1 Maximizing Test Performance
Before Beginning Your Review
Reviewing Practice Questions
2 Respiratory Embryology and Physiology
Anatomy and Development of the Respiratory System
Physical Influences on Lung Growth
Functional Development of the Lung
Ventilation–Perfusion Relationships and Gas Exchange
Principles of Diffusion and Oxygen Delivery
3 Respiratory Distress Syndrome, Transient Tachypnea of the Newborn, and Bronchopulmonary Dysplasia
Respiratory Distress Syndrome
Transient Tachypnea of the Newborn
Bronchopulmonary Dysplasia
4 Aspiration, Pneumonia, and Persistent Pulmonary Hypertension
Aspiration Pneumonia (Excluding Meconium Aspiration)
Persistent Pulmonary Hypertension of the Newborn
5 Pleural Disorders and Additional Causes of Respiratory Distress
Extrapulmonary Lesions Causing Respiratory Distress
Airway Obstruction Causing Respiratory Distress
Miscellaneous Lesions Causing Respiratory Distress
Pleural Disorders Causing Respiratory Distress
6 Apnea of Prematurity and Neonatal Respiratory Depression
Disorders of Control of Breathing
7 Assisted Ventilation, ECMO, and Pharmacologic Agents
Respiratory Pharmacologic Agents
Extracorporeal Membrane Oxygenation
Normal Cardiac Morphogenesis
Regulators of Cardiac Embryology
Abnormal Cardiac Morphogenesis
Developmental Changes of the Myocyte and Contraction
Maternal Diseases With Fetal Cardiac Manifestations
9 Cardiovascular Physiology
Postnatal Transition of Circulation
Monitoring Cardiovascular Function in the Fetus
Hemodynamic Consequences of Perinatal Events
10 Presentation of Congenital Heart Disease
Evaluation of an Infant With Suspected Congenital Heart Disease
Medical Interventions in Infants With Cyanotic Heart Disease
Common Surgical Interventions in Cyanotic and Single-Ventricle Infants
Left-to-Right Shunting Lesions
Left-Sided Obstructive Lesions
Right-Sided Obstructive Lesions
Double-Outlet Right Ventricle
L-Transposition of the Great Arteries
Arterial Vascular Lesions
11 Cardiopulmonary Dysfunction
Neonatal Cardiomyopathies
Pericardial Effusion and Cardiac Tamponade
Systemic Blood Pressure Regulation
12 Electrocardiography, Electrophysiology, and Dysrhythmias
13 Pharmacologic Therapy of Heart Disease
Maternal Drugs in Pregnancy
SECTION 3 Neurology and Neurodevelopment
Abnormalities Suggesting Increased Intracranial Pressure
15 Development of the Nervous System
Embryologic Prosencephalon (Forebrain) Defects
Neonatal Neurotransmitter Effects
16 Neonatal Encephalopathy
Hypoxic Ischemic Encephalopathy
Metabolic Encephalopathies
17 Intracranial Hemorrhageand Vascular Injury
Intraventricular Hemorrhage
Intraparenchymal Cysts, Echodensities, Periventricular Leukomalacia
Perinatal Cerebral Infarction
18 Neonatal Neurology Cranial and Neurologic Trauma
Seizure Classes and Characteristics
20 Central Nervous System Infections
21 Neonatal Abstinence Syndromes and Substance Exposure In Utero
Abstinence Syndromes After Opiate, Benzodiazepine, Barbiturate, and Cocaine Exposure
Selective Serotonin Reuptake Inhibitors
22 Hypotonia and Other Aspects
Congenital Cerebral Neoplasms
23 Neurodevelopmental Impairments
Overview of Neurodevelopmental Impairment
Protective and Mitigating Factors for NDI in Prematurity
Clinical Conditions at High Risk for NDI
24 Causes and Effects of Environment on Neurodevelopmental Impairment
Nutrition and Neurodevelopment
Overview of Dietary Nutrients and Their Impact In Utero
Postnatal Nutrition and Impact on the Neonate
Non-Nutritional Maternal–Infant Factors
Potential Interventions to Improve Maternal–Infant Bonding and Neonatal Outcomes
Family Risk Factors for Neurodevelopmental Impairment
Early Intervention and Its Impact on Infant and Toddler Development
Other Developmental Influences
25 Clinical Features of Neurodevelopmental Impairment
Developmental Assessments
Transient Neurologic Abnormalities
Developmental Coordination Disorder
SECTION 4 Immunology and Infectious Diseases
26 Development of the Immune System
Development of Solid Organs of the Immune System
Development of the Cellular Immune System
27 Components of the Immune System
Cellular Components of the Immune System
Development of Humoral and Soluble Components of the Immune System
28 Abnormal Immune System Development
Newborn Susceptibility to Infection (Normal Immune System)
Primary Immunodeficiencies
29 Infections of Organ Systems
Central Nervous System Infections
Cutaneous and Soft Tissue Infections
Gastrointestinal Infections
Osteoarticular Infections
30 Causative Agents of Infections
Group B Streptococci (GBS; Streptococcus agalactiae)
Coagulase-Negative Staphylococci
Escherichia coli and Other Gram-Negative Bacilli
Syphilis (Treponema pallidum)
Genital Mycoplasma and Ureaplasma
Candida albicans and Non–albicans spp.
Human Parechovirus Infections
Human Immunodeficiency Virus
31 Prevention of Infections and Immunization
Prevention of Specific Bacterial Infection
Prevention of Specific Fungal Infection
Prevention of Specific Viral Infection
Prevention of Specific Parasitic Infection
Large- and Small-for-Gestational-Age Infants
33 Minerals, Vitamins, and Trace Minerals
Complications of Parenteral Nutrition
SECTION 6 Gastroenterology and Bilirubin
36 Gastrointestinal Development
Gallbladder and Biliary Tree
37 Gastrointestinal Anomalies
Syndromes Associated With Gastrointestinal Malformation
38 Acquired Disorders of Gastrointestinal Tract
Gastrointestinal Bleeding
Disorders of Protein Absorption
Disorders of Fat Absorption
Disorders of Electrolyte Absorption
Congenital Sodium Diarrhea
Disorders of Villous Architecture
39 Liver Disease, Abdominal Masses, and Ascites in the Newborn
Cholestasis of the Neonate
Congenital Malformations of the Liver and Bile Ducts
40 Bilirubin Biochemistry Metabolism and Measurement
Bilirubin Physiology, Pathways of Synthesis, Transport, and Metabolism in the Newborn
How to Use Predischarge Bilirubin Measurement to Predict Risk of Severe Hyperbilirubinemia
Acute Bilirubin Encephalopathy
42 Physiologic and Breast Milk Jaundice
SECTION 7 Maternal-Fetal Medicine
Maternal Adaptation to Pregnancy
44 Fetal Assessment and Treatment
Genetic Screening and Testing
Invasive/Diagnostic Genetic Testing
Evaluation of Fetal Status
Normal Labor and Delivery
Labor and Delivery Complications
SECTION 8 Resuscitation and Stabilization
46 Resuscitation, Stabilization, and Asphyxia
Hypoxic–Ischemic Brain Injury
Chronic Perinatal Asphyxia
Pharmacology and Drugs Used in Resuscitation
Principles of Palliative Care
SECTION 9 Genetics and Dysmorphism
Decoding the DNA Blueprint
Three Different Types of RNA Participate in Protein Synthesis
Several Enzymes Play an Important Role in the Transmission of Genetic Information
Epigenetic Gene Regulation
Uniparental Disomy and Disorders of Imprinting
Single-Gene Disorders and Mode of Inheritance
Structural Chromosomal Abnormalities That Contribute to Human Genetic Disease
Diseases Caused by Trinucleotide Repeat Expansion
Commonly Used Genetic Tests
Diagnostic Approach to the Infant With Suspected Genetic Disease
Newborn Screening for Genetic Disorders
48 Patterns of Congenital Disorders
Types of Chromosomal Abnormalities
Trisomy 21 (T21) “Down Syndrome”
Trisomy 18 (T18) “Edward Syndrome”
Trisomy 13 (T13) “Patau Syndrome”
Triploidy (69, XXX or 69, XXY)
Chromosome 1p36 Deletion Syndrome (1p36)
Wolf-Hirschhorn Syndrome (4p-)
Cri du Chat Syndrome (5p-)
22q.11.2 Deletion Syndrome (DiGeorge Syndrome)
Single Gene (Mendelian) Disorders
Non-Mendelian Inheritance
49 Nongenetic Etiologies for Congenital Defects
Teratogens (see Table 49.1)
50 Evaluation of Infants With Congenital Anomalies
Etiology of Congenital Anomalies
51 Inborn Errors of Metabolism
Metabolic Disorder Classification
SECTION 10 Water, Salt, Renal
52 Water/Electrolyte Metabolism and Acid–Base Balance
Disorders of Water Metabolism
53 Abnormal Renal Development
Prenatal Ultrasound of Kidneys/Bladder
Prenatal Diagnosis: Hydronephrosis
Prenatal Treatment of Suspected Bladder Outlet Obstruction With Oligohydramnios
Oligohydramnios Sequence (Potter Syndrome)
Posterior Urethral Valves
Multicystic Dysplastic Kidney
Autosomal Recessive Polycystic Kidney
Autosomal Dominant Polycystic Kidney Disease
Intermediate (second week)
SECTION 11 Endocrine, Metabolic, Thermal
54 Normal and Abnormal Sexual Differentiation
Normal Sexual Differentiation
Developmental Anomalies of the Penis, Urethra, and Testicles
Adrenal Hormone Physiology
Congenital Adrenal Hyperplasia
Thyroid Embryology and Physiology
Congenital Hypothyroidism
Physiology of Energy Metabolism
58 Calcium, Phosphorus, and Magnesium Metabolism
Osteopenia of Prematurity (Metabolic Bone Disease of Prematurity)
SECTION 12 Hematology and Oncology
Sites of Erythropoiesis in the Embryo, Fetus, and Neonate
Developmental Biology of Hemoglobin
Red Cell Indices During Development
Erythropoietin, Regulation of Erythropoiesis and Physiologic Anemia of Infancy
Rh Incompatibility and Alloimmune Hemolytic Disease of the Newborn
Newborn Screening for Hemoglobinopathies
Approach to the Anemic Infant
Blood Destruction (Hemolysis): Immune Mediated
Hemolysis Due to Intrinsic Red Cell Defects (Nonimmune-Mediated Hemolysis)
62 Platelets and Coagulation
Platelet Production and Regulation of Platelet Levels
Maternal Factors Associated With Neonatal Thrombocytopenia
Neonatal Alloimmune Thrombocytopenia
Neonatal Autoimmune Thrombocytopenia
Placental Factors Associated With Neonatal Thrombocytopenia
Neonatal Disorders Causing Thrombocytopenia
Inherited Coagulation Disorders
Acquired Coagulation Disorders
Disseminated Intravascular Coagulation
Neonatal Deep Vein Thrombosis
Neonatal Renal Vein Thrombosis
Neonatal Purpura Fulminans
63 Transfusion Therapy in Neonates
Transfusion Therapy in Neonates
Clinical Indications for Packed Red Blood Cells
Etiology and Treatment of Thrombocytopenia
Clinical Indications for Platelets
Clinical Indications for Fresh Frozen Plasma
Complications From Transfusions
64 Solid Tumors and Leukemias
Langerhans Cell Histiocytosis
SECTION 13 Head (Ears, Eyes, Nose, Throat), Neck, and Skin
65 Eye Development, Retinopathy of Prematurity
Normal Development and Anatomy
Vascular Development of the Retina
66 Ear Development and Anomalies
General Management Concepts for Hearing Loss
67 Nose, Mouth, and Throat Development and Anomalies
Branchial (Pharyngeal) Arches
External Nose and Nasal Cavities
Necrotizing Tracheobronchitis
68 Skin Development and Function
Papulosquamous Disorders in Neonates
Congenital Infections of the Newborn
Vascular Anomalies (Vascular Tumors and Vascular Malformations)
Disorders of the Umbilical Cord
Genetic Neonatal Syndromes
Epidermolytic Hyperkeratosis
SECTION 14 Surgical and Complex NICU Patient Management
70 Neonatal Surgical Management
General Pre- and Postoperative Management Tools/Checklist Tasks
Select Cardiac Surgical Intervention Considerations and Therapies
Surgical Intervention Considerations and Therapies for Select Pulmonary Pathologies
Surgical Intervention Considerations and Therapies for Select Gastrointestinal Pathologies
Surgical Intervention Considerations and Therapies for Select Neurologic Pathologies
Surgical Intervention Considerations and Therapies for Select Otolaryngology Pathologies
Surgical Intervention Considerations and Therapies for Select Urologic Pathologies
71 Complex Neonatal Patient Management
Extreme Prematurity < 25 Weeks’ Gestation
Congenital Diaphragmatic Hernia (CDH)
Vein of Galen Aneurysmal Malformation (VGAM)
Acute Kidney Injury (AKI) and Renal Failure
Congenital High Airway Obstruction Syndrome (CHAOS)
Transposition of the Great Arteries (TGA) With Intact Ventricular Septum (IVS)
SECTION 15 Basic Pharmacology Principles
72 Drug Disposition and Pharmacokinetics
Quantitative Pharmacokinetics
Approach to Drug Categorization and Clinical Context
74 Indications, Mechanisms, and Adverse Reactions for Common Drugs
Antiviral Drugs: Acyclovir
Central Nervous System Drugs
US Food and Drug Administration Approval
SECTION 16 Management of Neonatal Care Systems
75 Organization of Perinatal Care
Principles of Resource Organization, Utilization, and Management
Health Care Advocacy of the Mother–Fetal Dyad
Health Equity and Health Disparities
Transfer of Care and Transport Principles, Tools, and Communication Strategies
Principles of Public and Population Health
Recognizing and Addressing Psychological Trauma
Principles of Clinical Guideline Development and Evaluation
76 Ethical and Legal Issues in Neonatology
Ethical and Legal Principles (Limit of Viability, Futility, and Decision-Making)
Palliative Care Principles
Genetic Testing and Gene Therapy
Gene-Based Therapies and Treatments for Neonatal Conditions
SECTION 17 Scholarly Activities and Quality Improvement
77 Biostatistics in Research
Assessing and Comparing Risks
Assessing Diagnostic Tests
Systematic Reviews and Meta-Analysis
78 Epidemiology and Clinical Research Design
Sources of Error in Clinical Studies
Causation Versus Association
Incidence Versus Prevalence
79 Applying Research to Clinical Practice
Assessment of Study Design, Performance, and Analysis
Assessment of Generalizability
Application of Information for Patient Care
Using the Medical Literature
Concepts in Quality Improvement Science
Optimizing Healthcare Through Paired Goals
81 Principles of Teaching and Learning
Teaching Preparation and Planning
Conflicts of Interest and Commitment
Misconduct and Professionalism in Research
Definitions of Research With Human Subjects
Role and Responsibilities of an Institutional Review Board
Further Application of Research Ethics to Human Subjects
Consent, Assent, and Permission
Research in Vulnerable Populations
SECTION 18 Diagnostic Imaging
Germinal Matrix and Intraventricular Hemorrhage
Periventricular Leukomalacia (PVL)
Mineralizing Vasculopathy
Dandy-Walker Malformation (DWM) Spectrum
Bronchopulmonary Dysplasia (BPD)
Pulmonary Interstitial Emphysema
Transient Tachypnea of the Newborn (TTN)
Congenital Diaphragmatic Hernia (CDH)
Congenital Lobar Emphysema (CLE)
Congenital Pulmonary Airway Malformation (CPAM)
Pneumomediastinum and Pneumopericardium
Total Anomalous Pulmonary Venous Return (TAPVR)
Transposition of the Great Arteries (TGA)
Tetralogy of Fallot (TOF)
Necrotizing Enterocolitis
Esophageal Atresia With Fistula
Esophageal Atresia Without Fistula
Hypertrophic Pyloric Stenosis
Normal Thymus/Clavicle Fracture
Cystic Hygroma (Cystic or Nuchal Lymphangioma)
Urinary Tract Dilation—Posterior Urethral Valves (PUVs)
Vesicoureteral Reflux (VUR)
Multicystic Dysplastic Kidney (MCDK)