Neonatology Flashcards
what is the most likely diagnosis for newborn presenting with small pelvis, flattened dimpled buttocks, hyperextended knees and Xray shpwing no sacrum in setting of maternal diabetes?
Caudal regression syndrome
What is the most likely diagnosis for a newborn presenting with elevated right hemidiaphragm, decreased air entry on right, weak cry and medially rotated right arm that hangs by the sign with forearm pronated in setting of difficult or breech birth?
Right diaphragmatic paralysis
What is the most likely diagnosis for newborn with abdominal distention associated with dilated bowel loops, a small amount of free intraperitoneal air, and bubbles of gas in the bowel wall?
Necrotizing enterocolitis
associated with prematurity and formula feeding
What is the most likely diagnosis for infant older than 6 months with softened spring like area of bone of the parietal region that gives a sensation of ping pong ball when depressed?
Craniotabes
due to treponema pallidum infection
What is considered inadequate prophylaxis in a group B strep positive mother?
penicillin/ ampicillin/ cefazolin given less than 4 hours prior to delivery
What nerve root is injured in congenital brachial plexus palsy associated with anisocoria?
T1
What is the likely diagnosis for newborn with phenotypic features consistent with Trisomy 13 or 18 but normal karyotype born to a mother who has Crohn disease?
Methotrexate exposure
what is the most likely diagnosis of newborn presenting with refusal to move limb, irritability, Xray showing bands of increased density across the metaphyses and periostitis, hemorrhagic rhinitis (snuffles), thrombocytopenia, liver dysfunction, and rash on palms and soles?
Congenital syphilis
What is the most likely diagnosis for newborn presenting with microcephaly, hydrocephaly, brain calcifications, cataracts, microphthalmia, chorioretinitis, dermatomal hypopigmented scarring, and limb malformations?
Congenital varicella infection
eye anomalies, limb malformation, CNS anomalies
What is the normal penile length of a newborn?
more than 2 cm
When is umbilical hernia surgery performed? (3)
- symptomatic (pain, nonreducible)
- persists at 5-6 years old
- increases in size between 1-2 years old
What nerve root injury results in Horner syndrome (ptosis, miosis, and anhidrosis) during a brachial plexus injury?
T1
What is the most likely diagnosis for newborn presenting with upper arm adducted and internally rotated with the forearm extended and normal movement of hand and wrist after delivery and what is the treatment?
Erb’s palsy
physical therapy and observation
(waiter’s tip posture)
What is the most important factor of supernumerary digits that prompts an orthopedic consultation?
a bony articulation in the digit
What is the most likely diagnosis for newborn with gross hematuria, flank mass, and thrombocytopenia in setting of hypertension and oliguria?
Renal vein thrombosis
associated with perinatal asphyxia, maternal diabetes, shock
What is the treatment for a newborn of a diabetic mother presenting with hypoglycemia and poor feeding?
IV D10W at 2 ml/kg
What is the most likely diagnosis for newborn presenting with bluish, nonblanching, fluctuant swelling lateral to the midline of the lower mouth like a belly of a frog?
Ranula
(pseudocyst associated with sublingual/ submandibular glands)
(tx: surgery)
What is the most likely diagnosis of newborn presenting with intense period of reddening of large portion of skin when newbon placed on their side and what is the treatment?
Harlequin color change
no treatment (benign due to imbalance of autonomic vascular system)
What group is at greatest risk for developmental dysplasia of hip?
females with breech presentation
What are the components of the APGAR score?
- heart rate (1 if less than 100)
- respiratory effort (1 for weak cry)
- skin color (1 for acrocyanosis)
- muscle tone (1 for arms legs flexed w/ little movement)
- reflex irritability (1 for facial grimace only)
what is a potential complication in both twins involved in a twin-to-twin transfusion syndrome?
hydrops fetalis
What maternal serum marker is a screening tool for neural tube defects like myelomeningocele?
alpha fetoprotein
What are neonatal side effects associated with maternal use of lisinopril (or other ACE inhibitors)?
- VSD
2. Meningomyelocele
What is the most likely diagnosis for newborn with fleshy colored smooth surfaced lesion protruding from the superior/ inferior portion of the vagina? and what is the treatment?
Hymenal tag
no treatment needed
What is the most likely diagnosis for newborn presenting with mitten hand (syndactyly of 2nd, 3rd, 4th, and 5th digits) and premature fusion of both coronal sutures and 1 sagittal suture?
Apert syndrome
What is the most likely diagnosis of newborn presenting with well circumscribed, nontender, nonfluctuant, reddish-purplish nodules over the lower posterior trunk and lateral portions of buttocks?
Subcutaneous fat necrosis
no tx
what gestational age is an infant born with a raised areola, superior incurving of ear, scant ear cartilage with slow return from folding and 2-3 anterior sole creases?
34-35 weeks
sole creases start at 32-33 weeks
what is the most likely diagnosis for newborn with delayed passage of meconium, abdominal distention with bilious vomiting, and contrast enema showing small sigmoid and descending colon with abrupt caliber trnasition at splenic flexure?
Small left colon syndrome
associated with maternal use of insulin
What is the most likely medical complication of a baby born to a mother using lithium for bipolar disorder?
Ebstein anomaly
apical displacement of the tricuspid valve
What cardiac abnormality is maternal SSRI use associated with?
Persistent pulmonary hypertension of newborn
What is the most likely diagnosis for a newborn presenting with respiratory depression, apnea, generalized hypotonia, and meconium plug syndrome after birth to a mother with hypertension?
Hypermagnesemia
mother treated with magnesium to prevent eclampsia
What maternal substance use is associated with gastroschisis?
Cocaine
What is the most likely diagnosis for newborn with aplasia/ hypoplasia of abdominal muscles, bilateral cryptorchidism, and urinary tract anomalies?
Prune Belly syndrome
Eagle-barrett
…. sign is asymmetry in the height of the knees due to shortening of the thigh on the affected side done with hips in 90 degree flexion
Galezzi sign
What is the diagnostic test of choice for hip dysplasia in an infant less than 4 months of age?
Ultrasound
Xray can be done if older than 4 months
What is the most likely diagnosis of infant presenting with abdominal distention, bilious vomiting, and Xray showing distended loops of intestine, absence of air-fluid levels and soap bubble appearance of portions of the intestine?
Meconium ileus
associated with pancreatic insufficiency
What is a side effect correlated with use of oral erythromycin (for Chlamydia conjunctivitis) or azithromycin?
Pyloric stenosis
What is the most likely diagnosis for newborn presenting with nasal hypoplasia and stippled epiphyses in mother with deep venous thrombosis?
Fetal Warfarin syndrome
what is the most likely diagnosis for newborn presenting with compressible, nonpulsatile mass on the posterolateral neck that transilluminates and is not attached to underlying skin?
Cystic hygroma
What is the next step in management for newborn with jaundice within the first 24 hours of life?
tbili, dbili, CBC with smear, retic count, direct coombs and blood culture
(pathologic jaundice)
What is the most likely diagnosis for pt presenting with thin upper lip, smooth thin philtrum, short palpebral fissures, shortened nose, midface hypoplasia, mild ptosis, and intellectual disabilties?
Fetal alcohol syndrome
associated with VSD
what is the recommended delivery room temperature?
71.6-78.8 degress F (22-26 degrees C)
What therapeutic treatment is used for type II Crigler-Najar for patients with prolonged unconjugated hyperbilirubinemia?
Phenobarbital
What is the gestational age associated with sole creases?
32-33 weeks: 1-2 creases
34-35 weeks: 2-3 creases
36-67 weeks: 2/3 of the sole has creases
38-41: entire sole has creases
What complication can results in respiratory distress in a newborn with Erb palsy?
diaphragmatic paralysis (due to phrenic nerve damage)
dx: fluoroscopy
What is the electrolyte imbalance associated with subcutaneous fat necrosis?
hypercalcemia
what is the most likely diagnosis for pt presenting with microcephaly, midfacial hypoplasia, low set ears, mild hypertelorism, depressed nasal bridge, cleft lip and palate, hypoplastic digits (finger like thumbs), and coarse hair?
Fetal hydrantoin syndrome
due to phenytoin
What is the best initial step in management of a newborn who had a resolved seizure episode?
check glucose and electrolytes
What is the most likely diagnosis for a healthy newborn with a rash described as macules with central pustules on an erythematous base?
Erythema neonatorum toxicum
What is the best initial step in management for a newborn with asymptomatic pneumothorax?
100% oxygen trial (no other treatments needed)
When should a newborn receive positive pressure ventilation?
if heart rate less than 100 bpm
