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Flashcards in Neonatology Deck (108):
1

The significance of having delayed cord clamping is to

Decrease incidence of anemia

2

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

Uninterrupted skin to skin contact

3

Breastfeeding must be done within hour many hours of life?

1 hour

4

Mechanism of heat loss from the cooler surrounding air

Convection

5

Mechanism of heat loss from the colder materials touching the newborn

Conduction

6

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

Radiation

7

Optimal method for maintaining temperature in a stable neonate?

Skin to skin contact

8

Also known as IUGR

BW is <3rd percentile for calculated gestational gestational age

Small for gestational age

9

LGA babies are at risk for

Hypoglycemia
Polycythemia

10

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

Symmetric

11

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

Asymmetric

12

Most important component of the APGAR score

Respiration

13

Diseases Included in the basic newborn screening

Congenital hypothyroidism
Congenital adrenal hyperplasia
Galactosemia
Phenylketonuria
G6PD
Maple Syrup Urine

14

When is NBS screening done

24-48 hours after feeding

15

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

2 weeks

16

What is the ideal time to do NBS in preterms?

5-7 years old

17

1st physical sign of a suspected congenital hypothyroidism baby

Prolonged jaundice

18

Most common cause of congenital hypothyroidism

Thyroid dysgenesis

19

Autosomal recessive disorders of cortisol biosynthesis

Congenital adrenal hyperplasia

20

Most common enzyme deficiency in congenital adrenal hyperplasia

21-hydroxylase

21

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

The 1st 6 months of life

22

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

2-3 days of life

23

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

6 weeks AOG

24

Sodium and potassium levels in CAH are

Decreased- Na
Increased-K

25

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

Galactosemia

26

Classic form of galactosemia

Galactose 1 phosphate uridyltransferase deficiency (GALT)

27

This enzyme deficiency in galactosemia presents with cataracts

Galactokinase deficiency

28

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

Brain
Kidney
Liver

29

Patients with galactosemia are at increased risk for this bacterial sepsis

E.coli neonatal sepsis

30

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

Reduced glutathione

31

Enzyme deficiency in phenylketonuria

Phenylalanine hydroxylase

32

Cheese like material that covers normal term infant in varying amounts

Vernix caseosa

33

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

Lacy cobblestone appearance

Cutis marmorata

34

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

Mongolian spots

35

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

Harlequin color change

36

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

Erythema toxicum

37

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

Pustular melanosis

38

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

Epstein pearl

39

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

Milia

40

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

Neonatal acne

41

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

Nevus simplex

42

Common cause of neonatal acne

Maternal estrogen transfer

43

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

Lanugo

44

Cephalhematoma or caput succedaneum?

Crosses suture lines

Caput

45

Cephalhematoma or caput succedaneum?

Subperiosteal hemorrhage

Cephalhematoma

46

Cephalhematoma or caput succedaneum?

Limited to the surface of one cranial bone

Cephalhematoma

47

Cephalhematoma or caput succedaneum?

With discoloration of overlying scalp

Caput

48

Cephalhematoma or caput succedaneum?

Edema, ecchymosis and swelling apparent right after birth

Caput

49

Cephalhematoma or caput succedaneum?

May cause jaundice

Cephalhematoma

50

Suggestive of tracheoesophageal fistula

Inability to pass an NGT

51

Term infant with severe respiratory distress and scaphoid abdomen on PE

Congenital diaphragmatic hernia

52

Most common type of congenital diaphragmatic hernia

Bochdalek

53

Immediate intervention for omphalocele/gastroschisis

Decompression and wrapping

54

Omphalocele or gastroschisis?

Associated with other congenital abnormality

Omphalocele

55

OEIS complex in omphalocele

Imperforate anus
Spinal

56

Gastroschisis is more common on what side of the umbilicus?

Right

57

Histologic finding in Necrotizing enterocolitis

Coagulation necrosis

58

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

Pneumatosis intestinalis

59

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

Duodenal atresia

60

Donut ring sign

Intussuception

61

Normal amniotic fluid L/S ratio

>2

62

Surfactant appears in amniotic fluid between ____ weeks AOG

28-32

63

Mature levels of surfactant usually present at what AOG

35 weeks AOG

64

Greatest risk factor of necrotizing enterocolitis

Prematurity

65

CXR findings:
Finely granular lungs
Ground glass appearance

Hyaline membrane disease

66

CXR findings:
Prominent pulmonary vascular markings
Fluid lines in fissure

Transient tachypnea

67

CXR findings:

Bubbly lungs - cystic lucencies

Bronchopulmonary dysplasia

68

CXR findings:

Coarse streaking granular pattern of both lung fields

Meconium aspiration

69

CXR findings:

Perihilar streaking

Pneumonia

70

The most serious complication of hyperbilirubinemia in the newborn is

Encephalopathy

71

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

Normal changes

72

Most common cause of jaundice in neonates

Physiologic

73

Physiologic or pathologic jaundice?

Direct hyperbilirubinemia at any time

Pathologic

74

Physiologic or pathologic jaundice?

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

Physiologic

75

Physiologic or pathologic jaundice?

Jaundice persistent after 10-14 days

Pathologic

76

Physiologic or pathologic jaundice?

Appears on the 1st 24-36 hours of life

Pathologic

77

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

ABO incompatibility

78

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

RH incompatibility

79

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

No prenatal check up

Sepsis

80

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

TORCH

81

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

Breastfeeding jaundice

82

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

Breastmilk jaundice

83

Treatment for breasfeeding jaundice

Continue breastfeeding

84

Treatment for breastmilk jaundice

Stop for 2 days

85

Substance in breastmilk that causes breastmilk jaundice

Glucuronidase

86

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

Kernicterus

87

Kernicterus may manifest if the serum bilirubin level is more than

25mg/dl

88

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

Direct Coombs

89

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

RH
ABO

90

Most common cause of hemolytic disease of the newborn

ABO incompatibility

91

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

ABO incompatibility

92

RH incompatibility is due to this antigen

D antigen

93

Treatment for RH incompatibility for subsequent pregnancies

Anti D gamma globulin injection

RhoGAM

94

Most important risk factor that predisposes a neonate to sepsis is

Prematurity

95

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

Vesicular lesions on the face and mouth

Heroes simplex 2

96

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

Purpuric hemorrhagic lesions all over the body

Rubella

97

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

Maculopapular rash

Imaging: periostitis of the bone

Syphilis

98

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

Chorioretinitis
Imaging: peri ventricular calcifications

CMV

99

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

Chorioretinitis, microcephaly, hepatosplenomegaly

Imaging: intracerebral calcifications

Toxoplasmosis

100

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

Cutaneous scars
Imaging: cortical atrophy

Varicella

101

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

Hydrocele

102

Hydrocele usually resolves by this age

12 months

103

Genitourinary anomaly that usually present as reducible scrotal swelling

Hernia

104

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

Medial

105

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

Inguinal ring

106

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

4 months

107

Undescended testes is treated at what age

9-15 months old

108

Majority of undescended testes descend at what age

1st 3 months of life