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1. Pediatrics > Neonatology > Flashcards

Neonatology Flashcards

1
Q

[Neo/Basic]

Preterm/term baby differentiating gestational week

A

37 week
(≥ 37 weeks term, ≤36 weeks and 6 days preterm)

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2
Q

[Neo/Basic]

Categories and gestational ages for preterm baby?

Extreme: ___
Very: ___
Moderate: ___
Late: ___

A

Extreme preterm: < 28 weeks
Very preterm: 28 weeks ≤ and < 32 weeks
Moderate preterm: 32 weeks ≤ and < 34 weeks
Late preterm: 34 weeks ≤ and < 37 weeks

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3
Q

[Neo/Basic]

Categories and gestational age for term baby?

Early: ___
Full: ___
Late: ___
Post: ___

A

Early term: 37 weeks ≤ and < 39 weeks
Full term: 39 weeks ≤ and < 41 weeks
Late term: 41 weeks ≤ and < 42 weeks
Post term: ≥ 42 weeks

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4
Q

[Neo/Basic]

Categories for low birth weight?

Extremely low: ___
Very low: ___
Low: ___

A

Extremely low birth weight: < 1000 g
Very low birth weight: 1000 g ≤ and < 1500 g
Low birth weight: 1500 g ≤ and < 2500 g

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5
Q

[Neo/Basic]

Dates of cleavage and chorion/amnion structures of twin

Morula (___ days) -> chorion/amnion (fraternal/identical)
Blastocyst (___ days) -> chorion/amnion (identical)
Implanted blastocyst (___ days) -> chorion/amnion (identical)
Formed embryonic disc (___ days) -> chorion/amnion (identical)

A

Morula (1-3 days) -> Dichorion/Diamnion (fraternal/identical)
Blastocyst (4-8 days) -> Monochorion/Diamnion (identical)
Implanted blastocyst (8-13 days) -> Monochorion/Monoamnion (identical)
Formed embryonic disc (13-15 days) -> cojoined twins (identical)

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6
Q

[Neo/Prenatal]

Prenatal schedule and purpose:

6-8 weeks: ___
10-14 weeks: ___
16-20 weeks: ___
22-26 weeks: ___
28 weeks: ___
32 weeks, 36 weeks, weekly after: ___

A

Prenatal schedule and purpose:

6-8 weeks: 1st prenatal visit and labs
10-14 weeks: fetal heart tones
16-20 weeks: blood work for NTD and chromosomal abnormalities, anatomic scans
22-26 weeks: routine return visit
28 weeks: glucose tolerance test, repeat CBC, Rh immunoglobulin
32 weeks, 36 weeks, weekly after: GBS at 36w ≤ < 38w

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7
Q

[Neo/Prenatal/GBS]

Prophylaxis indication for GBS (6)

A
  1. Previous history of infant with invasive GBS disease
  2. Positive GBS bacteriuria during any trimester of current pregnancy
  3. Positive GBS culture or NAAT positive (unless C-section before labor)
  4. < 37 weeks of gestation (Before GBS test at 36)
  5. ≥ 18 hours of rupture of membrane
  6. Mother fever 100.4 F
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8
Q

[Neo/Prenatal/GBS]

Prophylaxis choice if allergic to penicillin for GBS prophylaxis?

Low risk for anaphylaxis: ___
High risk for anaphylaxis: ___
High risk and resistant: ___

A

Low risk for anaphylaxis: Cefazolin
High risk for anaphylaxis: Clindamycin
High risk and resistant to clindamycin: Vancomycin

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9
Q

[Neo/Prenatal/PROM]

Delivery is recommended in PROM

if ____ is confirmed
and
gestational age is ___

A

Delivery is recommended in PROM

if _FETAL LUNG MATURITY _is confirmed
and
gestational age is ≥ 34 WEEKS

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10
Q

[Neo/Prenatal/Preeclampsia]

Symptoms of hypermagnesemia in newborn (4)

Lab value Mg > ___ mg/dL

A

Lab value Mg > 5 mg/dL

  1. Respiratory depression
  2. Failure to pass meconium
  3. Lethargy, flaccidity, hyporeflexia
  4. Poor feeding
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11
Q

[Neo/Prenatal/Preeclampsia]

Treatment of hypermagnesemia in newborn

A

IV Ca2+ and diuresis

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12
Q

[Neo/Prenatal/Preeclampsia]

Laboratory findings of newborn from preeclampsia mother (3)

A
  1. Hypermagnesemia
  2. Low WBC
  3. Low Platelet
    (all three are often transient)
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13
Q

[Neo/Prenatal/BPP]

Biophysical profile measurements at 32 and 36 weeks
Mneumonic:
M
R
H
A
T

A

Movement
Respiration
Heart rate reactivity
Amniotic fluid volume
Tone

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14
Q

[Neo/Delivery]

Weight and endotracheal tube size

< 1 kg: __
1-2 kg: __
> 2 kg: __

A

Weight and endotracheal tube size
< 1 kg: 2.5 mm
1-2 kg: 3.0 mm
> 2 kg: 3.5 mm

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15
Q

[Neo/Delivery]

Formula for length of tube to the baby’s lip

A

6 + weight in kg

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16
Q

[Neo/Delivery]

Epinephrine dose for neonatal resuscitation

IV: __
ET: __

A

IV: 0.02 mg/kg, 0.2 ml/kg of 1:10,000 epinephrine
ET: 0.1 ml/kg

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17
Q

[Neo/Delivery]

Which GA to use plastic wrap for resuscitation

A

< 29 weeks

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18
Q

[Neo/GA]

180 degree heel to ear
Sticky, friable, transparent skin
No lanugo
Imperceptible breast
Flat, smooth scrotum or prominent clitoris, flat labia

A

20 weeks

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19
Q

[Neo/GA]

Posture limbs extended
Gelatinous, red, translucent skin
Sparse lanugo
No plantar crease
Empty scrotum, faint rugae, or prominent clitoris and small labia minora

A

24 weeks

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20
Q

[Neo/GA]

Posture flexed on wrists and knees
Skin smooth, pink, visible veins
Abundant lanugo
Faint plantar crease
Flat areola, no bud
Slow recoil of ears
Tests in upper inguinal canal, rage rugae, or prominent clitoris, enlarging minora

A

28 weeks

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21
Q

[Neo/GA]

Posture flexed mildly on elbows and knees
Positive scarf sign, elbow at the midline
Skin superficial peeling, few veins
Thinning of lanugo
Plantar anterior transverse crease only
Stippled areola, no breast buds
Well curved pinna, soft, ready recoil ears
Testes descending, few rugae or majora and minora equally prominent

A

32 weeks

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22
Q

[Neo/GA]

Posture flexed
Negative scarf sign
Skin cracking pale areas, rare veins
Bald areas of lanugo
Plantar creases anterior 2/3
Raised areola, 1-2 mm breast buds
Formed and firm ears, instant recoil
Testes descended, good rugae, or majora large, minora small

A

36 weeks

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23
Q

[Neo/GA]

Posture flexed
Skin with parchment, deep cracking, no vessels
Almost no lanugo
Plantar creases over the entire sole
Full areola, 7-10 mm breast buds
Thick cartilage, stiff ears
Deep rugae or majora covers clitoris and minora

A

40 weeks

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24
Q

[Neo/Neonatal conjunctivitis]

Neonatal conjunctivitis usual onset and its treatment?
Neisseira: ___ days, treatment: ___
Chlamydia: ___ days, treatment: ___

A

Neisseria: 3-5 days, treatment: 3rd gen cephalosporin, prevented by topical erythromycin ointment

Chlamydia: 5-12 days, treatment: PO erythromycin or azithromycin

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25
Q

[Neo/Normal Newborn]

Periodic breathing patterns of neonate
is predominant at ____ age
resolves by ___ age
normal periodic breading if lasts ___ sec

A

Periodic breathing patterns of neonate
is predominant at 2-4 weeks age
resolves by 6 mo age
normal periodic breading if lasts <20 sec

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26
Q

[Neo/Normal Newborn]

Diastais recti surgical indication
If hernia persists till ___ age
or size increases between ___ and ___ age

A

Diastais recti surgical indication
If hernia persists till 5-6 age
or size increases between 1 and 2 age

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27
Q

[Neo/Maternal exposure]

Which teratogenic drugs?
Diagnosis?

Growth deficiency, developmental delays, craniofacial anomalies,
hypoplastic nails

A

Phenytoin
Fetal hydantoin syndrome

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28
Q

[Neo/Maternal exposure]

High risk of congenital anomaly caused by carbamazepine or valproic acid (2)?

A

Spina bifida
Neural tube defects

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29
Q

[Neo/Maternal exposure]

Which teratogenic drugs?

Limb anomalies, ear malformation with deafness
Medication used for leprosy, HIV, multiple myeloma

A

Thalidomide

30
Q

[Neo/Maternal exposure]

Which teratogenic drugs?

Craniosynostosis, craniofacial anomalities, limb defects

A

Methotrexate

31
Q

[Neo/Maternal exposure]

Which teratogenic drugs?

Cardiac defects,
Neural tube defects,
Renal dysgenesis, oligohydramnios, pulmonary hypoplasia, limb defects,
Skull ossification defects

A

Angiotensin-converting enzyme inhibitors (ACEis)

32
Q

[Neo/Maternal exposure]

Which teratogenic drugs?

Uterine abnormalities, vaginal adenosis, male infertility

A

Diethylstilbestrol (DES)

33
Q

[Neo/Maternal exposure]

Which teratogenic drugs?

Ebstein anomaly, congenital heart block

A

Lithium

34
Q

[Neo/Maternal exposure]

Which teratogenic drugs?

Similar to DiGeorge syndrome,
Microcephaly, facial nerve palsies, microtia, external auditory canal anomalies, cardiac defects, thymic hypoplasia, GU anomalies

A

Retinoids

35
Q

[Neo/Maternal exposure]

Streptomycin causes ____ in infant

A

Hearing loss

36
Q

[Neo/Maternal exposure]

Which teratogenic drugs?

Tooth discoloration
Growth defect

A

Tetracyclin

37
Q

[Neo/Maternal exposure]

Which teratogenic drugs?

Nasal hypoplasia
Stippled epiphyses

A

Warfarin

38
Q

[Neo/Maternal exposure/FAS]

Fetal alcohol syndrome diagnosis criteria (3)

A

All three categories
1. Facial abnormality, 2 of the following
Shortened palpebral fissures
Epicanthal folds
Hypoplastic nasal root
Short, upturned nose
Hypoplastic or absent philtrum
Thin upper lip
Midface hypoplasia

  1. Pre- or postnatal growth deficiency, 1 of the following
    Weight < 10th percentile
    Microcephaly
    Length-to-height ratio < 10th percentile
  2. Cognitive abnormality
39
Q

[Neo/Maternal exposure/Mercury]

Characteristics of newborns with mercury exposure?

A

Cerebral atrophy, seizures, developmental delay

40
Q

[Neo/Maternal exposure/Substance]

Which substance abuse?

Miscarriage, still birth, premature delivery
Placental abruption
Intracranial hemorrhage
Newborn abstinence syndrome: jitteriness, irritable, tremulous, rigidity, short half life

A

Cocaine

41
Q

[Neo/Maternal exposure/Substance]

Which substance abuse?

Miscarriage, still birth, prematurity
Low birth weight
Risk for sudden infant death

A

Cigarette

42
Q

[Neo/Maternal Medical condition]

What is mother’s medical condition?

Still birth, prematurity
Congenital heart block, cardiomyopathy, structural anomalies
Rash (raccoon eyes)
Elevated LFT, hepatosplenomegaly
Cytopenia

A

Systematic lupus erythematosus (SLE)
(Neonatal lupus)

43
Q

[Neo/Cong Infection]

Which prenatal infection?

Severe anemia, heart failure, hydrops fetalis

A

Human parvovirus B19

44
Q

[Neo/Cong Infection]

Which prenatal infection?

IUGR
Limb reduction defects
Microphthalmia, chorioretinitis,
skin scarring
Microcephaly

A

Varicella

45
Q

[Neo/Cong Infection]

Which prenatal infection?

IUGR
Microcephaly
Periventricular calcifications
Hearing loss
Intellectual disability

A

Cytomegalovirus (CMV)

(Toxo parenchymal calcification, CMV CircuMVent calcification)

46
Q

[Neo/Cong Infection]

Which prenatal infection?

Blueberry muffin rash
Up to 8 weeks: deafness
9-12 weeks: cataracts
12-30 weeks: heart defects

A

Rubella

47
Q

[Neo/Cong Infection]

Which prenatal infection?

Hydrocephalus
Choreoretinitis
Parenchymal cerebral calcification
Hepatosplenomegaly
Intellectual disability

A

Toxoplasmosis

(Toxo parenchymal calcification, CMV CircuMVent calcification)

48
Q

[Neo/Cong Infection]

Which prenatal infection?

Abnormal teeth/bones, intellectual disability,
Hutchinson triad (Teeth, cranial nerve 8 palsy, interstitial keratitis)

A

Syphilis

49
Q

[Neo/Cong Infection/Syphilis]

Treatment for
Category 1 (highly likely: abnormal newborn finding, ≥ 4 fold in VDRL or RPR)
And
Category 2 (less likely: <4 fold in VDRL or RPR and normal PE, mother was not treated)

A

Category 1
IV Penicillin G for 10 days
Category 2
Penicillin G IM one dose

50
Q

[Neo/Cong Infection/Syphilis]

Newborn investigation for
Category 1 (highly likely: abnormal newborn finding, ≥ 4 fold in VDRL or RPR)
And
Category 2 (possible: <4 fold in VDRL or RPR and normal PE, mother was not treated)

A

Category 2
CSF for VDRL, cell count, protein
CBC
Long bone x-rays

Category 1
Plus LFT, Chest x-ray, head ultrasounds, eye/hearing exam

51
Q

[Neo/Cong Infection/Syphilis]

Criteria for Category 3 (less likely) and category 4 (unlikely)

A

Category 3
Normal newborn finding AND
Titer < 4 folds AND
Treated at least > 4 weeks before delivery
-> one time Penicillin G IM

Category 4
AND treated before pregnancy
AND titer remained low during pregnancy
-> no treatment

52
Q

[Neo/Cong Infection/Syphilis]

Investigation and treatment for
Category 3 (less likely: treated before delivery, normal titer)
Category 4 (unlikely: treated before pregnancy, remained low titer)

A

Category 3
No newborn investigation
Penicillin G IM once

Category 4
No investigation, no treatment

53
Q

[Neo/neonatal sepsis]

Invasive GBS sepsis treatment?

Early onset: __
Late onset: __

A

Early onset: Penicillin G
Late onset: ampicillin and cefotzime or ceftazime (≤28 days), or ceftriaxone ( >28 days)

54
Q

[Neo/Maternal exposure]

Which teratogenic drugs?

Persistent pulmonary hypertension
neonatal withdrawal,
prematurity,
low birth weight

A

Selective Serotonin Reuptake inhibitor (SSRI)

55
Q

[Neo/Perinatal injury]

Klumpke injury
Which nerve involvement?

Horner syndrome, anisocoria, harlequine sign

A

T1 involvement: Horner

Klumpke injury (C7-T1)

56
Q

[Neo/GA]

Maximum vernix coverage at ____ weeks

A

37 weeks

57
Q

[Neo/GA]

Absent breast tissue till ___ weeks
Raised areola at ___ weeks

A

No breast till 33 weeks
Raised areola 34 weeks

58
Q

[Neo/GA]

Ear well defined incurving to lobe at ___ weeks

A

39

59
Q

[Neo/GA]

1-2 anterior sole crease at ___ weeks

A

32 weeks

60
Q

[Neo/GA]

Lanugo covers entire body till ___ weeks
Absent from the fact at ___ weeks

A

Full lanugo at 32 weeks
No face lanugo at 34 weeks

61
Q

[Neo/GA]

Lanugo disappears from the face between ___ and ___ weeks

A

32 to 37 weeks

62
Q

[Neo/GA]

Testicles palpable upper scrotum between ___ and ___ weeks

A

36 and 39 weeks

63
Q

[Neo/Newborn finding]

Diagnosis?

Infants followed by birth injury, hypoxia, meconium aspiration, forceps delivery
Self-limited 6-8 weeks
Hypercalcemia during the first 6 months

A

Subcutaneous fat necrosis

64
Q

[Neo/Cong infection]

Name of congenital infection?

Transverse bands of indreased density across metaphyses
Patchy areas of bony destruction in the diaphysis
Periosteal new bone formation

A

Congenital syphilis

65
Q

[Neo/Maternal exposure/FAS]

Congenital anomalies commonly seen in fetal alcohol syndrome (FAS)? (2)

A

Cardiac septal anomalies (VSD)
Minor joint and limb anomalies

66
Q

[Neo/TTTS]

Twin to twin transfusion syndrome

Donor child
CBC: ___
Amniotic fluid: ___

Recipient child
CBC: ___
Amniotic fluid: ___

A

Donor child
CBC: anemia
Amniotic fluid: oligohydramnions

Recipient child
CBC: polycythemia, hyperbilirubinemia
Amniotic fluid: polyhydramnios

67
Q

[Neo/Cong anomaly]

Most common site for congenital diaphragmatic hernia?

A

Left, posterolateral defect

68
Q

[Neo/Cong infection]

Which prenatal infection?

3-7 days of life
Myocarditis
Fulminant hepatitis
Encephalitis/meningitis

A

Enterovirus: coxsackievirus, enterovirus,

69
Q

[Neo/Cong infection]

Which prenatal infection?

Microcephaly
Seizure
Arthrogryposis
Sensorineural hearing loss

A

Zika virus

70
Q

[Neo/neonatal spesis]

Which bacteria?

Preterm birth
Pneumonia
Septicemia
Granulomatosis infantisepticum (erythematous rash with papules)

A

Listeria

1. Pediatrics (22 decks)

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