Neonatology Flashcards
Caudal regression syndrome is most likely associated with which maternal condition?
Gestational diabetes
What does VACTERL stand for?
V- vertebral anomalies A- anal atresia C- cardiac defects T-E fistula R- renal/radial anomalies L- limb (radial) anomalies
Most common site of diaphragmatic hernia
Posterolateral; second most common (right behind the sternum)
Depressed nasal bridge, hypertelorism, cleft palate, finger-like thumbs, coarse hair and hirsutism, hypoplasia of distal phalanges; name of syndrome and intrapartum exposure to which medication will cause this?
Fetal hydantoin syndrome; exposure to phenytoin
Neural tube defects are associated with which intrapartum medication exposure?
Valproic acid, carbamazepine (anti-seizure medications)
Difference between erythema toxicum vs transient pustular melanosis?
Erythema toxicum– not present at birth, erythematous base with central pustule (eosinophilic reaction of body)
Transient pustular melanosis– non-erythematous, pigmented base; common in AA infants; can be present at birth and can include palms and soles as well
Miliaria rubra/crystallina
Obstruction of sweat glands or over-heating/sweating of skin (heat rash) with papulovesicular lesions; rubra (red appearing), crystallina (clear appearing) involves different layers of the epidermis
% of those who are breech in the 3rd trimester developing DDH?
12%
When should you screen for DDH with hip ultrasound?
Ultrasound at 6 weeks of age
Concerns for low apgars with subsequent gross hematuria and decreased UOP; what are you concerned about?
Renal vein thrombosis secondary to hypercoagulable state related to perinatal asphyxia
Vernix covers the whole body between which gestational ages?
24-38 weeks
One to two anterior sole creases with no heel creases; what age?
32-33 weeks
Scant ear cartilage with slow return to normal upon folding; what gestational age?
32-35 weeks
No breast buds; what gestational age?
<36 weeks
Reduction in caliber of large intestine at the splenic flexure on barium enema with findings concerning for obstruction; diagnosis and what maternal comorbidity is this most likely related to?
Neonatal small left colon syndrome–related to maternal gestational or T1/2 diabetes
Difference between Crouzon and Apert syndrome?
Both have premature fusion of sutures (craniosynostosis) but fusion of 2-5th digits (syndactyly) is pathognomonic for Apert (digits are not apert?), syndactyly is not seen in Crouzon syndrome
Exposure to what maternal medication can also lead to withdrawal symptoms?
SSRIs, would do eat/sleep/console just like for NOWS; this is usually rare, but can happen in mom’s using SSRI for anxiety/depression
Manifestations of ACE-I use during pregnancy in a neonate?
Teratogenic effects (septal defects, neural tube defects)
True. IUGR is associated with an increased risk of metabolic syndrome in the future.
True.
Nerves affected by Erb’s vs Klumpke’s palsy
C5-C7 Erb’s and C8-T1 Klumpke (remember T1 contains sympathetic ganglia, and can manifest as ptosis as well)
Unconjugated hyperbilirubinemia etiologies
Crigler-Najjar Type I (absent UDP-glucuronyltransferase--severe) Crigler-Najjar Type II (partially functioning UDP-glucuronyltransferase) Gilbert Syndrome (Ineffective uptake of unconjugated bilirubin from the serum--most common, large portion of population is asymptomatic--may emergence in times of stress and adolescence *All are autosomal recessive
Medication that can help conjugate bilirubin?
Phenobarbital (can use for CN type II and Gilbert)
Risk factors for transient tachypnea of the newborn?
Late preterm delivery (34-37 weeks), maternal diabetes, maternal asthma, C-section delivery
Pneumothorax treatment
Symptomatic– needle thoracotomy
Not symptomatic– 100% FiO2 oxygen
