Newborn

Question 1

Newborn recusitation

Answer 1

Warm and dry the infant and remove any wet linens immediately.

Stimulate the infant to elicit a vigorous cry.

Suction amniotic fluid from the infant’s nose and mouth.

Initiate further resuscitation if required.

Question 2

APGAR score

Answer 2

Appearance (skin color)

Pulse (heart rate) < or > 100bpm)

Grimace=1 active cough = 2 pts

Activity (muscle tone) flexion of al limbs = 2 pts (some limbs = 1)

Respiration

Question 3

term =

Answer 3

born after 37 weeks

Question 4

TORCH infections

Answer 4

TOxoplasmosis
Rubella
CMV
HSV

Question 5

how to test for CMV in newborn

Answer 5

urine cx (can be positive for first 3 wks of life)

Question 6

erythromycin eye ointment at birth is ppx for

Answer 6

Gonnorhea

Question 7

congenital CMV findings

Answer 7

petechia, thrombocytopenia, calcifications on brain, chorioretinitis, b/l hearing loss

Question 8

mom on seizure meds may cause __ to baby

Answer 8

cardiac defects

small head

Question 9

Marfanoid body habitus, a hypercoaguable state, and possible developmental delay

Answer 9

homocystinuria

Question 10

hepatomegaly, ataxia, seizures, and progressive neurologic degeneration. Fundoscopic exam reveals a “cherry-red” macula.

Answer 10

Niemann-Pick disease (sphingomyelinase)

Question 11

hepatosplenomegaly, coarse facial features, frontal bossing, corneal clouding, and developmental delay. Affected individuals typically do not live past fifteen years old

Answer 11

Hurler syndrome (presents > 1yo) (defect in alpha-L-iduronidase)

Question 12

hypoglycemia, hepatomegaly, and metabolic acidosis.

Answer 12

Von Gierke’s disease (defect in glucose-6-phosphatase)

Question 13

WHat is morrow refelx?

Answer 13

limb flexion when extending head

Question 14

what is placinf reflex

Answer 14

steps up when stimulating dorsum of feet

Question 15

what is tonic neck refelx?

Answer 15

turnign neck causes arm extension on ipsl side and flexion on contralateral side

Question 16

what is pustular melanosis

Answer 16

benign, little pustules that leave hyperpigemented pot when rupture

Question 17

yellow white papules with surroundign edema, fluid shows eosinophils

Answer 17

erythema toxicum

Question 18

yellow orange lesion on scalp that must be resected

Answer 18

sebaceous nevus

Question 19

small reddish capillary malformation

Answer 19

strawberry hemangioma

Question 20

XR condition, inflammatory bullae that evolve into hyperpigmented lesiosn and is lethal in makes

Answer 20

incontinentia pigmenti

Question 21

Contraindications to LP

Answer 21

inc ICP w/o open fontanelle
Cardiopulmonary distress
puncture site cellulitis
sever coagulopathy

Question 22

circumcision contraindications

Answer 22

hypospadias–forskin use for repair

Question 23

renal problems due to dec amniotic fluid –> pulm hypoplasia + club feet abnormalities

Answer 23

oligiohydraminos

Question 24

what can cuase polyhydraminos

Answer 24

GI obstruction

maternal DM

Question 25

What is twin-twin transfusion syndrome?

Answer 25

abnormal vascular flow between monochorionic and diamnionic twins causing donor twin to be abemic and oligiohydraminos and recipient twin to ve polycythemic and polyhydraminos ** Hct diff > 15 btwn the 2

Question 26

difficulty breathing while feeding but normal when crying/ | Dx? how to make Dx? Tx

Answer 26

choanal atresia (non-canalized nasal passages) Dx with nasal catheter or checking for fog under nares Tx nasal tubes

Question 27

result of meconium aspiration tx

Answer 27

systemic hypoxia and pulmonary HTN (meconium is sterile but when aspirated it stims release of cytokines and vasoactive subst --> inflam) intubation + tracheal suction + o2 mask

Question 28

tachypnea, grunting, possible cyanosis in a c/s infant

Answer 28

transien tachypnea of the newborn

Question 29

pathophys of TTN? Dx made? treatment?

Answer 29

retained fetal lung fluid CXR shows pilmonary vascualr markings 100% o2 (will resolve in 3 days)

Question 30

TTN vs RDS

Answer 30

TTN improves with O2 and RDS does not

Question 31

neonatal hypothermia places baby at inc risk for ___

Answer 31

hypoglycemia

Question 32

what to do if neonate's blood sugar < 40 vs < 20

Answer 32

< 40, then feed | <20 then give D10

Question 33

%iles to be AGA

Answer 33

10-90%

Question 34

what is the cause of hyperviscosity syndrome in neonates? tx?

Answer 34

fetal hypoxia --> reactive polycythemia (hct > 65%) --> sludging/clotting in lungs, brain (seizures, tremors), kidney, GI (NEC) exchange transfusion

Question 35

lethargic/limp neonate in mom that got intrapartum opioids for pain control tx?

Answer 35

Narcosis--> give naloxone

Question 36

presents as drooling and choking on first feed

Answer 36

TEF

Question 37

bilious vomiting and polyhydramnios + KUB shows “double bubble”

Answer 37

duodenal atresia (trisomy 21)

Question 38

duodenal atresia vs intestinal atresia

Answer 38

intestinal = apple peal/tripple bubble appearence on XR, due to vascualr accident in utero PRESENTS SAME QAY (billous vomitting)

Question 39

Treatment for IVH

Answer 39

VP shunt

Question 40

complicaitions of cleft lip/palate

Answer 40

recurrent OM hearing losss speech defects

Question 41

when to repain cleft lip vs palate

Answer 41

lip 2-3 mos | palate in 6 mos

Question 42

micrognathia → posteriorly displaced tongue (glossoptosis) → cleft palate + airway obstruction

Answer 42

Pierre-Robin sequence

Question 43

constipation → distended abdomen → umbilical hernia, bradycardia, hypothermia, large fontanelles, etc Dx and Tx

Answer 43

congenittal hypothyroid levothyroxine

Question 44

tachycardia, tachypnea, irritability, diarrhea, vomiting, CHF dx and tx + pathophys

Answer 44

neonatal thyroxoxicosis proylthiouracil (PTU) for 2-4 mos as it gives time for mom's Abs to disappear (caused by maternal TSI crossing placenta)

Question 45

inc AFP in pregnancy =

Answer 45

neural tube defect

Question 46

rigidity, trismus, opisthotonus, risus sardonicus | Dx + how does newborn get this

Answer 46

tetanus (from dirt) toxin in umbilical stump

Question 47

presents w/ cranial bruits + high-output CHF

Answer 47

AVM of great vein of Galen

Question 48

pinky polydactylyl in white kid Next step?

Answer 48

remove and get echo bc these kids often have cardiac issues (NOT true in other races)

Question 49

What is colic? Tx?

Answer 49

unexplained crying for >3hrs in an infant < 3mos tx: swaddle

Question 50

presents as abdominal distention, vomiting, GI bleed, decreased bowel sounds next step? dx? tx?

Answer 50

KUB looking for pnuematosis intestinalis Tx: NPO/IVF/vanc and meropenem

Question 51

progressive hemorrhagic hydrocephalus in premature infant Dx? Tx?

Answer 51

IVH get VP shunt

Question 52

What is RDS? PPX? TX?

Answer 52

infant of diabetic mom or premature --> no surfactant ppx: 48 hrs maternal steroids Tx: surfactant + O2 therapy + CPAP

Question 53

What is retinopathy of prematurity? what inc your risk of getting this?

Answer 53

disorganized growth of retinal blood vessels in premies that leads to scarring and retinal detachment 1. premies 2. hyoxia 3. O2 toxicity

Question 54

transient erythema on dependent half of body, more common in premies

Answer 54

harlequin syndrome

Question 55

bleeding between periosteum and skull → “squishy” feel to scalp that doesn’t cross midline

Answer 55

cephalohematoma

Question 56

soft-tissue swelling of scalp where baby was delivered, crosses midline

Answer 56

caput succedaneum

Question 57

“squishy” feel to rapidly expanding scalp that crosses midline

Answer 57

subgaleak hemorrhage

Question 58

head trauma to temporal bone → torn middle meningeal artery → LOC w/ “lucid interval” → uncal herniation → death; Dx head CT shows convex lens, Tx emergent craniotomy

Answer 58

epidural hematoma