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Pediatrics > perinatal care triggers > Flashcards

perinatal care triggers Flashcards

1
Q

Early first-trimester insults like chromosomal or congenital abnormalities, resulting in global growth delay

this is the primary cause of what?

A

fetal grwoth restriction (FGR) and IUGR

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2
Q

what mechanism causes the closure of the PFO

A

Increased O2 in blood –> increased blood flow in lungs —> increased venous return to LA —> LA pressure increase closes PFO

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3
Q

what aids babies in learning to regulate their temperature and also helps moms milk production

A

skin to skin in the golden hour after birth

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4
Q

what ceases low-resistane circuit in the placenta and also increases systemic BP and relaxes lung vessels for a baby

A

clamping of the umbilical cord

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5
Q

Apnea/gasping & HR < 100 BPM indicates what should be done

A

PPV via BVM at 40-60 breaths per minute

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6
Q

when do we use MR SOPA

A

when PPV does not seem to be working properly

while doing MR SOPA place baby on SPO2 moniter and continuous EKG.

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7
Q

if the heart rate is <60 despite 30s of PPV what is the next step

A

intubate.

compressions recommended for resuscitation.
3:1 compressions for 90 compressions and 30 breaths.

consider umbilical vein catheterization

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8
Q

when should epinephrine be considered

A

if HR <60

(im assuming after youve tried PPV and compressions)

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9
Q

when should we examine for hypoxic ischemic encephalopathy or therapeutic hypothermia

A

if a newborn >= 36 weeks received resuscitation

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10
Q

Delayed resorption of lung fluid leading to pulmonary edema leading to tachypnea

A

TTN

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11
Q

CXR shows pleural effusions, perihilar densities with fissure fluids and hyperexpansion of the lungs

A

TTN

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12
Q

occurs in teh First 2 hours, lasting up to 72 hours but typically resolving within 12-24 hrs

A

TTN

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13
Q

respiratory distress and hypoxia triggered by uterine stress during delivery

A

meconium aspiration syndrome

(they just get so stressed that they poop everywhere and then inhale it)

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14
Q

CXR shows bilateral fluffy densities with hyperinflation of the lungs.

A

MAS

also diagnostic is to see meconium present in amniotic fluid or trachea during intubation

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15
Q

see meconium present in amniotic fluid or trachea during intubation

A

MAS

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16
Q

results in inflammation and surfactant inactivation, atelectasis, rupture of alveoli and V/Q mismatches

A

progression of MAS

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17
Q

it is NOT recommended to intubate these patients

A

MAS

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18
Q

ground glass opacities on CXR

A

RDS

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19
Q

glucocorticoids and postnatal surfactant with ventilation via NCPAP is tx for what

A

RDS

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20
Q

MC in GA>34 weeks

A

PPHN

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21
Q

associated with MAS, PNA and RDS

A

PPHN

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22
Q

this is associated with intrauterine/perinatal asphyxia as well as the exposure of fetus to SSRIs in the 2nd half of pregnancy

A

PPHN

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23
Q

presents with meconium staining, respiratory distress, and a possible harsh systolic murmur at the lower left sternal border

A

PPHN

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24
Q

echo showing normal anatomy with pulmonary HTN is diagnostic of which disease

A

PPHN

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25
Q

use nitric oxide or sildenafil in severe disease

A

PPHN

use ECMO as last resort

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26
Q

use ECMO as last resort for this disease

A

PPHN

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27
Q

risk factors include maternal exposure to labetalol or terbutaline bronchodilator, LGA, SGA, and maternal diabetes

A

neonatal hypoglycemia

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28
Q

high risk symptoms for this disease includes floppiness, exaggerated moro reflex, seizures irritability, and more

A

neonatal hypoglycemia

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29
Q

preterm babies, LGA, SGA and babies with diabetic mothers should all be screened for what

A

neonatal hypoglycemia

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30
Q

just gonna leave this right here in case anyone wants to look at it

A
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31
Q

what is pathognomonic of neonatal jandice

A

jaundice presenting within the first 24 hours of birth.

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32
Q

risk factors includes GA <38wks, albumin <3, hemolytic diseases, sepsis

A

neurotoxicity due to hyperbilirubinemia

33
Q

what does TcB have to be for you to suspect jaundice enough to run a TSB

A

within 3mg/dl of the threshold or >15

34
Q

What value is used as the definitive test to guide phototherapy and escalation of care decisions in jaundiced babies (including need for exchange transfusion)

A

TSB

35
Q

what is a significant conjugated/direct bilirubin in relation to TSB

A

when conjugated/direct bilirubin exceeds 20% of the TSB

36
Q

Fasting abd US for biliary atresia or choledochal cyst should be assessed when

A

when a baby has high bilirubin

37
Q

caused by poor feeding, Intestinal hypomotility or poor elimination of bilirubin in stool

A

breastfeeding jaundice

38
Q

Post 1st week of birth and lasts up to 3 wks, Inhibition of UGT and deconjugation of conjugated bilirubin

A

breast milk jaundice

39
Q

what treatment increases an infants neurotoxicity risk factors

A

phototherapy during treatment of hyperbilirubinemia

40
Q

feeding is considered the most important first line intervention for what diagnosis

A

jaundice

41
Q

IV fluids is NOT recommended in combination with what therapy?

A

phototherapy

42
Q

hypertonia of the extensor muscles such as opisthotonus and retrocollis si seen in what phase of neonatal acute bilirubin neurotoxicity

A

phase 2

43
Q

When can we D/C phototherapy for hyperbilirubinemia?

A

TSB < 2 mg/dl below the hour-specific threshold

44
Q

Venous Hct > 65% at term

A

polycythemia

45
Q

Hyperviscosity of blood, resulting in decreased perfusion of the capillary beds.

A

polycythemia

46
Q

delayed cord clamping can lead to what problem

A

benign neonatal polycythemia

47
Q

CNS: irritability, jittery, seizures, lethargy
Cardio: respiratory distress, CHF, PPH (postpartum hemorrhage)
GI: emesis, heme-positive stool, distension
Renal: Decrease output, rena vein thrombosis
Metabolic: Hypoglycemia
Heme: Hyperbilirubinemia, thrombocytopenia

this is alot but whats it for

A

benign neonatal polycythemia

48
Q

Isovolemic partial exchange transfusion with NS to dilute blood

but only if pt is symptomatic

A

benign neonatal polycythemia

49
Q

amino acidopathy with a deficiency in PAH

A

PKU

50
Q

this illness if left untreated leads to permanent brian injury due to accumulation of phe

A

PKU

treat by lifelong restriction of phe by eating phe - free proteins

51
Q

D10 IVF given to promote anabolic state. consider hemodialysis if elevated ammonia is present.

A

PKU

52
Q

Liver dysfunction, jaundice, and coagulopathy
E. coli sepsis and cataracts

metabolic decompensation of the infant

A

galactosemia

Metabolic decompensation when an infant gets formula with lactose in it.

53
Q

X linked recessive

A

G6PD

54
Q

if you test TRAbs in newborns with hypothyroidism and they are negative, what is the assumption of etiology

A

I think its inborn error or excess maternal iodine

may wanna lok this up becuase im only 86% sure

55
Q

Protruding abdominal organs without a protective sac, almost always to the right of umbilicus

A

gastroschisis

56
Q

Protruding abdominal organs with a protective sac

A

omphalocele

57
Q

Usually associated with genetic anomaly/syndrome in 1/2 of cases.

A

omphalocele

58
Q

this hernia goes straight through umbilicus

A

omphalocele

59
Q

Elevated AFP in mothers blood may suggest what problem (not chromosomal , think physiologic developement)

A

omphalocele/gastroschisis and NTD

60
Q

if you underestimate gestational age what lab level will be falsely elevated

A

AFP

61
Q

Blind esophageal pouch that does not connect with esophagus/airway or connects both the esophagus and airway later.

A

esophageal atresia

62
Q

Baby will be choking, coughing, cyanosis

A

esophageal atresia

63
Q

TX:
Acutely: suction, elevate head, IV glucose
Definitive: Make a fistula to solve problem

A

esophageal atresia

fistula connects esophagus

64
Q

presents with emesis after birth

A

upper/proximal intestinal obstruction

65
Q

presents with abdominal distension, late emesis, late/no stooling in baby

A

distal/lower intestinal obstruction

66
Q

dueodenal intestinal atresia is one of the MC intestinal atresias. what is it assocaited with

A

down syndrome

jejunoileal is the other MC cause and its assocaited with CF

67
Q

risk factors for this is smoking and being a preemie

A

intestinal atresias

68
Q

double bubble sign on Xray

A

duodenal

69
Q

triple bubble sign on Xray

A

jejunal atresia

70
Q

risk factors include inadequate folic acid, maternal DM, maternal Hyperthermia and VPA exposure

A

neural tube defects

71
Q

missing part of the brain/skull with inability to control swallowing

A

ancephaly

72
Q

tuft of hair on dimple

A

spina bifida occulta

73
Q

protrusion of only the meninges

A

meningocele

74
Q

protrusion of meninges + the spinal cord

A

myelomeningocele

75
Q

Extremely Elevated AChesterase in amniotic fluid can confirm

A

NTDs

76
Q
A
77
Q

which NTD has normal AFP

A

spina bifida occulta

78
Q

Encephalopathy due to hyperbilirubinemia (consequence of untreated jaundice)

A

kernicterus

Pediatrics (41 decks)

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