Quiz 1 Flashcards by Alex Han

Gestational age

Time elapsed since 1st day of LMP

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Ovulation age

2 weeks from 1st day of LMP

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Time frame of “embryo”

3-8 weeks

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Time frame of “fetus”

> 8 weeks

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Most sensitive period of gestation for teratogenicity

3-8 weeks

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How many weeks is full term

39-40 weeks

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When is a fetus considered viable

Week 24

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Why does physiologic anemia occur during pregnancy

Greater increase in plasma volume (30-50%) compared to RBC mass increase (20-30%)

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When is first prenatal visit and what is its purpose

6-8 weeks GA;

Date pregnancy

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When is the second prenatal visit and what is its purpose

15-16 weeks GA;

Quad screen

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Who is Rhogam indicated for and when is it given

Indicated for Rh- mothers;

Given at 28 weeks GA

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When should Group B Strep culture be done

35-37 weeks GA

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Primitive reflexes in an infant

Rooting, sucking, grasping, Moro

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Postural reflexes in an infant

Head up, parachute, maintain balance

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Locomotor reflexes in an infant

Crawling, stepping, swimming

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What is assimilation in an infant

New information being brought into existing scheme

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What is accommodation in an infant

Modification of old scheme or creating a new one

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Are the following stats increasing or decreasing?

Preterm births; LBW infants; Infant mortality rate

Decreasing, increasing (particularly ELBW infants), decreasing (bc of ventilators, surfactant, and antenatal steroids)

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Common complications of infant of diabetic mothers (IDM)

Macrosomia, respiratory distress syndrome (hyperinsulinemia inhibits cortisol = decreases surfactant), hypertrophic cardiomyopathy, cardiac malformation, lumbar neural tube defect, caudal regression, unilateral renal agenesis/renal vein thrombosis -> polycythemia, hypoglycemia -> seizures

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Common complications of extremely premature infant

Multi-system failure with prolonged hospital stay ($1.5 million for initial hospitalization);
Intraventricular hemorrhage, retinopathy of prematurity, necrotizing enterocolitis

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Multiple genes with additive effect that can be influenced by environment

Polygenic genes

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Genes that have small quantitative effect on level of expression of another gene

Modifier genes

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Epigenetics: definition and mechanisms

Def: transmission of info from cell to descendent without info encoded in nucleotide sequence;
Mechs: X-inactivation, imprinting, DNA methylation, histone/chromatin modification, RNA-modifiers

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Different genes at different loci producing same phenotype

Genetic (locus) heterogeneity

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What increases recurrence risk of multifactorial inheritance?

Increased recurrence risk if proband is of the less commonly affected sex

Polygenic condition

Offspring tend to be average of parents

Congenital viral pathogens

Toxoplasma, Rubella, CMV, HIV, Herpes, Syphilis (ToRCHHeS)

Path of congenital infections in newborn

Stillbirth, congenital malformation, preterm birth, long-term hearing/neurobehavioral disability

Pathogen that causes early onset neonatal sepsis (48-72 hours)

GBS, E. coli

Pathogen that causes late onset neonatal sepsis (3-7 days)

GBS, S. aureus

Diagnosis of neonatal sepsis

LP to look for meningitis

Clinical findings of respiratory distress syndrome

Premature baby

Radiographic findings in respiratory distress syndrome

reticulo-granular pattern ("groundglass"); symmetrical low lung volume

Pathophys of respiratory distress syndrome

hyaline membranes blocking gas exchange

Treatment of respiratory distress syndrome

Surfactant

Clinical findings of meconium aspiration syndrome

Term baby with fluid stained with meconium

Radiographic findings in meconium aspiration syndrome

Coarse markings, asymmetrical areas of hyperinflation

Pathophys of meconium aspiration syndrome

Mechanical obstruction, chemical inflammation (acidic), surfactant inactivation -> decreases compliance, decreases alveolar ventilation, increases pulmonary vascular resistance

Treatment of meconium aspiration syndrome

Suction of trachea

Clinical findings in persistent pulmonary hypertension of the newborn

Term baby; cyanosis from R -> L shunt = severe hypoxia

Pathophys of persistent pulmonary hypertension of the newborn

maladaption (increased pulmonary vascular resistance from hypoxia), maldevelopment (pulmonary vascular bed is abnormal from hypoplasia)

Clinical findings of cyanotic congenital heart disease

Unrelieved by 100% O2

Pathophys of cyanotic congenital heart disease

transposition of great vessels, truncus arteriosus (persistent), triscuspid atresia, tetralogy of Fallot, total anomalous pulmonary venous return

Radiographic findings in cyanotic congenital heart disease

Heart is too big for ribcage

Radiographic findings in congenital diaphragmatic hernia

Bowel seen above diaphragm

Treatment of congenital diaphragmatic hernia

Surgical repair once stable

Radiographic findings in bronchopulmonary dysplasia

Distortion of pulmonary architecture, cystic space, interstitial fibrosis, hyperinflation, atelectasis

Pathophys of bronchopulmonary dysplasia

Prolonged O2 requirement

Treatment of bronchopulmonary dysplasia

Gentle ventilation

Radiographic findings of surfactant deficiency

Diffuse, "ground glass" or finely granular appearance, air bronchograms, hypoventilation

When do clinical findings of surfactant deficiency present

1st 24 hours after birth

Radiographic findings of necrotizing enterocolitis

Pneumatosis intestinalis, pneumoperitoneum, portal venous gas

Clinical findings of necrotizing enterocolitis

Premature, ab distention, increased residuals, blood in stool, apnea, bradycardia, acidosis

Grade I germinal matrix hemorrhage

Caudo-thalamic groove

Grade II germinal matrix hemorrhage

Intraventricular hemorrhage with normal size

Grade III germinal matrix hemorrhage

Intraventricular hemorrhage with dilation

Grade IV germinal matrix hemorrhage

Parenchymal hemorrhage

Clinical findings of germinal matrix hemorrhage

Only occurs in preterm infants (GM is gone by 35 weeks)

Risk factors of germinal matrix hemorrhage

Low birth weight, cyanotic congenital heart dz, prolonged labor, multifetal preg

Sequelae of germinal matrix hemorrhage

Post-hemorrhagic hydrocephalus, cyst formation, periventricular leukomalacia

Compared to adults, newborns clear drugs more slowly or quickly? Toddlers? Adolescents?

Newborns clear drugs more slowly; Toddlers clear drugs more rapidly; Adolescents have a similar drug clearance

What are the FDA indications of treating children

There are none; must be treated "off label"

Maternal causes of preterm labor

Severe illness, uteroplacental underperfusion, uterine fundal and cervial abnormalities, UTI/pyelonephritis

Placental causes of preterm labor

Early rupture of membranes (NOS), infection, vascular thrombotic/bleeding problems

Indications for preterm delivery

Severe maternal HTN, severe DM, placental abruption, abnormalities of fetal growth

Pathophys of respiratory distress syndrome

Decreased synthesis, storage, release of surfactant by Type 2 pneumocytes: alveoli collapse easier -> hypoxia -> alveolar damage -> endothelial damage -> hyaline a/w developing PDA, intraventricular hemorrhage, NEC; Corticosteroids increase surfactant formation; Insulin decreases surfactant secretion

Tx of RDS

prophylactic surfactant, glucocorticoids, O2 (but increase risk of retinopathy of prematurity and bronchopulmonary dysplasia)

Clinical findings in necrotizing enterocolitis

Premature baby, PAF increase enterocyte apoptosis, pneumatosis intestinalis, death

Radiograph findings in necrotizing enterocolitis

Air trapping

Pathophys of germinal matric hemorrhage

Intraventricular bleed at anterior horn of lateral ventricle due to vascular bed immaturity

Neonatal sepsis

Infants

Risk factors for neonatal sepsis

Quiz 1 Flashcards

(72 cards)