CPS difficult numbers

Question 1

How much Vit K to give neonate based on weight class, and how much IM/PO?

Answer 1

give 0.5mg to <1500g, or 1.0mg to >1500g, or 2mg PO VIt K at birth and repeated at 2-4weeks, then 6-8 weeks

Question 2

Neonate with hypoglycemia - what to do on first fail, what to do on second fail?

Answer 2

Give 0.5mL/kg of 40% oral dextrose gel, or feed 5mL/kg formula (should breastfeed too in both situations) , but second time is 8mL/kg, if is less than 1.8 after 1st try then should do IV

Question 3

Early onset sepsis evaluation - do CBC at _ hours of life?

Answer 3

4 hours of life

Question 4

EOS eval - what are the abnormal parameters?

Answer 4

• WBC<5, *ANC<1.5, WBC>30

- can watch infants with resp distress alone for up to 6 hours before deciding to do bloodwork/antibiotics

Question 5

Pulse ox screening - what constitutes a borderline screen?

Answer 5

pulse ox screening is between 24 and 36 hours of life , 90 to 94% OR over 3 percent difference per and post is borderline. 3 or less difference is normal .

Question 6

ROP screen which babies, and when?

Answer 6

ROP screen all babies less than or equal to *30 +6 weeks GA, or 1250 g or less, and needs to done at 31 weeks corrected or 4 weeks whichever is older

Question 7

What minimum gestation to give iNO?

Answer 7

35 weeks

Question 8

If an infant takes in ____ volume of milk, they don’t need extra Vit D

Answer 8

1 litre

Question 9

Post splenectomy antibiotic prophylaxis - how long

Answer 9

post-splenectomy antibiotic prophylaxis - recommended for *2 years after splenectomy, and in all children <5 years, and ideally lifelong
*-for asplenia for other reasons - *at least until age 5, ideally lifelong

Question 10

Asplenia for other reasons antibiotic prophylaxis, how long?

Answer 10

at least until age 5, ideally lifelong

Question 11

Live vaccines can be given - __ month after high dose steroids?

Answer 11

1 month

Question 12

Live vaccines can be given ___ month after chemo?

Answer 12

3 months

Question 13

Live vaccines can be given ___ month after anti-b cell antibody thearpy?

Answer 13

6 months

Question 14

Live vaccines can be given ___ month after IVIG therapy

Answer 14

11 months

Question 15

Test mom for Zika serology AND PCR if the exposure was within _____(period of time?)

Answer 15

4 weeks

Question 16

DDH - when should first US be? When should X ray be done?

Answer 16

US - 4 weeks is earliest, 4-6 months for xray as ossification happens then

Question 17

NRP - what gestation should you increase FiO2?

Answer 17

less than 35 weeks

Question 18

NRP: After ___ seconds of PPV, assessment of HR should take place.

Answer 18

15 seconds

Question 19

NRP - reassess HR after how long of chest compressions?

Answer 19

60 seconds. Contrast this to BLS which is 2 minutes for reassessment after chest compressions. ECG is the preferred method to assess HR

Question 20

NRP - what gestation to use plastic bags?

Answer 20

Less than 32 weeks

Question 21

For LBW baby, how much iron to give for each weight class? For how long? if breast fed? if formula fed?

Answer 21

**Weight 2 to 2.5 kg - give additional iron 1 to 2 mg/kg/day for first 6 months
**Weight less than 2 kg - iron supplement 2-3 mgkgday for first year .
If they are predominantly formula fed , should give a high iron formula which should meet the requirements already (I.e. preterm formula )

Question 22

Rotavirus - when should you stop; past when can you not give?

Answer 22

rotavirus cannot start after 15 weeks or end after 8 months of age, i.e. start at 6 weeks, first dose latest is 15 weeks, second dose latest is 8 months

Question 23

Good asthma control is: ___ daytime symptoms/ Ventolin use per week?

Answer 23

Less than 4 times a week is good control

Question 24

Mild C diff is how many stools a day?

Answer 24

less than 4 stools a day, if 4 or more then is moderate

Question 25

Pregnant mom untreated syphillis?

Answer 25

LP, BCx and baby gets full course of penicillin

Question 26

Mom untreated gonorrhea?

Answer 26

conjunctival culture and baby gets 1 dose ceftriaxone

Question 27

Mom untreated chlamydia?

Answer 27

no testing or treatment unless symptomatic

Question 28

Mom HIV? How to confirm negative or positive status?

Answer 28

zidovudine for 6 weeks , HIV PCR at birth. Confirming negative status needs 2 PCRs negative at* >1 month and >2 month. Confirming positive status needs either 2 positive PCR *<18 months, or positive serology past *18 months

Question 29

How to define delayed puberty?

Answer 29

defined as no thelarche in age *12 to 13, no testicular enlargement age 13-14

Question 30

Screening for complications of diabetes: Nephropathy - start at what age, what interval?

Answer 30

Yearly screening starting age *12, only if duration diabetes >5 years

Question 31

Diabetes screening for : Retinopathy -

Answer 31

Yearly screening starting age 15, only if duration diabetes >5

Question 32

Diabetes screening for : Neuropathy -

Answer 32

Yearly screening starting age 15, if duration >5 years, and poor control

Question 33

Diabetes screening for : Dyslipidemia -

Answer 33

Screen at age 12 and 17

Question 34

Diabetes screening for : Hypertension

Answer 34

All children, twice a year

Question 35

Imaging preterm brain - what GA should infants get HUS ?

Answer 35

-All infants at 31+6 or less should get routine HUS - At 32-32+6, only do HUS if risk factors for hemorrhage or ischemia * Ex:the need for resuscitation or critical care out of keeping with the usual neonatal course for GA, a complicated monochorionic twin pregnancy, microcephaly, or a postnatal course complicated by sepsis, NEC, major surgery, or abnormal neurological signs

Question 36

If you are doing screening newborn HUS, what age should the first one be? What does the first HUS look for?

Answer 36

DOL4-7 - hemorrhage

Question 37

Do you do a 2nd screening newborn HUS? On which populations? If so, at what DOL? What does the repeat HUS look for?

Answer 37

**-Then do a repeat at 4-6 weeks if <=31+6, or if 32 weeker and first scan abnormal. Looks for PVHD, WMI

Question 38

Who needs a term HUS?

Answer 38

If <26GA, or if complicated NICU course, or mod-severe abnormality on previous HUS, do repeat Term HUS. Otherwise don’t need term HUS.

Question 39

Who should receive meningococcal chemoprophylaxis, and with what agent?

Answer 39

Rifampin for all contacts

Question 40

Who should receive HiB chemoprophylaxis, and with what agent?

Answer 40

Rifampin for: all occupants of contact households with infants <12 months old (who have not completed the primary Hib immunization series), children <4 years old who are incompletely immunized, or immunocompromised children of any age.

Question 41

Teeth : When should a baby see the dentist for the first time?

Answer 41

see dentist by 1 year or within 6 months of tooth eruption.

Question 42

What age is youngest for fluoride supp are you allowed ?

Answer 42

6 months

Question 43

Before age 1, how do you clean teeth?

Answer 43

Damp cloth

Question 44

Age 1 and 2, how clean teeth?

Answer 44

tooth brush, tooth paste, no fluoride

Question 45

What age do you start brushing with fluoride?

Answer 45

3 years

Question 46

Mom with active HSV lesions at delivery - first episode, born vaginally after membrane rupture , what to do?

Answer 46

Empiric acyclovir Swab at 24 hrs If swab positive, full workup and treatment If swab nevative, complete 10 days of IV acyclovir!!

Question 47

Mom with active HSV lesions at delivery - first episode, born C section after membrane rupture, what to do?

Answer 47

Empiric acyclovir Swab at 24 hrs If swab positive, full workup and treatment If swab nevative, complete 10 days of IV acyclovir!!

Question 48

Mom with active HSV lesions at delivery - first episode, born C section prior to membrane rupture, what to do?

Answer 48

Swab at 24 hrs - if positive, full workup and treatment | Otherwise no acyclovir needed

Question 49

Mom with active HSV lesions at delivery - recurrent episode , what to do?

Answer 49

Swab at 24 hrs - if positive, full workup and treatment | Otherwise no acyclovir needed