5: Sick term infants

Question 1

When in the 1st trimester are babies most likely to become ill?

Answer 1

First 28 days

Question 2

Which score is used to predict how well a baby will do post-birth?

Answer 2

Apgar score

Question 3

Which mnemonic is helpful for remembering the criteria of an Apgar score?

Answer 3

APGAR

Activity (muscle tone)

Pulse (heart rate)

Grimace (responsiveness)

Appearance (colour)

Respiration (resp. rate)

Question 4

What is a normal foetal heart rate?

Answer 4

120 - 160 bpm

Question 5

What is a normal foetal resp. rate?

Answer 5

40 - 60 / min

Question 6

Babies and children more commonly suffer (cardio / resp.) failure.

Answer 6

respiratory failure

Question 7

What are four likely reasons for illness in babies?

Answer 7

Infection

Congenital abnormalities

Complicated birth –> Foetal hypoxia

Metabolic problems

Question 8

What is the most common bacterial infection in babies?

Answer 8

Group B Strep

Question 9

Which condition is caused by foetal hypoxia and results in a poor Apgar score?

Answer 9

Hypoxic ischaemic encephalopathy

Question 10

Apart from those related to the foetal circulation (PFO, PDA), what are some rare congenital heart diseases?

Answer 10

Tetralogy of Fallot

Transposition of the great vessels

Coarctation of the aorta

Hypoplastic heart

TAPVD

Question 11

What is the presentation of hypoxic ischaemic encephalopathy?

Answer 11

Multi-organ failure

CNS symptoms - fluctuating HR and RR, poor tone, absent reflexes, seizures

Question 12

How is hypoxic ischaemic encephalopathy managed?

Answer 12

Cooling under sedation and ventilation

GIves brain time to develop and repair

Question 13

What causes transient tachypnoea in some newborns?

Answer 13

Inadequate fluid clearance from the lungs

e.g in premature or C section babies

Question 14

In which newborn disease does fluid accumulate in body cavities?

Answer 14

Hydrops foetalis

Question 15

What are some examples of abnormal fluid collections seen in hydrops foetalis?

Answer 15

Pleural effusions

Pericardial effusions

Ascites

Question 16

Which autoimmune disease can cause hydrops foetalis?

Answer 16

Rhesus disease

Question 17

Which respiratory disease can be seen in babies who haven’t fully adapted yet?

Answer 17

Persistent pulmonary hypertension (PPH)

Question 18

Which congenital syndrome is associated with renal hypoplasia / absence?

Answer 18

Potter’s syndrome

Question 19

The kidneys are involved in the production of which fluid?

Answer 19

Amniotic fluid

Question 20

Which foetal disease occurs if the kidneys fail to develop?

Answer 20

Oligohydramnios

Lack of amniotic fluid

Question 21

What is the presentation of Potter’s syndrome in a newborn?

Can you explain each symptom?

Answer 21

Respiratory distress - undeveloped lungs due to lack of amniotic fluid

Unusual facial appearance - high pressure of the uterus, no cushioning from amniotic fluid

Muscle contractures - “”

Question 22

What is the prognosis of Potter’s syndrome?

Answer 22

Incompatible with life