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Peds Shelf > Neonatology > Flashcards

Neonatology Flashcards

1
Q

APGAR categories 2 vs 1

A

Appearance– 2= pink 1=blue extremities
Pulse= 2= >100, 1=<100
Grimace= 2=cough with catheter, 1=grimace
Activity (tone)- 2=active motion, 1=some flexion
Respirations. 2= good cry, 1=slow

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2
Q

Milia

A

pustules on the face, dissapear after a few weeks

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3
Q

Pustular melanosis (def and tx)

A

pustule over a dark base. Disappears on its own

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4
Q

Erythema toxicum neonatorum (def, bx, tx)

A

pustules/papules with red base with EOSINOPHILS.

Benign, no tx needed

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5
Q

Nevus simplex (def, path, tx)

A

Red patch on the neck or face
Vascular anomoly
No tx

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6
Q

Nevus flammenus (path, tx)

A

Vascular malformation –> aka Port wine stain

Tx- r/o sturge webar syndrome

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7
Q

Caput succedaneum vs cephalohematoma

A

caput succedaneum is fluid under the scalp that CROSSES suture lines

Cephalohematoma is blood in the periosteal space that is CONTAINED by the sutures

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8
Q

Epstein pearls

A

White cysts on te hard palate of an infant, will disappear ont heir own

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9
Q

Classic poland syndrome finding

A

Absence of ribs or agenesis of the pectoralis muscle –> chest asymmtry

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10
Q

Diminished femoral pulses in a newborn

A

coarctation

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11
Q

Increased femoral pulses in a new born

A

PDA

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12
Q

One umbilical artery instead of two is concerning for

A

Renal pathology

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13
Q

Diastasis recti (path and tx)

A

Rectus abdominus muscle is not fused at midline.

No tx, it will improve as baby grows

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14
Q

MCC of abdominal mass in newborn

A

Hydronephrosis

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15
Q

Hydrometrocolpos (def and presentatino)

A

Imperforate hymen –> retain vaginal secretions –> presents with labial cyst or abdominal mass

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16
Q

Hypospadias path

A

Failure of uretheral folds to fuse

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17
Q

Epispadias is associated with which other malformation

A

bladder extrophy

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18
Q

First step in evaluating cyanotic infant

A

ABG + 100% O2

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19
Q

ABG shows massive improvement with 100% o2

A

Respiratory pathology

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20
Q

ABG improves by about 15-30 mmhg with 100% o2

A

Congential heart defect that doesn’t involve the pulmonic outflow tract (truncus)

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21
Q

ABG imnproves by only about 5mmhg

A

Congenital heart defect involving the pulmonary outflow tract (tetrology)

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22
Q

MCC of resipiratory distress in preterm infant

A

Respiratory distress syndrome

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23
Q

2MCC of resp distress in TERM infants

A

Meconium aspiration

Persistent pulmonary htn of newbown

24
Q

When does surfactant reach appropriate levels for life

A

30 weeks gestation

25
Q

2 things to look for in amniotic fluid to determine lu;ng maturity

A

Lecithin:Sphingo ratio >2

Presence of phosphatitylglycerol

26
Q

4 risk factors for RDS

A

Prematuirty
Maternal diabetes
Csection
Neonatal asphyxia

27
Q

Dx and characteristic findings of RDS

A

CXR –> diffuse ground glass opacities and air bronchograms

28
Q

Tx for RDS

A

O2 –> CPAP

29
Q

2 major acute complications of RDS

A

PTX

Interventricular hemorrhage

30
Q

2 common chronic complications of RDS

A 
Bronchopulmonary dysplasia (if on vent)
Retinopathy of prematuirty
31
Q

PPHN definition

A

anything BESIDES heart disease that causes decreased blood flow to the lungs

32
Q

2MCC of PPHN

A

Meconium aspiration and Perinatal asphyxia

33
Q

Characteristic blood gas of PPHN

A

Pre and post ductal PaO2 are extremely different

because increased lung pressure results in R–>L shunt through PFO or PDA

34
Q

2 tests to evaluate PPHN

A

CXR –> decreased lung markings

Echo

35
Q

Cornerstone of tx for PPHN

A

OXYGEN!! because hypoxemia is a vasoconstrictor in the lung, you give O2 to vasodilate

f/u with ventilation if o2 is insufficient

36
Q

2 times when MAS is most common

A 
after 42 weeks gestatino
Fetal distress (they poop sometimes)
37
Q

CXR findings of MAS

A

Increased lung volume with diffuse areas of atelectasis and parenchymal infiltrates

38
Q

Management of MAS

A

Suction airway of baby, and perineum of mom

O2 + vent if needed

39
Q

2 definitions of apnea of prematurity

A

1- apnea x15-20seconds

2- any apnic episode accompanied by bradycardia or cyanosis

40
Q

Central vs secondary apena

A

Central - no chest wall movement
Secondary- chest wall moves, but no airflow –> apnea monitors wont pick this up!! because it only looks for chest motions

41
Q

Workup guidelines for apnea of prematurity

A

Seek underlying cause (infection, lung dz, hyperthermia). if nothing is found, then consider idiopathic apnea of premaurity

42
Q

Idiopathic apnea of prematurity (IAP) course

A

Presents in first week of life, then resolves after several more weeks or months

43
Q

IAP management (non med vs medical)

A

Airway support

-Respiratory simulants! Caffeine or theophylline)

44
Q

When does jaundice lvl peak in term vs preemie

A 
Term= 3-4 days
Premie= 5-7 days
45
Q

3 critera for evaluating hyperbili in a newborn

A

1- hyperbili present in first 24h
2- bili rises >6 in a 24h period
3- rate of rice exceeds 0.5/h

46
Q

2 steps in Workup for indirect hyperbili

A

Coombs

CBC + Retic and smear

47
Q

Frist step in workup of conjugated hyperbili (then 2 other steps)

A

Hepatic ultrasound (for cysts)
HIDA + phenobarb (for biliary atresia)
Viral serologies for hepatitis

48
Q

When to use exchange transfusion for bilirubin

A

Rapidly rising, especially in the setting of hemolytic diseaes

49
Q

Management of diaphragmatic hernia

A

Intubation. NOT a bag mask, as this will further compress the lungs

50
Q

Which abdominal wall defect is associated with other congenital abonormalities

A

Omphalocele (heart dz, Beckwith wiedmann)

OmphaloCELE is CENtral and associated with CYNDromes

51
Q

Dx test and finigs for meconium ileus

A

Abdominal xray –> intestinal distention WITHOUT air fluid levels. Soap bubble appearance to the meconium plug

52
Q

3 features seen in babies of diabetic mothers

A

1- macrosomia (due to increased fat storage and hepatomegaly)
2-increase skeleton length, small head
3-Plethoric

53
Q

Failure to pass meconium in infant of diabeti cmother

A

Small left colon syndrome –> abdominal distention, FTPM

54
Q

Clinical features of polycythemia

A

Plethoric, cyanotic, poor feeding, jittery, acidosis

55
Q

Tx of polycythemia

A

Partial exchange transufsion

Peds Shelf (4 decks)

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