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48 Cards in this Set
- Front
- Back
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Apgar score
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Test: Heart Rate
Respiration Muscle tone reflex color -good if score is above 7 |
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Erthema toxicum neonatorum
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benign rash seen in the first 72 hrs of life
erythematous macules, papules, pustules on the trunk and extremities (not on soles or palms) - Lesions are filled with eosinophils -no treatment is required |
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Hemangiomas
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-benigne proliferative vascualar tumors
- most will resolve within 18 months |
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What causes an absent red reflex?
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cataracts
glaucoma retinoblastoma chorioretinitis |
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For cartio exam:
Diminished femoral pulse Increased femoral pulse |
1. coarctation of the aorta
2. patent ductus arteriosus |
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When is an infant considered "premature" and postterm
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if born less then 37 weeks
if born after 42 weeks |
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Is cycanosis considered an emergency in the neonate?
What is the treatment |
hell yes
-good to give oxygen and might need bag mask ventilation |
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What cause RDS?
How can you test for it? |
caused my the lack of surfactant in preterm infants
-surfactant is made at 30-32 weeks -to test for lung maturity: an aminocentiesis a lecithin-to-sphingomyelin ratio > 2:1 and phosphatidylglycerol |
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Clinical features of RDS
- how is it evaluated/diagnosed |
-respiratory distress
-tachypnea -retractions - expiratory grunting Dx: by CXR shows diffuse atelectasis with an increase density in both lungs and ground glasss appearance |
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How do you manage RDS
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supplemental O2
positive airway pressure Mechanical ventilation exogenous surfactant |
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Persistent Pulmonary Hypertension of the Newborn (PPHN)
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any condition ass with low blood flow to the lungs after birth
cause: perinatal asphyxia and meconium aspiration syndrome |
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Persistent Pulmonary Hypertension of the Newborn (PPHN)
- pathophysiology -treatment |
increased pulmonary vascular resistance results in significant right to left shunting through the foramen ovale or ductus arteriosus with hypoxemia
Tx: oxygen, nitric oxide |
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Meconium Aspiration Syndrome
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Meconium that is passed as a consequence of fetal distress
History: of meconium noted at or before delivery and the presence of respiratory distress and CXR |
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Apnea of Prematurity
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- is a respiratory pause without airflow lasting more than 15-20 seconds or respiratory pause with bradycardia and cyanosis
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DDx of Indirecrt hyerperbilrubinemia
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Physiologic: decreases enzyme
hymolysis inborn errors of metablolism Crigler Najjar Gilberts disease Breast milk (after first week of life) Breat feeding (first week) |
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T or F Indirect hyperbilirubinemia is pathologic in the newborn??
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NOOO only DIRECT IS PATHOLOGIC
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Jaudice should be evaluated when..
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1. appears < 24hrs of age
2. bilirubin rises > 5-8 in 24hrs 3. |
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Cause of direct Hyperbili
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biliary atresia
Sepsis neonatal hepatitis CF metabolic |
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Complications of indirect bilirubinima
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Kernicterus:
may pass though the BBB and go to the basal ganglia -choreoathetoid cerebral palsy, hearing loss, opisthotonus |
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Omphalocele
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in centraly abdomen
-abdominal organs are covered with a peritoneal sac -ass. with congenital anomalies |
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Gastroschisis
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- is a congenital fissue of the ant abd wall located in the right paraumbilical area (not in the midline)
- no peritoneal sac covering |
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Diaphragmatic Hernia
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abnormalitis in the development of the diaphragm that allows herniation of abd contents into the thorax
-mostly seen on left diaphram |
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Clinical features of Diaphragmatic Hernia
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-history of polyhydramnios
-scaphoid abdomen (with abd contents in thorax) -respiratory insufficiency from pulmonary hypoplasia -breath sounds are decreased |
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Diaphragmatic Hernia
-managment |
must NEVER us bag mask ventilation
must intubation with 100% O2 |
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Meconium ileus on x-ray
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intestinal distension w/ minimal air fluid levesl
Air remains trapped in the meconium gas bubbles may be sen in meconium producing a soap-bubble appearance |
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Necrotizing enterocolitis
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transluminal and mucosal necrosis in premature infants
clinical features: feeding intolerance with bilious aspirates and abdominal distention, extream abd tenderness with discolorations, occult blood tx: stop all foods by mouth must be NPO with NG tube |
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Pneumatosis intestinalis
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results from bacterial gas production in the bowel wall and can be detected by abd radiography and is hallmark for NEC
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What infants are at risk for polycythemia
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infants of diabetic mothers, SGA, hyperthyroidism, adrenogenital syndrome, trisomies (13,18,21), beckwith Wiedemann
Features: ruddy, plethoric. poor feeding, lethargy, hyperbilirubin Tx: partical exchange |
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Apnea of prematurity
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def as cessation of breathing for longer than 20 sec or shorter pause ass. with cyanosis, pallor, hypotonia.
- Central: complete cessation of air flow and respiratory efforts with no chest wall movement - Obstructive: respiratory effort and chest wall movement with no air |
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Clinical features of Apnea of prematurity
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ass with bradycardia (< 80) and cyanosis, pallor, hypotonia
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Failure of the kidneys to develop can lead to what?
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Oligohydramnios- decrese fluid in the amniotic cavity
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Congenital Toxo
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due to ingestion of oocyte from infected cat
features: Microcephaly hydrocephalus intracrinal calcicications, chorioretinits seizures |
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Congenital Rubella
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rare due to vaccination
menigoencephalitis microcephaly cataracts hearing loss CHD (patent ductus arteriosus) |
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Congential CMV
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newborn disese is ass with primary maternal infection with 50%
Infection occurs in 1% of pregnancys with recurrent or reactivated infection Clinical features **intrauterine growth retardation petechia and purpura jaundice hepatosplenomegaly microcephly chorioretinits intracranial calcifications |
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Low AFP means what?
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trisomies 21 and 18
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Cocaine use during preg
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causes maternal hypertension and constricion of placental circulation
withdrawl: irritability, tremulous, poor feeding, increase learing difficulites |
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A term 5 lb 2 day old infant has irritability nasal stuffiness and coarse tremor. He is feeding poorly and has diarrhea
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think cocain or heroin withdrawl
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What are some of the complicaiton of infants with mother that are diabetics
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macrosomia
hypglcemia polycythemia RDS malforations |
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Caput Succedaneum
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Area of edema over the presenting portion of the scalp during a vertex delivery
ass with bruising and petechiae can cross suture lines |
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Cephalohematoma
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caused by bleeding that occurs below the periosteum of the overlying bone
-ass with skull fractures in -Contained within the periosteum: does not cross suture lines |
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Klumpkes Palsy
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lower arm and affects the seventh and eight cervical and first thoraci
hand is paralyzed and has an absent grasp "claw hand" deformity often with a horners syndrome |
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Erbs Palsy
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upper arm and is the most common type
Involves the fifth and sixth cervical roots and the arm is adducted and internally rotated but grasp is intact |
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Group B strep
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vertical transmission
Early onset (< one week) sepsis, pneumonia, menigits, PPHN Late 1wk to 3 months bacteremia, menigitis, bulging gontannels Tx: ampicillin and gentamicin |
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Herpex Simplex and neonates
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risk of infection is higher with primary maternal infections
1. Cutaneous: involves the skin, mouth, and eyes vesicular eruptions appear 7-10 days 2. Encephalitic occurs 3rd week of life cc: lethergy, irritabilt, poor suck, seizure cutaneous lesions gone 3. Disseminated Sepsis: panea hypotonia hyptonsion Dx: cell culture or PCR Tx: acyclovir |
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3 week old infant present with a paroxysmal cough, tachypnea but no fever. Bilateral diffuse crackes, hyperinflation and pachy infiltrates had conguctivitis 10 days ago
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chlamydia trachomatis
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Chlamydia and the newborn
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acquired though pass of the birth canal
causes conjuctivitis (few days to several days) pneumonia Tx: erythromycin |
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Congenital Syphilis
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intermittent fever
ostitis manculopaular rash on palms and soles hepatosphlenomegaly late: saddle nose deformity, frontal bossing, hutchison teeth, mulberry molars. painless joint effusions DxL RPR and FTA Tx: Penicillin |
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What are some clinical signs of HIV?
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peristent trush
lymphadenopathy hepatosplenmealy |
