Neonatal

Question 1

Neonatal Hypoxic-Ischemic Brain Injury: imaging type (and why)

Answer 1

brain MRI
(Corticol, white matter injury, deep gray matter, etc)

Question 2

Imaging findings suggestive of Neonatal Encephalopathy

Answer 2

-injury to deep gray nuclei
-brainstem injury
-cerebral cortex parasagittal injury

Question 3

Neonatal Findings Hypoxic-Ischemic Encephalopathy

Answer 3

• 5,10 min Apgar: <5
• acidemia: pH <7 or base deficit >12mmol
• brain MRI injury
• sentinel hypoxic event (i.e. abruption, uterine rupture)
• FHR pattern (Cat III)

Question 4

Impact of opioids while breastfeeding

Answer 4

CNS depression risk (2-3%)

Question 5

brachial plexus injury incidence during shoulder dystocia

Answer 5

10-20%

Question 6

Erb’s Palsy:
-roots
-cause
-presentation

nerves

incidence

Answer 6

roots: C5-C6 (upper)
cause: stretching
presentation: waiter’s tip (pronated)

nerves: sc, axillary, suprascapular

1% of SVDs

Question 7

Klumpke’s Palsy:
-roots
-cause
-presentation

nerves

incidence

Answer 7

roots: C8-t1 (lower)
cause: stretch
presentation: claw hand

nerves: peripheral; ulnar and median

incidence: less common than Erb’s

Question 8

subgaleal hematoma:
location
short-term sequelae
long-term sequelae

cross suture lines?

Answer 8

location: b/t periosteum, galea aponeurosis
short-term sequelae: hemorrhagic shock
long-term sequelae: few

crosses suture lines (can hold a lot of blood!)

Question 9

cephalohematoma:
-location
-short-term sequelae
-long-term sequelae

crosses suture lines?

Answer 9

location: bleeding into fetal scalp (b/t skull and periosteum)
short-term sequelae: few (discomfort, swelling, lethargy)
long-term sequelae: none

does not cross suture lines (limited!)

Question 10

intracranial hemorrhage:
location
short-term sequelae
long-term sequelae

Answer 10

location: epidural, subdural or subarachnoid, intracerebral hemorrhage (broad spectrum)
short-term sequelae: morbidity, mortality high
long-term sequelae: CP, developmental delays, epilepsy

Question 11

Epidural bleed location (b/t what?)

cross suture lines?

shape on imaging

Answer 11

skull and dura mater

cross suture lines? no (dura matter is fused to skull at suture lines)

shape on imaging: lentiform (two curves)

Question 12

Subdural bleed location

Answer 12

between dura mater and brain

crosses suture lines? yes

shape on imaging: crescent

Question 13

relative infant dose of opiates that increases risk of CNS depression

Answer 13

> 10mg/kg

Question 14

late onset GBS dz in newborn:
-timing
-cause
-most common sign

Answer 14

timing: 7d-3mo postpartum
cause: maternal colonization (independent of intrapartum abx)
MC sign: temp >38deg

Question 15

Dx lab cx fetal encephalopathy

Answer 15

1. base excess >12mmol/L
2. pH <7
3. 2 MRI scans

Question 16

fetal blood volume at term

Answer 16

78mL/kg

Question 17

PTD b/t 23-23w6d:
-___ % intact survival w/o disability to 18-22mo

w/ neurodevelop?

% died?

Answer 17

13% chance w/o impairment

11% neurodev impairment

76% died