Neonatology: PE + EINC + Breastfeeding Flashcards
Perinatal period
28th week gestation to 7th day of life
Neonatal period
Day 1-28
Infancy
Birth to 1 year
Gestational Age: Pre-term
34-36 6/7 weeks
Gestational Age: Term
37-41 6/7 weeks
Gestational Age: Post term
≥ 42 weeks
Normal Vital signs of the neonate:
HR
120-160 bpm
Normal Vital signs of the neonate:
RR
30-60 bpm
Normal Vital signs of the neonate:
Temp
36.5-37.5ºC
APGAR Score components
Appearance
Pulse
Grimace
Activity
Respirations
APGAR score of a newborn with peripheral cyanosis, hr < 100, grimacing, full flexion of upper and lower ex, loud cry
7/10
Use of the APGAR Score
Predicts the need for newborn resuscitation
2 parameters of the ballard score for maturity
Physical maturity
Neuromuscular maturity
Classification of BW:
- Low BW
- Very Low BW
- Extremely Low BW
- Low BW: < 2500g
- Very Low BW: <1500g
- Extremely Low BW: <1000g
Definitions/measurements of BW:
- SGA
- AGA
- LGA
- SGA: < 10th percentile BW
- AGA: 10 < BW < 90
- LGA: > 90th percentile
Hydrocephalus the does not cross suture lines. Blood collection in the subperiosteum. Resolves in 2-3 weeks
Cephalhematoma
Hydrocephalus that crosses suture lines, underneath the scalp, lasts 2-3 days
Caput succedaneum
Hydrocephalus with due to damage to emissary veins, resulting in fluid collection in the epicranial aponeurosis, may present with racoon eyes, and resolves in 2-3 weeks
Subgaleal hemorrhage
A finding of bounding pulses and a wide pulse pressure suggests the following cardiac pathology
Patent ductus arteriosus
A finding of strong pulses in upper vs lower extremities suggests the following cardiac pathology
Coarctation of the Aorta
A finding of weak peripheral pulses in both upper and lower extremities suggests the following cardiac pathology
HLHS or Aortic Stenosis
A finding of Webbing of the neck suggests which pathology in females
Turner syndrome
Inability to pass a feeding tube through the nares
Choanal atresia
Congenital malformation of the eye causing defects in the iris, lens,
or retina (small notch to a large cleft)
Coloboma
White pupillary reflex
Leukocoria
Temporary accumulations of epithelial cells on the hard palate or either side of the rap he
Epstein pearls
Bowel sounds auscultated on the chest wall suggests the following:
Diaphragmatic Hernia
herniation of abdominal contents into base of umbilical cord, abdominal contents covered by a protective membrane
Omphalocele
Full thickness abdominal wall defect, extruded intestine not covered by membrane. Defect is usually located on the right side.
Gastroschisis
Intraabdominal contents protrude through a fascia! defect at the umbilicus that is covered by skin
Umbilical Hernia
Urethral orifice located on the glans or ventral surface
of the shaft
Hypospadias
Caudal curvature of the penis due to incomplete
development of the foreskin
Chordee
2 conditions caused by a Patent Processus Vaginalis
Inguinal hernia
Hydrocele
Finding of an arm adducted and pronated, forearm internally rotated. Absent moro reflex
Erb duchenne palsy of the Brachial plexus
Nerve involvement in Erb Duchenne Palsy
C5-C6
Findings of Claw hand, no wrist movement, absent grasp relex
Klumpke Palsy
Nerve involvement in Klumpke Palsy
C7-C8
Syndrome associated with the Extension of Klumpke Palsy to involve T1
Horner Syndrome (Ptosis, Miosis, Enophthalmos)
Age of Appearance and Disappearance of the Rooting Reflex
32 weeks AOG –> 1 month AOG
Age of Appearance and Disappearance of the Palmar Reflex
28 weeks AOG –> 2-3 months
Age of Appearance and Disappearance of the Moro Reflex
28-32 weeks –> 5-6 months
Age of Appearance and Disappearance of the Fencing Reflex
35 weeks AOG –> 6-7 months
Age of Appearance of the Parachute Reflex
4-9 months
EINC Core steps
- Immediate and thorough drying
- Skin-to-skin contact
- Properly timed Cord Clamping
- Non-separation of mother and baby
Eye prophylaxis given to prevent gonococcal ophthalmia neonatorum
Erythromycin ointment 0.5% or Tetracycline 1%
Given to prevent hemorrhagic disease of the newborn
Vitamin K 0.5-1.0mg IM
Vaccinations at birth
> BCG 0.05ml intradermally
> Hep B Vaccine 0.5mL IM
Conditions for giving HB Ig IM vaccine to neonates
Mother with (+) HBsAg or Mother with unknown HBsAg and BW < 2kg
RA 9288 is also known as the following
The Newborn Screening Act of 2004
Timing of newborn screening for the ff:
- Term neonate
- Preterm neonate
- Intensive care neonate
- 24 hours to 3 days
- 5-7 days
- 7 days
Enzyme deficiency in Congenital Adrenal Hyperplasia
21-hydroxylase
6 Diseases included in the NBS Act of 2004
- Congenital Hypothyroidism
- Congenital Adrenal Hyperplasia
- G6PD Deficiency
- Galactosemia
- Phenylketonuria
- Maple Syrup Urine Disease
Most common cause of Congenital Hypothyroidism
Thyroid dysgenesis
Hormonal levels of Cortisol and ACTH in CAH
low Cortisol
high ACTH
Most common Enzyme deficiency in Galactosemias
Galactose-1-phosphate uridyltransferase (GALT)
Enzyme deficiency in Phenylketonuria
Phenylalanine hydroxylase
Most common manifestation of Phenylketonuria
Developmental Delay (due to brain damage from increased phenylalanine)
Enzyme deficiency in Maple Syrup Urine Disease
Alpha-keto acid dehydrogenase complex
Characterstics of Foremilk vs Hindmilk
Foremilk: Released at the start of feeding, watery, high lactose and protein
Hindmilk: Released towards the end of feeding, thick, high fat
