5: Congenital Anomalies and Prematurity

Question 1

Four factors that cause higher infant mortality in the US

Answer 1

1. State: higher in south
2. Ethnicity: black > Native American > Hawaiian > Hispanic > white > Asian
3. Maternal age: under 20 and over 40
4. Infant gender: male at greater risk

Question 2

Four time spans of childhood that have different prevalent diseases, disorders, and neoplasms

Answer 2

1. Neonatal: first 4 weeks
2. Infancy: to age 1
3. Toddler: 1-4
4. School age: 5-14

Question 3

Period of childhood where most infant deaths occur

Answer 3

Neonatal (first 28 days)

Question 4

Smallest baby born on record

Answer 4

8.6 oz

Question 5

Disease

Answer 5

Deviation or interruption of normal structure/function of a part, organ, or system of the body manifested by characteristic S/S

Question 6

Disorder

Answer 6

A derangement or abnormality of function

Question 7

Neoplasm

Answer 7

Any new and abnormal growth

Question 8

Syndrome

Answer 8

A set of symptoms that occur together

Question 9

Congenital anomalies

Answer 9

Anatomic defects that are present at birth, but some may not become clinically apparent until years later

Question 10

Malformations

Answer 10

Primary errors of morphogenesis where there is an intrinsically abnormal developmental process

Question 11

Disruptions

Answer 11

Result from secondary destruction of an organ or body region that was previously normal

Question 12

Deformations

Answer 12

Caused by compression of the growing fetus by abnormal biomechanical forces

Question 13

Malformation syndrome

Answer 13

Constellation of congenital anomalies believed to be pathologically related, but in contract to a sequence cant be explained on the basis of a single localized initiating defect

Question 14

Most common causes of malformation syndromes

Answer 14

Viral infections, specific chromosomal abnormality

Question 15

S/S fetal alcohol syndrome

Answer 15

Prenatal and post-natal growth retardation, facial anomalies (microcephaly, short palpebral features, maxillary hypoplasia), psychomotor disturbances

Question 16

When is the embryo most susceptible to teratogenesis?

Answer 16

Weeks 3-9

Question 17

How many deliveries in the US are preterm?

Answer 17

About 10%

Question 18

How do FGR infants compare to preterm infants?

Answer 18

Preterm infants have low birth weight, but its usually appropriate once adjusted for gestational age; FGR infants are under grown rather than immature

Question 19

What % of extremely preterm infants (less than 28 weeks gestation) have RDS?

Answer 19

93%

Question 20

Lungs on exam of an infant with RDS

Answer 20

Lungs normal size, solid, airless, reddish-purple, alveoli poorly developed and those that are developed are collapsed

Question 21

How to control RDS

Answer 21

1. Delay labor until fetal lungs are mature

2. Induce maturation of lungs by using antenatal steroids

Question 22

How to test for level of surfactant in alveolar lining?

Answer 22

L/S ratio from amnionic fluid analysis

Question 23

What portions of GI are typically affected by NEC?

Answer 23

Terminal ileum, cecum, and right colon

Question 24

Description of GI tract in NEC

Answer 24

Segment is distended, friable, congested, sometimes gangrenous, intestinal perforation may occur with accompanying peritonitis

Question 25

Two categories of perinatal sepsis

Answer 25

1. Early onset: first 7 days of life

2. Late onset: 7 days to 3 months

Question 26

Possible S/S of Rubella syndrome in a toddler

Answer 26

Microcephaly, MR, hearing loss, PDA, bone disease, low birth weight, purpura and thrombocytopenia, hepatosplenomegaly, cataracts