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Pediatrics > Neonatology + Premature Infant > Flashcards

Neonatology + Premature Infant Flashcards

1
Q

what gestational week is considered a preterm infant?

A

less than 37 weeks

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2
Q

induction of labor prior to what gestation, is not recommended, unless medically indicated?

A

prior to 39 weeks

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3
Q

what is the border of viability?

A

22-24 weeks

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4
Q

what is considered extreme preterm?

A

less than 28 weeks

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5
Q

what is considered very preterm?

A

28-31 weeks

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6
Q

what is considered moderate to late preterm?

A

32-36 weeks

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7
Q

what is considered term?

A

37-42 weeks

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8
Q

what is considered post term?

A

over 42 weeks

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9
Q

what are the 4 questions for pre-delivery report?

A

what is the expected gestation age?
amniotic fluid clear?
any additional risk factors?
plan for umbilical cord management?

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10
Q

what are the 3 questions for time of birth?
what to do if YES?

A

baby term gestation
does baby have good tone?
is baby crying or breathing?

delay cord clamping x 60 secs + evaluate on mother

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11
Q

what to do if baby does not have good tone or if not crying or breathing?

A

dry, stimulate, clear airway
positive pressure ventilation if HR below 100 bpm

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12
Q

what can we assume if baby is crying?

A

HR is above 100

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13
Q

evaluates the newborn’s transition to outside the womb

A

apgar score

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14
Q

bleeding within the thin walled capillary bed of the germinal matrix near the lateral ventricles of the brain; usually seen by day of life 7

A

intraventricular hemorrhage

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15
Q

what gestational age and weight do common problems occur?

A

less than 32 weeks gestation
less than 1500 grams

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16
Q

what is the preventative for intraventricular hemorrheage?

A

antenatal steroids

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17
Q

how does intraventricular hemorrhage usually present?

A

asymptomatic

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18
Q

what is the first line diagnostic for intraventricular hemorrhage?

A

head ultrasound by day 7

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19
Q

identify grade: intraventricular hemorrhage in germinal matrix

A

grade 1

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20
Q

identify grade: intraventricular hemorrhage within lateral ventricles

A

grade 2

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21
Q

identify grade: intraventricular hemorrhage within the lateral ventricle causing dilation

A

grade 3

22
Q

identify grade: intraventricular hemorrhage within the periventricular white matter

A

grade 4

23
Q

treatment for intraventricular hemorrhage? (4)

A

blood transfusion
resp support
sodium
serial LP

24
Q

deficiency of surfactant resulting in high surface tension in lungs; major cause of M&M in preterm infants

A

respiratory distress syndrome

25
Q

what causes surfactant inactivation that leads to RDS?

A

aspiration of blood or meconium during delivery

26
Q

preventative for RDS?

A

antenatal steroids

27
Q

baby has tachypnea (>60), nasal flaring, grunting, intercostal retractions. Dx?

A

RDS

28
Q

first line diagnostic for RDS and results?

A

chest xray
diffuse ground glass

29
Q

treatment for RDS? (2)

A

noninvasive positive pressure ventilation
surfactant w/in 6 hours of birth

30
Q

what is a long term outcome of RDS?

A

bronchopulmonary dysplasia

31
Q

requiring O2 support / mechanical ventilation at 28 days of life or 36 weeks, whichever comes last

A

bronchopulmonary dysplasia

32
Q

at what age do most PDAs in preterm infants spontaneously close?

A

6 months

33
Q

what is the most important risk factor for PDA?

A

prematurity

34
Q

preventative measure for PDA?

A

antenatal steroids

35
Q

what is the largest reason to treat PDA?

A

failure to thrive

36
Q

how to diagnose PDA?

A

echo

37
Q

medical treatment for PDA? (2 options)

A

indomethacin
acetaminophen

38
Q

surgical treatment for PDA? (2 options)

A

ligation
piccolo

39
Q

ischemic necrosis of the intestinal mucosa, severe inflammation, invasion of enteric gas forming organisms, and dissection of gas into the bowel wall

A

necrotizing enterocolitis

40
Q

what is the most common GI emergency in preterm infants?

A

necrotizing enterocolitis

41
Q

baby is born with feeding intolerance, distended abdomen, apnea, bradycardia, hypothermia, bloody stool, dusky abdomen, and lethargy. Dx?

A

necrotizing enterocolitis

42
Q

how to diagnose necrotizing enterocolitis?

A

KUB xray (kidney, ureter, bladder)

43
Q

treatment for mild-moderate necrotizing enterocolitis? (4)

A

NPO
zosyn antibiotic
fluids
serial KUB xrays

44
Q

treatment for severe necrotizing enterocolitis in which there is free air?

A

exploratory sx with removal of dead bowel

45
Q

who manages failure to thrive?

A

licensed dietician

46
Q

how to increase caloric intake in infants with failure to thrive?

A

fortification of formula or breast milk

47
Q

what is the optimal growth for premature infants?

A

20-30g/kg/day

48
Q

which virus is avoided in the NICU? why?

A

rotavirus
it is live

49
Q

what weight can Hep B be given?

A

> 2000 g

50
Q

all infants discharged from the NICU receive which vaccine during RSV season?

A

beyfortus (RSV monoclonal antibody)

51
Q

when it is recommended that all preterm infants follow up in a NICU specific clinic?

A

during 1st two years of life

Pediatrics (6 decks)

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