Neonatology + Premature Infant

Question 1

what gestational week is considered a preterm infant?

Answer 1

less than 37 weeks

Question 2

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

Answer 2

prior to 39 weeks

Question 3

what is the border of viability?

Answer 3

22-24 weeks

Question 4

what is considered extreme preterm?

Answer 4

less than 28 weeks

Question 5

what is considered very preterm?

Answer 5

28-31 weeks

Question 6

what is considered moderate to late preterm?

Answer 6

32-36 weeks

Question 7

what is considered term?

Answer 7

37-42 weeks

Question 8

what is considered post term?

Answer 8

over 42 weeks

Question 9

what are the 4 questions for pre-delivery report?

Answer 9

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

Question 10

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

Answer 10

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

delay cord clamping x 60 secs + evaluate on mother

Question 11

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

Answer 11

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

Question 12

what can we assume if baby is crying?

Answer 12

HR is above 100

Question 13

evaluates the newborn’s transition to outside the womb

Answer 13

apgar score

Question 14

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

Answer 14

intraventricular hemorrhage

Question 15

what gestational age and weight do common problems occur?

Answer 15

less than 32 weeks gestation
less than 1500 grams

Question 16

what is the preventative for intraventricular hemorrheage?

Answer 16

antenatal steroids

Question 17

how does intraventricular hemorrhage usually present?

Answer 17

asymptomatic

Question 18

what is the first line diagnostic for intraventricular hemorrhage?

Answer 18

head ultrasound by day 7

Question 19

identify grade: intraventricular hemorrhage in germinal matrix

Answer 19

grade 1

Question 20

identify grade: intraventricular hemorrhage within lateral ventricles

Answer 20

grade 2

Question 21

identify grade: intraventricular hemorrhage within the lateral ventricle causing dilation

Answer 21

grade 3

Question 22

identify grade: intraventricular hemorrhage within the periventricular white matter

Answer 22

grade 4

Question 23

treatment for intraventricular hemorrhage? (4)

Answer 23

blood transfusion
resp support
sodium
serial LP

Question 24

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

Answer 24

respiratory distress syndrome

Question 25

what causes surfactant inactivation that leads to RDS?

Answer 25

aspiration of blood or meconium during delivery

Question 26

preventative for RDS?

Answer 26

antenatal steroids

Question 27

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

Answer 27

RDS

Question 28

first line diagnostic for RDS and results?

Answer 28

chest xray diffuse ground glass

Question 29

treatment for RDS? (2)

Answer 29

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

Question 30

what is a long term outcome of RDS?

Answer 30

bronchopulmonary dysplasia

Question 31

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

Answer 31

bronchopulmonary dysplasia

Question 32

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

Answer 32

6 months

Question 33

what is the most important risk factor for PDA?

Answer 33

prematurity

Question 34

preventative measure for PDA?

Answer 34

antenatal steroids

Question 35

what is the largest reason to treat PDA?

Answer 35

failure to thrive

Question 36

how to diagnose PDA?

Answer 36

echo

Question 37

medical treatment for PDA? (2 options)

Answer 37

indomethacin acetaminophen

Question 38

surgical treatment for PDA? (2 options)

Answer 38

ligation piccolo

Question 39

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

Answer 39

necrotizing enterocolitis

Question 40

what is the most common GI emergency in preterm infants?

Answer 40

necrotizing enterocolitis

Question 41

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

Answer 41

necrotizing enterocolitis

Question 42

how to diagnose necrotizing enterocolitis?

Answer 42

KUB xray (kidney, ureter, bladder)

Question 43

treatment for mild-moderate necrotizing enterocolitis? (4)

Answer 43

NPO zosyn antibiotic fluids serial KUB xrays

Question 44

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

Answer 44

exploratory sx with removal of dead bowel

Question 45

who manages failure to thrive?

Answer 45

licensed dietician

Question 46

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

Answer 46

fortification of formula or breast milk

Question 47

what is the optimal growth for premature infants?

Answer 47

20-30g/kg/day

Question 48

which virus is avoided in the NICU? why?

Answer 48

rotavirus it is live

Question 49

what weight can Hep B be given?

Answer 49

> 2000 g

Question 50

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

Answer 50

beyfortus (RSV monoclonal antibody)

Question 51

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

Answer 51

during 1st two years of life