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PGY-2 > Newborn/NICU > Flashcards

Newborn/NICU Flashcards

1
Q

TTN- what is it

A

transient pulmonary edema due to delayed clearance of fetal lung liquid

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2
Q

TTN-physiology

A

pulmonary epithelium changes from a chloride secreting membrane to a sodium absorbing membrane 2-3 days before birth
hence liquid goes away from alveolar spaces

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3
Q

TTN-risk factors

A

C/S before labor
maternal DM
late preterm or early tearm

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4
Q

TTN- CXR

A

increased interstitial markings, fluid in interlobar fissures

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5
Q

TTN- Symptoms

A

tachypnea, increased WOB for 24-72 hours

minimal oxygen needs although may required CPAP

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6
Q

Neonatal PNA CXR-

A

diffuse infiltrates, air bronchograms, lobar consolidation

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7
Q

Neonatal PNA Treatment

A

PCN + aminoglycoside

> 4 days in hospital, add vancomycin

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8
Q

RDS

A

previously known as hyaline membrane disease, deficiency of alveolar surfactant
respiratory distress in first hours of life

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9
Q

Grunting =

A

trying to maintain an adequate FRC with poorly compliant lungs and partial subglottic closure

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10
Q

RDS risk factors

A

prematurity
GDM
male infant
multiple gestations

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11
Q

RDS CXR

A

diffuse fine granular infiltrates

+ pulmonary edema

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12
Q

RDS Course of Illness

A

usually improved in 3-4 days with onset of diuretic stage

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13
Q

Meconium Aspiraton Syndrome

A

respiratory distress after delivery
seldom seen in those less than 37 weeks (34 weeks is when it gets into low colon)
toxic meconium causes a chemical pneumonitis, partial obstruction, and air trapping

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14
Q

MAS Cxr-

A

streaky with diffuse infiltrates

hyperinflated with patchy areas of atelectasis

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15
Q

Early onset GBS

A

0-6 days

most common in first 24 hours

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16
Q

Late onset GBS

A

7d-3m

most common at 3-4 weeks

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17
Q

Late, Late-onset GBS

A

beyond 89 days

typically very preterm infants

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18
Q

ROP and oxygen

A

oxygen increases risk of ROP

but hypoxia increases risk of cerebral palsy and mortality

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19
Q

Highest risk of IVH (time period)

A

first 3 days after birth, most occurs in 7 days after birth

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20
Q

What can be used for IVH prophylaxis

A
  • ANCS

- Indomethacin

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21
Q

Apnea in preterm infants, type of event pathology

A

mixed, central causing obstruction or vice versa

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22
Q

When does apnea of prematurity stop?

A

37 PMA in 92%
40 PMA in 98%
prolonged by 2-4 weeks if BPD present

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23
Q

When to stop caffeine for apnea?

A

off of positive pressure
no events in 5-7 days
33-34 PMA

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24
Q

Apnea of prematurity and reflux

A

preterm infants have a hyperreactive laryngeal chemoreflex

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25
Q

BPD VON definition

A

oxygen supplementation at 36w PMA

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26
Q

BPD NIH mild definition

A

oxygen for at least 28 days and at 36w PMA

on room air

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27
Q

BPD NIH moderate definition

A

oxygen for at least 28 days and at 36w PMA

<30% FiO2

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28
Q

BPD NIH severe definition

A

oxygen for at least 28 days and at 36w PMA

>30% FiO2 or positive pressure

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29
Q

BPD Complications

A

pulm HTN
cor pulmonae
apnea

30
Q

Caput

A
  • soft tissue swelling
  • crosses suture lines
  • should resolve within hours to days
31
Q

Physiological cause of caput

A

pressure of fetal head against cervix during labor

resultant decreased blood flow and edema

32
Q

Cephalohematoma

A
  • subperiosteal hemorrhage
  • does not cross suture lines
  • can worsen days after birth
33
Q

Consequences of cephalohematoma

A
  • underlying skull fracture
  • intracranial pressure
  • jaundice
34
Q

Sub-Galeal Hematoma

A
  • bleeding in the space between skull periosteum and scalp aponeurosis
  • can cross suture lines
  • usually due to vacuum
35
Q

Nevus Sebaceous of Jadassohn

A

yellow to tan hairless patch on face, scalp
enlarges with growth
often removed due to risk for secondary malignancy

36
Q

Cutis Aplasia

A

hair collar sign

get xray for underlying abnormalities of bone/skull

37
Q

cutis marmorata

A

normal reticuled bluish mottling of the skin

response to chilling with dilation of capillaries and small venules

38
Q

Time course of Mongolian spots

A

increase over first year, then regress

39
Q

Time course of seborrheic dermatitis in infants

A

appears 2-10 weeks of life
resolves by 12 months
anti-keralytics, topical steroids, etc

40
Q

erythema toxicum neonaturm time line

A

day 3 of life

usually gone by 2 weeks

41
Q

erythema toxicum neonaturm - description

A

resemble flea bites

wright stain shows eosinophils

42
Q

congenital neonatal acne

A

first few weeks of life, regresses over several months

open and closed comedones

43
Q

infantile neonatal acne

A

3-6 months of life

more persistent

44
Q

Rationale for why babies are low in Vitamin K

A
  • absence of gut flora
  • inability of fetal liver to store K
  • low levels of tranplacental passage
45
Q

Hemmorhagic disease of newborn

A

low vitamin k

bruising, bleeding, umbilical bleeding, ICH

46
Q

indications for vitamin d supplemention

A

400 units if brestfed

less than 1 L or 32 ounces of formula

47
Q

Prune Belly (triad)

A

abdominal muscle deficit
severe urogenital tract abnormalities (like VUR)
bilateral cryptochoridisim in males

48
Q

Hemolytic anemia –> PATHOPHYS

A

destruction of RBC

49
Q

Most common infection following cephalohematoma

A

S aureus

50
Q

Neonatal Jaundice and tonicity

A

initially hypotonic –> hypertonic –> back arching

51
Q

Galeazzi maneuver for DDH

A

difference in knee/leg length

52
Q

Most important complication of DDH

A

avascular necrosis

53
Q

DDH - gait abnormalities in older children

A

toe walking due to longer leg

54
Q

Rales

A 
small airways (often filled with fluid)
popping/Velcro pulling apart
55
Q

Breast Milk - Immune Mechanisms

A

Secretory IgA
acts at mucosal level
oligosaccharides in milk promote growth of GI microbiota

56
Q

Breast Feeding benefits

A

decreased resp infections, OM

57
Q

Meconium physiology in air way

A

acts as ball valve

air gets into it, but cannot get out

58
Q

PHHI - persistent hyperinsulinemic hypoglycemia of infancy

A

hypoglycemia persiting beyond two weeks
m
positive response to glucagon

59
Q

Treatment for PHHI/continued hypoglycemia

A

diazoxide

60
Q

Octerotide - AE for treating hypoglycemia

A

necorizing enterocolitis

61
Q

Iris Heterochromia

A

irises are different colors

associated w/ HIrschsprung and Waardenburg Syndrome

62
Q

Hirschsprung Disease cause

A

absence of parasympathetic ganglion cells (failure of neural crest cells to migrate)

63
Q

Lymphedema in newborns…

A

Turner syndrome

64
Q

Anemia in preterm infants

A

lower HCT than full term infants
impaired production of eryhtopoietin
earlier, deeper and longer nadir in Hct

65
Q

normal liver span

A

plus/minus 2-3 cm

66
Q

Still’s murmur

A

innocent systolic murmur
LLSB and apex
, vibratory

67
Q

When does PDA close

A

10-15 h after birth

68
Q

PDA - in utero function

A

directs blood away from pulmonary bed

69
Q

PDA - connection between

A

pulmonary artery

(thoracic) aorta

70
Q

IUGR risk factors

A

fetal infection (CMV, toxoplasmosis)
structural/genetic anomalies
placental ischemia- preeclampsia, abruption
maternal factors- DM, smoking, chronic illness

PGY-2 (21 decks)

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