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6337 > Test #3 (surgical, metabolic, NEC, Neuro, GU) > Flashcards

Test #3 (surgical, metabolic, NEC, Neuro, GU) Flashcards

1
Q

What defect is when the umbilical cord in uninvolved and to the right of the umbilicus?

A

gastroscheisis

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2
Q

What does gastroschisis appear in embryonic life?

A

4 week

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3
Q

What abd midline defect is associated with heart defects?

A

omphalocele

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4
Q

Where does an omphalocele defect herniate?

A

through the umbilical ring

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5
Q

When does omphalocele efect fail to return to abd cavity?

A

11 weeks

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6
Q

What test should you have done before you do surgery on omphalocele?

A

ECHO

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7
Q

What should you start IV fluids at 150ml/kg/day on day 1 with abd wall defects?

A

Bc of continuous sx on og output

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8
Q

What is the % of Cardiac anomalies with TEF/eso atresia?

A

30%

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9
Q

What defect has an x-ray with a gasless abd?

A

Eso atresia ONLY

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10
Q

What is another cue on an x-ray with EA?

A

dilation esophageal pouch

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11
Q

What is an ER surgery for EA/TEF?

A

gastrostomy for decompression

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12
Q

Long term probs with EA/TEF: stricture/GE reflux, anastamotic leak, esophageal dysmotility all cause ____.

A

risk of aspiration

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13
Q

What defect shows a double bubble?

A

Duodenal atresia

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14
Q

Where is the level of obstruction in duodenal atresia?

A

distal to ampulla of Vater

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15
Q

What is the sign seen on 1st DOL with malroatation/volvulus?

A

Bilious vomiting

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16
Q

What disease is seen with congenital aganglionic megacolon?

A

Hirschprung’s disease

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17
Q

What should you think when an infant has a meconium ileus?

A

Cystic fibrosis (90%)

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18
Q

What abd defect should be repaired ASAP?

A

gastroschisis

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19
Q

NEC correlates with degree of ____

A

Prematurity

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20
Q

What is a critical finding in NEC that is uncorrectable?

A

Dead gut

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21
Q

Free air seen in the abdominal x-ray is ____ with NEC

A

Pneumoperitoneum

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22
Q

Persistent acidosis suggests what in NEC?

A

Necrotic bowel

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23
Q

What is removed with surgery with NEC?

A

Frankly necrotic bowel

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24
Q

What is a normal finding on NBS r/t prematurity?

A

decrease T4

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25
Q

If left untreated what leads to irreversible brain damage and death?

A

Hypothyriodism

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26
Q

What is an inborn error of with smelly urine?

A

Maple syrup urine diesase

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27
Q

An X-ray with a double bubble, what else would you evaluate if the baby had trisomy 21?

A

Cardiac anomalies

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28
Q

If a baby has galactosemia what formula should you feed?

A

Isomil

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29
Q

Why in the fetus unaffected with inborn errors of metabolism?

A

the placenta removes the toxins

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30
Q

What are some clues in family hx with Inborn errors of metabolism?

A

MR, SIDS, unexplained neonatal death

31
Q

What are some common s/s inborn errors of metabolism?

A

vomiting, poor fdg, no wt gain, diarrhea, jaundiace, heptomegaly

32
Q

When the radiologist says the cecum is riding high think!

A

Its not in the right place and probably malrotation

33
Q

When there is an increase in lactate with metabolic acidosis you should think?

A

Pyruvate metabolism defects

34
Q

What are the first dx studies for inborn errors of metabolism?

A

CBC
Urinalysis
CBG
Electrolytes, glucose, ammonia level

35
Q

With dx studies for inborn errors of metabolism, a urinalysis should be tested for?

A

reducing substances

36
Q

What is seen in inborn errors of metabolism with hypoglycemia?

A
  • urine non-glucose reducing substances

- galaxtosemia, tyrosimemia type 1

37
Q

In 21-OH deficiency what should be given to suppress SCTH and androgen overproduction?

A

Cortisol replacement - hydrocortisone

38
Q

what is the medical mgnt for Congential Adrenal hyperplasia?

A

glucocorticoid therapy
mineralocorticoid therapy
Na supplementation

39
Q

What is the typical age of onset for NEC?

for late preterm?

A

2-3 weeks

~7days

40
Q

What are two major associations with NEC?

A

preinatal hypoxia

polycythemia

41
Q

What NEC is diminished bowel sounds, dilation, and pneumatosis.

A

Stage 2

42
Q

What NEC shows portal vein gas, metabolic acidosis, and throbocytopenia

A

Stage 2B

43
Q

What NEC stage is Neutropenia, abdominal wall erythema, hyoptension

A

Stage 3A

44
Q

What NEC stage has perforated bowel, shock, and pneumoperitoneum?

A

Stage 3B

45
Q

What is a tale tell sign with NEC?

A

Hyponatremia and hypothermia

46
Q

What is when a piece of bowel does not move and can indicate dead bowel?

A

Sentinel loop

47
Q

What is the tx for intestinal perf in ELBW along with explo lap?

A

PPD (peritoneal drainage) pin rose drain

48
Q

What defines short bowel syndrome?

A
49
Q

What intestinal disease that is not assoc. with pneumoatosis, unrelated to feeds?

A

Spon intestinal perforation

50
Q

What are 3 signs consistent with acute peripartum event?

A

APGAR 12

51
Q

What are some treatment options to prevent severe CND deficits?

A

Ventilate, prevent hypoxia, treat seizures, stable Vitals

52
Q

What are the eligibility criteria for therapeutic hypothermia?

A

Fetal cord gas with pH 16
acute perinatal event,
APGAR

53
Q

What is the most common type of seizure and most often missed?

A

Subtle seizure

54
Q

Seizure or Jitters:

when activity easily elicited with stimulation

A

Jitterness

55
Q

What drug and dosage used for seizures?

A

Phenobarbital: Load with 20mg/kg, sz cont: 20mg/kg

theraputic level 15-40mg

56
Q

What are the outcomes for lower birth wt infants?

A

The outcome is worse with more severe neurological disease.

57
Q

Describe a grade 2 and 3 IVH?

A

II - IVH with normal ventricles

III - IVH with dilated ventricles

58
Q

PVL can occure separate from what?

A

P/IVH

59
Q

What will you see with a LP in Subarachnoid hemorrhage?

A

Blood in the LP

60
Q

what are some disease that cause prerenal failure

A

asphyxia, CHF, dehydration, hypotension, RDS, CHD

61
Q

What are some examples of Postrenal failure?

A

prune belly, renal calculi, blood clots, neurologenic dysfunction, ureterocele

62
Q

What is a good indicator of renal failure?

A

Urine SG prerenal >1.015, posrenal

63
Q

What is a good indicator of renal intrinsic dz?

A

granulae casts and spitheleal cells in urine

64
Q

What is the most common abdominal mass?

A

hydronephrosis

65
Q

What test can be preformed if there is a vesicourethral reflux?

A

VCUG

66
Q

What is the abnormal flow or urine from the bladder back into the ureters?

A

vesicourethral reflux?

67
Q

What are three clinical manifestations of ureterocele?

A

hematuria, abd mass, UTI

68
Q

What is the most common cause of bladder outlet obstruction in male infants?

A

Posterior urethreal valve

69
Q

What is a common sign of Posterior urethreal valves?

A

palpable distended bladder

70
Q

What is an autosomal recessive disease that is rare with poor prognosis?

A

Polycystic kidney disease

71
Q

What are some preinatal causes of renal vein thrombosis?

A

toxemia, maternal diabetes, placental insufficiency

72
Q

What are the most common S/S of renal vein thrombosis?

A

Mass, gross hematuria, and HTN!!!

73
Q

When there is a sudden severe blockage of the renal artery?

A

Renal artery thrombosis - lines

74
Q

What is a good indication of renal ARTeral thrombosis?

A

systemic HTN

6337 (4 decks)

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