ABP Neonatal-Perinatal Medicine flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

First-trimester CRL dating

Crown-rump length measurement before 14 weeks estimates gestational age within 5–7 days, making it the most accurate dating method; later ultrasounds have greater error.

Antenatal corticosteroids

Betamethasone or dexamethasone given to mothers at 24–34 weeks' gestation who are at risk of preterm delivery reduces neonatal respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and mortality.

Magnesium sulfate neuroprotection

Administered to mothers before preterm birth at less than 32 weeks, magnesium sulfate reduces the risk of cerebral palsy in the offspring; a common regimen is a 4 g load followed by 1 g/hour.

Fetal anemia Doppler

Middle cerebral artery peak systolic velocity greater than 1.5 multiples of the median suggests fetal anemia, often from Rh alloimmunization; it guides the need for cordocentesis or intrauterine transfusion.

Positive pressure ventilation

For a newborn with apnea, gasping, or heart rate below 100 beats per minute, start positive pressure ventilation; use 21% oxygen for term infants and 21–30% for preterm infants, titrating to target saturation.

Chest compressions ratio

Begin chest compressions when the heart rate remains below 60 beats per minute after 60 seconds of effective ventilation; use a 3:1 compression-to-ventilation ratio, giving 90 compressions and 30 breaths per minute.

Epinephrine in resuscitation

For persistent neonatal bradycardia despite effective ventilation and compressions, give epinephrine 0.01–0.03 mg/kg intravenously or 0.05–0.1 mg/kg endotracheally, repeating every 3–5 minutes.

Therapeutic hypothermia

Infants at 36 weeks or more with moderate-to-severe hypoxic-ischemic encephalopathy receive cooling to 33.5°C for 72 hours, started within 6 hours of birth, to reduce death and neurodevelopmental disability.

Respiratory distress syndrome

Surfactant deficiency in premature infants causes grunting, retractions, tachypnea, and ground-glass lungs with air bronchograms; treatment includes early surfactant replacement and respiratory support.

Transient tachypnea newborn

A self-limited condition in term or near-term infants characterized by tachypnea, perihilar streaking, and fluid in fissures; it usually resolves within 24–72 hours with supportive care.

Inhaled nitric oxide

Inhaled nitric oxide at 20 ppm is used for persistent pulmonary hypertension of the newborn when the oxygenation index exceeds 20–25; improvement in oxygenation often occurs within 30–60 minutes.

Bronchopulmonary dysplasia

Chronic lung disease defined by need for oxygen or respiratory support at 36 weeks' postmenstrual age in preterm infants; prevention includes avoiding volutrauma and using caffeine.

Congenital heart disease screening

Pulse oximetry screening at 24–48 hours measures oxygen saturation in the right hand and either foot; a saturation below 90% or a difference greater than 3% is a failed screen.

Prostaglandin E1 infusion

Prostaglandin E1 at 0.01–0.05 mcg/kg/min keeps the ductus arteriosus open in ductal-dependent congenital heart lesions; apnea is an important adverse effect requiring monitoring.

Supraventricular tachycardia

A narrow-complex tachycardia with a heart rate above 220 beats per minute in newborns; initial management includes vagal maneuvers and adenosine 0.1 mg/kg intravenous push.

Intraventricular hemorrhage grading

Papile grading: grade I is germinal matrix hemorrhage, grade II is intraventricular blood without dilation, grade III includes ventricular dilation, and grade IV is parenchymal hemorrhage.

Neonatal seizures treatment

Phenobarbital 20 mg/kg intravenous loading is first-line for neonatal seizures, with additional 10 mg/kg doses if needed; levetiracetam is an alternative.

Hypoxic-ischemic encephalopathy

A clinical syndrome after perinatal asphyxia with altered tone, reflexes, and consciousness; Sarnat staging guides prognosis, and therapeutic hypothermia is standard for moderate-to-severe cases.

Total parenteral nutrition

In preterm infants, start amino acids at 2–3 g/kg/day and advance to 3.5–4 g/kg/day; start lipids at 1 g/kg/day and advance to 3 g/kg/day.

Necrotizing enterocolitis

A serious intestinal disease in preterm infants with feeding intolerance, abdominal distension, and bloody stools; management includes stopping feeds, nasogastric decompression, and antibiotics.

Neonatal fluid requirement

Term newborns typically need 60–80 mL/kg/day of fluid initially, while preterm infants may need 80–100 mL/kg/day, advancing by 10–20 mL/kg/day with monitoring of weight and electrolytes.

Early-onset sepsis

Sepsis within 72 hours of birth, commonly from group B Streptococcus or Escherichia coli; empiric treatment is ampicillin plus gentamicin after blood cultures.

Group B Streptococcus prophylaxis

Intrapartum penicillin G is given to carriers or women with risk factors; alternatives include ampicillin, cefazolin, or clindamycin based on susceptibility, and vancomycin for severe allergy.

Neonatal herpes simplex

Disseminated or central nervous system herpes simplex virus infection is treated with high-dose intravenous acyclovir 60 mg/kg/day divided every 8 hours for 21 days.

Physiologic anemia

Hemoglobin nadir occurs at 8–12 weeks in term infants and 4–8 weeks in preterm infants; it results from decreased erythropoietin and shortened red cell survival.

Vitamin K prophylaxis

All newborns receive vitamin K 1 mg intramuscularly at birth to prevent vitamin K deficiency bleeding, including intracranial hemorrhage.

Congenital hypothyroidism

Newborn screening shows elevated thyroid-stimulating hormone and low thyroxine; treatment with levothyroxine 10–15 mcg/kg/day should start promptly to prevent intellectual disability.

Trisomy 21 features

Hypotonia, flat facial profile, upslanting palpebral fissures, single palmar crease, and increased risk of atrioventricular septal defect and duodenal atresia.

22q11 deletion syndrome

Also called DiGeorge syndrome; features include conotruncal heart defects, hypocalcemia from hypoparathyroidism, thymic hypoplasia, and cleft palate.

Newborn screening timing

Heel-stick blood spot screening is ideally collected between 24 and 48 hours of age, after feeding has begun, to detect metabolic, endocrine, and hematologic disorders.

Root cause analysis

A systematic review after a serious safety event that identifies contributing system factors rather than individual blame, aiming to prevent recurrence through changes in processes and policies.

PDSA cycle

Plan-Do-Study-Act is a quality improvement method that tests small changes, measures results, and refines interventions before broader implementation.