Neonatology Flashcards
Sig of delayed cord clamping
Decrease incidence of anemia
Essential NB care, prevent neonatal hypothermia, increase colonization of protective family bacteria
Uninterrupted skin to skin contact
Essential NB care, Prevents Hypothermia
Immediate Drying
Essential NB care, Within 1st hour prevents 19.1% of all neonatal deaths
Breasfeeding
Low BW
<2500
Very Low BW
<1500
Extremely Low BW
<1000
Late Preterm
Equal/>34 to >37 weeks
Very Preterm
<32
Extremely Preterm
<28
BW < 3rd percentile for calculated Gestational Age
SGA/ IUGR
IUGR: Fetus affected late gestation
Asymmetric
IUGR: Fetus affected early gestation
Symmetric
Birthweight >90th percentile
LGA
Ideal time for NBS in preterm infants
5-7 days
M/C Cuase of Congenital Hypothyroid
Thyroid agenesis
CAH: Enzyme deficient in dec cortisol
21 hydroxylase
elevated in CAH
17 hydroxyprogesterone
Tx for CAH
Gluc (Hydrocort), Mineralcort, Sx, Prenatal Dexa
Galactosemia Type: Classic type, complete or near complete def
GALT
Galactosemia Type: Cataracts
GALK
Galactosemia Type: Enzyme deficiency limited to leukocytes and erythrocytes
GALE (Benign)
Tx for Galactosemia
Lactose free Milk
Oxidant substances -> Hemolytic anemia
G6PD
Heinz Bodies
G6PD
Enzyme Def in Phenylketonuria
Phenylalanine Hydroxylase
M/C common manifestation ok PKU
Developmental Delay
Musty odor urine
PKU
Enzyme deficient in MSUD
Branched chain alpha keto acid dehydrogenase
Tx of MSUD
Removal of branched chain AA in diet
Cheese like material that covers infant
Vernix Caseosa
Absent Moro, Abnormal crepitus around clavicle
Clavicular Fracture
Absent Moro, Arm abducted, Pronated, Internally rotated
Brachial plexopathy
Extend across sutures
Caput succedaneum
Not cross sutures
Cephalohematoma
Frothing of mouth, feeding exacerbates symptoms
Esophageal atresia
Dx for Esophageal atresia
Inability to pass NGT/OGT
Tx of EA
Surgical ligation of TEF and end to end anastomosis of esophagus
Scaphoid Abdomen
Diaphragmatic Hernia - Bochdalek
Immediate intervention for Omphalocoele and Gastroschisis
Decompression and wrapping
(+) Sac
Omphalocoele
Associated with other congenital anomalies - OEIS Complex
Opmhaolcoele
Inflamed bowel and delayed alimentation
Gastrochisis
Abdominal Distention with erythema
NEC
Histologic finding of NEC
Coagulation Necrosis
Thickened bowel walls and air in bowel wall
Pneumatosis intestinalis
Surfactant first appears
20 weeks
Mature surfactant
35 weeks
Cessation of breathing > 20 secs or any duration accompanied by cyanosis and bradypnea
Apnea
M/CC of Apnea
Idiopathic apnea of prematurity
DOC Apnea
Methyxanthines
Primary cause of Transient Tachypnea of the NB
Slow absorption of fetal lung fluid
Reticular Granularity of Lung Parenchyma
RDS
Prominent pulmonary vascular markings
TTN
PaO2 Gradient
PPHN
Persistencer R->L Circulation through PDA and Formen Ovale
PPHN -> Normal Chest findings
Diagnostics for PPHN
Real time echocardiogram with Doppler flow
Interstitial, Wandering atelectasis, concomitant hyperinflation,, CYST Formation
BPD
Tx BPD
> 21% Oxygen
Bubbly lungs
BPD
Grunting
RDS
Relieved by O2
TTN
Peak within 3 days -> Improves
RDS
Excessive PVR
PPHN
Pulmonary Hypoplasia
PPHN
Potter’s disease
PPHN
Jaundice w/in 24h: First Born
ABO incomp - M/C
Jaundice w/in 24h: 2nd Born
Rh
Jaundice w/in 24h: Prolonged labor, No prenatal check up
Sepsis
Jaundice w/in 24h: Maternal infection during pregnancy
TORCH
Jaundice > 24h: Purely Breast Fed
Breast Milk Jaundice
Jaundice > 24h: Supplements breast feeding with sugar feeding
Breastfeeding Jaundice
Unconjugated bilirubin in basal ganglia and brainstem
Kernicterus >25 mg/dl
(-) COOMBs, Inc Hb
Polycythemia
COOMB’s test positive
Rh vs ABO
M/C hemolytic disease of the Newborn
ABO incomp
COOMB’s positive, spherocytosis, Inc reticulocytes, Inc B1
ABO inc
D Antigen
Rh incomp
Tx Rh Incomp
Anti D Gamma Globulin/ Rhogam
Tx Neonatal Sepsis
Ampicilin + Amikacin
M/C risk factor for neonatal sepsis
Prematurity
IUGR with history of infection during pregnancy: Vesicular lesion on face
HSV
IUGR with history of infection during pregnancy: Purpuric lesions all over body
Rubella
Accumulation of fluid in the tunica vaginalis
Hydrocoele
Reducible scrotal swelling
Indirect Hernias
Undescended testes: Remains undescended if does not descend by ____months
4
Surgical tx of undescended testes no later than
9-15 months