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20 Cards in this Set
- Front
- Back
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16. Factors associated w/↑d risk of early-onset GBS disease?!?
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1. Rupture of membranes more than 18 hours before delivery
2. Chorioamnionitis or intrapartum temp greater than 100.4 F (38 C) 3. Previous infant w/GBS infection 4. Mother younger than 20 5. Low birth weight or prematurity (<37 weeks’ gestation). |
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17. Major neurologic sequelae for infants who survive meningitis (occur in 10-30%)?
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a. Cortical blindness
b. Spasticity c. Global mental retardation. |
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18. Guidelines for reduction of GBS incidence?!?!?!
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a. Screening women at 35-37 weeks!
b. Offering intrapartum abx prophylaxis to those w/risk factors or positive GBS cultures at 35-37 weeks gestation. |
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19. Note: infants born at less than 35 wks GA or born to women who received inadequate intrapartum prophylaxis sometimes undergo a limited eval that often includes a CBC and blood culture.
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19. Note: infants born at less than 35 wks GA or born to women who received inadequate intrapartum prophylaxis sometimes undergo a limited eval that often includes a CBC and blood culture.
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20. Rx of suspected early-onset disease? Abx directed at the common pathogens listed above:
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a. Combination of:
1. IV aminoglycosides (gentamicin or tobramycin) 2. PCN (often ampicillin). |
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21. Rx of suspected late-onset disease? Abx directed at the common pathogens listed above:
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a. Combination of:
1. Β-lactamase-resistant abx (such as vanco) 2. 2nd or 3rd gen cephalosporin. |
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22. For how long are abx continued in tx of neonatal sepsis?
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a. For at least 48-72 hours.
b. If cultures are negative and pt is well, abx often are stopped. c. For infants presenting w/convincing s/s of sepsis, abx may be continued even w/negative cultures!!! |
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23. Tx duration for infants w/+ cultures?
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a. 10-21 days depending on organism and the infection site.
b. Close observation for signs of abx toxicity is important for all infants. |
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24. Note: the type of onset for neonatal conjunctivitis is important.
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24. Note: the type of onset for neonatal conjunctivitis is important.
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25. Neonatal conjunctivitis: Onset 6-12 hours after birth and is self-limited?
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a. Chemical conjunctivitis. Result of ocular silver nitrate or erythromycin prophylaxis irritation.
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26. Neonatal conjunctivitis: Onset 2-5 days after birth?
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a. Gonococcal conjunctivitis. It is the most serious of the bacterial infections!
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27. Tx of Gonococcal conjunctivitis?
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a. Prompt and aggressive topical tx and systemic abx can prevent serious complications such as corneal ulceration, perforation, and resulting blindness.
b. Parents are tx’d for gonococcal disease to prevent a child’s reinfection. |
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28. Neonatal conjunctivitis: Onset 5-14 days after birth?
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a. Chlamydia.
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29. Tx of Chlamydial conjunctivitis and risk?
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a. Systemic erythromycin (in part to reduce the infant’s risk of chlamydial pneumonia at 2-3 months of age).
b. The risks of oral erythromycin must be weighed against the increased risk of hypertrophic pyloric stenosis, a condition associated w/oral erythromycin use in children. c. Both parents are also treated |
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30. Transient tachypnea of the newborn?
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a. A respiratory condition resulting from incomplete evacuation of fetal lung fluid in full-term infants.
b. Occurs more commonly w/C-sections and usually disappears w/I 24-48 hours of life. c. Often no tx is indicated unless the infant requires low amounts of supplemental oxygen. d. Abx would be indicated if pneumonia was suspected. |
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31. Clinical feature pointing to Transient tachypnea of the newborn?
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a. These children usually do not have a vigorous suck.
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32. Listeria bacteria type?
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a. Gram-positive rod.
b. It can be isolated from soil, streams, sewage, certain foods, silage, dust, and slaughterhouses. |
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33. How does newborn acquire listeria?
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a. Transplacentally or by aspiration or ingestion at delivery.
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34. Mortality rate of early-onset disease for listeria?
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a. ~30%.
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35. complete
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35. complete
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