Test 1

Question 1

When the infant has an increased HR and temp think…

Answer 1

sepsis or CHF, SVT

Question 2

What is the purpose of the R atrial blood being shunted across the PFO to the Left atrium?

Answer 2

to provide the highest oxygenated blood to coronary, carotid and subclavian arteries

Question 3

The APGAR score is

Answer 3

an initial assessment of the infant’s transition to extrauterine life

Question 4

which of the following facilitates transition to extrauterine life?

Answer 4

decreased plumonary and increased systemix vascular resistance

Question 5

at birth, an infant has a HR of 140, loud cry, some flexion of the arms and legs, withdrawal of the feet when stimulated, and a pink body with blue extremities. This infant’s APGAR score is.

Answer 5

8

Question 6

When is Breastfeeding contraindicated in the US

Answer 6

maternal HIV

Question 7

What milk has the highest concentration of immunoglobulins?

Answer 7

Colostrum

Question 8

When is it acceptable for full terms infants to regain their birth weight?

Answer 8

2 weeks

Question 9

What type of care helps the mother’s breast milk supply increase?

Answer 9

Skin to skin contact

Question 10

What vitamin is very low in human milk and is recommended to provide supplements

Answer 10

Vit D

Question 11

What formula is required for infants if they have galactosemia?

Answer 11

Soy based - Prosobee

Question 12

What are the four main reasons elective cesarean births are rising?

Answer 12

1. VBAC rates have fallen by 55% since 1996
2. C/S rates have increased 33% from 1996-2004
3. half of all c/s are repeats
4. 50% of all late preterm infants are born by c/s

Question 13

What is the main effort to reduce iatrogenic prematurity?

Answer 13

Wait for the onset of spontaneous labor

Question 14

Infant tend to start sucking at different ages. What makes a difference on suck maturation?

Answer 14

Every week

Question 15

In periventricular leukomalacia, the infants are at risk for ___ and the incidence of PVL is not known.

Answer 15

increased vulnerability to injury

Question 16

After 32 weeks, what is when the cell increase in size (plumping up)

Answer 16

Hypertrophic

Question 17

When the height and age growth patterns are mismateched?

Answer 17

IUGR

Question 18

There is a proportional decrease in weight related to the # of _____ per day by the mom

Answer 18

cigarettes smoked

Question 19

With a SGA infant, the temp should be taken Q ____ until stable and then Q 4 hours

Answer 19

Q 30 mins

Question 20

With an IDM mother the infant can be expected to have

Answer 20

Hypocalcemia (hormonal response) and MAJOR anomalies including Heart

Question 21

What vitals would you see in the first 30 minutes after birth?

Answer 21

HR 160-180
RR 60-80
alerts, startles, tremors, crying

Question 22

What happens to a cold stressed infant?

Answer 22

tachypnea and metabolic acidosis

Question 23

What is the difference between colostrum and transitional milk?

Answer 23

Colostrum has high concentrations of IgG

Question 24

When breastfeeding the infant will become____ and must feed more frequently than Q5 hours!

Answer 24

sleepy

Question 25

The protein hydrolysate formula is used for infants with shourt gut or intractable diarrhea because of

Answer 25

of malabsorption

Question 26

To calculate intake, you add all the volumes and see if it is enough

Answer 26

add up divide my 24 hrs and divide by weight

Question 27

When should the infant regain BW by

Answer 27

2 weeks

Question 28

What organ produces the greatest amount of glucose?

Answer 28

The liver - 4-6mg/kg/min

Question 29

Why is the infant of an IDM mother quickly get hypoglycemia after birth?

Answer 29

Because the infant is in hyperinsulinemia

Question 30

When a mother is receiving MgSo4, the infant will be...

Answer 30

hyponia and decrease variability while in utero

Question 31

What are two major complications from PROM?

Answer 31

1. cord prolapse | 2. chorioamnionitis

Question 32

Chronic HTN can be diagnosed in a mother if symptoms occurred before ____weeks

Answer 32

20weeks

Question 33

When is the Glucose tolerance test completed?

Answer 33

At 27-28 weeks

Question 34

What are three cardiac disease an infant can develop being from an IDM mom?

Answer 34

1. pulmonary HTN 2. Coarctation of aorta w. valve involvement 3. Marfan's syndrome w. aortic involvement

Question 35

What is the most significant effect in an infant r/t PKU disease?

Answer 35

Brain growth

Question 36

When a mother has a CMV infection, the infant may be born with? (2)

Answer 36

Hepatomegaly and microcephaly

Question 37

When polyhydramnios is diagnosed, you should think...

Answer 37

esophageal atresia

Question 38

When monitoring the fetal well being, what are the 5 things the MD test for?

Answer 38

1. fetal breathing 2. Gross body movements 3. Fetal tone 4. Non-stress test 5. Amniotic fluid index

Question 39

What test observes the accelerations in FHR following a stimulus such as fetal activity?

Answer 39

Non-stress test

Question 40

During a contraction stress test, a negative result (no decelerations during a contraction predicts...

Answer 40

fetal well being for at least 7 more days

Question 41

What results when the amniotic sacs and the placentas do not split? the infants are at risk for cord entanglment and TTTS

Answer 41

Monoamnioyic and Monochorionic.

Question 42

When twins are discordant, what are the three measurements used to determine when the smaller one says its time to deliver?

Answer 42

Abd, head (BPD), and weight

Question 43

In the second trimester, what serum is screened? if the level is high = ____ if the level is low = ____

Answer 43

Alpha-fetoprotein high = NTD low = chromosomal effects

Question 44

At what weeks does the AF peak?

Answer 44

32 weeks (900-1000ml)

Question 45

What are two indications for an amniocentesis?

Answer 45

1. abnormal maternal serium | 2. fetal structural abnormality

Question 46

How many weeks is it safe and considered routine to do an amniocentesis? and it is def not to determine gender!!

Answer 46

16 weeks

Question 47

What test is used to assess FHR and reactivity in response to fetal movement?

Answer 47

Non-stress test

Question 48

When there is reverse end diastolic flow _____

Answer 48

delivery baby!

Question 49

What is considered fetal tachycardia?

Answer 49

>160 HR

Question 50

The fetus will exhibit early decelerations during a contraction when ______

Answer 50

there is pressure on the fetal head

Question 51

The fetus will exhibit variable decelerations during a contraction when ______

Answer 51

compression on the umbilical cord

Question 52

The fetus will exhibit late decelerations when there is _____

Answer 52

uteroplacental insufficiency

Question 53

What is a good biophysical profile score?

Answer 53

8/10 + normal AF = well fetus

Question 54

When a mother is diagnosed with polyhydramnios, what si most likely to happen d/t a distended uterus.

Answer 54

premature delivery and increase rate of c/s

Question 55

How is the anterior fontanel described in an SGA infant?

Answer 55

increased in size with decreased membransous bone formation

Question 56

What are three important short term morbidities in an SGA infant?

Answer 56

Impaired thermoregulation, hypoglycemia, and NEC

Question 57

What does an LGA infant from an IDM mother have hypocalcemia?

Answer 57

the maternal diabetes causes immaturity of parathyroid function in the infant

Question 58

In cervical length measurements, what together has the highest risk of preterm labor?

Answer 58

Short cervix and funneling cervix

Question 59

What protein, if present in the secretions (found between the amnion and chorion) predicts preterm labor?

Answer 59

glycoprotein

Question 60

Dichorionic and diamniotic is what percent of all twin deliveries?

Answer 60

88%

Question 61

Normal twin growth parallels singletons until?

Answer 61

30weeks

Question 62

What is when the AFI is < 5cm (pockets) and the infant will most likely have respiratory problems?

Answer 62

Oligohygramnios (<500mls of AF)

Question 63

What is when the AFI is >25cm and you should think Esophageal TEF. >2000mls of AF

Answer 63

Polyhydramnios

Question 64

What is defined by "late preterm"

Answer 64

34-36 6/7 weeks

Question 65

What is the primary substrate for brain development?

Answer 65

glucose

Question 66

When does bilirubin peak?

Answer 66

5-7 DOL

Question 67

In the first 16weeks, there is a rapid increase in cell number (not size). This is? Insult at this stage calls for IUGR (symmetric)

Answer 67

Hyperplastic growth

Question 68

From 16-32 weeks, there is an increase in size and number of cells. this is? Insult at this stage calls for Asymmetric or symmetric growth

Answer 68

Hyperplastic and hypertrophic cell growth

Question 69

What does the Ponderal Index measure?

Answer 69

Weight and length (femur length)

Question 70

In an LGA infant, he will have Cardiomegaly which is..

Answer 70

Enlargement of walls of the heart but not the size of the chambers

Question 71

What occurs when IV glucose is administered straight into pancreatic circulation?

Answer 71

increase in insulin production, which causes a decease in serum glucose

Question 72

Infant is most likely to have type 2 diabetes later in life if (mom or Dad) has diabetes?

Answer 72

Dad

Question 73

When should you begin IV glucose immediately?

Answer 73

If infant is symptomatic with a serum <40mg/dL

Question 74

What are the common growth patterns for infants? 1st week: 6 months: 1 year:

Answer 74

1st week: regain BW 6 months: 2x BW 1 year: 3x BW

Question 75

Closure of the foramen ovale during transition | from fetal to neonatal life occurs due to

Answer 75

increase in left atrial pressure

Question 76

All of the following are indicative of perinatal asphyxia EXCEPT: a. Apgar scores of 0/1 minute, 1/5 minutes and 3/10 minutes b. Hypotonia c. Initial pH of 7.18 on an umbilical artery sample d. Oliguria with hematuria at 12 hours of life

Answer 76

c. Initial pH of 7.18 on an umbilical artery sample Must be below 7.00pH

Question 77

An SGA infant is at risk for... when compared to LGA or AGA

Answer 77

multiple congential anomalies

Question 78

How many calories should a term infant have each day?

Answer 78

110

Question 79

An SGA/LGA/ AGA infant will have

Answer 79

decreased vernix and immature labia

Question 80

The breakdown of amino acids and fats for glucose is called

Answer 80

gluconegensis

Question 81

How many ml/kg should a term infant have?

Answer 81

110-120

Question 82

After the initial screen for BG is low, what is the next step?

Answer 82

send off to lab

Question 83

What drug causes an infant to have a increase in neonatal glucose?

Answer 83

cortisol

Question 84

What is a normal vs after 30 minutes of life?

Answer 84

no bowel sounds

Question 85

When does the bilirubin peak in a term baby?

Answer 85

At 100hrs old