Neonatology Flashcards
[EINC]
What are the steps in EINC?
- Immediate drying
- Uninterrupted skin-to-skin contact
- Delayed cord clamping after 1-3 minutes
- Breastfeeding
[EINC]
What are the mechanism of heat loss in a newborn?
- Convection
- Conduction
- Heat radiation
- Evaporation
[Birth weight]
Low birth weight
<2500g
[Birth weight]
Very low birth weight
<1500g
[Birth weight]
Extremely low birth weight
<1000g
[Gestational Age]
Late preterm
> / 34 but < 37 weeks
[Gestational Age]
Very preterm birth
<32
[Gestational Age]
Extremely preterm birth
<28
____ BW is less than 3rd percentile for calculated age
SGA
____ BW is > 90th percentile for gestational age
LGA
associated with maternal DM and obesity, risk for hypoglycemia, polycythemia
[EINC]
What is the objective of thorough drying?
To stimulate breathing, provide warmth
[EINC]
What is the objective of early skin to skin contact?
To provide warmth, bonding, prevent infection, and hypoglycemia
[EINC]
What is the objective of delayed cord clamping
- Reduce anemia in term and preterm
2. Reduce IVH and transfusions in preterm
What are the components of APGAR?
Activity - active Pulse - >100bpm Grimace - Active motion Appearance - body pink, extremities blue Respiration - vigorous cry
RA ____
Newborn Screening test
RA 9288
In normal infants, NBS is done at __ hours
24 to 48 hours
If blood was collected <24hrs, repeat at 2 weeks old
For preterm infants, NBS should be done _____ day old
5-7 days old
How many diseases does Expanded NBS covers?
28 diseases
[Diagnosis]
Normal birth weight and length
Delayed physical, mental and sexual development;
Sluggish, deeding difficulties
Edema of scrotum and genitals, prolonged jaundice
Congenital Hypothyroidism
What is the most common cause of congenital hypothyroidism?
Thyroid Dysgenesis
[Diagnosis]
Normal at birth but with signs of sexual and somatic precocity within 1st 6 months of life
Hyponatremia, hyperkalemia, hypoglycemia
Congenital Adrenal Hyperplasia
Marked elevation of 17-OHprogesteron is normally elevated in the first ____ DOL in sick pre-term infants
2-3 DOL
Most common enzyme deficiency associated with CAH?
21-hydroxylase enzyme
What is the treatment for CAH
Glucocorticoid replacement 15 to 20mg/m2/24 hours administered orally in 3 divided doses
What is the DOC for salt-wasting type of CAH
Fludrocortisone
What are the enzyme deficiency in Galactosemia?
- Galactose-1-phosphate uridyltansferase (classic)
- Galactokinase (cataract)
- Galactose-4-epimerase
What is the enzyme deficient in phenylketonuria?
Phenylalanine hydroxylase
Increased Phe
What is the damaging by product of phenylalanine that disrupts normal metabolism and causes brain damage?
Phenylethylamine
unpleasant musty odor
What is the most common manifestation of phenyketonuria?
developmental delay
Infant: severe vomiting, hypertonic, hyperactive DTRs
Older: hyperactive with purposeless movements, rhythmic rocking and athetosis, unpleasant musty odor
What is the enzyme deficiency in MSUD?
Branched chain alpha-keto acid dehydrogenase complex
L, I, V
[PE findings at birth]
slate blue, well demarcated areas of pigmentation over the buttocks and back
Mongolian spots
[PE findings at birth]
small, white, vesiculopustular papules on an erythematous base after 1-3 days, with eosinophils
Erythema toxicum
[PE findings at birth]
Vesiculopustular eruption over a dark macular base around the chin, neck, back and soles. contains neutrophils
Pustular melanosis
[PE findings at birth]
Cysts appearing on the hard palate which is composed on accumulations of epithelial cells
Epstein pearls
[PE findings at birth]
pearly white papule seen mostly on the chins and around the cheeks
Milia
[PE findings at birth]
open and closed comedones or inflammatory pustules after a weeks from delivery
Neonatal acne
[PE findings at birth]
pink macular lesions on the nape, glabella, upper eyelids, nasolabial region
Nevus simplex