Ipapburke Ped Test 1- Hypoglycemia/anemia/jaundice

Front 1

Definition of low blood sugar

Back 1

blood glucose less than 45 mg/dL with smptoms

Front 2

MC causes of hypoglycemia in newborn

Back 2

diabetic mothers, IUGR, sepsis

Front 3

Clinical presentation of hypoglycemia

Back 3

lethargy, poor feeding, hypotonia, jitteriness, seizures

Front 4

Tx for hypoglycemia in infants with BS 20-40 and no sxs

Back 4

oral feeds and monitor with repeat testing

Front 5

Tx for hypoglycemia in infants with BS 20-40 and symptoms or BS less than 20

Back 5

Bolus 10W at 2 cc/kg then 6 mg/kg/min; treat undelrying cause if possible

Front 6

MC cause of neonatal seixures

Back 6

hypoglycemia

Front 7

Common reversible causes of neonatal seizures

Back 7

hypooglycemia, hypocalcemia, sepsis/encephalitis, kernicterus, and drug withdrawal

Front 8

Common irreversibel causes of neonatal seizures

Back 8

metabolic syndromes, familial seizures, ischemia

Front 9

Clinical presentation of neonatal seizures

Back 9

seizure often subtle and hard to diagnose; look for rhythmicity and patterns, EEGs to diagnose

Front 10

What labs do you need to draw with acute seizure?

Back 10

CBC, Chem &, Ca

Front 11

2 causes of neonatal anemia

Back 11

hemolytic disease of newborn and blood loss

Front 12

MC cause of hemolytic disease of the newborn

Back 12

ABO incompatibility

Front 13

3 causes of hemolytic disease of the newborn

Back 13

ABO incompatibility; Rh incompatibility, and other antigen Rh C, E, Kell, Duffy

Front 14

What are the causes of birth related blood loss?

Back 14

maternal-fetal hemorrhage, placenta previa, and cord rupture/ early cord clamping

Front 15

How is iatrogenic blood loss caused in neonates?

Back 15

repeat labs on NICU patients

Front 16

Level of bilirubin in all newborns.

Back 16

elevated

Front 17

Jaundice

Back 17

staining of skin due to breakdown of bili- doesn't really matter that the color is different, but that it leads to an undelrying process

Front 18

Kernicterus

Back 18

staining of brain similar to jaundice---> causes mental retardation

Front 19

Reasoons why babies have elevated bilirubin

Back 19

increased RBC mass and turnover, insufficient hepatic clearance, decreased gut motility and excretion

Front 20

Types of bilirubin

Back 20

pathologic (unconjugated and conjugated) and physiologic (breastfeeding jaundice and breast milk jaundice)

Front 21

Why do babies get breastfeeding jaundice?

Back 21

they may not get real food for 5-7 days so they will not poop a lot and then develop jaundice

Front 22

Why do babies get breast milk jaundice?

Back 22

After the milk supply is being produced, in some moms there is a free fatty acid that blocks the conjugation of bili in breastfeeding kids--> not really high enough to cause kernicterus

Front 23

Unconjugated pathologic jaundice is caused by what two means?

Back 23

hemolyis usually due to Abo/Rh isoimmunization OR insufficient conjugation

Front 24

Rare profound jaundice as a result of insufficent conjugation

Back 24

Crigler-Najjar

Front 25

very common syndrome where molecule doesn't work quite fast enough to cause suffiicent conjugation--> usually not serious, runs in family

Back 25

Gilbert's syndrome

Front 26

Coonjugated jaundice is a result of what?

Back 26

obstruction distal to liver

Front 27

Factors that make jaundice more likely to be pathologic (kernicterus causing)

Back 27

peak level over 15 mg/dl (kernicterus doesn't start here, but we want to prevent it)--> age dependent- if premie, may be as low as 7; nomogram rate of rise greater than 5 mg/dl per day; and onset within 24 hrs of life

Front 28

Look for jaundice here

Back 28

under tongue, sclera, scalp, then progresses head to toe(jaundice at belly button is at least 12)

Front 29

Coomb's test

Back 29

looking for maternal antibodies in blood

Front 30

Peripheral smear purpose

Back 30

look for broken RBCs

Front 31

What groups do you do G6PD test in?

Back 31

African, Asian, and Med. Male

Front 32

Tx for jaundice

Back 32

improve/increase feeding (do not stop breastfeeding); phototherapy; exchange transfusion

Front 33

Severe gut dysfunction due to feeding a premature GI tract

Back 33

necrotizing enterocolitis (ischemia not infectious)

Front 34

Classic radiograph findings in necrotizing enterocolitis

Back 34

pneumonia intestibalis (gas between the subserosal and muscularis layer of the small bowel wall) plus free air or ileus

Front 35

Tx for necrotizing enterocolitis

Back 35

stop feedings (start TPN), NG decompression, broad spectrum Abx, surgical excision in 50%

Front 36

Classic presentation in necrotizing enterocolitis

Back 36

feeding intolerable, abd. Distention, and rectal bleeding in premie (severe- DIC and shock)