19.1 Neonatology 4

Question 1

You have a neonate that is unwell. What should you never forget?

Answer 1

Sepsis

Start antibiotics within the hours

Question 2

What are the causes of respiratory rate being over 60?

Answer 2

Mild- transient, transient tachypnoea of the newborn

Severe- Sepsis, meconium aspiration

Question 3

What should you consider (not first though) in a newborn baby

Answer 3

Heart defect

Question 4

What does birth asphyxia lead to?

How is it treated?

Answer 4

Hypoxic ischaemic encephalopathy

Early management and cooling improves outcomes

Question 5

What is involved in the newborn check?

Answer 5

Baby MOT after 72 hours of life

Question 6

What common pathologies do you look for on the skin?

Answer 6

Colour- jaundice, pallor, cyanosis

Rashes

Birthmarks

Question 7

If a baby looks red what should you do?

Answer 7

Check heamatocrit and red blood cells

Looks for polycythemia

Causes low blood sugars

Question 8

What are normal O2 sats for a newborn?

Answer 8

60 and above

Question 9

Discuss physiological jaundice

Answer 9

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

Question 10

What test looks for haemolytic jaundice caused by incompatible blood between mum and baby?

Answer 10

Coombs Test

Question 11

Why does a cephalhaematoma cause jaundice?

Answer 11

Due to head trauma during deceivery. Need more heamolysis leading to jaundice

Question 12

What are the causes of prolonged jaundice?

Answer 12

Breast milk
Hypothyroidism
Pyloric stenosis
Cholestasis- biliary atresia (needs sorted in first 6 days of life)

Question 13

What should you look for in conjugated jaundice?

Answer 13

BILIARY ATRESIA!

Question 14

How do you treat jaundice?

Answer 14

Treat underlying cause?

Hydrate

Phototherapy

Exchange transfusion

Immunoglobulin

Question 15

Describe erythema toxicum?

Answer 15

Most common neonate rash

Red, maculopapular rash (red background, small raised bits)

Comes and goes in different places

Benign

Question 16

What is Mongolian blue spots?

Answer 16

Blue- grey pigmentations

Often lower back and buttocks

Accumulation of excess melanocytes

Benign

Question 17

Discuss a stork mark?

Answer 17

Naevus simplex

Capillary vascular malformation

Pale, pink rash, salmon patches

Gradually fade in 1-2 years

Question 18

Discuss port wine stain?

What condition may it be associated with

Answer 18

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

Question 19

What is a strawberry naevus?

Answer 19

Capillary heamonfioma

Red raised mark. Looks like a strawberry

Benign and spontaneously regress

Only intervene if on eyelids

Question 20

What is the energy triangle?

Answer 20

Very very key!

Keep babies pink war, and sweet

Hypothermia, hypoxia and hypoglycaemia very closely linked in children

Question 21

What are the body feathers of Down syndrome?

Answer 21

Low set ears ….

Question 22

What are some other complications of Down syndrome?

Answer 22

Hypotonia

Cardiac defects

Learning problems

Heamatological problems

Thyroid problems

Question 23

How do you test for downs?

Answer 23

Central hold test

Single palm crease

Genetic testing