Neonatology Flashcards
T/F: Mothers with prior pregnancies with + GBS screen should be treated prophylactically automatically on current pregnancy
False- only if prior infant had invasive GBS disease
What should women receive if GBS+ and had anaphylactic response to penicillin?
Clindamycin
What is the biggest risk factor for preterm delivery?
Prior preterm delivery
What test can be done to confirm the diagnosis of premature rupture of membranes (PROM)?
Nitrazine paper test
Amniotic fluid is pH 7-7.3 compared to vaginal pH of 3.8-4.2
When should fetal pulmonary maturity testing be done?
Between the weeks of 32-39 weeks gesttaion
If a mom is PROM, what is the goal gestational age to be reached for delivery if baby’s lungs are mature?
34 weeks
What is HELLP?
Hemolysis
Elevated liver enzymes
Low platelets
What is an important measure of incidence of malformations associated with maternal DM?
Degree of hyperglycemia PRIOR TO conception
Which type of deceleration prenatally is associated with uteroplacental insufficiency?
Late deceleration
What is the only APGAR association to worsened mortality and severe neurologic sequelae?
APGAR < 3 at 15 minutes of life
How do you estimate the length of an ETT for a neonatal intubation?
6 + weight in kg
What are the stages of ear form development in the newonate?
24-33 weeks: flat, shapeless
34-35: superior incurving
36-38: upper 2/3 incurving
> 39: well defined incurving to lobe
What are the stages of sole crease development by gestational age?
24-31: no anterior sole creases 32-33: 1-2 anterior sole creases 34-35: 2-3 anterior sole creases 36-37: creases covering 2/3 of anterior sole 38-41: heel creases present > 42: deep creases on entire sole
What are the stages of lanugo presence by gestational age?
entire body: 22-32 weeks
absent from face- 33-37 weeks
present on shoulders only - 38 - 41 weeks
none present > 42 weeks
What is the name of the rash in the newborn defined as an ulcerated, noninflammatory, well-demarcated congenital absence of skin?
Aplasia cutis congenita
When does the anterior fontanelle close?
Between 9-18 months
When does the posterior fontanelle close?
By 4 months age
Which type of neonatal skull fracture has the worst prognosis?
Basilar skull fracture
What is the likely organism responsible for conjunctival purulence in the first 2-5 days of life?
Neisseria Gonorrhea
What is the likely organism responsible for conjunctival purulence in the first 5-14 days of life?
Chlamydia trachomatis
What is the treatment of chlamydia conjunctivitis?
Erythromycin x 14 days
What is the treatment of gonorrhea conjunctivitis?
3rd generation cephalosporin
What is a benign mass on the floor of the mouth due to dilatation of the salivary gland?
Ranula
T/F: Coughing int he newborn is a normal finding
False, almost never normal
What maternal diagnosis should be considered in a neonate with complete heart block?
SLE
What is the pressure difference betwen upper and lower extremities in coarctation?
> 20 mm Hg
What is the likely diagnosis in a neonate with sudden onset gross hematuria, unilateral/bilateral flank masses and thrombocytopenia?
Renal vein thrombosis
Are omphaloceles are gastroschisis more likely to be associated with a genetic syndrome?
Omphalocele
What are common risk factors for gastroschisis?
Maternal young age and drug use
What is the possible immunodeficiency associated with delayed umbilical cord separation?
LAD (Leukocyte adhesion deficiency)
What is considered an abnormally small penile length in a neonate?
< 2.5cm
What is the syndrome:
- Pancytopenia (aplastic anemia)
- Skin findings (cafe au lait)
- Skeletal anomalies
- Microcephaly
- Thumb hypoplasia
Fanconi anemia
What is the syndrome:
- Hypoplastic anemia, low Hgb and retic count
- Short stature
- Limb abnormalities
Diamond Blackfan anemia
What is the syndrome:
- normal/increased WBC, normal Hgb
- Thrombocytopenia
- Absent bilateral radii
Thrombocytopenia with absent radii (TAR) syndrome
What should be given to babies born to mothers with HbsAg positive? How soon after birth?
HBIG and Hep B vaccine, within 12 hours
What is considered a pass on the CCHD screen?
Sats > 95% in pre and post ductal sats
Sats =< 3% difference between pre and post ductal
Which antiepileptic increases the risk of fetal hydantoin syndrome?
Phenytoin
What is the risk of maternal use of methotrexate in pregnancy?
Limb defects and craniosynostosis
What is the risk associated with maternal use of ACE-inhibitors during pregnancy?
Renal dysgenesis, oligohydramnios and skull ossification defects
What is the side effect of maternal use of streptomycin during pregnancy?
Hearing loss in infant
What is the effect of maternal tetracycline use after 20 weeks gestation in neonate?
Tooth discoloration
What is the effect of maternal warfarin use during pregnancy on the neonate?
Fetal warfarin syndrome: Nasal hypoplasia and stippled epiphyses
What are the three categories of FAS abnormalities in the neonate?
Facial abnormality + Growth deficiency + Cognitive abnormality
What is the most common cause of intellectual disability?
FAS
What congenital infection is associated with abnormal teeth/bones, ID and proteinuria?
Syphilia
What is the etiology of RDS in an IDM?
Insulin blocks enzymes necessary for synthesis of precursor of surfactant
Which test on the amniotic fluid can be done to evaluate for lung maturity?
L/S ratio
What is a side effect of iNO therapy in pulmonary hyprtension?
Methemoglobinemia
What is the finding of CT with intraabdominal calcifications concerening for?
Meconium peritonitis
What is the impact of phenobarbital on the development of Crigler Najjar?
Phenobarb induces expression of enzyme in patients with TII Crigler Najjar, decreases serum bili level
