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Gestation and Birth Flashcards

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1
Q

What is the main source of energy for a growing fetus?

A

Carbs - preterm babies don’t have time to build glycogen stores - more likely to be hypoglycemic

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2
Q

Week 1 of development

A

Fertilization - fallopian tube ampulla

Implantation begins

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3
Q

Week 2 of development

A

Implantation complete

Endoderm & Ectoderm form

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4
Q

Week 3 of development

A

Mesoderm formed = “tri” laminar embryo

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5
Q

Week 5 of development

A

Forebrain, midbrain and hindbrain

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6
Q

Week 7 of development

A

Heart formed

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7
Q

Week 8 of development

A

Organogenesis complete

Placentation

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8
Q

Week 9 of development

A

Permanent kidneys (metanephri) begin functioning

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9
Q

Week 10 of development

A

Midgut returns (counterclockwise rotation)

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10
Q

Week 24 of development

A

Primary alveoli are formed and surfactant production begins

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11
Q

Week 26 of development

A

Testicles descend

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12
Q

What is the CNS/PNS, sensory epithelia of ear/eye/nose, epidermis, mammary glands, pituitary gland, and tooth enamel formed from?

A

Ectoderm

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13
Q

What are the spinal nerves, CN, autonomic ganglia, adrenal medulla, meninges, pigment and peripheral glial cells formed from?

A

Neural Crest (Ectoderm)

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14
Q

What forms the CT, bone, striated and smooth muscle, blood/lymph, gonads, spleen, adrenal cortex and serous membranes lining body cavities?

A

Mesoderm

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15
Q

What forms the epithelial lining of the GI tract/Resp tract/ and middle ear, thymus, parathyroid/thyroid, liver, and pancreas?

A

Endoderm

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16
Q

What forms the valve of the foramen ovale?

A

Septum primum

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17
Q

What is the path of O2 from mom to fetus?

A

Umbilical vein - ductus venosus - IVC - *RA - foramen ovale - aorta

or *RV - pulmonary trunk - ductus arterosus - aorta

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18
Q

Where does fetal erythropoiesis occur?

A

3-8 wks = Yolk sac

6-8 wks = Liver

9-28 wks = Spleen

28 + wks = Bone Marrow

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19
Q

What induces primary male sex cords to develop into male gonads?

A

Testis-determining factor

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20
Q

Failure of the neural tube to close can result in __________.

A

Spina bifida = unfused spinal arch +/- unfused dura and spinal cord

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21
Q

What ratio of lecithin to sphingomyelin in the amniotic fluid indicates fetal lung maturity?

A

> 3

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22
Q

When is maternal α-fetoprotein high?

A

Multiple gestation

Fetal neural tube defects

Gastroschisis

**Incorrect dating**

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23
Q

Maternal α-fetoprotein is low in what 2 disease?

A

Trisomy 21 and 18

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24
Q

What is the most common cause for abnormal AFP?

A

Incorrect Dates!!!

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25
What intrauterine infection leads to microcephaly, hydrocephalus, _intracranial calcifications_, _chorioretinitis_, and seizures?
**Toxoplasmosis** Cats!
26
What intrauterine infection can lead to meningoencephalitis, microcephaly, cataracts, _sensorineural deafness_, and PDA or pulmonary artery stenosis?
Rubella - rare post-vaccine
27
IURG, low birth weight, jaundice, HSmegaly, chorioretinitis and intracranial calcifications can be caused by what?
CMV
28
What are causes of IUGR? (5)
Renal agenesis Maternal vascular disease Alcohol/Cocaine/Narcotics/Phenytoin PPROM CMV
29
What does this baby have?
Fetal Alcohol Syndrome
30
What does a newborn receive for ppx?
GC/CT eye ppx - **1% silver nitrate** and **erythromycin** Hemorrhagic disease of the newborn - **Vitamin K**
31
When does the anterior fontanelle close?
9-12 months
32
True or False: Acrocyanosis (blue hands and feet) is always pathologic in a newborn?
False, can be normal
33
A bulging fontanelle can indicate what?
Increased intracranial pressure Hydrocephalus Meningitis (Late-onset GBS)
34
Symmetrically small babies = Normal HC, small body =
Early onset (\<28wks): HTN, renal disease, ch. abnormalities Late onset (\>28 wks): Multiple gestation, preeclampsia
35
What is the most common bone fractured during delivery?
Clavicle
36
What is the most common cause of an abdominal mass in a newborn?
Enlarged kidney
37
Caput Succedaneum
Area of edema over presenting portion of scalp during vertex delivery +/- bruising petechiae
38
Cephalohematoma
Bleeding below periosteum of **parietal bone** - *usually* 5-10% have skull fractures
39
"Claw Hand" deformity is caused by traction on what nerve roots?
C7 - C8 \*\*Often seen with Horner's Syndrome\*\*
40
Erbs Palsy
C5-C6 "Waiter's Tip"
41
How can you tell the difference between caput succedaneum and a cephalohematoma?
**Caput** = _external_ to periosteum, _crosses midline/suture lines_ **Cephalohematoma** = below periosteium, doesn't cross lines
42
What are risk factors for perinatal infections?
ROM \> 18 hrs Age \< 37 wks Chorio Maternal fever Maternal GBS+
43
What drug combos are used for neonatal sepsis?
**Amp and Gent** (Amp for listeria) or Amp and Cefotaxime
44
3 wk infant presents with paroxysmal cough and tachypnea, bilateral diffuse crackles, hyperinflation and patchy infiltrates on CXR. Had conjunctivitis at 10 days.
Chlamydia pneumonia PO erythromycin for 2 wks
45
+Ortolani and Barlow tests indicate what?
**Developmental Dysplasia of the hip** \*Female, white, breech\* unilateral, left, short affected leg
46
What is the most common presentation of CF in the neonatal period?
**Meconium Ileus** \*Failure to pass stool, abdominal distention, vomiting\*
47
How do you diagnose and treat Developmental Dysplasia of the Hip?
US Pavlik harness or casting
48
What other problems can be seen with a diaphragmatic hernia?
Chromosomal abnormalities LBW/IUGR
49
True or False: High indirect serum bilirubin _in the first 24 hours of life_ is always pathologic.
True A/O or B/O incompatibility Rh iso-immunization Infection Liver disease
50
What is the cause of physiologic jaundice? When do you see it?
Inc. bilirubin 2/2 increased enterohepatic circulation Starts at 24hrs Peaks at 3 days Resolves within 2 weeks
51
Kernicterus
**Bilirubin neurotoxicity** - deposits in basal ganglia Deaf, encephalopathy, death
52
At what bilirubin do you treat with phototherapy? Exchange transfusion?
12-20 20-25
53
Premature infant
\< 37 weeks
54
Low-birth-weight infant Very-low-birth-weight infant
\<2500 grams \<1500 grams
55
RDS of the newborn is caused by what? How do you diagnose it?
2/2 insufficiency of lung surfactant - alveoli don't stay open Fine, diffuse reticulogranular **"ground glass"** and **air bronchograms**
56
If an infant needs supplemental O2 \> 28 days what do they have?
**Bronchopulmonary Dysplasia** - squamous metaplasia/hypertrophy of small airways \*\*Can be **wheezing**\*\*
57
What causes **Bronchopulmonary Dysplasia**? (4) How do you treat it? (3)
Immature lung Prolonged ventilation/Barotrauma Oxygen toxicity to the lungs O2 - PO steroids - bronchodilators
58
An infant that is intolerant of feeds - bilious vomit - with abdominal distention, temp instability, RDS, sepsis, etc has what?
**Necrotizing Enterocolitis** \*\*Bowel ischemia and bacterial invasion of intestinal wall\*\*
59
Impression: Distended loops of bowel and pneumatosis intestinalis What is it, how do you treat it?
**Necrotizing enterocolitis** d/c feeds, ng tube, IV fluids, antibiotics, surgery
60
What causes retinopathy of prematurity?
Proliferation of immature retinal vessels 2/2 **excessive O2 use** in premie
61
Intraventricular Hemorrhage
Rupture of germinal matrix bv 2/2 **hypoxic/hypotensive injury** dx w/ cranial US \*Correct underlying problem\*
62
How do you diagnose Rickets of Prematurity?
XR: Cupping/fraying of metaphyses, osteopenia, subperiosteal new bone formation
63
What does an infant with the following have? How do you treat * Hypotonia * Craniotabes - *occipital flattening* * Harrison's Groove - *rib indentation at the diaphragm* * Rachitic rosary - *swelling of costochondral junction* ​
Ricket's of Prematurity - Ca/Phos occurs during 3rd trim. **Vitamin D** and **Calcium** \*\***AlkPhos** will also be inc.\*\*
64
Do you give vaccinations based on postnatal or gestational age?
Postnatal

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