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Year 3 Paediatrics > 18.1 Neonatology 2 > Flashcards

18.1 Neonatology 2 Flashcards

1
Q

What causes respiratory distress?

A

Sepsis
Transient Tachypnoea of the newborn
Meconium aspiration

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2
Q

What is grunting?

A

Breathing against a partially closed glottis causing back pressure

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3
Q

What are the signs of respiratory distress?

A

Grunting
Intercostal recession
Nasal flaring

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4
Q

What is transient tachypnoea of a newborn?

A

Self limiting and common, present in 1st few hours of life

Delay of clearance of fluid in the first few days of life

Clinically- grunting, tachypnoea, oxygen requirement, normal blood gases

On x-Ray- fluid in the horizontal fissure

More common in children with planned c section

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5
Q

What is the management of transient tachypnoea of the newborn?

A

Antibiotics and fluids (incase it’s actually sepsis)

Oxygen

Airway support

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6
Q

What is meconium aspiration?

A

Babies poo as they are stressed during delivery

They inhale this into their lungs

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7
Q

What are the risk factors for meconium aspiration?

A

Post dates

Maternal diabetes

Maternal hypertension

Difficult labour

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8
Q

What are the symptoms of meconium aspiration?

A

Cyanosis

Increased work of breathing

Grunting

Apnoea

Floppiness

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9
Q

What are the investigations for meconium aspiration?

A

Chest x Ray

Septic screen

Blood gas

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10
Q

What is the treatment of meconium aspiration?

A

Do suction, intubate and ventalate (if v unwell)

Fluids and antibiotics IV, need surfactant,

If you’re very ill they need inhaled nitrous oxide

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11
Q

How do you investigate a blue baby?

A

Sepsis screen

Blood gas and glucose

CXR, ECG, ECHO

Pulse oximetry

Hyperoxia Test- breathe 100% o2 for 10 mins. Does this improve blood gas? If not cardiac problem

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12
Q

How do you remember the major heart conditions?

A
  1. Truncus arteriosus- 1 big vessel
  2. TGA- 2 main vessels are switched
  3. Tricuspid atresia- tricuspid has 3 flaps
  4. Tetralogy of fallot- 4 abnormalities

5- TAPVD- 5 letters in this one

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13
Q

How do you manage hypoglycaemia of the newborn?

A

Admit to NNU and monitor

Start IV 10% glucose

Increase fluids

Increase glucose concentration (IV access)

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14
Q

What gives you hypoglycaemia in a new born?

A

Twins- twin to twin transfusion- smaller one doesn’t have glycogen

Macrosomnia- used to high glucose, then they don’t have it. Uh oh

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15
Q

How do you treat hypothermia?

A

Admit to NNU and incubate

Septic screen and antibiotics

Consider checking thyroid function

Monitor blood glucose

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16
Q

What do you do for severe jaundice in a baby?

A

Incubate and IV fluids

Phototherapy and rarely exchange transfusion

17
Q

What is brith asphyxia?

A

Lack of oxygen at birth leads to multi organ dysfunction

18
Q

What are the causes of birth asphyxia?

A

Placental problem

Long difficult delivery

Umbilical cord prolapse

Infection

Neonatal airway problem

Neonatal anaemia (rhesus negative)

19
Q

What are the two stages of hypoxic damage in birth asphyxia?

A

Stage 1- within minutes, cell damage due to lack of blood flow and O2

Stage 2- repercussion injury, can last days or weeks, toxins released form damaged cells

20
Q

What is hypoxic ischemic encephalopathy?

A

Damage to the baby due to birth asphyxia

Loss of reflexes

Clonus

21
Q

What is the management of hypoxic ischemiac encephalopathy

A

Rectal thermometer

Intubator- for morphine

Kept at 33-34 degrees then gradually rewarmed

Manage seizures, cardio and resp problems

Fluid restriction (cerebral oedema)

22
Q

What surgical problems should we know about

A

Oesophageal atresia

Duodenal atresia and other GI atresias (polyhydraminos)

Failure to pass stool

Abdo wall defects

Diaphragmatic hernia

23
Q

What are the causes of failure to pass stool (48 hours no poo)

A

Constipation

Large bowel atresia

Imperforate anus (+/- fistula)

Hirschprungs disease- not enough nerves is lower bowel

Meconium ileum (think CF)

24
Q

What are the common abdo wall defects they get

A

Exophalemous hernia?- hernia into umbilical cord (multiple defects)

Gastrochesis- abdo wall doesn’t close property (isolated)

25
Q

What are the complications of abdo wall defects?

A

Heat loss

Need fluid

26
Q

Discuss a diaphragmatic hernia?

How is it treated?

A

Usually occurs on left

Bowel (or abdo organs) move through diaphragm causes lung problems

Need intubated, surgery,

27
Q

What is neonatal abstinence syndrome

A

Withdrawl from maternal addictive substances

Usually opioids, benzodiazepines, cocaine, amphetamine

28
Q

How do you treat neonatal abstinence sydrome?

A

Monitor/ diagnosis

Finnegan score

Urine toxicology

Give Morphine or Phenobarbitone

Discharge planning

Babies may have BBV or other diseases

Year 3 Paediatrics (42 decks)

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