Peds that is also OB Flashcards
appropriate weight loss in newborn who is exclusively breastfed?
~7%. Should start regaining by about 3 days and be back to birth weight at 2 weeks
features of fragile X
CGG (chin, giant gonads)
large head circumference
-risk fr MVP
-risk for focal seizures
what is indication for phototherapy in neonatal jaundice
number one tx for unconjugated hyperbilirubinemia
- tx if >15 in 48 hours old infant
- tx if >20 in 96 hour old infant
**this is contraindicated in CONJUGATED hyperbili due to risk for bronze baby syndrome
when is exchange transfuion indicated in neonatal jaundice?
most rapid way to dec bilirubin use when: -phototherapy doesn't work -acute encaphalopathy ->20mg/dl in first 24 hours
what are side affects of phototherapy?
diarrhea, dehydration –> give plenty of fluids!!
inc risk for AML
separation from mom
brnze baby syndrome –> when give to babies with conjugated hyperbili
tetanus infx in the newborn?
myoclonus, weak suck, spasms
***unvaccinated babe, likely from transmision of contaminated umbilical cord cut during home birth
fetal hydantoin syndrome
use of meternal anticonvulsants (folate deficiency)
- facial abnormalities
- nail hypoplasia
- short webbed neck
- IUGR (oligohydramnios)
neonatal sepsis bugs
GBS –> occurs 2-3 daysPROM is a risk factor!
e.coli
listeria –> occurs later, about 2-4 weeks
give amp/gent
congenital toxo triad
hydrocephalus
intracranial calcifications
chorioretitinis
why do you treat neonatal conjunctivitis with ORAL erythromycin?
late onset= chlamydia, and chlamydia conunctivitis is suggestive of systemic infx that will turn into chlamydia PNA if untreated
gonnococcal or chlamydial conjunctivitis?
gonnococcal= early, 2-7 days –> IV/IM ceftriaxone
**prevent by doing topical erythromycin at birth
chlamydia= late, 5-14 days –> Oral erythromycin
granulomatous infantiseptica
early onset listeriosis, characterized by multiple visceral granulmas like in liver and lungs
tx with amp/gent
babe born at home with no medical intervention AT TERM is most at risk for?
hemmorrage–> no vitamin K because no gut colonization yet
Fe deficiency anemia is a risk for exclusively breastfed babes when they are premies
how to spot crigler najjer
Indirect hyperbilirubinemia w/o any conjugation –> 20-50mg/dl
- presents in first week of life
- athetosis 2/2 to kernicterus
how to spot hemolytic cause of jaundice in newborn?
look for anemia as well as other signs
time frame for maternal estrogen w/drawl sx in newborn?
1-2 weeks
-vaignal bleeding/ dc, breast buds, labial swelling
increased lung volumes, interlobular fluid, resp distress in a newborn >35 weeks by c-section?
likely transient tachypnea of the newborn, tx supportively
*c section!!
when to use CPAP in a newborn?
RDS –> premie with bilateral opacities on CXR, RR >60
** v occasionally in transient tachypnea if not responding to O2
premie babe in resp distress does NOT respond to O2 –> whats the dx?
RDS caused by insufficient surfactant –> avleolar collapse –> requires CPAP to blow open alveoli
time frame that can separate breast feeding failure jaundice from breast milk jaundice
failure= 1st week, lookat weight loss %!!
breast milk (beta gluc)= 2 weeks
all trisomies are likely to have assoc VSD!
ok.
PEP for baby born to HIV mom?
<1000 viral copies in mom = zidovudine
> 1000 viral copies in mom= zidovudine as part of 3 drug reg
painless bright red bleeding with hemodynamic change in mom, in the third trimester? (probably in someone who has no prenatal care?)
placenta previa
beckwith-weidmann syndrome
big baby!!
- macrosomia
- macroglossia
- hepatomegaly
- associated with: abd wall defects,
**poor feeding + hyperinsulinemia= big risk for hypoglycemia!!
triad of pulm hypoplasia, craniofacial abnl, clubbed feet?
potter’s seq –> 2/2 oligohydramnios
hydrops is what?
fluid accumulation in at least 2 body cavities
- think of parvo (erythema infectiousum) (arthralgias + URI like illness)
- think of syphhillis
