NICU Exam Questions with Correct Answers

NICU Exam Questions with Correct Answers Level 1 NICU - Answer-Normal Newborn Nursery Level 2 NICU - Answer-Special Care Nursery Level 3 NICU - Answer-Newborn Intensive Care: Respiratory, Neonatal Surgery, Special Diagnostics, Very Pre-term Infants Level 4 NICU - Answer-Newborn Intensive Care: Cardiac Surgery Diagnoses of Infants Admitted to NICU - Answer-Prematurity, Respiratory distress, Surgical (GI, cardiac, renal), Neurological problems, Congenital anomalies (trisomy 18, 21), Infection, Metabolic (low blood sugar) Very Preterm Infant - Answer-23-26 wks GA Moderately Preterm Infant - Answer-27-33 wks GA Late Preterm Infant - Answer-34-36 wks GA Normal Birth Weight - Answer-2500 g Low Birth Weight - Answer- g Very Low Birth Weight - Answer- g Extremely Low Birth Weight - Answer-1000 g Appropriate for Gestational Age - Answer-10-90th Percentile - size for dates Small for Gestational Age - Answer-10th percentile Large for Gestational Age - Answer-90th percentile Intrauterine Growth Restriction Issues - Answer-6.9 point IQ deficit at 7 y/o compared to normal birth weight. Pre-term infants with and without postnatal nutrition. 8 point deficit on one year MDI if 2 wks postnatal malnutrition. Common Diagnoses of the Preterm Infant - Answer-- Respiratory distress syndrome (due to lack of surfactant. - Chronic lung disease or bronchopulmonary dysplasia - Sepsis - necrotising enterocolitis - Retinopathy of prematurity - intraventricular hemorrhage Incidence of prematurity - Answer-in the US: 12% of infants are premature, 2% very preterm, 10% moderately preterm IVH Grade 1 - Answer-Isolated germinal matrix bleed IVH Grade 2 - Answer-Blood in the lateral ventricles IVH Grade 3 - Answer-IVH with acute ventricular dilation IVH Grade 4 - Answer-Hemorrhage into the periventricular white matter Incidence of major handicap for infants 1500 g with IVH - Answer-- No hemorrhage: 10% - Grade I or II: 12% - Grade III: 36% - Grade IV: 75% Periventricular Leukomalacia - Answer-Hypoxic-ischemic etiology. Periventricular echo densities are common on early ultrasound and are not prognostic. 2 mm cysts at 1 month are 95% predictive of CP if lesions extend from anterior to posterior. Spastic diplegia CP is most common. Problems associated with late pre-term infant - Answer-Respiratory distress, feeding difficulties, hyperbilirubinemia, sepsis, hypothermia, re-hospitalization. Increasing focus on higher incidence of difficulties at school-age. (34-36 wks GA. Account for majority of pre-term births.) Major Morbidity of Prematurity - Answer-Mental retardation, CP, blindness, severe hearing loss