Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

US Pediatric Boards > Neonatology > Flashcards

Neonatology Flashcards

You may prefer our related Brainscape-certified flashcards:
U.S. Geography flashcards
1
Q

What is primary vs secondary apnea?

A

Primary is reversed with tactile stimulation but secondary requires positive pressure ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the diagnosis in a healthy newborn with respirations>60, retractions and grunting but normal CXR?

A

Transient tachypnea of the newborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Newborn had increased anion gap metabolic acidosis, thrombocytopenia, high serum ammonia and elevated urine ketones, what is the likely diagnosis?

A

Organic acidemias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Newborn with high ammonia, high PT/PTT and serum glutamic oxaloacetic transaminase who presents with respiratory alkalosis?

A

Citrullinemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What could be the cause of elevated AFP?

A

RAIN= renal disease, abdominal wall defects, incorrect dates /multiple pregnancy and neuro defects (anencephaly or spina bifida)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Low AFP is associated with what?

A

Trisomy 21 and 18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a measure of fetal autonomic nervous system integrity?

A

Non stress test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What measures uteroplacental insufficiency and tolerance of labor?

A

Stress test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is included in the biophysical profile?

A

Non stress test + ultrasound for fetal movement, HR, breathing, tone and amniotic fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the result of deficient surfactant in alveolar lining?

A

Rds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the diagnosis and what should you do of the fetus has HR>240?

A

Svt- Give anti arrhythmic to mother to avoid congestive Heart failure and hydrops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What condition causes X-ray findings of granular lung opacification and air bronchograms? What is the classic description on chest xray

A

Rds - ground glass appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are symptoms or rds?

A

Respiratory distress in the newborn. Cyanosis is possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How can you distinguish RDS from pneumonia in a newborn ?

A

Calculate ratio of bands to neutrophils. If >0.2, think sepsis !

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What 6 coexisting conditions can worsen RDS?

A 
PDA 
Hypoglycemia
Hypocalcemia
Anemia
Acidosis
Hyperbili
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What can occur in a patient with RDS and hyperbilirubinemia?

A

Threshold for kernicterus is lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What 3 factors increase the risk for RDS?

A

Diabetes, c sections, birth asphyxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What 2 factors decrease the risk for RDS?

A

Prolonged rupture of membranes, prenatal steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What test can predict the risk of RDS?

A

L:S ratio > 2 suggests a low risk for RDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When is mechanical ventilation indicated in a patient with RDS?

A

Ph <7.2 and pCo2 > 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What 3 things does administration of surfactant cause in the lungs?

A

Decreased oxygen requirements, reduces inspiratory pressure and improved lung compliance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is pulmonary interstitial emphysema ?

A

Air leak into the interstitium due to mechanical ventilation – leads to PTX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the goal po2 in an infant with RDS?

A

50-70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Patients on prolonged ventilator support are at risk for what and why?

A

Bronchopulmonary dysplasia due to prolonged oxygen exposure and barotrauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the indications for ECMO?

A

Infant with reversible lung disease for less than 14 days and failure of other methods. Pt can not have intracranial bleed or congenital heart disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the treatment of BPD and what is a side effect of this treatment?

A

Diuretics - can increase risk of hypocalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is found on X-ray in a newborn with BPD?

A

Diffuse opacities, cystic areas with streaky infiltrates and ground glass appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the name of a chronic lung disease of the newborn that is not associated with prolonged ventilator use?

A

Wilson Mikity syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the difference between BPD and Wilson Mikity syndrome ?

A

BPD has inflammatory changes in lung tissues but MKS does not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the empiric treatment of neonatal sepsis?

A

Ampicillin and gentamicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What bacteria should you be concerned about if infants mother had flu like illness during pregnancy?

A

Listeria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

When toxoplasmosis infection occurs early in pregnancy, what is the risk and severity of infant infection?

A

Lower chance of infection but more severe disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are some symptoms of toxoplasmosis in a newborn?

A

Microcephaly, hydrocephaly, chorioretinitis, cerebral calcifications, jaundice and hepatosplenomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How is diagnosis of toxoplasmosis made?

A

Immunofluorescence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the best imaging study for toxoplasmosis?

A

MRI to diagnose encephalitis if ring enhancing lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the difference between cmv and toxo when looking at MRI?

A

Cmv calcifications are peri ventricular but with toxoplasmosis are diffuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

If asymptomatic at birth, what later signs can toxoplasmosis cause?

A

Deafness, blindness, seizures, MR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the treatment for toxoplasmosis?

A

Pyrimethamine, sulfadiazine and folinic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What two palsied are associated with clavicle fracture in the newborn?

A

Erbs and phrenic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the injury associated with the arm internally rotated and addicted with flexed wrist?

A

Erbs palsy, c5-7 Injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What should you be concerned about if clavicle fracture leads to respiratory distress?

A

Phrenic nerve palsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the injury associated with claw hand?

A

Klumpke palsy at C8 T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the difference between klumpke and Erb palsy in relation to reflexes?

A

In Erb palsy the grasp reflex is intact but is lost in klumpke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Which palsy can be associated with Horner syndrome?

A

Klumpke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What two maternal conditions can cause neonatal heart block?

A

Lupus and sjogren

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What do you do if you find a newborn with a single umbilical artery?

A

Renal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are the common complications of umbilical artery and vein catheter placement?

A

NEO CATH = Necrosis , embolize ruin (liver), omphalitis, compromised femoral pulse, accidental hemorrhage, traumatic perforation thrombosis and hepatic (dysfunction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

When should the umbilical cord fall of and what is the concern if it does not?

A

Should fall off by 2 weeks ; if attached past 1 month, consider leukocyte adhesion deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

When is a baby considered SGA?

A

In the lower 10th percentile for gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

When is a baby considered LGA?

A

In the upper 10th percentile for weight for gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is considered a full term baby?

A

38-42 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is seen in a post term newborn?

A

Dry peeling skin, long fingernails, decreased lanugo, ears with strong recoil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the most common cause of fetal demise?

A

Chromosomal abnormalities and congenital malformations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is a normal scalp pH?

A

7.25 or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are some causes of delayed passage of meconium?

A

Meconium plug syndrome
Hirschsprung
Imperforate anus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

For the purpose of boards, when do you intubate a meconium baby?

A

If baby is floppy, suction and intubate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the presentation and How do you diagnose Hirschsprung’s disease?

A

No meconium passage after 48 hours or abdominal distention with diarrhea may be present - diagnosis with biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What condition is Hirschsprung’s disease associated with?

A

Down’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is meconium ileus associated with?

A

Cystic fibrosis

60
Q

What occurs in the affected segment of bowel with Hirschsprung’s ?

A

The recto-sigmoid colon is contracted and the region proximal is distended

61
Q

What do you do in an infant with bilateral ankle clonus?

A

Nothing - can be normal

62
Q

How much pressure is needed to inflate the lungs for the first breath?

A

60 mmHg

63
Q

What should you do in the presence of bradycardia and impaired ventilators efforts in a newborn?

A

Positive pressure ventilation

64
Q

How should apgars be used to determine use of CPR?

A

Do NOT wait for one minute apgar scores to decide to start CPR !

65
Q

What is the normal fetal placental weight ratio of a term baby? How should it change during pregnancy?

A

6.5 - 7

The ratio should increase progressively - if not, think of decreased fetal growth

66
Q

When should chest compressions be started in a newborn?

A

If HR <60 despite adequate ventilation

67
Q

How should chest compressions be delivered in a neonate?

A

100 per minute with one ventilation per 3 compressions

68
Q

What should you look out for in a newborn who was born at home??

A

Hemorrhage
Sepsis
Vit K deficiency and bleeding

69
Q

What is the difference between silver nitrate and erythromycin ophthalmic eye ointment

A

Silver nitrate only protects against Gonorrhea. Erythromycin is needed to prevent chlamydia infection

70
Q

What do you do for an anuric infant?

A 
Evaluate abdomen and genitals
Make sure adequate fluid intake
Cath urine specimen
Bun/creatinine
Renal ultrasound
71
Q

What is a very low birth weight infant?

A

Infant <1500 g

72
Q

What is an appropriate arterial BP of a preterm baby?

A

Should not be less than the corrected gestational age

73
Q

What must be done for every VLBW infant with no obvious cause for preterm birth?

A

Septic workup + amp and gent

74
Q

What type of fluid is appropriate for VLBW infants?

A

D10

75
Q

What bone disease is at increased risk in premies and why?

A

Rickets because of inadequate intake and absorption of calcium and phosphorus

76
Q

What is the caloric requirement for a premie?

A

120 kcal/kg/day

77
Q

What are some classic signs of NEC?

A

Bloody stool, abdominal wall erythema and thrombocytopenia

78
Q

What is the classic X-ray finding in NEC?

A

Air in the biliary tree & pneumatosis intestinalis

79
Q

What is the long term complication of NEC?

A

Intestinal strictures

80
Q

How should NEC be managed?

A

NG tube to LIS, IVF, antibiotics
Possible surgical intervention
NPO x 3 weeks

81
Q

Up to What bilirubin level is considered normal in the first 24 hours in a full term newborn?

A

12.4

82
Q

Up to what age can anemia of ABO or Rh incompatibility be seen?

A

Up to 2 months

83
Q

Which type of blood incompatibility can occur in a first born child?

A

ABO or

Rh only if previous miscarriage

84
Q

What jaundice occurs in the first few days of life due to dehydration?

A

Breast feeding jaundice

85
Q

In which type of jaundice should newborns not be given breast milk?

A

Breast milk jaundice

86
Q

When is phototherapy contraindicated?

A

Elevated direct bili or family hx of light sensitive porphyria

87
Q

What causes bronze baby syndrome ?

A

Phototherapy in a child with high conjugated (direct) bilirubin

88
Q

What should you do in a newborn <24 hours old with jaundice and why ?

A

Total and direct bili levels - elevated bili in first 24 hours is never normal

89
Q

What risk factors DECREASE incidence of neonatal jaundice?

A

Maternal heroin, smoking, alcohol and phenobarbital

90
Q

What types of endocrine disorders can cause jaundice?

A

Hypothyroid and hypopituitary

91
Q

What are two syndromes that can cause jaundice?

A

Gilbert disease and Lucy Driscoll syndrome

92
Q

What 4 causes of increased enterohepatic Circulation can lead to jaundice?

A

Obstruction, pyloric stenosis, meconium ileus, Hirschsprung’s

93
Q

What are 4 causes of jaundice that lead to elevated direct and indirect bili?

A

Galactosemia, tyrosinosis, hypermethioninemia and cystic fibrosis

94
Q

What medication can cause high bilirubin and why?

A

Sulfonamides - compete for space on albumin

95
Q

What are 4 complications of exchange transfusion ?

A

Elevated potassium, thrombocytopenia, hypocalcemia and hypovolemia

96
Q

If dextrostix accucheck read is abnormal, what is the next step?

A

Verify with serum glucose

97
Q

What is the definition of hypoglycemia in premies and full term newborns ?

A

<25 in a premie

<35 in full term newborn

98
Q

What is the most important initial step for management of very low birth weight infant?

A

Maintaining euglycemia and body temp

99
Q

How would you treat hypoglycemia in a newborn?

A

2-3 ml/kg of D10 bolus or glucagon IM

100
Q

What abnormalities should you be concerned about in a newborn born to a mother treated with tocolytics? Why?

A

Hypoglycemia ( tocolytics stimulate fetal insulin )

101
Q

What are some classic exam findings in a newborn with hypoglycemia ?

A

Jitteriness, lethargy, apnea,
Cyanosis, seizures
Tachypnea

102
Q

What are 3 common complications seen in an LGA baby?

A

Hypoglycemia , polycythemia and hypo plastic left colon

103
Q

What EKG finding may indicate hypocalcemia?

A

Prolonged QT

104
Q

What are two classic signs of hypocalcemia?

A

Chvosteks - facial twitching on tapping

Trousseau - carpopedal spasm

105
Q

What may be the cause of late onset hypocalcemia on an infant?

A

Giving cows milk causes high phosphate load on the kidneys

106
Q

What is the definition of hypocalcemia?

A

Ionized Ca < 4.5 or

Total Ca < 8.5

107
Q

What problem should you think of in an infant born to a mother on mag sulfate? Why?

A

Hypocalcemia - high mag will decrease PTH secretion

108
Q

How do you treat hypocalcemia ?

A

Increase calcium in IV or with calcium gluconate

109
Q

What test will detect fetal cells in mothers blood?

A

Kleihauer Betke

110
Q

What percentage of hgb is fetal hgb at birth?

A

50%

111
Q

What hgb level is considered to be “anemia” in a full term infant?

A

< 13

112
Q

What meets the criteria for polycythemia ?

A

Central venous hct >65 (not valid in heelstick)

113
Q

What are the complications of having polycythemia in a newborn?

A

Hypoglycemia, hyperbilirubinemia and thrombocytopenia

114
Q

When and what is the treatment for polycythemia ?

A

HCT >70 needs partial exchange transfusion

115
Q

What is the apt test?

A

Test for maternal blood in neonatal gastric aspirate

116
Q

What is a common cause of thrombocytopenia in a newborn?

A

Maternal ITP

117
Q

When do you see early onset hemorrhage in a newborn?

A

Within 3 days in Breast fed babies not given vitamin K

118
Q

What 3 medications may increase risk of hemorrhagic disease in the newborn?

A

Anticoagulants
Anticonvulsants
Antibiotics (tb meds, cephalosporins and quinolones)

119
Q

When should you give oral vitamin k in a newborn?

A

Never - it is insufficient for preventing hemorrhagic disease

120
Q

What test would you order in a newborn with protein and blood in the urine?

A

Renal ultrasound - look for ATN

121
Q

What is the cause and prognosis of a newborn with a seizure in the first 24 hours of life?

A

Birth asphyxia - likely to NOT have long term neuro developmental sequelae

122
Q

What is the initial drug of choice in a newborn with seizure ?

A

Phenobarbital

123
Q

What causes hyperalimentation induced cholestasis?

A

Protein intake > 2g/kg/day

124
Q

What medication can be used to treat hyperalimentation induced cholestasis?

A

Phenobarbital to stimulate bile secretion and decrease serum bili level

125
Q

What are some syndromes associated with cleft lip/palate?

A

Crouzon syndrome, apert and treacher Collins

126
Q

What are 4 common findings in beckwith wiedemann syndrome?

A

Omphalocele
Macroglossia
Macrosomia
Hypoglycemia

127
Q

How is gastroschisis different than omphalocele?

A

It is not covered by a membrane and only involves intestinal contents because it is near the umbilicus (not through the umbilicus like omphalocele)

128
Q

What is the most important goal in management of gastroschisis ?

A

Keep bowel moist!

129
Q

Which is associated with chromosomal defect, omphalocele or gastroschisis ?

A

Omphalocele

130
Q

What syndrome is TE fistula commonly associated with?

A

VACTERL

131
Q

What should you think in a patient with scaphoid abdomen?

A

Diaphragmatic hernia

132
Q

How do you manage TE fistula?

A

Protect the airway from secretions with auctioning and elevating the head

133
Q

What is an imperforate anus with a high obstruction?

A

Fistula connects into vagina or urinary tract

134
Q

What are grades 1-4 of IVH?

A

Grade 1 = germinal matrix
Grade 2 = IVH without dilation
Grade 3 = IVH with dilation
Grade 4 = IVH plus parenchymal involvement

135
Q

What is soft putting that crosses suture lines?

A

Caput succedaneum

136
Q

what is a firm bulge on the scalp that does not cross suture lines?

A

Ceohalohematoma

137
Q

How do you image an unstable vs stable newborn with suspected IVH?

A

Ultrasound if unstable

CT if stable

138
Q

What May terbutaline increase the risk for in a newborn?

A

Hyperinsulinemia and hypoglycemia

139
Q

What are 4 neonatal complications associated with maternal cocaine use?

A

Placental abruption
Cerebral infarction
Limb anomalies
Urogenital defects

140
Q

What symptoms are associated with alcohol withdrawal?

A

Hyperactivity, irritability and hypoglycemia

141
Q

What 4 symptoms are associated with barbiturate withdrawal?

A

Hyperactivity
Hyperphagia
Irritability
Poor suck swallow

142
Q

Cigarette smoking is associated with increased risk for what?

A

Low birthweight
Miscarriage
Prematurity
Cleft lip/palate

143
Q

What 6 symptoms are associated with opioid withdrawal ?

A 
Irritability
Tremors
Hypertonic
Diarrhea/vomiting 
Feeding difficulties
Seizures
144
Q

Of the following choices, What is the most important thing to do within the first hour of life?
A. Vitamin K
B. Erythromycin eye drops
C. Skin to skin contact w mother

A

Skin to skin contact

145
Q

You are presented with a 2 month old infant who “cries continuously”. Mother reports 1 hour of crying at 1 am and then 2 hours of crying at 5 am. What should you do?

A

Reassurance.

Crying of up to 3 hours per day is normal in infants >6 weeks old

146
Q

What are the 5 basic causes of apnea?

A

Metabolic, infectious, neurological, cardiac and Gi

US Pediatric Boards (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions