
Q

when does RDS occur?

A

babies born <36 weeks, results from lack or insufficient surfactant production

48
Q

transient tachypnea

A
  • delay in removal of fetal lung fluid
  • MC in C-section
  • no tx req
49
Q

meconium aspiration

A

) Passing meconium in amniotic fluid, winds up in oropharynx…..baby get nose and mouth suctioned before thorax is delivered to prevent fluid from going into lungs

50
Q

3rd leading cause of birth defects leading to MR

A

fetal alcohol syndrome

51
Q

fetal alcohol syndrome associated manifestations

A
  • microcephaly
  • flat philtrum
  • short palpebral fissures
  • VSD
  • CNS neural tube defects
  • skeletal
52
Q

risks of crack cocaine

A

intra-uterine growth restriction

53
Q

what is though to cause cerebral palsy?

A

Fetal growth restriction, preeclampsia, placental disorders (thrombophilia), major birth defects

54
Q

SUID

A

leading COD in first year of life

unknown COD even after autopsy, dx of exclusion

55
Q

always place babies on their….

A

back to prevent aspiration

Peds 1 (5 decks)

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