Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NICU > NICU > Flashcards

NICU Flashcards

1
Q

Elevated AFP

Hint RAIN

A

R. Renal (nephrosis, agenesis, pckd)
A. Abdominal wall defects
I. Incorrect dates/ multiple pregnancies
N. Neuro (ancephaly or spins bifida)

RAIN elevates the level of AFP reservoirs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Low AFP

A

Trisomy 21- downs

Trisomy 18- Edwards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The most common cause of fetal bradycardia is…….

A

Heart block

May be seen in maternal lupus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the difference in fetal medicine between a non stress test and a contraction stress test?

A

Non stress test- measures spontaneous fetal movements and HR
Measures fetal autonomic nervous system integrity

Contraction stress test- measures fetal HR in response to contractions
Measures uteroplacental insufficiency and tolerance of labor
Positive= late deceleration after 50% of contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 2 components of a BPP (biophysical profile)

A

Non stress test

US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 5 things and US measures in a BPP

A 
Fetal movement
Reactive HR
Breathing
Tone
Volume of fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What’s the difference between apnea and periodic breathing

A

Apnea lasts for longer than 20s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2 treatments for apnea of prematurity

A

Caffeine

Theophylline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is primary apnea and how do you treat it?

A

See this post delivery
Gasping with increased depth and RR followed by apnea

Treat with stimulation
Also blow by o2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is secondary apnea and how do you treat?

A

Occurs if primary apnea does not resolve

Rule of thumb is greater than 30s of apnea after delivery

More gasping apnea

Oxygen and stimulation do not help

Treat with PPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How much pressure is needed to inflate the lungs with the first breath?

A

60 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Definition of TTN

A

Tachypnea in otherwise health infants caused by retained fetal fluid

See with CS babies

Diagnosis of exclusion
Presents in first few hours of life
Tachypnea >60
Retractions, nasal flaring, grunting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the X-ray of TTN look like

A

Fluid in the inter lobar fissures

Increased pulmonary markings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How long does TTN last?

A

72hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

TTN treatments

A

NPO

Close monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HIE definition/head cooling requirement

A

Apgar <5 at 10 min
Apgar <3 for longer than 5 min
pH <7
Base deficit >16

> 36 wks
< 6 HOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Metabolic disturbances seen in HIE

A 
NORMAL anion gap
Elevated ammonia
Lactic acidosis
Hypoglycemia
Hypocalcemia
Hyponatremia
pH <7
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

At what weeks of development does surfactant surge?

A

33-36 wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

CXR in RDS

A

GROUND GLASS
granular opacifications
air bronchograms
obscure heart and diaphragm borders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Think of this when there is temperature instability in an infant

A

INFECTION!

GBS pna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what happens in children with RDS & hyperbilirubinemia

A

higher risk of kernicterus!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

increased risk of RDS with…. (5)

A 
1- premies
2- IDM---> can interfere with the accuracy to L:S
3- CS deliver
4- birth asphyxia
5- surfactant B deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

decreased risk of RDS with…. (3)

A

1- PROM
2- antenatal steroids
3- L:S >2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

start on vent if pH…. and PCO2…..

A

<7.2

>60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what do you want your PO2 to be with RDS babies on vents/ECMO/HFOV

A

50-70 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the difference between prophylactic and rescue surfactant

A

1- prophylactic- given in first 2 HOL to babies <30 wks

2- rescue- given later after dx RDS made

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what does surfactant do to the following….
____ O2 requirement
____ inspiratory pressure
____ lung compliance

A

decrease
decrease
improve/increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

ECMO criteria

A

reversible lung dz <10-14 day duration
failure of other methods

  • no systemic or intracranial bleeding
  • no CHD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

PIE definition

A

pulmonary interstitial emphysema
cause of deterioration of babies with RDS on vents
air leaks into the interstitium
can end up as pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the cause of BPD

A

bronchopulmonary dysplasia/chronic lung disease

arrest of nl lung development in premature infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

when does bilirubin peak in term infants? in premies?

A

3-5 DOL

5-7 DOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

CXR findings with BPD

A

GROUNG GLASS
diffuse opacities
cystic areas with streaky infiltrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

when are mothers screened for GBS?

A

35-37 weeks GA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

when do you see…
early onset GBS?
late onset GBS?
late, late onset GBS?

A

first 7 days after birth
~4 weeks after birth (but up to 90d)
up to 6 mos after birth (premies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

the difference between mothers with babies with GBS vs listeria

A

GBS mom often asymptomatic

Listeria mom often with flu-like illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

when it’s OK not to tx babies with GBS+ mothers

A

mom adequately tx
OR
CS prior to ROM

*if mother not adequately tx, but asym and baby asym, monitor baby for 48HOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Erb’s palsy

A

C5-7
waiter’s tip- adducted, internally rotated, wrist and fingers flexed
grasp intact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

with a baby with Erb’s palsy and respiratory distress- think of this

A

Phrenic nerve palsy

C3-5 keeps the diaphragm alive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

klumpke palsy

A

C8-T1
claw hand
can be associated with Horners syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

cord that stays attached >1 month… think of this (2)

A

1- LAD - leukocyte adhesion deficiency

2- low WBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

further work up for infant with single umbilical artery

A

Renal US

can have associated renal dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

definition of SGA

A

<10th percentile weight for GA

< 2500 g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

definition of LGA

A

> 90th percentile weight for GA

>3900 g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Term baby

A

38-42wks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

normal scalp pH

A

> 7.25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

hint for knowing MAP (mean arterial pressure) in premies

A

MAP should not be lower than corrected GA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

definition of VLBW

A

<1500g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What does CXR look like with meconium aspiration

A

areas of atelectasis and areas of hyperinflation

can lead to pneumothorax (10-20%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

PE findings of baby with meconium aspiration

A

barrel chest

crackles and coarse breath sounds

50
Q

xray findings with NEC

A

pneumatosis intestinalis
air in the biliar tree
pneumoperitoneum

51
Q

long term complication of NEC

A

intestinal stricture –> obstruction

52
Q

how long should you keep a baby NPO after NEC

A

~3 wks

53
Q

treatment of NEC

A 
NG tube to suction
NPO
IVF
antibiotics
CBC (low plt), lyte, coags
serial AXR
surgery consult
54
Q

this can be a nl bili within the first 24h for FT babies

A

<12.4

55
Q

when is phototherapy contraindicated

A

1- elevated direct/conjugated bili

2- family hx of light sensitive porphyria

56
Q

causes of increased enterohepatic circulation leading to jaundice (5)

A 
hirschsprungs
obstruction
ileus
pyloric stenosis
meconium ileus
57
Q

medications that worsen jaundice

A

anything that binds to albumin and displaces bilirubin
-sulfonamides, ceftriaxone

increased risk of kernicterus

58
Q

causes of hyperbilirubinemia

LIE and GLOW

A

L- lysed RBC- hemolytic dz, defects of red cell metabolism, isoimminization
I- increased
E- entterohepatic circulation (obstruction, ileus, pyloric stenosis, hirschsprung, meconium ileus) & Endo (hypotheyroid, hypopit)

G- gilberts
L- Lucy Driscoll syndrome
bOth direct & indirect- galactosemia, tyrosinosis, hypermethioninemia, CF
W- wasted blood- caput, bruising, petechiae, cephalohematoma, swallowed maternal blood

59
Q

Exchange transfusion complications

A 
imPaCT NO!
Potassium high
Calcium low
Thrombocytopenia 
Volume NO! (hypovolemia)
60
Q

treatment for hypoglycemia

A

2-3 cc/kg D10

or glucocorticoids- hydrocortisone, prednisone

61
Q

what labor drugs can cause hypoglycemia

A

tocolytics- stimulate fetal insulin

62
Q

signs of hypoglycemia in an infant (6)

A 
tachypnea
jitteriness
lethargy
apnea
cyanosis
seizures
63
Q

risks for IDMs (5)

A 
RDS (decreased surfactant)
hypoglycemia (high insulin)
LGA (insulin promotes growth)
polycythemia (d/t increased erythropoietin)
hypoplastic L colon

Large body, small Left colon, Lots of RBCs

64
Q

definition of hypocalcemiain infant

A

ionized ca <4.5

ca <8.5

65
Q

ekg change in hypocalcemia

A

prolonged qt

66
Q

what do you do in an infant with hypocalcemia who has been receiving calcium replacement and continues to show signs of hypocalcemia?

A

give magnesium
Mg and Ca are directly correlated
hypoMg can cause intractable hypocalcemia that will not respond to calcium replacement until you correct magnesium

67
Q

definition of polycythemia

A

> 65

tx if >70

68
Q

yellow bananas are not sweet

A

jandiced kiddos are hypoglycemic

69
Q

when does physiologic nadir for anemia occur

A

2-3 mos in FT kids

1-2 mos in premies

70
Q

what is the Apt test

A

test gastric aspirate for maternal blood

71
Q

what is the cause of hemorrhagic dx of the newborn

A

vitK deficiency

72
Q

what maternal drugs cause hemorrhagic dz

A

anticoagulants
anticonvulsants
antibiotics- quinolones, cephalosporins, TB meds

73
Q

cause of neonatal seizure in first 24HOL

A

neonatal asphyxia

74
Q

antiepileptic to use in neonatal seizure

A

phenobarbital

75
Q

omphalocele vs gastroschisis

A

omphalocele is protrusion of the bowel through the umbilicus covered with a membrane!
gastroschisis- bowel is not covered and protrudes through NEAR the umbilicus, not THROUGH!

76
Q

genetic condition seen with omphalocele

A

beckwidth wiedmann

- also hypoglycemia, big tongue, macrosomia, ear pits, hepatoblastoma

77
Q

caput succedaneum vs cephalohematoma

A

caput succedaneum- CROSSES SUTURES, boggy, soft pitting

cephalohematoma- confined, firm and tense

78
Q

grading IVH

A

1- germinal matrix
2- IVH without dilitation
3- IVH + dilitation
4- parenchyma involvement

79
Q

mother given tertbutaline for tocolysis… what is the effect on baby?

A

hyperinsulin & hypoglycemia

80
Q

antenatal steroids reduce the risk of…. (3)

A

1- RDS
2- IVH
3- NEC

81
Q

phenobarb and bili

A

decreases risk of hyperbili

82
Q

signs of EtOH withdrawal in babies (2)

A

hyperactivity/irritability

hypoglycemia

83
Q

signs of cocaine withdrawal in babies

A

no official withdrawal sx

84
Q

teratogenic affects of cocaine (4)

A

cause vasoconstriction of placenta

  • cerebral infarct
  • limb anomalies
  • urogenital defects
  • abruption
85
Q

babies exposed to amphetamines

A

irritable and agitated
IUGR
developmental/cognitive delays

86
Q

babies exposed to barbituates (3)

A

hyperactivity/irritable
hyperphagia
poor suck-swallow coordination

87
Q

opioid withdrawal in babies (7)

A 
hyperirritability
tremors/jitters
hypertonia
loose stools
emesis
feeding problems
seizures
88
Q

definition of LBW

A

<2500g

89
Q

definition of VLBW

A

<2000g

90
Q

definition of ELBW

A

<1500g

91
Q

what is the most common cause of a single umbillical a

A

trisomy 18

also need to worry about congenital anomalies, renal problems, cardiac problems

92
Q

what is an early deceleration

A

decel that mirrors contractions

2/2 head compression

93
Q

what is a late deceleration

A

recovery after contraction subsides

?uteroplacental insufficiency or acidosis

94
Q

what does a variable decel indicate

A

cord compression

95
Q

what should be the temperature in the DR

A

73-76 deg F (23-24 C)

96
Q

at was GA do you have lanugo over your entire body

A

<32 wks

97
Q

at was GA do you have facial clearing of lanugo

A

33-37 wks

98
Q

at was GA do you have lanugo over your shoulders only

A

38-41 wks

99
Q

at was GA do you have NO lanugo

A

> 42 wks

100
Q

at was GA are testes in canal, few rugae

A

28-35 wks

101
Q

at was GA are testes in upper scrotum, anterior rugar

A

36-39 wks

102
Q

at was GA are testes in lower scrotum, rugae complete

A

40-41 wks

103
Q

at was GA pendulous scrotum

A

> 42 wks

104
Q

at was GA clitoris prominent, small labia majora

A

30-35 wks

105
Q

at was GA labia majora covers clitoris

A

36-39 wks

106
Q

at was GA labia majora covers minora

A

40 wks

107
Q

at was GA no foot sole creases

A

24-31 wks

108
Q

at was GA 1-2 foot sole creases

A

32-33 wks

109
Q

at was GA 2-3 foot sole creases

A

34-35 wks

110
Q

at was GA 2/3 foot with sole creases

A

36-37 wks

111
Q

at was GA foot sole creases to heel

A

> 38 wks

112
Q

what is the dx?

newborn with subcutaneous fat necrosis

A

hypercalcemia

113
Q

what is the dx?

newborn with cutis congenita aplasia

A

trisomy 13

114
Q

findings on path with etox?

A

eosinophils

115
Q

findings on path with pustular melanosis?

A

neutrophils

116
Q

what is the dx?

newborn with cyanosis that resolves with crying

A

choanal atresia

think CHARGE
babies are obligate nose breathers

117
Q

what is the dx?

newborn with single upper middle tooth

A

GH deficiency

midline defect

118
Q

what is the most common congenital cyanotic heart disease

A

Transposition

119
Q

what is the dx?

and infant with a “doughy” distended abdomen, bilious emesis, and intraabdominal calcifications on KUB

A

meconium peritonitis

complication of meconium ileus

120
Q

at what wavelength of light is most effective for phototherapy

A

450 nm

want 460-490

NICU (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions