Neonatal ICU conditions: Clinical

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Neonatal ICU conditions: Clinical

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A 48-hour-old male neonate is under evaluation in the neonatal ICU for an episode of a seizure. Since starting breastfeeding, he has been irritable, has been feeding poorly, and has had several episodes of vomiting. He was born at 40 weeks gestation to a 35-year-old woman following an uncomplicated spontaneous vaginal delivery. Temperature is 36.4°C (97.5°F), pulse is 145/min, and respiratory rate is 34/min. Abdominal examination is unremarkable. Neurological examination reveals intermittent cycling movements in his lower extremities.   Laboratory evaluation reveals elevated serum levels of leucine, isoleucine, and valine. Supplementation of which of the following could be considered in the treatment of this patient? 


Preterm infants sometimes develop life-threatening complications that require immediate Neonatal ICU admission and management.

Some common issues that occur in a preterm infant include intraventricular hemorrhageretinopathy of prematurityapnea of prematuritybronchopulmonary dysplasia, persistent pulmonary hypertension of the newborn, respiratory distress syndromefeeding difficultiesgastroesophageal reflux diseasenecrotizing enterocolitisneonatal jaundice, and fetal growth restriction.

Now, prematurity is defined as a birth that occurs before 37 completed weeks of gestation.

The different degrees of prematurity can be defined by gestational age and birth weight.

The classification based upon gestational age is as follows: late preterm birth is when the gestational age is between 34 and less than 37 weeks; moderate preterm birth is between 32 and less than 34 weeks; very preterm birth is under 32 weeks; and extremely preterm birth - when the gestational age is below 28 weeks.

The birth weight classification is as follows: low birth weight is when the baby weighs less than 2500 grams, very low birth weight is under 1500 grams; and extremely low birth weight is when the baby weighs less than 1000 grams.

First, in intraventricular hemorrhage, bleeding in the germinal matrix occurs within the first day after birth.

The germinal matrix is located between the caudate nucleus and the thalamus, at the level of the foramen of Monro.

The etiology is multifactorial but it’s primarily attributed to vascular fragility and to disturbances in cerebral blood flow.


The neonatal intensive care unit (NICU) is a specialized unit within a hospital that provides care for newborn babies who are born prematurely or have serious health problems. In the NICU, newborns receive a variety of medical interventions and treatments to support their growth and development. Some of the conditions that may necessitate NICU include:

Intraventricular hemorrhage: a condition characterized by bleedings that occur in the germinal matrix within the first days after birth. Retinopathy of prematurity: conditions in which the blood vessels of the retina grow in an abnormal pattern, resulting in vision loss. Apnea of prematurity: a condition characterized by the presence of apneic spells in preterm infants apnea. Bronchopulmonary dysplasia: a condition characterized by scarring and abnormal development of the airways and lung tissue, which can lead to breathing problems and impaired blood oxygenation. Persistent pulmonary hypertension: a condition in which newborns' pulmonary vascular resistance doesn’t decrease as it should after birth, causing high blood pressure in pulmonary arteries. Respiratory distress syndrome: a condition that occurs when the lungs are not fully developed and have surfactant deficiency, which impairs effective alveolar-capillary gas exchange. Feeding difficulties: usually happen due to underdeveloped oral feeding skills or anatomical anomalies. Gastroesophageal reflux disease: a condition that occurs when the stomach contents flow back into the esophagus and irritates its mucosa. Neonatal necrotizing enterocolitis: an inflammatory disorder characterized by coagulation necrosis secondary to intestinal mucosal injury followed by bacterial invasion. Neonatal jaundice: a condition that occurs when there is an excess of bilirubin in the blood, becoming visible on the skin and the sclera as a yellowish discoloration.


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