Neonatology Flashcards
1
Q
The significance of having delayed cord clamping is to
A
Decrease incidence of anemia
2
Q
This intervention in the EINC is to prevent neonatal hypothermia and to increase colonization with protective family bacteria
A
Uninterrupted skin to skin contact
3
Q
Breastfeeding must be done within hour many hours of life?
A
1 hour
4
Q
Mechanism of heat loss from the cooler surrounding air
A
Convection
5
Q
Mechanism of heat loss from the colder materials touching the newborn
A
Conduction
6
Q
Mechanism of heat loss from the infant to other nearby cooler objects
A
Radiation
7
Q
Optimal method for maintaining temperature in a stable neonate?
A
Skin to skin contact
8
Q
Also known as IUGR
BW is <3rd percentile for calculated gestational gestational age
A
Small for gestational age
9
Q
LGA babies are at risk for
A
Hypoglycemia
Polycythemia
10
Q
This type of IUGR is associated with genetic and metabolic conditions and seen early in gestation
A
Symmetric
11
Q
This type of IUGR is associated with poor maternal nutrition
Weight is more affected
Fetus affected in late gestation
A
Asymmetric
12
Q
Most important component of the APGAR score
A
Respiration
13
Q
Diseases Included in the basic newborn screening
A
Congenital hypothyroidism Congenital adrenal hyperplasia Galactosemia Phenylketonuria G6PD Maple Syrup Urine
14
Q
When is NBS screening done
A
24-48 hours after feeding
15
Q
If NBS is done <24 hours, it must be repeated after
A
2 weeks
16
Q
What is the ideal time to do NBS in preterms?
A
5-7 years old
17
Q
1st physical sign of a suspected congenital hypothyroidism baby
A
Prolonged jaundice
18
Q
Most common cause of congenital hypothyroidism
A
Thyroid dysgenesis
19
Q
Autosomal recessive disorders of cortisol biosynthesis
A
Congenital adrenal hyperplasia
20
Q
Most common enzyme deficiency in congenital adrenal hyperplasia
A
21-hydroxylase
21
Q
Newborns with CAH are normal at birth but exhibit sexual and somatic precocity within
A
The 1st 6 months of life
22
Q
Elevation in 17- hydroxyprogesterone is seen in how many days of life
A
2-3 days of life
23
Q
Dexamethasone given prenatally can supress androgens and prevents virilization in females if given by
A
6 weeks AOG
24
Q
Sodium and potassium levels in CAH are
A
Decreased- Na
Increased-K
25
This disease detected in newborn screening is an absolute contraindication to breastfeeding
Galactosemia
26
Classic form of galactosemia
Galactose 1 phosphate uridyltransferase deficiency (GALT)
27
This enzyme deficiency in galactosemia presents with cataracts
Galactokinase deficiency
28
Without the enzyme in galactosemia, galactose will accumulate in these organs
Brain
Kidney
Liver
29
Patients with galactosemia are at increased risk for this bacterial sepsis
E.coli neonatal sepsis
30
What product of the pentose phosphate pathway counteracts oxidative stress that is lacking in G6PD deficiency?
Reduced glutathione
31
Enzyme deficiency in phenylketonuria
Phenylalanine hydroxylase
32
Cheese like material that covers normal term infant in varying amounts
Vernix caseosa
33
Purplish reticulated pattern noted on the skin of a neonate when exposed to cold
Lacy cobblestone appearance
Cutis marmorata
34
Slate blue well demaracated areas of pigmentation over the buttocks and back
Mongolian spots
35
Red, sharply demarcated area 1/2 of body, due to imbalance of cutaneous blood vessel tone, premature hypothalamus
Harlequin color change
36
Small, white occasionally vesiculopustular papules on an erythematous base that contains eosinophils and develop after 1-3 days
Erythema toxicum
37
Vesiculopustular eruption over a dark macular base around the chin, neck, back and soles. Contains neutrophils
Pustular melanosis
38
Cysts appearing on the hard palate which is composed of accumulations of epithelial cells
Epstein pearl
39
Pearly white papules seen mostly on the chin and around the cheeks
Milia
40
Open and closed comedones or inflammatory pustules and papules on the cheeks of the baby usually after a week from delivery
Neonatal acne
41
Pink macular lesions on the nape, glabella, upper eyelids or nasolabial region
Nevus simplex
42
Common cause of neonatal acne
Maternal estrogen transfer
43
Hair that covers the skin of preterm infants; seen on term infants around the shoulders
Lanugo
44
Cephalhematoma or caput succedaneum?
Crosses suture lines
Caput
45
Cephalhematoma or caput succedaneum?
Subperiosteal hemorrhage
Cephalhematoma
46
Cephalhematoma or caput succedaneum?
Limited to the surface of one cranial bone
Cephalhematoma
47
Cephalhematoma or caput succedaneum?
With discoloration of overlying scalp
Caput
48
Cephalhematoma or caput succedaneum?
Edema, ecchymosis and swelling apparent right after birth
Caput
49
Cephalhematoma or caput succedaneum?
May cause jaundice
Cephalhematoma
50
Suggestive of tracheoesophageal fistula
Inability to pass an NGT
51
Term infant with severe respiratory distress and scaphoid abdomen on PE
Congenital diaphragmatic hernia
52
Most common type of congenital diaphragmatic hernia
Bochdalek
53
Immediate intervention for omphalocele/gastroschisis
Decompression and wrapping
54
Omphalocele or gastroschisis?
Associated with other congenital abnormality
Omphalocele
55
OEIS complex in omphalocele
Imperforate anus
| Spinal
56
Gastroschisis is more common on what side of the umbilicus?
Right
57
Histologic finding in Necrotizing enterocolitis
Coagulation necrosis
58
Thickened bowel walls and air in the bowel is highly suggestive of
Pneumatosis intestinalis
59
Greenish yellow vomitus
Nondistended non tender abdomen
Double bubble sign on xray
Duodenal atresia
60
Donut ring sign
Intussuception
61
Normal amniotic fluid L/S ratio
>2
62
Surfactant appears in amniotic fluid between ____ weeks AOG
28-32
63
Mature levels of surfactant usually present at what AOG
35 weeks AOG
64
Greatest risk factor of necrotizing enterocolitis
Prematurity
65
CXR findings:
Finely granular lungs
Ground glass appearance
Hyaline membrane disease
66
CXR findings:
Prominent pulmonary vascular markings
Fluid lines in fissure
Transient tachypnea
67
CXR findings:
Bubbly lungs - cystic lucencies
Bronchopulmonary dysplasia
68
CXR findings:
Coarse streaking granular pattern of both lung fields
Meconium aspiration
69
CXR findings:
Perihilar streaking
Pneumonia
70
The most serious complication of hyperbilirubinemia in the newborn is
Encephalopathy
71
Jaundice appearing between the 2nd and 3rd day after birth in full terms infants is likely due to
Normal changes
72
Most common cause of jaundice in neonates
Physiologic
73
Physiologic or pathologic jaundice?
Direct hyperbilirubinemia at any time
Pathologic
74
Physiologic or pathologic jaundice?
Peaks at 5-6mg/dl on the 2nd-4th day
Physiologic
75
Physiologic or pathologic jaundice?
Jaundice persistent after 10-14 days
Pathologic
76
Physiologic or pathologic jaundice?
Appears on the 1st 24-36 hours of life
Pathologic
77
Most likely etiology of jaundice in the 1st 24 hours in the first born child
ABO incompatibility
78
Most likely etiology of jaundice in the 1st 24 hours in the second born child
RH incompatibility
79
Most likely etiology of jaundice in the 1st 24 hours with a history of prolonged 2nd stage of labor
No prenatal check up
Sepsis
80
Most likely etiology of jaundice in the 1st 24 hours with a history of maternal infection during pregnancy
TORCH
81
Most likely etiology of jaundice with an onset of 3-4 days and mother supplements breastfeeding with sugar water
Breastfeeding jaundice
82
Most likely etiology of jaundice with an onset of 1 week and mother exclusively breastfeeds
Breastmilk jaundice
83
Treatment for breasfeeding jaundice
Continue breastfeeding
84
Treatment for breastmilk jaundice
Stop for 2 days
85
Substance in breastmilk that causes breastmilk jaundice
Glucuronidase
86
This results from deposition of unconjugated bilirubin in the basal ganglia and brainstem
Kernicterus
87
Kernicterus may manifest if the serum bilirubin level is more than
25mg/dl
88
This type of Coombs test is used to detect antibodies that are bound to the surface of RBC
Direct Coombs
89
This conditions may be implicated if the direct coombs test is positive
RH
| ABO
90
Most common cause of hemolytic disease of the newborn
ABO incompatibility
91
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Positive direct coombs
Spherocytes in blood smear
Hemoglobin may be normal
Increased retic count
Increased B1
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ABO incompatibility
92
RH incompatibility is due to this antigen
D antigen
93
Treatment for RH incompatibility for subsequent pregnancies
Anti D gamma globulin injection
RhoGAM
94
Most important risk factor that predisposes a neonate to sepsis is
Prematurity
95
An IUGR baby born to a mother with a history of infection during pregnancy presents with
Vesicular lesions on the face and mouth
Heroes simplex 2
96
An IUGR baby born to a mother with a history of infection during pregnancy presents with
Purpuric hemorrhagic lesions all over the body
Rubella
97
An IUGR baby born to a mother with a history of infection during pregnancy presents with
Maculopapular rash
Imaging: periostitis of the bone
Syphilis
98
An IUGR baby born to a mother with a history of infection during pregnancy presents with
Chorioretinitis
Imaging: peri ventricular calcifications
CMV
99
An IUGR baby born to a mother with a history of infection during pregnancy presents with
Chorioretinitis, microcephaly, hepatosplenomegaly
Imaging: intracerebral calcifications
Toxoplasmosis
100
An IUGR baby born to a mother with a history of infection during pregnancy presents with
Cutaneous scars
Imaging: cortical atrophy
Varicella
101
Genitourinary abnormality that is an accumulation of fluid in the tunica vaginalis
Hydrocele
102
Hydrocele usually resolves by this age
12 months
103
Genitourinary anomaly that usually present as reducible scrotal swelling
Hernia
104
Direct hernia is ___ to the epigastric vessels and projects to the abdominal wall
Medial
105
Direct hernia is lateral to the epigastric vessels and projects to the
Inguinal ring
106
If the testes remains undescended by this age, it will remain undescended
4 months
107
Undescended testes is treated at what age
9-15 months old
108
Majority of undescended testes descend at what age
1st 3 months of life
