Pre-natal neonata Flashcards
What is morgani hernia ?
they are a form of CDH anteriorly, USUALLY quite benign but can present as an obstruction?
What age do the alveolar ducts completely form at ?
8 years of age
Fetal hydatoin syndrome: cleft lip and palate, small nose, hypertelorism and hypolastic extremities and nails is associated with which medication during pregnancy ?
Phenytoin ( Dilantin)
As per CPS statement:
Well appearing term baby > 37 wks
with-positive mothers with adequate intrapartum antibiotic prophylaxis (IAP), no additional risk factors OR mothers who are GBS-negative or GBS-unknown status, with one other risk factor and adequate IAP:
Recommendation: observe for 24 hours, and no work up to be done
Ebstein anomalie, fetal goitre, hypotonia, arrythmia and seizures are associated with which exposure during pregnancy ?
Lithium
What would the 1st trimester screen be if + for T. 21?
T. 18 ?
- T21 -> > 3.5MM IN nuchal transuluency,
- PAPP-A - (reduced in T21)
- hcg - normal or increased - T18
hcg -decreased
pappa - normal
Syndrome associated with micropenis, increased risk of testicular cancer or breast cancer, could appear TALL ie. marfans (1)
Kleinfelters
Test karyotype
what is the treatment for graves disease and hyperthyroidism ?
methimazole
and symtompatic ie. beta blocker
you see a baby with:
cutis aplasia
cleft lip palate (mid line defects)
polydactyly
What syndrome are you thinking of ?
What is the work up and mangement ?
Patau ( t. 13)
work up ? -confirm testing with karyotype -MRI head, us echo, audio -renal US
80 % of of intussception occur before age? true or false
True
If you were concerned about a) t21 ? or t18 what would you expect.
1.T21 - AFP- low estriol-low -hcg -high -inhibin A - high
- T18
-afp - low
-estriol low
hcg- low
What is you ddx for a distal obstruction ie. bile emesis
- meconium ileus
- Hirshsprungs
- Ileal atresia
4.
Quad screen (15 to 22 wk), involves which markers ? (4)
- AFP
- Estriol
- Hcg
- inhibin A
As per CPS statement:
For GBS-positive mothers with inadequate IAP and no additional risk factors OR mothers who are GBS-negative or GBS-unknown status, with one other risk factor and inadequate IAP:
close obs of vitals and examination before discharge
You see a baby with: cutis aplasia -hypertonia -rocker bottom feet -clenched fists -CHD
What syndrome are you thinking of ?
What is the work up and management ?
Edward (t.18)
confirmatory karyotype
Echo
Abdo US
AS PER CPS statement
For un well term baby - what do you do ?
full septic work up and amp/ gent work up
What anomalies are associated with IDM ?
- LGA
- IUGR
- birth trauma thus cerebral edema
- symptomatic hypoglycemia - neuroimpact
- hypoglycemia, hypocalcemia
- congenital anomalies: cardiological
- hematology: polycythemia
- congenital anomalies: DA, atresia of the bowel. left colon syndrome
Rewiew of GIR CALCULATIONS
D10W = 10 g per 100 mL
1 mL has 10/100 = 0.1 g = 100 mg dextrose
To calculate in mg/kg/min convert time units
100 mg/mL x 60 mL/kg/d ÷ 24 h per day ÷ 60 min per hour
=4.2 mg/kg/min
Which type of twins is most at risk for TTTS ?
MCDA (15%)
MCMA (5)
where would you feel the mass in intussception ?
upper adbdomen
This syndrome is associated with the RAS/MAPK pathway and involves mutation in multiple genes ?
Auto dominant inheritance, FTT but can have risk of of heap
Noonan syndrome
Thus what are some features to screen for ? -growth, thus gh -cv management ie right sided lesions -tx for coagulopathies
Abnormal fluid accumulation in ≥2 fetal compartments Skin thickening Fetal ascites Pleural effusion Pericardial effusion (±)Polyhydramnios is reffered to ?
Hydrops fetalis
How can you miss a mechel in a tech 99 ?
when it is behind the bladder
In what population of mothers is neonatal lupus highest risk ?
any with a autoimmune disease
Cleft lip/palate
Cardiac anomalies
Hemorrhagic disease of the newborn
is associated with which drug ?
” nose things “
Nasal hypoplasia, depressed bridge
Stippled bone epiphyses
with which drug?
Phenobarbital
Warfarin
what is important in the management of CDH?
gentle lung ventilation to prevent pulmonary dysplasia
Neural tube defects
Face narrow bi-frontal diameter, telecanthus, anteverted nostrils
Cardiac defects, long thin fingers/toes
Which drug
VPA
Most common inherited reason for intellectual delay ?
Based ont he FMR1 gene, and can still present in girls with variable stregnths
FRAGILE X
CGG tri repeats
>200 is a mutation
A baby presenting at 48 hours of life to a Mom of high risk behaviors with high pitched cry, irritability, apeneas, dysautonomia, irritability, is likely due to which substance ?
cocaine
What traumatic injury is associated with a brachial plex injury ?
1) clavical #
2) humeral #
3) facia nerve palsy
4) subluxation of c-spine
IMPORTANT BULLETS
When in doubt when the congenital abnormality occurs
10-12 weks
Differential for Fetal tachycardia ? ( think fatimah)
F- fever arrythmia Thyrotoxicosis Infection (torch sepsis ) Meds anemia h-hypoxia and fetal distres
What are the management of CDH when dx antenatally
- counselling, echo, genetics w/u
- experimental with tracheal closure, and thus increase amnio fluid
What is the criteria for pyloric stenosis ? (3) (think pie )
> 3 cm thick > 14 mm long
-failure to open
What is the main reason RBC production decrases at birth in comparison to in-utero ?
Babe has incrased exposure to O2, thus decrease epo and erthropoeisis
How Does Choanal atresia present ?
Can present if bilateral with cyanosis , respiratory distress that improves with positive pressure ventillation.
Review APGARs
APEARANCE PULSE GRIMACE ACTIVITY RESP
WHAT IS THE most COMMON COMPLICATIONS FOR nec?
ACUTE: infection,
CHRONIC: strictures, intestinal failure, NEC, adhesion ileus
CPS STATEMENT for NEONATAL TRANSFUSION
O2. no O2
- WK 115 AND 100
- 110 and 85
- 85 and 75
