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Pedia > Neonatology > Flashcards

Neonatology Flashcards

1
Q

The significance of having delayed cord clamping is to

A

Decrease incidence of anemia

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2
Q

This intervention in the EINC is to prevent neonatal hypothermia and to increase colonization with protective family bacteria

A

Uninterrupted skin to skin contact

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3
Q

Breastfeeding must be done within hour many hours of life?

A

1 hour

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4
Q

Mechanism of heat loss from the cooler surrounding air

A

Convection

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5
Q

Mechanism of heat loss from the colder materials touching the newborn

A

Conduction

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6
Q

Mechanism of heat loss from the infant to other nearby cooler objects

A

Radiation

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7
Q

Optimal method for maintaining temperature in a stable neonate?

A

Skin to skin contact

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8
Q

Also known as IUGR

BW is <3rd percentile for calculated gestational gestational age

A

Small for gestational age

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9
Q

LGA babies are at risk for

A

Hypoglycemia

Polycythemia

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10
Q

This type of IUGR is associated with genetic and metabolic conditions and seen early in gestation

A

Symmetric

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11
Q

This type of IUGR is associated with poor maternal nutrition
Weight is more affected
Fetus affected in late gestation

A

Asymmetric

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12
Q

Most important component of the APGAR score

A

Respiration

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13
Q

Diseases Included in the basic newborn screening

A 
Congenital hypothyroidism
Congenital adrenal hyperplasia
Galactosemia
Phenylketonuria 
G6PD
Maple Syrup Urine
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14
Q

When is NBS screening done

A

24-48 hours after feeding

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15
Q

If NBS is done <24 hours, it must be repeated after

A

2 weeks

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16
Q

What is the ideal time to do NBS in preterms?

A

5-7 years old

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17
Q

1st physical sign of a suspected congenital hypothyroidism baby

A

Prolonged jaundice

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18
Q

Most common cause of congenital hypothyroidism

A

Thyroid dysgenesis

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19
Q

Autosomal recessive disorders of cortisol biosynthesis

A

Congenital adrenal hyperplasia

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20
Q

Most common enzyme deficiency in congenital adrenal hyperplasia

A

21-hydroxylase

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21
Q

Newborns with CAH are normal at birth but exhibit sexual and somatic precocity within

A

The 1st 6 months of life

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22
Q

Elevation in 17- hydroxyprogesterone is seen in how many days of life

A

2-3 days of life

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23
Q

Dexamethasone given prenatally can supress androgens and prevents virilization in females if given by

A

6 weeks AOG

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24
Q

Sodium and potassium levels in CAH are

A

Decreased- Na

Increased-K

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25
Q

This disease detected in newborn screening is an absolute contraindication to breastfeeding

A

Galactosemia

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26
Q

Classic form of galactosemia

A

Galactose 1 phosphate uridyltransferase deficiency (GALT)

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27
Q

This enzyme deficiency in galactosemia presents with cataracts

A

Galactokinase deficiency

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28
Q

Without the enzyme in galactosemia, galactose will accumulate in these organs

A

Brain
Kidney
Liver

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29
Q

Patients with galactosemia are at increased risk for this bacterial sepsis

A

E.coli neonatal sepsis

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30
Q

What product of the pentose phosphate pathway counteracts oxidative stress that is lacking in G6PD deficiency?

A

Reduced glutathione

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31
Q

Enzyme deficiency in phenylketonuria

A

Phenylalanine hydroxylase

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32
Q

Cheese like material that covers normal term infant in varying amounts

A

Vernix caseosa

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33
Q

Purplish reticulated pattern noted on the skin of a neonate when exposed to cold

Lacy cobblestone appearance

A

Cutis marmorata

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34
Q

Slate blue well demaracated areas of pigmentation over the buttocks and back

A

Mongolian spots

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35
Q

Red, sharply demarcated area 1/2 of body, due to imbalance of cutaneous blood vessel tone, premature hypothalamus

A

Harlequin color change

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36
Q

Small, white occasionally vesiculopustular papules on an erythematous base that contains eosinophils and develop after 1-3 days

A

Erythema toxicum

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37
Q

Vesiculopustular eruption over a dark macular base around the chin, neck, back and soles. Contains neutrophils

A

Pustular melanosis

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38
Q

Cysts appearing on the hard palate which is composed of accumulations of epithelial cells

A

Epstein pearl

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39
Q

Pearly white papules seen mostly on the chin and around the cheeks

A

Milia

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40
Q

Open and closed comedones or inflammatory pustules and papules on the cheeks of the baby usually after a week from delivery

A

Neonatal acne

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41
Q

Pink macular lesions on the nape, glabella, upper eyelids or nasolabial region

A

Nevus simplex

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42
Q

Common cause of neonatal acne

A

Maternal estrogen transfer

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43
Q

Hair that covers the skin of preterm infants; seen on term infants around the shoulders

A

Lanugo

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44
Q

Cephalhematoma or caput succedaneum?

Crosses suture lines

A

Caput

45
Q

Cephalhematoma or caput succedaneum?

Subperiosteal hemorrhage

A

Cephalhematoma

46
Q

Cephalhematoma or caput succedaneum?

Limited to the surface of one cranial bone

A

Cephalhematoma

47
Q

Cephalhematoma or caput succedaneum?

With discoloration of overlying scalp

A

Caput

48
Q

Cephalhematoma or caput succedaneum?

Edema, ecchymosis and swelling apparent right after birth

A

Caput

49
Q

Cephalhematoma or caput succedaneum?

May cause jaundice

A

Cephalhematoma

50
Q

Suggestive of tracheoesophageal fistula

A

Inability to pass an NGT

51
Q

Term infant with severe respiratory distress and scaphoid abdomen on PE

A

Congenital diaphragmatic hernia

52
Q

Most common type of congenital diaphragmatic hernia

A

Bochdalek

53
Q

Immediate intervention for omphalocele/gastroschisis

A

Decompression and wrapping

54
Q

Omphalocele or gastroschisis?

Associated with other congenital abnormality

A

Omphalocele

55
Q

OEIS complex in omphalocele

A

Imperforate anus

Spinal

56
Q

Gastroschisis is more common on what side of the umbilicus?

A

Right

57
Q

Histologic finding in Necrotizing enterocolitis

A

Coagulation necrosis

58
Q

Thickened bowel walls and air in the bowel is highly suggestive of

A

Pneumatosis intestinalis

59
Q

Greenish yellow vomitus
Nondistended non tender abdomen
Double bubble sign on xray

A

Duodenal atresia

60
Q

Donut ring sign

A

Intussuception

61
Q

Normal amniotic fluid L/S ratio

A

> 2

62
Q

Surfactant appears in amniotic fluid between ____ weeks AOG

A

28-32

63
Q

Mature levels of surfactant usually present at what AOG

A

35 weeks AOG

64
Q

Greatest risk factor of necrotizing enterocolitis

A

Prematurity

65
Q

CXR findings:
Finely granular lungs
Ground glass appearance

A

Hyaline membrane disease

66
Q

CXR findings:
Prominent pulmonary vascular markings
Fluid lines in fissure

A

Transient tachypnea

67
Q

CXR findings:

Bubbly lungs - cystic lucencies

A

Bronchopulmonary dysplasia

68
Q

CXR findings:

Coarse streaking granular pattern of both lung fields

A

Meconium aspiration

69
Q

CXR findings:

Perihilar streaking

A

Pneumonia

70
Q

The most serious complication of hyperbilirubinemia in the newborn is

A

Encephalopathy

71
Q

Jaundice appearing between the 2nd and 3rd day after birth in full terms infants is likely due to

A

Normal changes

72
Q

Most common cause of jaundice in neonates

A

Physiologic

73
Q

Physiologic or pathologic jaundice?

Direct hyperbilirubinemia at any time

A

Pathologic

74
Q

Physiologic or pathologic jaundice?

Peaks at 5-6mg/dl on the 2nd-4th day

A

Physiologic

75
Q

Physiologic or pathologic jaundice?

Jaundice persistent after 10-14 days

A

Pathologic

76
Q

Physiologic or pathologic jaundice?

Appears on the 1st 24-36 hours of life

A

Pathologic

77
Q

Most likely etiology of jaundice in the 1st 24 hours in the first born child

A

ABO incompatibility

78
Q

Most likely etiology of jaundice in the 1st 24 hours in the second born child

A

RH incompatibility

79
Q

Most likely etiology of jaundice in the 1st 24 hours with a history of prolonged 2nd stage of labor

No prenatal check up

A

Sepsis

80
Q

Most likely etiology of jaundice in the 1st 24 hours with a history of maternal infection during pregnancy

A

TORCH

81
Q

Most likely etiology of jaundice with an onset of 3-4 days and mother supplements breastfeeding with sugar water

A

Breastfeeding jaundice

82
Q

Most likely etiology of jaundice with an onset of 1 week and mother exclusively breastfeeds

A

Breastmilk jaundice

83
Q

Treatment for breasfeeding jaundice

A

Continue breastfeeding

84
Q

Treatment for breastmilk jaundice

A

Stop for 2 days

85
Q

Substance in breastmilk that causes breastmilk jaundice

A

Glucuronidase

86
Q

This results from deposition of unconjugated bilirubin in the basal ganglia and brainstem

A

Kernicterus

87
Q

Kernicterus may manifest if the serum bilirubin level is more than

A

25mg/dl

88
Q

This type of Coombs test is used to detect antibodies that are bound to the surface of RBC

A

Direct Coombs

89
Q

This conditions may be implicated if the direct coombs test is positive

A

RH

ABO

90
Q

Most common cause of hemolytic disease of the newborn

A

ABO incompatibility

91
Q 
Positive direct coombs
Spherocytes in blood smear
Hemoglobin may be normal
Increased retic count
Increased B1
A

ABO incompatibility

92
Q

RH incompatibility is due to this antigen

A

D antigen

93
Q

Treatment for RH incompatibility for subsequent pregnancies

A

Anti D gamma globulin injection

RhoGAM

94
Q

Most important risk factor that predisposes a neonate to sepsis is

A

Prematurity

95
Q

An IUGR baby born to a mother with a history of infection during pregnancy presents with

Vesicular lesions on the face and mouth

A

Heroes simplex 2

96
Q

An IUGR baby born to a mother with a history of infection during pregnancy presents with

Purpuric hemorrhagic lesions all over the body

A

Rubella

97
Q

An IUGR baby born to a mother with a history of infection during pregnancy presents with

Maculopapular rash

Imaging: periostitis of the bone

A

Syphilis

98
Q

An IUGR baby born to a mother with a history of infection during pregnancy presents with

Chorioretinitis
Imaging: peri ventricular calcifications

A

CMV

99
Q

An IUGR baby born to a mother with a history of infection during pregnancy presents with

Chorioretinitis, microcephaly, hepatosplenomegaly

Imaging: intracerebral calcifications

A

Toxoplasmosis

100
Q

An IUGR baby born to a mother with a history of infection during pregnancy presents with

Cutaneous scars
Imaging: cortical atrophy

A

Varicella

101
Q

Genitourinary abnormality that is an accumulation of fluid in the tunica vaginalis

A

Hydrocele

102
Q

Hydrocele usually resolves by this age

A

12 months

103
Q

Genitourinary anomaly that usually present as reducible scrotal swelling

A

Hernia

104
Q

Direct hernia is ___ to the epigastric vessels and projects to the abdominal wall

A

Medial

105
Q

Direct hernia is lateral to the epigastric vessels and projects to the

A

Inguinal ring

106
Q

If the testes remains undescended by this age, it will remain undescended

A

4 months

107
Q

Undescended testes is treated at what age

A

9-15 months old

108
Q

Majority of undescended testes descend at what age

A

1st 3 months of life

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