Peds that is also OB

Question 1

appropriate weight loss in newborn who is exclusively breastfed?

Answer 1

~7%. Should start regaining by about 3 days and be back to birth weight at 2 weeks

Question 2

features of fragile X

Answer 2

CGG (chin, giant gonads)
large head circumference
-risk fr MVP
-risk for focal seizures

Question 3

what is indication for phototherapy in neonatal jaundice

Answer 3

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

Question 4

when is exchange transfuion indicated in neonatal jaundice?

Answer 4

most rapid way to dec bilirubin
use when:
-phototherapy doesn't work
-acute encaphalopathy
->20mg/dl in first 24 hours

Question 5

what are side affects of phototherapy?

Answer 5

diarrhea, dehydration –> give plenty of fluids!!
inc risk for AML
separation from mom
brnze baby syndrome –> when give to babies with conjugated hyperbili

Question 6

tetanus infx in the newborn?

Answer 6

myoclonus, weak suck, spasms

***unvaccinated babe, likely from transmision of contaminated umbilical cord cut during home birth

Question 7

fetal hydantoin syndrome

Answer 7

use of meternal anticonvulsants (folate deficiency)

• facial abnormalities
• nail hypoplasia
• short webbed neck
• IUGR (oligohydramnios)

Question 8

neonatal sepsis bugs

Answer 8

GBS –> occurs 2-3 daysPROM is a risk factor!
e.coli
listeria –> occurs later, about 2-4 weeks

give amp/gent

Question 9

congenital toxo triad

Answer 9

hydrocephalus
intracranial calcifications
chorioretitinis

Question 10

why do you treat neonatal conjunctivitis with ORAL erythromycin?

Answer 10

late onset= chlamydia, and chlamydia conunctivitis is suggestive of systemic infx that will turn into chlamydia PNA if untreated

Question 11

gonnococcal or chlamydial conjunctivitis?

Answer 11

gonnococcal= early, 2-7 days –> IV/IM ceftriaxone
**prevent by doing topical erythromycin at birth

chlamydia= late, 5-14 days –> Oral erythromycin

Question 12

granulomatous infantiseptica

Answer 12

early onset listeriosis, characterized by multiple visceral granulmas like in liver and lungs

tx with amp/gent

Question 13

babe born at home with no medical intervention AT TERM is most at risk for?

Answer 13

hemmorrage–> no vitamin K because no gut colonization yet

Fe deficiency anemia is a risk for exclusively breastfed babes when they are premies

Question 14

how to spot crigler najjer

Answer 14

Indirect hyperbilirubinemia w/o any conjugation –> 20-50mg/dl

• presents in first week of life
• athetosis 2/2 to kernicterus

Question 15

how to spot hemolytic cause of jaundice in newborn?

Answer 15

look for anemia as well as other signs

Question 16

time frame for maternal estrogen w/drawl sx in newborn?

Answer 16

1-2 weeks

-vaignal bleeding/ dc, breast buds, labial swelling

Question 17

increased lung volumes, interlobular fluid, resp distress in a newborn >35 weeks by c-section?

Answer 17

likely transient tachypnea of the newborn, tx supportively

*c section!!

Question 18

when to use CPAP in a newborn?

Answer 18

RDS –> premie with bilateral opacities on CXR, RR >60

** v occasionally in transient tachypnea if not responding to O2

Question 19

premie babe in resp distress does NOT respond to O2 –> whats the dx?

Answer 19

RDS caused by insufficient surfactant –> avleolar collapse –> requires CPAP to blow open alveoli

Question 20

time frame that can separate breast feeding failure jaundice from breast milk jaundice

Answer 20

failure= 1st week, lookat weight loss %!!

breast milk (beta gluc)= 2 weeks

Question 21

all trisomies are likely to have assoc VSD!

Answer 21

ok.

Question 22

PEP for baby born to HIV mom?

Answer 22

<1000 viral copies in mom = zidovudine

> 1000 viral copies in mom= zidovudine as part of 3 drug reg

Question 23

painless bright red bleeding with hemodynamic change in mom, in the third trimester? (probably in someone who has no prenatal care?)

Answer 23

placenta previa

Question 24

beckwith-weidmann syndrome

Answer 24

big baby!!

• macrosomia
• macroglossia
• hepatomegaly
• associated with: abd wall defects,

**poor feeding + hyperinsulinemia= big risk for hypoglycemia!!

Question 25

triad of pulm hypoplasia, craniofacial abnl, clubbed feet?

Answer 25

potter’s seq –> 2/2 oligohydramnios

Question 26

hydrops is what?

Answer 26

fluid accumulation in at least 2 body cavities

• think of parvo (erythema infectiousum) (arthralgias + URI like illness)
• think of syphhillis