43. Neonatal Presentations Flashcards
What is meconium aspiration, how does it present and what is its DDx?
Meconium passes in utero = MSUF = airway obstruction, surfactant dysfunction, pulmonary vasoconstriction, infection, chem pneumonitis
S+S = Rapid or laboured breathing, chest wall recessions, grunting sounds, cyanosis, low apgar score (color, heartbeat, reflexes, muscle tone, respiration), limp body
DDx = Congenital Heart Disease with Pulmonary Hypertension, Sepsis, Surfactant Deficiency,
What is HDoN, how does it present and what is its DDx?
Rh-ve mother with Rh+ve baby, possible anti-D IgG Ab = subsequent preg these cross placenta = Rh haemolytic disease
S+S = jaundice, yellow vernix, CCF (oedema, ascites), hepatosplenomegaly progressive anaemia, bleeding, kernicterus (bilirubin brain damage)
DDx = thalassaemia, infection (CMV, toxoplasmosis), maternal DM
What is hypoxic-ischaemic encephalopathy, how does it present and what is its DDx?
Clinical syndrome of brain injury sec to hypoxic-ischaemic insult (cord prolapse, placental abruption, maternal hypoxia, inadequate postnatal cardio-pulmonary circulation)
S+S = resp depression (resus, IPPV), floppy, seizures, feeding probs, significant hypotonia, diminished deep tendon reflexes
DDx = Disorders of pyruvate metabolism, urea cycle defects, Zellweger syndrome, mitochondrial disorders
What is biliary atresia, how does it present and what is its DDx?
Biliary tree occlusion by being abnormally narrow, blocked, or absent at around 3w
S+S = jaundice, yellow urine, pale stools, splenomegaly
DDx = cholestasis, idiopathic neonatal hepatitis, neonatal hemochromatosis, toxoplasmosis, viral infections
What is sticky eye, how does it present and what is its DDx?
Commonly from a blocked tear duct (can be born with), infection
S+S = white or yellow discharge in the corner of the eye
DDx = ophthalmia neonatorum, chlamydia (swab)
What is are birth marks, how do they present and what a DDx?
Areas of discoloured and/or raised skin - pigment cells or blood vessels
VASCULAR = Infantile haemangiomas(rapid growth), capillary malformation (port-wine stain - red-pink stain on face/neck), nevus flammeus (forehead/eyelids/neck)
PIGMENTED = Café au lait spot (flat, ten), Slate grey nevus (mongolian blue spot - lower back), congenital nevus (mole)
What is the types of birth trauma and how do they present?
Caput Succedaneum = scalp swelling by vacuum/vaginal/uterus pressure (swelling)
Cephalohematoma = accumulation of blood below the periosteum by rupture of blood vessels crossing the periosteum due to the pressure on the fetal head during birth (jaundice, swelling)
Bruising and broken bones = tools, physical stresses of the passage through the birth canal or contact with the pelvis (not using limbs, malformations)
Subconjunctival haemorrhage = increased pressure (red eye)
Bell’s Palsy = brachial plexus injury (waiters tip)
Oxygen Deprivation = cord prolapse, premature loss of placenta (pale, floppy baby, CP)
What is a cephalohematoma, how does it present and what is its DDx?
Accumulation of blood below the periosteum by rupture of blood vessels crossing the periosteum due to the pressure on the fetal head during birth
S+S = jaundice, bulges on head
DDx = forceps, vacuum
What is paediatric chronic lung disease, how does it present and what is its DDx?
Long-term breathing and lung problems in premature babies
S+S = rapid breathing, flaring of the nostrils, grunting, chest retractions
Continued need for positive pressure respiratory support or oxygen after a premature baby reaches 36 weeks of gestation
DDx = pneumonia, aspiration syndrome, SLE, CF
What is erythema toxicum, how does it present and what is its DDx?
Therapy - hypersensitivity reaction
Common benign self-limiting, small papule/pustule surrounded by erythematous wheel
S+S = small papule/pustule surrounded by erythematous wheel
DDx = sepsis, staphylococcal folliculitis, acne neonatorum, pyoderma, congenital candidiasis, herpes simplex
What is paediatric failure to feed, how does it present and what is its DDx?
S+S = little interest in feeding, failure to thrive
DDx = congenital hypothyroidism, infant botulism, DS, diarrhoea, ear infections, coughs and colds, teething
What is a Hep B infection, how does it present and what is its DDx?
S+S = anorexia, nausea, malaise, vomiting, arthralgias, myalgias, headache, photophobia, pharyngitis, cough, coryza, jaundice, dark urine, clay-colored or light stools, and abdominal pain
DDx = autoimmune Hepatitis, paediatric Cytomegalovirus Infection, paediatric Hepatitis A, paediatric Hepatitis C, paediatric Herpes Simplex Virus Infection
What is paediatric hypothermia, how does it present and what is its DDx?
Body temp <36.5 = not drying, lack of skin-to-skin, lack of wrapping, cold delivery environment, no aftercare of newborn
S+S = weak cry, low energy level, lethargic, reddish cold skin, cool extremities and abdo, poor feeding, hypoglycaemia
DDx = haemorrhagic shock, medications (benzodiazepine, opioid, alcohol), carbon monoxide toxicity
What is Meconium delay, how does it present and what is its DDx?
Failure of the newborn to pass meconium within 24-48 hours
S+S = no meconium, poor feeding, lethargy, vomiting, diarrhoea, bloody stools, and constipation
DDx = Hirschsprung disease, meconium plug syndrome, meconium ileus, anorectal malformation,
What is Neonatal apnoea, how does it present and what is its DDx?
Unexplained episode of cessation of breathing for >20s
S+S = >20s, cyanosis, bradycardia
DDx = bacteraemia, bronchiolitis, bronchopulmonary dysplasia, croup, CHF, influenza, asthma, bacterial meningitis, head trauma, pneumonia, Guillain–Barré syndrome, prematurity, WPW syndrome
What is Neonatal collapse, how does it present and what is its DDx?
S+S = apnoea, limp child, pallor, bradycardia, cyanosis, collapse, cardiac/resp failure
DDx = congenital heart disease, sepsis, metabolic/endocrine disorders, head injury, hypothermia, intussusception, pneumothorax, pulmonary HTN, pneumonia, seizures, toxins
