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CCPR STUDY WORKBOOK QUESTIONS QUESTIONS AND ANSWERS 2024
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CCPR STUDY WORKBOOK QUESTIONS QUESTIONS AND ANSWERS 2024
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CCPR STUDY WORKBOOK QUESTIONSList the major inclusion criteria for therapeutic hypothermia: - ANSWERS-1. GA>/=
36weeks or BW >2000g
2. Hx of acute perinatal event (placental abruption/cord prolapse, prolonged
decelerations)
3. cord pH<7, or base deficit >16 within 1 HOL
4. 10 min agars </=5
5. PPV for >10 min at birth
6. Evidence of moderate to severe encephalopathy: abnormal exam, abnormal
ECG (not required if exam abnormal)
How long does head cooling occur? how long does rewarming take? - ANSWERS-
cooling 72 hours, rewarm by 0.5C q2hrs to 36.5 (after 10-12 hours)
Management of temperature during cooling: - ANSWERS-begin cooling within 6
hours of age. Target temp 33.5, range 32.5-34.5. Monitor core temp q15min until
1 hr after goal temp reached. May monitor with esophageal temp probe.
Management of respiratory status with head cooling: - ANSWERS-ABG's should be
monitored at baseline, then 4, 8, 12, 24, 48, & 72 hr of treatment (also monitor
lactate)
,Fluid and electrolyte management (also renal/GI) during head cooling: -
ANSWERS-NPO, monitor glucose, lytes, ca, bun/creat, AST/ALT, at baseline, 24,
48, & 72hrs. May provide trophics. Provide TPN/Lipids, prevent cerebral edema by
keeping Na goal >140. Monitor coags daily
Neurologic monitoring during head cooling: - ANSWERS-full EEG monitoring, MRI
should be obtained post-treatment and again after 10-14 days
Mortality rate of perinatal asphyxia: - ANSWERS-20%
The risk of cerebral palsy is elevated ______ over the normal population in
perinatal asphyxia. - ANSWERS-5-10%
The presence of ______ increases the risk of CP 50-70fold. - ANSWERS-seizures
Low voltage EEG activity is an indicator of _____ outcomes. - ANSWERS-poor
Newborn brain's immaturity and how that influences clinical seizure presentation:
- ANSWERS-Clinical seizure patterns in the neonate reflects 'reduced connectivity'
in neonatal brain, with. prominence of focal ictal characteristics & rarity of
generalized pattens of clinical seizures. Balance of excitatory & inhibitory
processes in the immature brain one weighted towards excitation with an excess
of glutamatergic synapses over inhibitory synapses. System processes are
immature leading to altered drug handling. Immature brain is more susceptible to
developmental effects of anticonvulsants.
,Focal clonic seizures: - ANSWERS-unilaterally, sequentially in different limbs or
simultaneously but asynchronously. Rhythmic . Face, upper/lower limbs, trunk
involved.
Focal tonic seizures: - ANSWERS-sustained posture of single limb, tonic horizontal
eye deviation, asymmetric tonic truncal postures.
Myoclonic seizures: - ANSWERS-rapid movements, usually of flexion. Generalized
myoclonus of both upper limbs.
Autonomic seizures: - ANSWERS-events such as apnea with associated
tachycardia (rather than bradycardia, and/or pupillary dilation)
Role of EEG in diagnosing seizures: - ANSWERS-Continuous EEG (>3hrs) is the gold
standard of diagnosis, b/c many seizures are subclinical. Video analysis can be
helpful to R/O interventions as cause of waveform alteration
T/F: infants with pyridoxine deficiency require lifelong treatment - ANSWERS-true
Three drug therapies for neonatal seizures: - ANSWERS-Phenobarbital,
phenytoin/fosphenytoin, benzodiazepines
Three types of neural tube defects: - ANSWERS-1. Myelomeningocele
2. Encephalocele
, 3. Anencephaly
Overall frequency of neural tube defect is: - ANSWERS-1 in 2,000 live births
Etiologies for both primary and secondary neural tube defects are: - ANSWERS-
heterogenous
As a preventive measure it is recommended that pregnant women take: -
ANSWERS-folic acid
An increased risk of cognitive delay in neonates with neural tube defects is
associated with: - ANSWERS-1. high thoracic level lesions
2. severe hydrocephalus at birth
3. development of severe CNS infection
4. intracranial hypertension
5. seizures
Preoperative management of hydrocephalus in the neonate with neural tube
defects: - ANSWERS-Place infant prone, cover defect with sterile saline moistened
gauze. Cranial ultrasound should be obtained. May need to place shunt if fluid
pressure compromises integrity of skin.
Tortocollis is caused by a shortening of the: - ANSWERS-sternocleidomastoid
muscle
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