2nd through

Question 1

Warning to f/u café-au-lait macule criteria?

Answer 1

> = 6
5mm
Not confined to single segment/region

Question 2

Pre-term infant defined?

Low vs Very low birth weight defined?

Answer 2

<38wk ga
LBW - <2500g
VLBW - <1500g

Question 3

APGAR stands for?

Answer 3

Appearance/Pulse/Grimace/Activity/Resp
H - HR
R - RR
M - Musc
R - Reflex
C - Color

Question 4

Care for newborn based upon Heart rate?

Answer 4

HR
>100 - Routine care
60-99 - Ventilation
<60 - Ventilation + Chest compressions

Question 5

What is normal response of neonate to hypoxia?

Answer 5

Tachypnea

Question 6

Nursery care vitamins supplementation?

And breast vs formula?

Answer 6

Vit D - 400/d for Breast fed infants

Iron - Breast fed - Begin at 4mo and Formula fed - none

Question 7

Neck cysts/bulges?

Answer 7

Anterior midline = thyroid
Anterior to SCM = brachial cleft cyst
Posterior to SCM = cystic hygroma

Question 8

Weak pulses may indicate what cardiac finding?

Answer 8

Aortic stenosis - low CO

Question 9

Bounding pulses may indicate what cardiac finding?

Answer 9

PDA - high CO

Question 10

Pathologic murmurs?

Answer 10

Holosystolic - continuous - harsh murmur
Grade 3 or higher murmur
Diastolic murmur

Question 11

Congenital hip dysplasia screening?

Answer 11

U/S of hips after 6wk

• Girls w/ positive family Hx
• Breech presentation

Question 12

Elevated pulse pressure >40mmHg of newborn
OR
Decreased pulse pressure indicates?

Answer 12

PDA - Elevated

COA - Decreased

Question 13

Reflexes gone by?

Answer 13

Fencer - 3mo
Galant - 4mo
Rooting/placing - 4-6mo
Moro/Grasp - 6mo
Babinski - 12-18mo

Question 14

Jaundice during 1st 24hr of life is normal? Y/N

Answer 14

NO!

Question 15

GBS positive mother - discharge protocol?

Answer 15

1. • Infant have S/S of sepsis/infx? NO otherwise TXT
2. • <35wks EGA? Yes = Eval+48d hold
3. • Mom Abx 2 doses? Yes - no eval/48h - eval/48h

Question 16

TXT of Neonatal sepsis? Rx/duration?

Answer 16

(IV) Ampicillin+Gentamicin or Cefotaxime
+ Vancomycin - If late onset sepsis and/or meningitis
+ Acyclovir - If HSV

TXT until
1. Cx = 2. Sepsis - 14d 3. Meningitis - 21d

Question 17

Attributes/Pathophys of Respiratory distress syndrome

Answer 17

AKA - Hyaline membrane disease 
Insufficient surfactant by T-II pneumatocytes >
End-expiration atelectasis
MC - <34wk premmie
CXR - Bilateral ground glass

Question 18

PVT before birth AND TXT after birth for RDS?

Answer 18

Maternal CCS 32-34wks

Intubate AND artificial surfactant

Question 19

Complications of RDS?

Answer 19

PDA - PG - Indomethacin/IBPRF to close
PTX - chest tube
Bronchopulm dysplasia- Vent-O2 toxicity/barotrauma
Retinopathy of prematurity - O2 toxicity on eyes

Question 20

Apnea of maturity causes?

Answer 20

Central - Medulla/Pons don’t stimulate phrenic nerve

Periph - AW obstruction - malformation or positioning

Question 21

TXT of Apnea of maturity ?

Answer 21

O2
Stimulants - caffeine OR theophylline
Trxf - if anemic

Question 22

Breath sound of Tracheomalacia?

Answer 22

High pitch or Rattling/noisy breath sounds

Question 23

Meconium present during delivery indicates?

Answer 23

Stressed baby - (+- suction/intubation or PPV w/ PPV)

Question 24

CXR of Meconium aspiration syndrome?

Answer 24

Coarse irregular infiltrates

Question 25

CXR of Transient tachypnea of newborn?

Answer 25

Fluid in fissures

Question 26

MC population to see Transient tachypnea of newborn?

Answer 26

C-section or LGA

Question 27

Causes of respiratory distress in newborn?

Answer 27

Sepsis/Pneumonia MAS > PTX Transient tachypnea CHD - (PDA)

Question 28

Pulm HTN classifications/causes?

Answer 28

Primary - Hypoxia w/ ABNL heart/lungs Non-primary - L>R shunt (PFO/PDA) Inherited, autoimmune, Rx

Question 29

Hyperbilirubinemia is defined as?

Answer 29

>5mg/dL

Question 30

Kernicturus Bilirubin levels?

Answer 30

Nl Term infant >20-25 | Premmie or Stessed term infant (sepsis etc. +- <20

Question 31

ABNL levels of Bilirubin during 1st days of life?

Answer 31

>13mg/dL 1st day of life in term infants Rate rise >0.5/h --OR-- >5mg/dL/d Onset of jaundice during 1st/24h of life

Question 32

NL bilirubin levels during 1st days of life?

Answer 32

TERM - <12 on day 3 --OR-- up to 17 if breast fed | PRE-T - <15 on day 5

Question 33

When does jaundice become evident per bilirubin levels?

Answer 33

5-6mg/dL

Question 34

1st areas jaundice begins?

Answer 34

1st - Under tongue > Sclera

Question 35

F/U timing per discharge of jaundice infant?

Answer 35

Discharged - F/U <24h - 72h 24-48h - 96h 48-72h - 120h

Question 36

Difference between - B. feed Jaundice vs B. milk Jaundice

Answer 36

B. feed Jaundice - supply issue (synth/intake) 1st wk but also decreases gut motility - MC in 1st time mom B. milk Jaundice - Fatty acid unconjugates bili from albumin +- increases intestinal bili reabsorption occurring after 1st week lasting 1-2w - labs - increased unconj bili <20 - W/OUT hemolysis

Question 37

Gross motor - red flags of development?

Answer 37

Hypertonia = Rolling prior to 3mo Hypotonia = Poor head control at 5mo / cant sit 7mo Neuro d/o contralateral side = Hand dominance <18mo

Question 38

Language - red flags of development?

Answer 38

``` Cant vary voice @ 4mo Cant babble/localize sound @ 6mo No true words/gestures by 15mo No pointing by 18mo <50% intelligible speech by 2yr ```

Question 39

Anemia screening is at what age?

Answer 39

4mo - high risk | 12mo

Question 40

Lead screening is at what age?

Answer 40

12 and 24mo

Question 41

When is immunizations post-poned in premature infants?

Answer 41

Hep B - <2000g and mom is HBsAg NEG > Give Hep B at 1mo

Question 42

Counterindications of Immunizations?

Answer 42

Hx of anaphylaxis No live vaccines: x-imm states or pregnancy Mod to Severe illness (Not related to previous imms) Egg Allergy (flu or yellow fever)

Question 43

Car safety age?

Answer 43

2yr > front facing > booster seat at 4ft 9in and 8-12yo | <13yo = in backseat

Question 44

When to refer child for plagiocephaly?

Answer 44

No improvement by 4-6mo

Question 45

Nutrition in infants? stool habits.

Answer 45

Breast milk - only source until 6mo - 8-12 feeds/d | 6-8 wet diapers, >=4 loose stools/day

Question 46

Aboslute CI to breastfeeding

Answer 46

Lithium, radioactive compounds, Anti-cancer/immune/thyroid ETOH/Drugs Infections - HIV, Active TV, varicella, H1N1, HSV of tit

Question 47

When should a child be a diet for obesity?

Answer 47

>3yo

Question 48

Teeth grow in what order?

Answer 48

Low, up, lateral incisors

Question 49

Max amount of cow milks/day?

Answer 49

24oz/d