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Avery’s Neonatology Board Review, 2nd Edition

Certification and Clinical Refresher

ISBN: 9780443106385
ISBN: 9780443106385
Διαστάσεις 28 × 22 cm



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Certification and Clinical Refresher

Διαθεσιμότητα: 11-14 ημέρες


Ace your neonatology board exams and prepare for clinical practice with Avery’s Neonatology Board Review: Certification and Clinical Refresher, 2nd Edition. This up-to-date review tool follows the exam blueprint, is based on the trusted content found in Avery’s Diseases of the Newborn, and has been carefully tailored for effective exam review by renowned neonatologist and educator, Patricia Batchelor Chess, MD. Concise, relevant information is presented in a way that’s easy to study and remember, giving you an important advantage on this challenging exam, as well as in the daily, fast-changing practice of neonatology.
New to this edition
    • Based on new core content outline from neonatology board
  • Expanded question bank
  • Expanded content on pulmonary mechanisms and on diversity/equity
Key Features

The most up-to-date, thorough, and effective board review book for neonatology . . .

  • Equips residents, fellows, and attending physicians with an efficient, comprehensive system for study, designed specifically to optimize performance on the board exam.
  • Presents information in a high-yield, outline format highlighted by key points, graphs, tables, images, and algorithms.
  • Includes expanded content on pulmonary mechanisms and on diversity and equity, reflecting the newly revised board exam core content outline.
  • Contains more than 450 board-style questions and answers, both in print and interactively online, related to each chapter.
  • Features board-style vignettes with full, discursive answers online.
  • Written by experts in the field of Neonatal-Perinatal Medicine and supporting subspecialists, representing a wealth of trusted insight and guidance.
  • An eBook version is included with purchase. The eBook allows you to access all of the text, figures, and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud. Additional digital ancillary content may publish up to 6 weeks following the publication date.


Cover image
Title page
1 Maximizing Test Performance
Before Beginning Your Review
The Review Itself
Reviewing Practice Questions
More Advice
Section 1 Respiratory
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
Suggested Readings
3 Respiratory Distress Syndrome, Transient Tachypnea of the Newborn, and Bronchopulmonary Dysplasia
Respiratory Distress Syndrome
Transient Tachypnea of the Newborn
Bronchopulmonary Dysplasia
Suggested Readings
4 Aspiration, Pneumonia, and Persistent Pulmonary Hypertension
Meconium Aspiration
Aspiration Pneumonia (Excluding Meconium Aspiration)
Neonatal Pneumonia
Persistent Pulmonary Hypertension of the Newborn
Suggested Readings
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
Suggested Readings
6 Apnea of Prematurity and Neonatal Respiratory Depression
Disorders of Control of Breathing
Suggested Readings
7 Assisted Ventilation, ECMO, and Pharmacologic Agents
Assisted Ventilation
Respiratory Pharmacologic Agents
Extracorporeal Membrane Oxygenation
Suggested Readings
SECTION 2 Cardiovascular
8 Cardiac Development
Normal Cardiac Morphogenesis
Regulators of Cardiac Embryology
Abnormal Cardiac Morphogenesis
Developmental Changes of the Myocyte and Contraction
Maternal Diseases With Fetal Cardiac Manifestations
Suggested Readings
9 Cardiovascular Physiology
Fetal Circulation
Postnatal Transition of Circulation
Monitoring Cardiovascular Function in the Fetus
Hemodynamic Consequences of Perinatal Events
Suggested Readings
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
Mixing Lesions
Double-Outlet Right Ventricle
L-Transposition of the Great Arteries
Arterial Vascular Lesions
Suggested Readings
11 Cardiopulmonary Dysfunction
Neonatal Cardiomyopathies
Cardiac Tumors
Pericardial Effusion and Cardiac Tamponade
Systemic Blood Pressure Regulation
Suggested Readings
12 Electrocardiography, Electrophysiology, and Dysrhythmias
Suggested Readings
13 Pharmacologic Therapy of Heart Disease
Maternal Drugs in Pregnancy
Suggested Readings
SECTION 3 Neurology and Neurodevelopment
14 Neurologic Evaluation
Physical Examination
Mental Status
Cranial Nerves
Primitive Reflexes
Motor Tone and Strength
Deep Tendon Reflexes
Abnormalities Suggesting Increased Intracranial Pressure
Suggested Readings
15 Development of the Nervous System
Neural Tube Defects
Embryologic Prosencephalon (Forebrain) Defects
Neonatal Neurotransmitter Effects
Suggested Readings
16 Neonatal Encephalopathy
Neonatal Encephalopathy
Hypoxic Ischemic Encephalopathy
Metabolic Encephalopathies
Suggested Reading
17 Intracranial Hemorrhageand Vascular Injury
Subdural Hemorrhage
Subarachnoid Hemorrhage
Epidural Hematoma
Intraventricular Hemorrhage
Intraparenchymal Cysts, Echodensities, Periventricular Leukomalacia
Cerebellar Hemorrhage
Prenatal Vascular Injury
Perinatal Cerebral Infarction
Suggested Readings
18 Neonatal Neurology Cranial and Neurologic Trauma
Caput Succedaneum
Subgaleal Hemorrhage
Skull Fractures
Spinal Cord Injuries
Brachial Plexus Injury
Facial Nerve Injury
Phrenic Nerve Injury
Laryngeal Nerve Injury
Suggested Readings
19 Neonatal Seizures
Seizure Classes and Characteristics
Suggested Reading
20 Central Nervous System Infections
Bacterial Meningitis
Other Pathogens
Suggested Readings
21 Neonatal Abstinence Syndromes and Substance Exposure In Utero
Abstinence Syndromes After Opiate, Benzodiazepine, Barbiturate, and Cocaine Exposure
Selective Serotonin Reuptake Inhibitors
Suggested Readings
22 Hypotonia and Other Aspects
Hypotonia and Weakness
Vascular Malformations
Congenital Cerebral Neoplasms
Neurocutaneous Disorders
Suggested Readings
23 Neurodevelopmental Impairments
Overview of Neurodevelopmental Impairment
Demographics of NDI
Risk Factors for NDI
Protective and Mitigating Factors for NDI in Prematurity
Clinical Conditions at High Risk for NDI
Suggested Readings
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
Suggested Readings
25 Clinical Features of Neurodevelopmental Impairment
Developmental Assessments
Transient Neurologic Abnormalities
Developmental Coordination Disorder
Cerebral Palsy
Quality of Life
Suggested Readings
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
Suggested Readings
27 Components of the Immune System
Cellular Components of the Immune System
Development of Humoral and Soluble Components of the Immune System
Suggested Readings
28 Abnormal Immune System Development
Newborn Susceptibility to Infection (Normal Immune System)
Primary Immunodeficiencies
Suggested Readings
29 Infections of Organ Systems
Central Nervous System Infections
Cutaneous and Soft Tissue Infections
Gastrointestinal Infections
Genitourinary Infections
Ocular Infections
Otitis Media
Osteoarticular Infections
Suggested Readings
30 Causative Agents of Infections
Group B Streptococci (GBS; Streptococcus agalactiae)
Staphylococcus aureus
Coagulase-Negative Staphylococci
Listeria monocytogenes
Escherichia coli and Other Gram-Negative Bacilli
Syphilis (Treponema pallidum)
Chlamydia trachomatis
Genital Mycoplasma and Ureaplasma
Anaerobic Bacteria
Candida albicans and Non–albicans spp.
Other Fungal Infections
Herpes Simplex Virus
Varicella-Zoster Virus
Human Parvovirus B19
Human Parechovirus Infections
Rubella Virus
Human Immunodeficiency Virus
Hepatitis B Virus
Hepatitis C Virus
Zika Virus
Suggested Readings
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
Suggested Readings
SECTION 5 Nutrition
32 Nutrition and Growth
The Fetus
Newborn Infants
Large- and Small-for-Gestational-Age Infants
Suggested Readings
33 Minerals, Vitamins, and Trace Minerals
Trace Minerals
Suggested Readings
34 Enteral Nutrition
Human Milk
Suggested Readings
35 Parenteral Nutrition
Complications of Parenteral Nutrition
Suggested Readings
SECTION 6 Gastroenterology and Bilirubin
36 Gastrointestinal Development
Gallbladder and Biliary Tree
Suggested Readings
37 Gastrointestinal Anomalies
Salivary Glands
Small Intestine
Large Intestine
Rectum and Anus
Meconium Syndromes
Abdominal Wall Defects
Syndromes Associated With Gastrointestinal Malformation
Suggested Readings
38 Acquired Disorders of Gastrointestinal Tract
Gastrointestinal Bleeding
Malabsorption Syndromes
Transport Defects
Disorders of Protein Absorption
Disorders of Fat Absorption
Disorders of Electrolyte Absorption
Congenital Sodium Diarrhea
Disorders of Villous Architecture
Suggested Readings
39 Liver Disease, Abdominal Masses, and Ascites in the Newborn
Cholestasis of the Neonate
Congenital Malformations of the Liver and Bile Ducts
Abdominal Masses
Suggested Readings
40 Bilirubin Biochemistry Metabolism and Measurement
Bilirubin Biochemistry
Bilirubin Physiology, Pathways of Synthesis, Transport, and Metabolism in the Newborn
How to Use Predischarge Bilirubin Measurement to Predict Risk of Severe Hyperbilirubinemia
Suggested Readings
41 Bilirubin Toxicity
Acute Bilirubin Encephalopathy
Suggested Readings
42 Physiologic and Breast Milk Jaundice
Breastfeeding Jaundice
Breast Milk Jaundice
Suggested Readings
SECTION 7 Maternal-Fetal Medicine
43 Pregnancy
Maternal Adaptation to Pregnancy
Prenatal Care
Pregnancy Complications
Suggested Readings
44 Fetal Assessment and Treatment
Genetic Screening and Testing
Invasive/Diagnostic Genetic Testing
Specific Genetic Testing
Ultrasound Screening
Evaluation of Fetal Status
Fetal Therapy
Suggested Readings
45 Labor and Delivery
Normal Labor and Delivery
Labor and Delivery Complications
Suggested Readings
SECTION 8 Resuscitation and Stabilization
46 Resuscitation, Stabilization, and Asphyxia
Perinatal Asphyxia
Acute Perinatal Asphyxia
Hypoxic–Ischemic Brain Injury
Chronic Perinatal Asphyxia
Laryngeal Mask Airway
Endotracheal Intubation
Chest Compressions
Volume Resuscitation
Pharmacology and Drugs Used in Resuscitation
Principles of Palliative Care
Suggested Readings
SECTION 9 Genetics and Dysmorphism
47 Molecular Genetics
Basics of Human Genetics
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
Suggested Readings
48 Patterns of Congenital Disorders
Chromosomal Disorders
Types of Chromosomal Abnormalities
Trisomy 21 (T21) “Down Syndrome”
Trisomy 18 (T18) “Edward Syndrome”
Trisomy 13 (T13) “Patau Syndrome”
Turner Syndrome (45,X)
Triploidy (69, XXX or 69, XXY)
Deletion Syndromes
Chromosome 1p36 Deletion Syndrome (1p36)
Wolf-Hirschhorn Syndrome (4p-)
Cri du Chat Syndrome (5p-)
Microdeletion Syndromes
22q.11.2 Deletion Syndrome (DiGeorge Syndrome)
Single Gene (Mendelian) Disorders
Fragile X Syndrome
Mitochondrial Disorders
Non-Mendelian Inheritance
Multifactorial Disorders
Suggested Readings
49 Nongenetic Etiologies for Congenital Defects
Teratogens (see Table 49.1)
Suggested Readings
50 Evaluation of Infants With Congenital Anomalies
Etiology of Congenital Anomalies
Suggested Readings
51 Inborn Errors of Metabolism
Metabolic Tests
Metabolic Disorder Classification
Suggested Readings
SECTION 10 Water, Salt, Renal
52 Water/Electrolyte Metabolism and Acid–Base Balance
Water Metabolism
Disorders of Water Metabolism
Suggested Readings
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
Eagle-Barrett Syndrome
Renal Agenesis
Renal Dysplasia
Multicystic Dysplastic Kidney
Autosomal Recessive Polycystic Kidney
Autosomal Dominant Polycystic Kidney Disease
Renal Artery Thrombosis
Renal Vein Thrombosis
Hydrops Fetalis
Placental Edema
Acute Kidney Injury
Early (first week)
Intermediate (second week)
Late (after second week)
Suggested Readings
SECTION 11 Endocrine, Metabolic, Thermal
54 Normal and Abnormal Sexual Differentiation
Normal Sexual Differentiation
Ambiguous Genitalia
Other DSDs
Developmental Anomalies of the Penis, Urethra, and Testicles
Suggested Readings
55 Adrenal Disorders
Adrenal Hormone Physiology
Congenital Adrenal Hyperplasia
Suggested Readings
56 Thyroid Disorders
Thyroid Embryology and Physiology
Congenital Hypothyroidism
Neonatal Hyperthyroidism
Suggested Readings
57 Glucose Metabolism
Physiology of Energy Metabolism
Suggested Readings
58 Calcium, Phosphorus, and Magnesium Metabolism
Bone Mineral Metabolism
Neonatal Hypercalcemia
Neonatal Hypocalcemia
Osteopenia of Prematurity (Metabolic Bone Disease of Prematurity)
Suggested Readings
59 Thermoregulation
Suggested Readings
SECTION 12 Hematology and Oncology
60 Erythrocytes
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
Anemia of Prematurity
Red Blood Cell Antigens
ABO Incompatibility
Rh Incompatibility and Alloimmune Hemolytic Disease of the Newborn
The Hemoglobinopathies
Newborn Screening for Hemoglobinopathies
Approach to the Anemic Infant
Blood Loss (Hemorrhage)
Blood Destruction (Hemolysis): Immune Mediated
Hemolysis Due to Intrinsic Red Cell Defects (Nonimmune-Mediated Hemolysis)
RBC Hypoproduction
Suggested Readings
61 White Blood Cells
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
The Coagulation System
Inherited Coagulation Disorders
Von Willebrand Disease
Acquired Coagulation Disorders
Disseminated Intravascular Coagulation
Neonatal Deep Vein Thrombosis
Neonatal Renal Vein Thrombosis
Neonatal Purpura Fulminans
Suggested Readings
63 Transfusion Therapy in Neonates
Transfusion Therapy in Neonates
Packed Red Blood Cells
Clinical Indications for Packed Red Blood Cells
Etiology and Treatment of Thrombocytopenia
Clinical Indications for Platelets
Fresh Frozen Plasma
Clinical Indications for Fresh Frozen Plasma
Rare Blood Products
Complications From Transfusions
Suggested Readings
64 Solid Tumors and Leukemias
Congenital Leukemia
Langerhans Cell Histiocytosis
Neonatal Teratoma
Wilms Tumor
Suggested Readings
SECTION 13 Head (Ears, Eyes, Nose, Throat), Neck, and Skin
65 Eye Development, Retinopathy of Prematurity
Normal Development and Anatomy
Congenital Abnormalities
Acquired Abnormalities
Vascular Development of the Retina
Suggested Readings
66 Ear Development and Anomalies
Outer Ear
Middle and Inner Ear
General Management Concepts for Hearing Loss
67 Nose, Mouth, and Throat Development and Anomalies
Branchial (Pharyngeal) Arches
External Nose and Nasal Cavities
Mouth and Palate
Neonatal Airway
Necrotizing Tracheobronchitis
Suggested Readings
68 Skin Development and Function
Suggested Readings
69 Neonatal Skin Lesions
Newborn Dermatoses
Papulosquamous Disorders in Neonates
Congenital Infections of the Newborn
Vascular Anomalies (Vascular Tumors and Vascular Malformations)
Aplasia Cutis Congenita
Disorders of the Umbilical Cord
Pigmented Lesions
Infectious Disease
Genetic Neonatal Syndromes
Epidermolytic Hyperkeratosis
Suggested Readings
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
Suggested Readings
71 Complex Neonatal Patient Management
Perinatal Counseling
Extreme Prematurity < 25 Weeks’ Gestation
Congenital Diaphragmatic Hernia (CDH)
Vein of Galen Aneurysmal Malformation (VGAM)
Severe Anemia
Acute Kidney Injury (AKI) and Renal Failure
Hydrops Fetalis
Congenital High Airway Obstruction Syndrome (CHAOS)
Complete Heart Block
Transposition of the Great Arteries (TGA) With Intact Ventricular Septum (IVS)
Suggested Readings
SECTION 15 Basic Pharmacology Principles
72 Drug Disposition and Pharmacokinetics
Drug Disposition
Quantitative Pharmacokinetics
Suggested Readings
73 Clinical Toxicology
Approach to Drug Categorization and Clinical Context
Drugs in Pregnancy
Drugs in Lactation
Suggested Readings
74 Indications, Mechanisms, and Adverse Reactions for Common Drugs
Antibacterial Drugs
Antifungal Drugs
Antiviral Drugs: Acyclovir
Cardiovascular Drugs
Central Nervous System Drugs
US Food and Drug Administration Approval
Suggested Readings
SECTION 16 Management of Neonatal Care Systems
75 Organization of Perinatal Care
Principles of Resource Organization, Utilization, and Management
Principles of Leadership
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
Suggested Readings
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
Suggested Readings
SECTION 17 Scholarly Activities and Quality Improvement
77 Biostatistics in Research
Understanding Variables
Distribution of Data
Hypothesis Testing
Statistical Tests
Assessing and Comparing Risks
Measuring Correlation
Regression Analysis
Survival Analysis
Diagnostic Tests
Assessing Diagnostic Tests
Systematic Reviews and Meta-Analysis
Suggested Readings
78 Epidemiology and Clinical Research Design
Study Types
Sources of Error in Clinical Studies
Causation Versus Association
Incidence Versus Prevalence
Decision Analysis
Cost Analyses
Sensitivity Analysis
Qualities of Measurement
Suggested Readings
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
Suggested Readings
80 Quality Improvement
Concepts in Quality Improvement Science
Summary of Approaches
Optimizing Healthcare Through Paired Goals
Project Design
Project Implementation
Data Analysis
Suggested Readings
81 Principles of Teaching and Learning
Educational Theory
Teaching Preparation and Planning
Suggested Readings
82 Ethics in Research
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
Research in Children
Suggested Readings
SECTION 18 Diagnostic Imaging
83 Neurologic Imaging
Germinal Matrix and Intraventricular Hemorrhage
Periventricular Leukomalacia (PVL)
Hypoxia and Ischemia
Mineralizing Vasculopathy
Cavum Velum Interpositum
Chiari II Malformation
Dandy-Walker Malformation (DWM) Spectrum
Choanal Atresia
Suggested Reading
84 Chest Imaging
Surfactant Deficiency
Bronchopulmonary Dysplasia (BPD)
Pulmonary Interstitial Emphysema
Transient Tachypnea of the Newborn (TTN)
Meconium Aspiration
Congenital Diaphragmatic Hernia (CDH)
Congenital Lobar Emphysema (CLE)
Congenital Pulmonary Airway Malformation (CPAM)
Pleural Effusion
Tension Pneumothorax
Pneumomediastinum and Pneumopericardium
Total Anomalous Pulmonary Venous Return (TAPVR)
Transposition of the Great Arteries (TGA)
Tetralogy of Fallot (TOF)
Suggested Reading
85 Abdominal Imaging
Necrotizing Enterocolitis
Biliary Atresia
Hirschsprung Disease
Esophageal Atresia With Fistula
Esophageal Atresia Without Fistula
Duodenal Atresia
Hypertrophic Pyloric Stenosis
Suggested Reading
86 Miscellaneous Imaging
Normal Thymus/Clavicle Fracture
Cystic Hygroma (Cystic or Nuchal Lymphangioma)
Thanatophoric Deformity
Urinary Tract Dilation—Posterior Urethral Valves (PUVs)
Vesicoureteral Reflux (VUR)
Multicystic Dysplastic Kidney (MCDK)
Suggested Reading
Questions Section
Answers Section