B. Diseases Of Infancy And Childhood 2

Front 1

What are the 3 classes of infants born, based on gestational age?

Back 1

-Appropriate for GA (AGA)
-Small for GA (SGA)
-Large for GA (LGA)

Front 2

What is considered AGA?

Back 2

Birthweight between 10th and 90th percentiles

Front 3

What is considered pre-term birth?

Back 3

Birth before 37 weeks gestation

Front 4

What is considered post-term birth?

Back 4

Birth after 42 weeks gestation

Front 5

What makes up a large portion of perinatal mortalities?

Back 5

Infants that are SGA and/or preterm

Front 6

What are the top two causes of neonatal mortality?

Back 6

1. Congenital anomalies
2. Prematurity

Front 7

What is the typical weight of babies born before 37 weeks (preterm)?

Back 7

<2500 grams

Front 8

What are 4 major risk factors for Preterm Birth?

Back 8

1. PPROM
2. Intrauterine infection
3. Uterine/cervical/placental structural abnormalities
4. Multiple gestation

Front 9

What is the #1 identifiable cause of prematurity?

Back 9

PPROM

Front 10

What is PPROM?

Back 10

Preterm Premature rupture of placental membranes

Front 11

What are 3 risk factors for PPROM?

Back 11

-Maternal smoking
-Prior history of preterm delivery
-Vaginal bleeding at any time during said pregnancy

Front 12

What histologic morphologies are seen in intrauterine infections (2)?

Back 12

1. Chorioamnionitis
2. Funisitis (inflamm of the umbilical cord)

Front 13

What are the 5 most common organisms causing intrauterine infections?

Back 13

-Ureaplasma urealyticum
-Mycoplasma hominis
-Gardnerella vaginalis
-Trichomonas
-Gonorrhoeae/Chlamydia

Front 14

What is the pathologic mechanism of intrauterine infections causing preterm delivery?

Back 14

Release of cytokines and inflammation
-Collagenase/Elastase -> ROM
-Prostaglandins -> sm muscle

Front 15

What are most preterm infants in terms of size?

Back 15

AGA - they are small, but appropriate for age

Front 16

What is the predominant cause of SGA?

Back 16

Fetal growth restriction - FGR

Front 17

What are the 3 main groups of factors that cause FGR?

Back 17

1. Fetal
2. Placental
3. Maternal

Front 18

What are fetal factors that induce FGR?

Back 18

-Chromosomal disorders
-Congenital anomalies
-Congenital infections

Front 19

What are the most common congenital infections causing FGR?

Back 19

TORCH
-toxoplasmosis
-rubella
-CMV
-Herpes

Front 20

What is a main way to differentiate between fetal causes versus placental causes of FGR?

Back 20

Fetal = symmetric FGR

Placental = assymetric FGR

Front 21

What does symmetric FGR mean?

Back 21

All organ systems affected equally

Front 22

What is normally spared in assymetric FGR?

Back 22

the Brain

Front 23

When does most fetal GROWTH occur during gestation?

Back 23

3rd trimester

Front 24

What is very important to ensure such growth will be supported?

Back 24

Placental growth in the 2nd trimester

Front 25

What are the most COMMON factors associated with SGA?

Back 25

maternal

Front 26

What are the top 2 maternal causes of SGA caused by FGR?

Back 26

1. Preeclampsia (toxemia in pregnancy)
2. Chronic hypertension

Front 27

What is the other major obstacle of Preterm infants, beyond SGA?

Back 27

Immaturity of organ systems

Front 28

What 4 organ systems are mostly affected by premature birth?

Back 28

1. Lungs
2. Kidneys
3. Brain
4. Liver

Front 29

When is full alveolar development reached?

Back 29

Not until 8 yrs old

Front 30

What in the kidneys is not mature in a premature infant?

Back 30

Glomeruli

Front 31

What is the main effect of immature brain matter in the preterm infant?

Back 31

Poor homeostatic regulation

Front 32

What do almost all newborns and especially preemies exhibit as a result of liver lack of development?

Back 32

Physiologic jaundice

Front 33

What are the 2 causes of physiologic jaundice?

Back 33

-Breakdown of fetal red cells
-Inadequete biliary excretion by liver cells

Front 34

What is the clinical method of evaluating physiologic condition and infant responsiveness?

Back 34

Apgar score

Front 35

When is a newborn infant evaluated?

Back 35

Min1
Min5

Front 36

What is the best possible Apgar score?

Back 36

10

Front 37

What are the most common birth INJURIES that occur in hospitals?

Back 37

1. Clavicular fracture
2. Facial nerve injury
3. Brachial plexus injury
4. Intracranial injury
5. Humerus fracture
6. Lacerations

Front 38

What infants are at greater risk of birth injury?

Back 38

LGA

Front 39

What is the worst birth injury?

Back 39

Intracranial hemorrhage

Front 40

What is Caput succedaneum?

Back 40

Edema and fluid in the area of the head where it begins to enter the lower uterine canal.

Front 41

What is Cephalhematoma?

Back 41

When hemorrhage accompanies the caput succedaneum

Front 42

Are Caput succedaneum and Cephalhematoma common?

Back 42

YES - in even normal uncomplicated births.

Front 43

What are the 2 ways that fetal and perinatal infections are acquired?

Back 43

1. Transcervically (ascending)
2. Transplacentally (hematologic)

Front 44

What infections are mostly ascending?

Back 44

-bacterial
-Some viral

Front 45

What infections are mostly transplacental?

Back 45

-Parasitic
-Viral
-a few bacterial

Front 46

What is the most common cause of early onset infection (within the first week of life)?

Back 46

Group B strep

Front 47

What does Group B strep cause in the newborn?

Back 47

Neonatal Meningitis

Front 48

What are the 2 more common causes of late onset infections (after first week up to 3 months)?

Back 48

-Listeria
-Candida