Ipapburke Ped Test 1- Syst D/o

Front 1

Anything that goes wrong with a newborn should make you think of ____________.

Back 1

sepsis (3 things no matter how minor--> treat like sepsis)

Front 2

Risk factors for sepsis

Back 2

prematurity (6x greater), prolonged rupture of membrane (PROM), Maternal Group B Strep (GBS) colonization

Front 3

Etiology of sepsis in newborn

Back 3

GBS, E. coli, Listeria monocytogenes, Staphylococcus (usually late onset)

Front 4

Incidence of sepsis

Back 4

0.50%

Front 5

Clinical presentation of sepsis in babies 1-7 days old

Back 5

usually infant declines rapidly; fever, hypotonia, hypotension, resp. distress if pneumonia is present

Front 6

Clinical presentation of sepsis in babies over 7 days old

Back 6

usually more insidious onset, fever, poor feeding, lethargy, more likely associated with meningitis

Front 7

W/up when sepsis is suspected?

Back 7

CBC, BC times 2, UA, UC, and glucose; CXR if resp. sxs, consider lumbar puncture

Front 8

Tx for sepsis in newborn

Back 8

IV ampicillin and gentamycin after workup drawn and await culture results in 48 hours

Front 9

When do you consider adding Vancomycin for sepsis in newborn?

Back 9

if late onset and/or meningitis present

Front 10

If sepsis is confirmed by culture, how many days do you treat?

Back 10

14 days

Front 11

If meningitis is confirmed by culture, how many days do you treat?

Back 11

21 days

Front 12

MC cause of newborn sepsis

Back 12

GBS

Front 13

Herpes- more likely early or late onset sepsis?

Back 13

later onset

Front 14

Normal white count in baby

Back 14

18-30,000

Front 15

Normal H and H in baby

Back 15

Hematocrit close to 60

Front 16

What is "full eval" in GBS Positive mother?

Back 16

CBC, BC times 2, UA, UC, and glucose; CXR if resp. sxs, consider lumbar puncture

Front 17

What is "limted eval" in GBS Positive mother?

Back 17

CBC, BC X2

Front 18

MC pathway for sepsis

Back 18

respiratory distress

Front 19

Common causes of respirastaory distress in preterm infants

Back 19

sepsis/pneumonia; Respiratory Distress Syndrome (RDS), and apena of prematurity

Front 20

Common causes of respiratoty dstress in term infants

Back 20

sepsis/pneumonia; meconium aspiration syndrome, transent tachypnea of the newboen, primary persistant pulmonary hypertention (PPHN)

Front 21

Transient tachypnea of the newborn

Back 21

diagnosis of exclusion

Front 22

Result of Respiratory Distress Syndrome

Back 22

end expiration atelectasis

Front 23

CXR appearance with Respiratory Distress Syndrome

Back 23

bilateral "ground glass" appearance

Front 24

This condition is as a result of insufficient surfactant productinon by Type II pneumatocytes

Back 24

Respiratoy Distress Syndrome

Front 25

What do type II pneumotocytes make?

Back 25

surfactant

Front 26

Tx of respiratory distress syndrome.

Back 26

maternal steroids prior to deliver, intubation and resp. support, and artificail surfactant via ET tube

Front 27

When is insufficient surfactant production commonly seen?

Back 27

less than 34 weeks

Front 28

Complications of RDS?

Back 28

persistent patent ductus arterious; oxygen to

Front 29

What are the two types of oxygen toxicity in RDS?

Back 29

bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP)

Front 30

Two classes of causes of apnea

Back 30

central and peripheral

Front 31

What happens in central apnea?

Back 31

medulla and pons don't stimulate the phrenic nerve

Front 32

What happens in peripheral apnea?

Back 32

airway obstruction due to malformation or positioning

Front 33

Which is most common- central or peripheral apnea?

Back 33

central

Front 34

Tx for apnea of prematurity

Back 34

oxygen, stimulants (caffeine*** or theophylline), anemia correction

Front 35

How is caffeine given to babies?

Back 35

as they outgrow their dose, we see if they are able to breath on their own; if they don't breath, we up the dose after helping them to breath; eventually they outgrow it

Front 36

Chemical burns due to meconium predispose the baby to ___________ infections, most commonly Group b strep.

Back 36

bacterial (takes hold due to damaged tissue)

Front 37

What is seen on chest xray of MAS?

Back 37

coarse, irregular infiltrates

Front 38

Retained amniotic fluid causes mild hypoxia shortly after birth with resolution in 24 hours

Back 38

Transient Tachypnea of the Newborn

Front 39

What does CXR in TT of newborn show?

Back 39

fluid in fissures

Front 40

What infants are more likely tohave Transient Tachypnea of the Newborn?

Back 40

more common in C section, LGA infants

Front 41

Explain primary pulmonary hypertension as a cause of respiratory distress in term babies.

Back 41

hypoxia without evidence of structural cardiac or pulmonary disease usually as a result ot another process such as PFO, PDA