Neonatology Flashcards by Jed Dano

Sig of delayed cord clamping

Decrease incidence of anemia

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Essential NB care, prevent neonatal hypothermia, increase colonization of protective family bacteria

Uninterrupted skin to skin contact

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Essential NB care, Prevents Hypothermia

Immediate Drying

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Essential NB care, Within 1st hour prevents 19.1% of all neonatal deaths

Breasfeeding

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Low BW

<2500

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Very Low BW

<1500

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Extremely Low BW

<1000

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Late Preterm

Equal/>34 to >37 weeks

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Very Preterm

<32

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Extremely Preterm

<28

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BW < 3rd percentile for calculated Gestational Age

SGA/ IUGR

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IUGR: Fetus affected late gestation

Asymmetric

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IUGR: Fetus affected early gestation

Symmetric

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Birthweight >90th percentile

LGA

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Ideal time for NBS in preterm infants

5-7 days

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M/C Cuase of Congenital Hypothyroid

Thyroid agenesis

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CAH: Enzyme deficient in dec cortisol

21 hydroxylase

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elevated in CAH

17 hydroxyprogesterone

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Tx for CAH

Gluc (Hydrocort), Mineralcort, Sx, Prenatal Dexa

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Galactosemia Type: Classic type, complete or near complete def

GALT

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Galactosemia Type: Cataracts

GALK

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Galactosemia Type: Enzyme deficiency limited to leukocytes and erythrocytes

GALE (Benign)

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Tx for Galactosemia

Lactose free Milk

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Oxidant substances -> Hemolytic anemia

G6PD

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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

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

Surgical tx of undescended testes no later than

9-15 months