19.1 Neonatology 4 Flashcards
You have a neonate that is unwell. What should you never forget?
Sepsis
Start antibiotics within the hours
What are the causes of respiratory rate being over 60?
Mild- transient, transient tachypnoea of the newborn
Severe- Sepsis, meconium aspiration
What should you consider (not first though) in a newborn baby
Heart defect
What does birth asphyxia lead to?
How is it treated?
Hypoxic ischaemic encephalopathy
Early management and cooling improves outcomes
What is involved in the newborn check?
Baby MOT after 72 hours of life
What common pathologies do you look for on the skin?
Colour- jaundice, pallor, cyanosis
Rashes
Birthmarks
If a baby looks red what should you do?
Check heamatocrit and red blood cells
Looks for polycythemia
Causes low blood sugars
What are normal O2 sats for a newborn?
60 and above
Discuss physiological jaundice
Comes on around day 3 resolves by day 7
Caused by increased heamolysis and unconjugated bilirubin due to immature pathways
This can lead to kernicticas, damage to the brain due to high bilirubin
What test looks for haemolytic jaundice caused by incompatible blood between mum and baby?
Coombs Test
Why does a cephalhaematoma cause jaundice?
Due to head trauma during deceivery. Need more heamolysis leading to jaundice
What are the causes of prolonged jaundice?
Breast milk
Hypothyroidism
Pyloric stenosis
Cholestasis- biliary atresia (needs sorted in first 6 days of life)
What should you look for in conjugated jaundice?
BILIARY ATRESIA!
How do you treat jaundice?
Treat underlying cause?
Hydrate
Phototherapy
Exchange transfusion
Immunoglobulin
Describe erythema toxicum?
Most common neonate rash
Red, maculopapular rash (red background, small raised bits)
Comes and goes in different places
Benign
What is Mongolian blue spots?
Blue- grey pigmentations
Often lower back and buttocks
Accumulation of excess melanocytes
Benign
Discuss a stork mark?
Naevus simplex
Capillary vascular malformation
Pale, pink rash, salmon patches
Gradually fade in 1-2 years
Discuss port wine stain?
What condition may it be associated with
Naevus flammeus (capillary vascular malformation)
Dilated capillaries, do not regress. Bright purple/pink spots
Normal benign
May be associated with surge Weber syndrome if found in V1 distribution
What is a strawberry naevus?
Capillary heamonfioma
Red raised mark. Looks like a strawberry
Benign and spontaneously regress
Only intervene if on eyelids
What is the energy triangle?
Very very key!
Keep babies pink war, and sweet
Hypothermia, hypoxia and hypoglycaemia very closely linked in children
What are the body feathers of Down syndrome?
Low set ears ….
What are some other complications of Down syndrome?
Hypotonia
Cardiac defects
Learning problems
Heamatological problems
Thyroid problems
How do you test for downs?
Central hold test
Single palm crease
Genetic testing
