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Year 3 Paediatrics > 18. Neonatology > Flashcards

18. Neonatology Flashcards

1
Q

What are some terms for small for date babies?

A

Small for gestational age (SGA)
Inter uterine growth restrictive
Hypotrophy

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2
Q

How do you define IUGR?

A

IUGR <10th centile

Severe IUGR<0.4th centile

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3
Q

What causes a baby to be small for dates?

A

Maternal drug use e.g. smoking
Maternal pre-eclamptic toxemia (pet)
Chromosomal abnormalities e.g. edwards syndrome
Foetal infection e.g congenital cytomegalovirus
Placental abruption
Twins

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4
Q

What Complications do small fro date babies have?

A 
Perinatal problems
Hpoglycaemia
Hypothermia
Polycythaemia
Thrombocytopenia
Hypoglycamia
GI problems
RDS, infection
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5
Q

What long term problems do small for date babies have?

A

Hypertension
Reduced growth
Obesity
Ischaemic heart disease

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6
Q

What are the different classes of preterm babies?

A

Late preterm- 34-37 weeks
Very preterm<32 weeks
Extremely preterm<28 weeks of pregnancy

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7
Q

How can weight help class a premature baby?

A

low B/w- 2500g
very low B/w- <1500g
Extremely low birth weight<1000g

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8
Q

What is infant respiratory distress syndrome and how is it treated?

A

Respiratory distress syndrome, caused by reduced surfactant at birth

Treated with antenatal steroids to prevent and surfactant is given to the child.

They are given non invasive support (N-CPAP)

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9
Q

What is bronchiopulmonary dysplasia and how is it treated?

A

Overstretched lungs due to volubaro- trauma
Infection
O2 toxicity
Inflammatory changes

Treated with time, nutrition and growth and steroids

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10
Q

What are common minor respiratory problems children get?

How are they treated?

A

Apnoea/irregular breathing/desaturations

Treated with caffeine

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11
Q

What is intraventricular haemorrhage and how is it treated?

A

most common limiting factor in preterm babies
prevented with antenatal steroids
Symptoms are treated and the head drained

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12
Q

Describe the physiology of a patent ductus arteriousus

A

change in pressure from aorta to pulmonary artery. Causes a left to right shunt
This causes over perfusion of he lungs and lung oedema

This can lead o low renal perfusion and GI ischaemia

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13
Q

How do you treat patent ductus arteiosus?

A

Time
NSAIDS
Surgical closure
Catheter procedures

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14
Q

How do you treat someone with necrotising entero-colitis

A 
ischaemic and inflammatory changes
Necrosis of the bowel
Surgical intervention is often required
Conservative management is sometimes possible
Antibiotics and parental nutrition
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15
Q

explain why nutrition is a major aspect of neontal care

A

Enormous requirements
Patients often triple in size during hospital stay
Building new tissues

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16
Q

What are the commonest reasons for term admissions

A 
Sepsis- very common!
Respiratory- very common!
Neonatal abstinence syndrome- common 
Low sugar, low temp, Jaundice
Birth asphyxia 
Cardiology
17
Q

What are risk factors for sepsis in neonates?

A

prolonged rupture of membranes (prom)

Maternal pyrexia

Maternal GBS carriage

18
Q

What are the symptoms of sepsis in neonates?

A 
Baby pyrexia or hypothermia
Poor feeding
Lethargy or irritable
Early jaundice 
Floppy
Hypo or hyperglycaemia 
Tachypnoea- good sign
19
Q

What is the commonest cause of early onset sepsis (85%)

A

Group B strep- most common

E.coli- makes up remainder of 85%

(Less common listeria, co-ag neg staph, haem. Influenzae)

20
Q

How do you manage presumed sepsis in a neonate?

A

Admit to NNU

Septic screen- FBC, CRP, Blood cultures, blood gas

CXR,LP

IV fluids and treat acidosis

Monitor vital signs closely

21
Q

What antibiotics should you take for suspected sepsis?

A

IV penicillin and gentamicin first line

2nd line vancomycin and gentamicin

If abdo concerns add in metronidazole

22
Q

Discuss the pathological process of group B strep?

A

Early onset 48 hours- 1 week

Late onset/recurrence after 3 months

Crashingly septic within 12 hours

DIC, resp collapse, pneumonia, hypotension,shock

23
Q

What are the common congenital infections?

A

TORCH!

Toxoplasmosis
Rubella
Cytomegalovirus (CMV)-deafness (give antivirals)
Herpes

24
Q

What do congenital infections result in?

A 
IUGR
Brain calcification
Neurofevelopmental delay
Visual impairment
Recurrent infection
25
Q

Discuss the symptoms of children with Torch?

A 
Hydrocephalus
Cataracts
Hepatomegaly, jaundice, hepatitis, splenatomegaly
Anemia, neutropenia, thrombocytopenia
Rash
Deafness (CMV)
Small head
26
Q

What is blueberry muffin baby?

A

Blood forming cells set up in skin. If they have this rash then they probably have cancer or TORCH

Year 3 Paediatrics (42 decks)

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