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Flashcards in NICU Deck (75)
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1

Management of temperature instability in a newborn

- Plastic wrap
- Radiant heat source
- Incubator with heat and humidity (40-60%)
- Continuous monitoring of the infant’s temperature to avoid hypothermia

2

Prevention of IVH in newborn

- Avoid operative delivery (forceps/vacuum)
- Avoid clinical instability (acidosis, hypoxia, hypotension) – fluctuations in BP or Pco2 can impact development of IVH
- Antenatal corticosteroids (decrease risk of death, grade II and IV IVH and PVL)
- Prophylactic administration of low-dose indomethacin (0.1 mg/kg/d x 3 ds) for VLBW preterm infants – reduces severe IVH
- “Neuroprotection” – head midline, cluster handling

3

Initial fluids for pre-term infant

D10W at 80 cc/kg/day

4

Prevention of RDS

- Antenatal corticosteroids to infants 24-32 weeks GA
- Intrapartum fetal monitoring (to reduce risk of asphyxia – associated with worse RDS)

5

Prevention of ROP

Minimize exposure to inspired O2

6

Retinal angiogenesis begins..and ends...

begins at 16 weeks GA and ends by 40 weeks

7

Most common type of craniosynostosis

Scaphocephaly - sagittal suture fusing prematurely (80% of cases in males)

8

Complications of being post-dates (3)

(1) Fetal macrosomia
(2) Meconium aspiration
(3) Shoulder dystocia

9

Most common cause of sensorineural hearing loss

Genetic causes (50%) - usually bilaterally (others include infections [e.g., CMV, toxoplasmosis, congenital rubella, congenital syphillis] and anatomic)

10

Features of Noonan syndrome

Common findings include a short webbed neck, chest deformity (pectus excavatum), cryptorchidism, intellectual disability (mental retardation), bleeding diathesis, and lymphedema (puffy hands and feet); cardiac defects: pulmonic stenosis and hypertrophic cardiomyopathy
ALSO: Hypotonia in neonatal period

11

Presenting features of PUV

Abdominal distension due to enlarged overdistended bladder or urinary ascites, difficulty with voiding, or a poor urinary stream, failure to thrive, urosepsis, poor urinary stream, and straining or grunting while voiding

12

Appearance of erythema toxicum

Multiple erythematous macules and papules (1 to 3 mm in diameter) that rapidly progress to pustules on an erythematous base

13

Marijuana use and breastfeeding?

Not enough evidence. Existing evidence suggest THC excreted into breast milk in moderate amounts.

14

Effects of twin-twin transfusion syndrome

Recipient twin: CHF, hydrops, polycythemia, respiratory issues
Donor: hypovolemic, hypoglycemic

15

Nerves involved in Erb's palsy

Brachial plexus: C5-T1
Erb's palsy: C5,C6 +/- C7

16

Features of Erb's palsy

Asymmetric Moro
Absent biceps reflex
Intact grasp
No wrist extension

17

Red flags for sacral dimple

>0.5cm
Above gluteal crease (>2.5cm from anus)
Multiple dimples
Associated with patch of hair, hemangioma
(looking for spina bifida occult)
Neurological findings

18

Duration of risk for hypoglycaemia in neonates

LGA, IDM = 12 hours
SGA = 36 hours

19

Period of time after which you can stop resuscitating neonate with no heart rate

10 minutes

20

Most common cause of hypertension in a newborn

Renovascular - accounts for 50% of cases of hypertension in neonates, including thrombi related to UV lines

21

Indications for LP in newborn

Unwell baby
WBC <5

22

GBS prophylaxis with penicillin allergy

History of anaphylaxis - clindamycin or erythromycin
No history of anaphylaxis - cefazolin
(cefazolin preferred)

23

Components of Sarnat staging

Level of consciousness, tone, reflexes, seizures (yes/no)

24

Reason for giving babies irradiated blood?

To prevent GVHD

25

In preterm babies, are vaccines given based on corrected or chronological age?

Chronological age

26

What are the criteria for cooling in HIE?

TWO of the following:
1. Apgars 16 within first hour
*and*
Sarnat stage II or III (moderate or severe) encephalopathy

27

Who are antenatal steroids indicated for?

< 34 weeks, improve lung development, decrease IVH/NEC/mortality

28

Indication for MgSO4

< 32 weeks - neuroprotection, decrease rates of CP

29

CNS finding in congenital CMV

periventricular calcifications

30

Electrolyte abnormalities in IDM

hypocalcemia, hypoglycemia