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Peds boards newborn medstudy Flashcards

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0
Q

Penis <2.5 cm

A

ABNORMAL

do Endo work up

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1
Q

Polycythemia assoc

A

Delayed cord clamping

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2
Q

Diff Btwn omphalocele and gastrochisis

A

Omphalocele - defect in peri umbilical near umbilical cord MEMBRANe enclosed

Gastrochesis- defect of lat ventral folds = small and large bowel outside abd
NO membrane

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3
Q

Prune belly

A

No abd wall m.

Assoc with gu anom and cryptochord

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4
Q

Single umbilical a assoc

A

Trisomy 18

But can be nl in 85%

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5
Q

Delayed cord separation

A

> 1month

Can occur in leak adhesion deficiency (neutrophil chemo defects)

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6
Q

Diastasis recti

A

Midline gap Btwn abd rectus m.
See when crying
Goes away at 1 year

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7
Q

Cyanotic except when crying

A

Bilateral choanal atresia

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8
Q

Jaundice in 1st day of life

A

ABNORMAL

sepsis vs hemolytic anemia

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9
Q

Persistent post font + jaundice + umbilical hernia

A

Hypothyroidism

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10
Q

T or F neuro complications of isolated craniosynostosis are common

A

False

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11
Q

Skull frx: linear, depressed, basal

A

Linear: uncommon, can happen during uncomplicated delivery, no eval, good prog

Depressed: forceps or nsvd ping-pong ball shape
Prog good if neuro exam nl

Basal- Occital bone sep=brain injury can cause bleeding if veins ruptured, bad prog

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12
Q

Subarachnoid vs epidural hem

A

Subarachnoid- can happen from nl birth trauma
Seizures
Dx LP or ct

Epidural- rare in newborn trauma in delivery 
Associates cephalohematomas
dx Ct 
Often need surgery 
Bad prog
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13
Q

White reflex

A

Retinoblastoma
Retinal coloboma
Chorioretinitis
ROP

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14
Q

Horners in newborn

A 
Dt lower brachial plexus injury (1st thoracic n.)
Anhidrosis
Ptosis
Miosis
Enophthalmos (post displacement of eye)
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15
Q

Inclusion blennorhea

A

Chlamydia trachomstis
1st week of life
Eye injection + /- purulent discharge

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16
Q

Preauricular pits inheritance , assoc. do you do a work up for other things?

A

Inherited Auto Dom
Assoc with deafness

So are ear appendages

Don’t look for gu anom unless other abnl (ears malformed or low set, etc)

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17
Q

Protruding tongu, small mouth with or without cleft palate

A

Pierre robin sequence - micrographia assoc with displacing of tongue post = resp compromise

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18
Q

Erb paralysis

What to look for?

A

Lat traction on upper brach plexus 5 and 6th cervical n. root
Waiters tip
No tx until 2 weeks then rx PT

LOOK FOR IPSILSTERAL CLAVICLE FRX

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19
Q

Klumpke paral

A 
Lower brach plexus injury 
7 and 9 cervical roots
Breech
Claw hand 
Rx PT
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20
Q

coughing in newborn

A

ABNORMAL

viral PNA

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21
Q

Investigate murmur in newborn if

A 
Cyanosis
Poor perfusion
>grade 2
Increase RR
There after 2nd day of life
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22
Q

Pulses in newborn

A

So all 4 extremity

  • bp upper >20mm hug than Lower is coarc
  • PDA =wide pulse p
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23
Q

Widely spaced nipples with a shield like Chest

A

Turner syndrome

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24
Typical frx of the newborn
Femur humerus clavicles
25
Impaction of meconium leading to intestinal obstruction
CF
26
assoc of meconium ileous
CF SMall bowel atresia Hirachsprung Can lead to toxic megacolon
27
Screen who for congenjtal hip dysphasia
Females of affected mother with ddh
28
Hypo plastic extra or bifid thumbs and absent radii
Fanconi
29
Bilateral radial anom + thrombocytopenia
TAR
30
What to give to baby with hepB surface antigen + mom
Hep b immunoglobulin | Hep b vaccine
31
What does eye erythro or silver nitrate prevent
Neisseria Gonorrhea NOT chlamydia
32
Defin of hypoglycemia in newborn | What to do
<40 Send serum glucose Give 2ml/kg d10 Bolud
33
Who to screen for hypoglycemia
NOT universal ``` Screen: Baby of DM mom LGA ans SGA PREMIE <37 weeks Low birth weight <2.5kg Plycythemia hct >70% Hypothermic ``` ``` Sxs: Weak or high pitched cry Poor suck Jittery Seizures Lethargy Hypotonia ```
34
in what type of twins does Twin to twin transfusion occur?
Only in monochorionic placenta | Av connection in placenta
35
Low birth weight def as
<2.5kg Very low birth weight <1.5kg Elbw 1kg
36
Iugr
Rate of growth <5% of expected for normal SGA <10%ile for gest age
37
Symmetric small vs Asxs small
Symmetric = interstic factor Assymetric =extrinsic
38
Hypocalcemia in newborn causes what EKG changes? if sxs how to tx?
Qt prolong Seen in infant of DM mom If sxs infuse 10%ca gluconate
39
Complications of newborn to DM mom
``` Hypoglycemia Hypocalcemia Macrosomia Iugr Polycythemia Cardiomyopathy CHD congen anomalies: lumbosacral dysgeneis Caudal regression Small L colon (looks like hirschsprungs but normal nerves Renal anom NTD situs inversus Renal vein thrombosis Increase likely to be obese and have DM later in life Hyperbili Surfactant def ```
40
Infants highest risk of having diabetes later inlife
Those with insulin dependent FATHERS
41
Surfactant made of and what makes it
Most is lecithin Also phosphatidylglycerides Apo proteins SP-a thru D MADE IN: Type 2 alveolar cells
42
PPH diff dx
TAPVR Hypoglycemia Sepsis Polycythemia
43
Risk factors for hyaline membrane dz
``` Male White Asphyxia / fetal distress in uterine C/s Second born twin DM mom +fam hx ```
44
``` Lung exam clear Baby CS TERM infant Typnea / grunting Cxr fluid in fissures ```
TTN
45
Who's a candidate for surfactant
Infants <28 wkn give in delivery room Some older get it if need >50%fiO2 to keep PaO2 above 50
46
Persistent pulmon hypertension What predisposes
Syndrome RR increases DIFFERNETIAL cyanosis - higher oxygen sats in UE (dt right to left pda shunt) First 12 hours of life Refractory to oxygen ``` Assoc with: Mec aspiration Pulmon infx Birth asphyxia HMD sepsis Pulmon hypoplasia ```
47
Treatment for PPH
``` Mech vent Tolazoline Hypervent (lowers pco2 and decreases pulmon construction) Inhaled NO ECMO ```
48
Inhaled NO SE
Methemoglobina
49
Common complication of mec aspiration
Pneumothorax and pneumomediastinum if ventilated Also pphn
50
t or F unilateral pneumothorax is common in newborn
True 1-2%
51
Pneumothorax
Heart shifted away from affected lung No tx unless compromise then rx with 22 gauge needle If >20% or hypoxia distress put Ct in
52
Who do you see interstitial pulmon fibrosis (wilson Mikity syndrome)
Baby with HMD <32 weeks Bw <1500g Gradual onset first month Cxr with bilat reticular infiltrates Ana see multicystic lesions
53
GBS EARLY ONSET
<7 days | Sepsis pna meningitis
54
GBS labs
Sev leukopenia Thrombocytopenia Abnl pt and ptt
55
Mom GBS + and got ppx | And baby born <37 weeks or rom >18 hrs
Do limited eval (blood cx and CBC with diff) Obs 48 hrs Full septic w/o if needed
56
Mom GBS + and got ppx baby >37 weeks born what eval to do?
If ppx >4 hrs but ROM <18 hrs just obs for 48 hrs Of ppx ???????
57
Tx a normal baby with GBS +antigen in urine?
NO- nl colonization
58
Contraindications for indomethacin
``` NEC cr > 1.6 Low UOP Bleeding diathesis Plts <50 ``` (Ok to use though if infant has IVH)
59
Where do CF babies get mec ileus obstruction
Obstruction at terminal ileum
60
Mec ileus exam findings? What does the KUB look like?
1. Doughy abdomen due to bowel filled with mec and not air | 2. KUB has distension of prox bowel and mec peritonitis can have calcifications
61
Treat mec ileus
Most no surgery Use diatrizoate sodium enema - watch lytes though Do sweat test or genetic test for CF
62
Mc sites NEC affects
Distal ileum and prox Colon
63
Mc presentation of NEC
first 2 weeks of life in premie infant But can happen in up to 3 mon old if micropremie Abdominal distension +/- bloody stool
64
X-ray findings of NEC and most ominous sign
Pneumotosis intestinalis - gas in submucosa off bowel wall Air in hepatic portal system is bad
65
NEC tx
NG decompress Ivf NPO Correct lytes After get blood cx - start abx (amp or pioerscillin and gent) and tpn Surg consult
66
Do surgery for what babies with NEC?
Instestinal perf Abdominal cellulitis Peritoneal tap showing feces or pus
67
Time of peak bilirubin for normal newborns and normal peak level
4 days old Normal peak levels 15-18
68
Typical but high risk infant to get bili level on?
Breastfed Male <38 wks Dc from hospital <72 hrs
69
Which newborns to get bili on?
Clinical jaundice during list 24 hrs of life Or sending home from hospital before peak level reached
70
Hyperbili risk factors
Jaundice in first 24 hol Pre dc serum bili >95th %ile for age Hemolytic dz due to immune Gest age 35-36wks Previous sibling needing photo Delayed BM cephalohematoma or bruising dt birth trauma Exclusive Bf infant down >12% body weight East Asian or greek race
71
Urgent tx levels for hyperbili
-->photo of level 15 at 24 to 48 hrs of life Treat no matter what with photo when bili >25 Do exchange transfusion if level >30 or signs of kernicterus
72
Defin kernicterus
Depo of i conjugated Bili in basal ganglia brain cells Can be seen on MRI
73
Sxs of kernicterus
Day 1-2: poor sucking hypotonia seizures Then hypertonia fever retrocollis Chronic: hypotonia delayed motor skills
74
2 Pathologic etiologies of hyperbili in a newborn. Which is more common
1. Increased production - think hemolysis this is MOST COMMON 2. Decreased elimination - ex Gilbert's or Asians = decreased hepatic uptake of bili
75
Causes of persistent jaundice, after 1-2 weeks
``` Drug induced cholestatis TORCH infx Hepatitis Biliary atresia Galactosemia ```
76
Mcc hyperbili in day 3 to 7?
Sepsis UTI congrnital infx - syphilis cmv
77
Mcc hyperbili after first week
``` BM jaundice Sepsis Galactosemia Hypothyroidism CF Biliary atresia Hepatitis HS Other hemolytic anemia - G6PD, pyruvate kinase def ```
78
Causes of hemolysis in a newborn
Blood group incompatability - RH ABO minor group RBC enzyme def - G6PD or pyruvate kinase def RBC structural defects - spherocytosis
79
When can you stop photo tx
When level decreases by 4-5 mg/dl
80
When is exchange transfusion useful?
For ongoing hemolysis (Rh incompatability, G6pd) If photo fails and/or Bili reaches 25 by 48 hol ->do it!
81
Complications of exchange transfusion
``` Thrombocytopenia NEC portal vein thrombosis Lyte problems GVHD infx ```
82
Jaundice on first day of life
Always pathologic!!!!!! eval and suspect infx
83
Erythroblastosis fetalis
Hemolytic dz of the newborn Maternal antibodies of RBC antigens on infant passed across the placenta Mcc = D ANTIGEN of Rh group (C or E next mc) or ABO incompatibility Mom D negative becomes sensitized to D positive infant Next D positive infant - moms IgG antibodies attack fetus Can lead to fetal hemolysis then pancytopenia Also can lead to HSM - dt extra RBC precursor production = splenic rupture at delivery
84
How to prevent erythroblastosis fetalis
Give mom rhogam (anti D globulin) at third trimester and at delivery Must be done with each pregnancy!
85
T or F newborn with erythroblastosis fetalis is usually jaundiced at birth
False! Uncong Bili crosses placenta and mom conjugates and eliminates it After birth quickly becomes jaundiced though
86
Hemolysis and hyperbili Affect on glucose?
These babies usually hypoglycemic | Elevated Hb = hyperinsulinemia, once delivered baby can be sev hypoglycemic
87
What are infants of mom with gestational DM at risk for
Same as regular DM mom EXCEPT no congen anom/ CHD No risk for future obesity or DM
88
which type of apnea can be reversed with tactile stim?
primary | infant gasps with increased depth and rate of resp then goes apneic
89
what to do for secondary apnea
stim won't work! | be PPV
90
what's the general rule for deliveries with tactile stim and then PPV
all apenic newborns who fail to respond to tactile sim and remain apneic for 30 sec after delivery get PPV
91
TTN definition and how to tx? what to do about feeds?
TTN = dx of exclusion RR>60 typically resolves within 72 hours tx= if grunting/nasal flaring = NPO and obs start feeds asap once no grunting or increased WOB ->start feeds as long as RR <80!! advance feeds slowly until RR <60
92
newborn with galactosemia are at increased risk for what?
sepsis | therefore lethargy in a kid with galactosemia doesn't rule out sepsis
93
normal delivery sxs later = increase anion gap metabolic acidosis and thrombocytopenia elevated urine ketones + serum ammonia
organic acidemias elevated urine ketones in proprionic acidemia
94
which organic academia is at increased risk for sepsis?
proprionic acidemia
95
infant presenting with lethargy, vom, poor feeding, coma increased ammonia increased serum glutamic-oxaloacetic transaminase and glutamic-pyruvate transaminase incr PT/PTT resp alkalosis
citrullinemia (will also have incr citrulline)
96
citrullinemia has resp alkalosis or metabolic acidosis
resp alkalosis! | NO metabolic acidosis!!!
97
what hx and labs do you see in HIE?
complicated delivery elevated serum ammonia, lactic acidosis, hypoglycemia, hypocalcemia, hyponatremia NORMAL ANION GAP
98
causes of elevated AFP
renal (nephrosis, renal agenesis, polycystic kidney dz) abdominal wall defects INCORRECT DATES / multiple pregnancies ancephaly and SPINI BIFIDA
99
LOW AFP
Trisomy 21 or 18
100
what does the non stress test measure?
spon fetal movements and heart rate activity therefore also =measures fetal autonomic NS integrity
101
what does the contraction stress test measure?
fetal heart rate in response to uterine contraction | =uteroplacental insuff and tolerance of labor
102
what gest age do surfactant levels gradually increase
33-36 weeks
103
mcc bradycardia in an infant
maternal lupus
104
whats defined as SVT for a fetus? what's the tx?
HR >240 tx with anitarrthymics to the mom to prevent CHF and hydrops
105
key diff in RDS XR and | how does it look diff from mec aspiration?
granular opacification air bronchograms, ground glass will be symmetric and mec aspiration = asymmetric
106
how can CBC tell you if newborn has RDS vs. GBS PNA?
if cbc given calc | ratio of bands to total neutrophils if >0.2 = sepsis / PNA
107
when hyperbili + RDS what can this do?
LOWER the threshold for kernicterus
108
what decreases a baby's risk for RDS
PROM | prenatal steriods
109
a lecithin:sphingomyelin ratio of what lowers the risk for RDS?
>2
110
what can decrease the accuracy of the L:S ratio?
maternal DM
111
which RDS infants get a vent? what's the goal of tx?
ph<7.2 and pCo2 >60 goal = Po2 50-70 mmHg
112
at what gest age do newborn automatically get surfactant?
<30 weeks
113
what does surfactant do to inspiratory pressure and compliance?
decrease inspiratory pressures increase lung compliance
114
how do you get BPD?
bronchopulmonary dysplasia | infants with RDS that require prolonged ventilator support get it from prolonged O2 exposure and barotrauma
115
twin A or B is at higher risk for resp prob?
twin B
116
what type of twins are at higher risk for complications?
monozygotic (share chorion and amnion)
117
BPD CXR, how do you tx it? what electrolyte abnl are they at risk for?
CXR: diffuse opacities, cystic areas with streaky infiltrates tx: diuretics at risk for HYPOCALCEMIA (dt diuretcis
118
what's the eligibility criteria for ECMO?
infants with Reversible lung dz of <10-14 days with failure of other methods NOT allowed to have any systemic or intracranial bleed or CHD
119
Wilson Mikity syndrome (how can you tell its not BPD)
CLD of the newborn but no RDS or prolonged oxygen exposure cystic changes on xr AND fine lacy infiltrates Changes in the lung often start BEFORE the sxs
120
abx for neonatal sepsis
AMP and GENT (atlas until confirm not GBS - don't do amp and cefotax on the boards)
121
late onset GBS is within the first
month
122
is the incidence of late onset GBS increased with prematurity?
NO
123
menignitis occurs more commonly in late onset GbS t or f
true
124
what neonatal infx is assoc with maternal flu like sxs in preg
listeria
125
chance of fetal infection if mom catches toxo early on vs. later in preg
early in preg= lower risk of fetal infx but if gets it = severe prob later in preg= high risk of fetal infx but less severe
126
sxs of mom if toxo infection
usually none | sometimes LAD = only sxs
127
what congenital infection causes microceph/hydroceph chorioretinitis jaundice HSM and cerebral calcifications (ring enhancing lesions? how do you dx it?
toxo Dx with Immunofluorescence (IFA)
128
cerebral calcifications in CMV are ____ vs. toxo calcifications are ____
cmv = periventricular toxo= diffuse
129
toxo complications / sequalae when child older
seizures deafness blind MR
130
if mom infected with toxo chance she'll pass it on to fetus
50% | 1/2 of these babies are born asymptomatic
131
t or f the later a mom gets toxo in preg the more likely she is to pass it along to fetus?
TRUE but less likely it is to be severe
132
why can't woman change kitty litter in pregnancy
toxo infection
133
tx for congenital toxo
pyrimethamine sulfadiazine folinic acid
134
tx for clavical frx, when does callous go away?
obs | goes away by 2 yo
135
what can be assoc with an ipsilat clavicle frx
erbs palsy and phrenic n palsy (resp distres)
136
Erbs palsy does the grasp reflex remain intact?
yes - nerve stretched not broken | c5-7
137
Klumke's paralysis what nerves what's it assoc with
affects Lower down c8 and t1 affects m of hand = claw hand may lose the ability to grasp can be assoc with HORNERS syndrome
138
when should umbilical cord fall off?
by the 2nd week visit | if still there by one month->
139
baby's who breasts producing milk, what to do?
leave it alone!
140
t or f the baby should be kept below the cord before clamping for 30 sec
true to prevent decreased red cell volume (but don't milk it towards the kid bc can cause polycythemia)
141
what test to get for single umbilical a?
renal US
142
SGA and LGA are in the lower and upper __ %ile
10th
143
IUGR is assoc with
prenatal asphyxia
144
what moms are at risk for SGA babies
chronic illness | teen moms
145
at what age do SGA babies have catch up growth
2 yo
146
normal newborn arterial blood gas values
p02 60-90 pCo2 35-45
147
normal scalp pH
>7.25 | but <7.2 = BAD
148
Hirschprungs is assoc with what
DOWNS
149
mcc mec aspiration
persistent pulmonary hypertension
150
what pressure is needed to inflate the lungs with the first breath
60 mmHG
151
what to do for a newborn at delivery with bradycardia and impaired ventilatory efforts
PPV
152
what happens to the fetal/placental weight ratio during preg?
increases | ratio should be 6.5-7 at birth
153
VLBW infants can't have an apgar > than what
6 | bc low tone and neuro immaturity
154
definition of VLBW infant (wt)? | what do you need to give them/
<1500g | need to give them d10
155
what factors affect prognosis of VLBW infant?
gest age morbidity while in the nicu IVH
156
a premies mean arterial p should not be < than what?
should not be < gest age in weeks | 28 week gest premie needs to have MAP >28
157
when does catch up growth occur in premies? | when should they get to normal height?
in first 2 years | get to normal height by age 2
158
what's the calorie requirement for a premie?
120 kcal /kg/day
159
what does optional premie formula include
- 60/40 whey / casein - more glucose (less lactose) bc more easily absorbed - MCTs - high Ca and phos (bc high risk for rickets bc can't absorb these as well - 24 kcal/oz
160
air in the biliary tree | peumatosis intestinalis
NEC
161
what's NEC assoc with
``` hypoxic injury (RDS, birth asphyxia, prolonged apnea) bacterial infection (blood cx often +) ```
162
how long to keep NPO after NEC
3 weeks
163
long term complication of NEC
intestinal strictures
164
ABO set up / incompatibility
mom O and baby A or B
165
t or f the anemias of both ABO incompat and Rh immcompat can be severe and occur at 1-2 months of age
true!
166
ABO incompat anemia can occur with first born
true (usually Rh only after previous kid or miscarriage!)
167
breast fed jaundice vs. breast MILK jaundice (tx) vs. physiologic
- breast fed = first days of life, decr calories/dehydration - breast milk = first week -->tx = withholding BM for one day and having mom pump vs. physiologic = first 2-5 DOL dx of exclusion, due to immature conjugation
168
neonatal jaundice incidence is decreased with what?
maternal heroin use | smoking, alcohol, phenobarb and phenytoin
169
neonatal jaundice can be worsened by what?
``` sulfonamides severe acidosis a PDA (blood shunted from the liver = increase indirect) ```
170
complications of an exchange transfusion
high K low Ca thrombocytopenia hypovolemia
171
most important step to prevent hypoglycemia in a VLBW infant
maintain good body temp
172
a mom who had tocolytics in labor, infant at risk for what
hypoglycemia (stim's fetal insulin)
173
what can be the only sign of hypoglycemia?
tachypnea
174
what happens to calcium in an infant mistakenly given cow's milk
hypo calcemia (dt high phosphate load on the kidneys)
175
hypocalcemia def
iCa <4.5 | Ca <8.5
176
electolyte abnl in infant born to mom on mg sulfate
hypocalcemia | also get a Mg level (esp if no response to ca admin)
177
Hbg < 13 at birth
ANEMIA
178
Kleihauber Betkle test
detects for the presence of fetal cells in the mother's blood, used to eval neonatal anemia
179
defin of polycythemia? | how do you tx?
central venous Hct of 65 or higher | tx when hct >70
180
what can polycythemia lead to?
hypocalcemia hyperbili thrombocytopenia tx = partial exchange transfusion if symptomatic
181
physiologic nadir in premies vs FT
``` much earlier (HCT is lower and bottoms out earlier at 1-2 months hb 7-8) FT = 2-3 months hb 9-11 ```
182
hyperviscosity syndrome cause and sxs
from polycythemia lethargy hypotonia irritability
183
what to do for an infant being gavage fed with blood in residuals
Apt test
184
thrombocytopenia def, main cause in newborn
plts <100K | maternal ITP ->can last SEVERAL weeks until maternal IgG cleared out
185
prolonged PTT in a newborn
can be normal in neonates <9 months
186
infant BF and dev diarrhea | or baby who didn't get vit K and only got oral
late onset hemorrhagic dz of the newborn | oral K = insuff
187
Mom taking what during preg increases risk for hemorrhagic dz in newborn?
abx (quinolones, cephlasporins, TB meds)
188
neonatal seizure within first 24 hours likely dt what? do they have long term complications?
birth asphyxia most FT infants with these do NOT have any long term neurodevelopment complications but child with HIE and seizures = assoc with incr risk epilepsy, motor and cog problems
189
how do you tx seizures from HIE
rule out metabolic disorder then tx with phenobarb
190
HAL induced cholestatis assoc with what?
protein intake (limit to 2 g/kg/day
191
name 3 assoc syndromes for cleft lip and palate
crouzon apert treacher collins (auto dom)
192
when to correct cleft lip/palate
6 months (use special nipple until then)
193
omphalocele assoc with what syndorme
defect thru the umbilicus with membrane can contain intestines and other organs Beckwith Wiedemann syndrome (macroglossia macrosomia hypoglycemia) ***omphalo aslso assoc with chrom abnormalities
194
gastrochisis
herniation of bowel near the umbilicus usually limited to intestinal contents no membrane
195
best first step for management of omphal /gastrochisis
keep bowel contents moist | NG tube placement
196
polyhydraminos intermittent cyanosis excessive secretions pooling and causing airwar obstruction
TE fistula (MC = esophageal atresia) VACTERL
197
how to manage TE fistula until surgery
freq suctioning | keep infant in position to elevate the head
198
scafoid abd | decreased breath sounds on the left side
Diaphragmatic hernia
199
IVH managmenet
number 1 = ABCs | dx with cranial US at bedside
200
sxs IVH | when does it usually occur
``` if sxs: anemia hyperglycemia thrombocytopenia hyponatremia acidemia ``` usually occurs within 96 hours of life
201
cephalohematoma feels like what
firm and tense doesn't cross suture lines (vs caput a cap and is soft and boggy)
202
IVH grades
grade 1 germinal matrix 2 IVH without dilatation 3 IVH with dilatation 4 IVH with dilatation and parenchymal involvement
203
terbutaline to mom in labor can cause what in the newborn
its a tocolytic so can cause hyperinsulinemia in the newborn = hypoglycemia
204
a single one time use of corticosteroids decreases risk of what in newborn
IVH NEC RDS
205
don't use narcan when
when mom addicted to drugs so can cause rapid withdrawal in newborn = seizures
206
if newborn exposed to drugs in utero what do you need to get
urine drug screen within 24 hours of delivery | can't dc them early from the hospital
207
withdrawal symptoms infant from alcohol
hyperactive, irritable | hypoglycemia
208
affects on infant after maternal cocaine use in utero
``` no withdrawal syndrome but have increased vasc constriction cerebral infarcts limb anom urogenital defects increased risk placental abruption ```
209
amphetatmine use in preg
no withdrawal syndrome irritable IUGR, dev or cog impairment
210
barbiturate use my mom in preg
withdrawal in infant: hyperactive, hyperphagia irritable, crying and poor or swallow coordination
211
opiod use in preg, sxs of withdrawal
hyperirritability, tremors, jitteriness, hypertonia, loose stools, emesis and feeding diff seizure activity
212
tobacco in preg assoc
low birth weight miscarriage IUGR premature increased risk of SIDS and asthma (even if no post natal exposure)
213
t or f cocaine and amphetamines have no true withdrawal syndrome but can cause impairment to brain dev and uteroplacental circ
True
214
t or f most infants with +PKU screen don't have PKU
true | screen = elevated phenyl aline levels probs delayed maturation of enzyme or biopterin def

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