NEONATAL JEOPARDY

Sepsis

100

Empiric treatment for neonatal sepsis 

1. Ampicillin

2. Aminoglycoside

200

Name 4 signs of sepsis in a neonate

1.Temperature instability

2.Respiratory Distress

3.Tachycardia

4.Hypotonia

5.Seizures

6.Hypotension, acidosis

300

Two most common pathogens for early onset sepsis

1. GBS

2. E coli

400

Name 3 maternal risk factors for early onset sepsis

1. Rupture of membranes ≥ 18 hours

2. Maternal fever ≥ 38 degrees

3.Intraparum GBS colonization

4. GBS bacteriuria during pregnancy

500

Define adequate intrapartum prophylaxis 

Atleast one dose of IV Pen G ( 5 million units) or ampicillin (2g) given atleast 4 hours prior to birth

HIE

100

What is the target temperature for hypothermia ?

Therapeutic hypothermia should be continued for 72 hours, with a target rectal temperature of 33°C- 34°C for whole body cooling, or 34°C-35°C for selective head cooling

200

How long should hypothermia be continued?

Most centres cool infants for 72 hours and rewarm infants by 0.5°C every 1 to 2 hours over the course of 6-12 hours

300

Name 3 clinical signs of encephalopathy

1.Lethargy

2.Hypotonia

3. Weak/absent reflexes

4.Decerberate positioning

5.Bradycardia

6.Irregular breathing

400

Name 4 side effects of hypothermia

1. Bradycardia

2.Hypotension

3. Pulmonary HTN

4. Coagulopathy

5. Arrhythmias

6.Anemia, leukopenia

7.Hypoglycemia

500

What are the criteria for initiating cooling in a newborn?

A. Cord pH ≤7.0 or base deficit ≥−16, OR

B.
 pH 7.01- 7.15 or base deficit −10- −15.9 within 1 h AND

1. 
History of acute perinatal event (such as but not limited to cord prolapse, placental abruption or uterine rupture) AND
2. Apgar score ≤5 at 10 minutes or at least 10 minutes of 
positive-pressure ventilation 


C. Evidence of moderate-to-severe encephalopathy, demonstrated by the presence of seizures OR at least one clinical sign of moderate or severe encephalopathy.

Neuroprotection

100

These measures focus on optimizing care to minimize secondary brain injury and promote optimal brain development in neonates

What are neuroprotective measures?

200

The critical window for acute preterm brain injury

The first 72 hours after birth

300

Name 3 developmental care strategies to reduce risk of IVH

1.Skin to skin contact

2.Minimizing handling 

3. Neutral position with head midline

4.Elevate HOB 30 degrees

5.Safeguarding sleep

400

Target C02 to prevent IVH

45-55 mmHg

500

Name 2 antenatal measures to promote neuroprotection in the newborn

1. MgS04

2. Glucocorticoids

Post-prem life

100

The survival rate for infants born at this gestation age is 82%

25 weeks GA 

40% for 22 weeks GA

50% for 23 weeks GA

73% for 24 weeks GA

90% for 26 weeks GA

93% for 27 weeks GA

95% for 28 weeks GA

200

_____ is chronological age minus the number of weeks born before 40 weeks gestation

Corrected age 

300

Name 3 major neonatal morbidities associated with prematurity 

1.BPD

2.ROP

3.NEC

4.Metabolic bone disease of prematurity 

5.Neurological injury

400

Iron supplementation is needed to prevent or treat anemia of prematurity. What is the correct dose of iron supplementation ?

2 mg/kg/day to 3 mg/kg/day elemental iron for the first year of life

500

Name 3 neuro-developmental consequences infants born <28 weeks GA are at risk of developing

1. Cerebral palsy

2. Autism Spectrum Disorder

3.Cognitive impairment

4.Hearing impairment

5. Vision impairment