Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3rd Year - Paediatrics > 6.4. Neonatology - Term Admission to Neonatal Unit > Flashcards

6.4. Neonatology - Term Admission to Neonatal Unit Flashcards

1
Q

What are the Categories of Term Admission to the Neonatal Unit?

A
  1. Sepsis
  2. Respiratory Distress
  3. Cardiac - “Blue Baby”
  4. Hypoglycaemic
  5. Hypothermic
  6. Jaudice
  7. Birth Asphyxia
  8. Surgical Problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the Symptoms of Sepsis in a Neonate?

A
  1. Pyrexia / Hypothermia
  2. Poor Feeding
  3. Lethargy
  4. Early Jaundice
  5. Hypo/Hyperglycaemia
  6. Asymptomatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the Risk Factors for Sepsis in a Neonate?

A
  1. Premature Rupture of Membranes (PROM)
  2. Maternal Pyrexia
  3. Maternal Group B Streptococci Carriage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the Management of Presumed Sepsis?

A
  1. Partial Septic Screen (FBC / CRP / Blood Cultures)
  2. Blood Gas +/- Chest X-Ray / Lumbar Puncture
  3. I.V. Penicillin (or Vancomycin) and Gentamicin
  4. Add Metronidazole if Surgical / Abdominal Concerns
  5. Fluid Management / Treat Acidosis
  6. Monitor Vital Signs / Support Respiratory and Cardiovascular System
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the Commonest Causative Agents of Neonatal Sepsis?

A
  1. Group B Streptococcus
  2. E. Coli
  3. Listeria
  4. Coagulase Negative Staphylococci
  5. Naemophilus Influenzae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the Features of Group B Streptococcal Sepsis?

A
  1. Early Onset - Birth to 1 Week
  2. Late Onset / Recurrence - Up to 3 Months
  3. Symptoms may be Non-Specific
  4. May have No Risk Factors
  5. Complications - Meningitis / DIC / Pneumonia / Respiratory Collapse / Hypotension . Shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are common Congenital Infections?

A 
ToRCH:
Toxoplasmosis
Rubella
CMV
Herpes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the Complications of Congenital Infections?

A
  1. Intra-Uterine Growth Restriction
  2. Brain Calcifications
  3. Neurodevelopmental Delay
  4. Visual Impairment
  5. Recurrent Infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the Causes of Respiratory Distress?

A
  1. Sepsis
  2. Transient Tachypnoea of the Newborn (TTN)
  3. Meconium Aspiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the Features of Transient Tachypnoea of the Newborn (TTN):

  1. Clinical?
  2. Management?
A

Delay in Clearance of Foetal Lung Fluid - Self-Limiting Condition which Presents within the First Few Hours of Life:

  1. Grunting / Tachypnoea / O2 Requirement / Normal Gasses
  2. Supportive / Antibiotics / Fluids / O2 / Airway Support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the Features of Meconium Aspiration:

  1. Risk Factors?
  2. Symptoms?
  3. Investigations?
  4. Treatment?
A

Meconium is inhaled into the Lungs:

  1. Post Dates / Maternal Diabetes / Maternal Hypertension / Difficult Labour
  2. Cyanosis / Dyspnoea / Grunting / Apnoea
  3. Blood Gas / Septic Screen / Chest X-Ray
  4. Suction / Airway Support / I.V. Fluids / I.V. Antibiotics / Surfactant / Nitrus Oxide or Extracorporal Membrane Oxygenation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the Investigations of the “Blue Baby”?

A
  1. History / Examination
  2. Sepsis Screen
  3. Blood Gas / Glucose
  4. Chest X-Ray
  5. Pulse Oximetry
  6. ECG / Echo
    Note - Cyanosis occurs > 5g/dL of Deoxyhaemoglobin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the Differential Cardiac Diagnosis of the “Blue Baby”?

A
  1. Transposition of the Great Arteries (TGA)
  2. Tetralogy of Fallots
  3. Total Anomalous Pulmonary Venous Drainage
  4. Hypoplastic Left Heart Syndrome
  5. Tricuspid Atresia
  6. Truncus Arteriosus
  7. Pulmonary Atresia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Treatment of Transposition of the Great Arteries (TGA)?

A
  1. Urgent Septostomy

2. Arterial Switch Later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the Features of the Tetralogy of Fallot?

A
  1. Formed by:
  2. a) Pulmonary Stenosis
  3. b) Thickened Right Ventricle
  4. c) Ventricular Septal Defect
  5. d) Overriding Aorta
  6. Treated by Surgery - May need Shunt between Pulmonary Artery and Aorta prior to it
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the Features of Total Anomalous Pulmonary Venous Drainage?

A
  1. Pulmonary Veins are Connected to one of the Veins from the Main Circulation, instead of the Left Atrium
  2. Oxygenated Blood thuse goes to the Right Side of the Heart
  3. Early Surgery to Reconnect Pulmonary Veins to Left Atrium is needed
17
Q

What are the Features of a Hypoplastic Left Heart?

A
  1. Underdevelopment of the Left Heart
  2. Poor Oxygenation / Perfusion
  3. Worse when Duct Shuts
  4. Complex Surgical Repair
18
Q

What are the Features of Tricuspid Atresia?

A
  1. Absence of a Patent Tricuspid Valve
  2. Hypoplastic Right Ventricle
  3. ASD and VSD / PDA Necessary for Survival
  4. Urgent Surgery to Shunt Blood to Lungs
  5. Further Surgery at 6 Months
19
Q

What are the Features of Truncus Arteriosus?

A
  1. Single Blood Vessel from Left and Right Ventricles

2. Requires Surgery to make 2 Vessels

20
Q

What are the Features of Pulmonary Atresia?

A
  1. Abnormal Pulmonary Valve
  2. Obstructs Blood from Right Ventricle to Lung
  3. Required ASD and VSD or PDA to Survive
  4. Shunts and Surgical Repair
21
Q

What are the Features of Coarctation of the Aorta?

A
  1. Narrowing of the Aorta
  2. May be Asymptomatic
  3. Requires Surgical Repair
22
Q

What is the Treatment of the “Blue Baby”?

A
  1. ABC
  2. Iontropes as Required
  3. Fluid Resuscitation
  4. Respiratory Support
  5. Prostin
  6. Nitric Oxide
  7. Cardiology Referal
23
Q

What is the Management of Neonatal Hypoglcaemia?

A
  1. May change with Enteral Feeds
  2. Start I.V. 10% Glucose
  3. Increase Fluids
  4. Increase Glucose Concentration
  5. Glucagon
  6. Hydrocortisone
24
Q

What is the Management of Neonatal Hypothermia?

A
  1. Admit and Place in an Intubator
  2. Sepsis Screen and Antibiotics
  3. Consider checking Thyroid Function
  4. Monitor Blood Glucose
25
Q

What is the Management of Neonatal Jaundice?

A
  1. Intensive Phototherapy
  2. Exchange Transfusion
  3. Incubator and I.V. Fluids (may be Required)
26
Q

What are the Causes of Birth Asphyxia?

A
  1. Placental Problem
  2. Long, Difficult Delivery
  3. Umbilical Cord Prolapse
  4. Infection
  5. Neonatal Airway Problem
  6. Neonatal Anaemia
    Note - Lack of O2 at / Around Birth leads to Multiorgan Dysfunction
27
Q

What are the Stages of Birth Asphyxia?

A

1 - Within minutes without O2 - Cell damage occurs

2 - Reperfusion Injury / Toxins are released from Damaged Cells - Can Last Days / Weeks

28
Q

What are the Symptoms of:

  1. Mild Hypoxic Ischaemic Encephalopathy?
  2. Moderate Hypoxic Ischaemic Encephalopathy?
  3. Severe Hypoxic Ischaemic Encephalopathy?
A
  1. a) Muscle Tone Increase / Brisk Reflexes
  2. b) Transient Behavioural Abnormalities
  3. c) Typically Resolves in 24 hours
  4. a) Lethargic / Hypotonia / Areflexia / Apnoea
  5. b) Sluggish Grasping / Moro / Sucking Reflexes
  6. c) Seizures Occur within the First 24 hours
  7. d) Full Recovery in 1-2 Weeks
  8. Delayed Seizures - Frequency Increases during 24-48 Hours after onset (due to Reperfusion injury)
29
Q

What is the Management of Hypoxic Ischaemic Encephalopathy?

A
  1. Supportive (Respiratory / Cardiac)
  2. Fluid Resuscitation
  3. Monitor for Liver / Renal Failure
  4. Treat Seizures
  5. Therapeutic Hypothermia
30
Q

What are the Features of Cooling Criteria A?

A

Infant >36 weeks +

  1. Apgar Score of <5 at 10 minutes
  2. Continued Need for Resuscitation > 10 minutes
  3. Acidosis within the 1st Hour
  4. Base Deficit > 16 within 1 Hour
31
Q

What are the Features of Cooling Criteria B?

A

Seizures / Moderate - Severe Encephalopathy Consisting of:

  1. Altered State of Consciousness
  2. Abnormal Tone
  3. Abnormal Primitive Reflexes
32
Q

What are the Features of Cooling Criteria C?

A

aEEG / CFAM - At Least 30 minutes of some Abnormal Electrical Activity:

  1. Normal Background with Seizure Activity
  2. Moderatly Abnormal Background
  3. Suppressed Activity
  4. Coninuous Seizure Activity
33
Q

What are the Features of Cooling / Further Management?

A
  1. Baby Cooled to 33 degrees for 72 hours
  2. Then Rewarmed Slowly over 12 hours
  3. Sedated for Cooling
  4. Monitored with Cerebral Function Analysing Monitor (CFAM)
  5. Cranial Ultrasounds
  6. MRI at 7-10 days
  7. Neurodevelopmental Follow-Up
34
Q

What are common Surgical Problems?

A
  1. Oesophageal Atresia / Fistula
  2. Duodenal Atresia / other G.I. Atresias
  3. Causes of Failure to Pass Stool
  4. Abdominal Wall Defects
  5. Diaphragmatic Hernia
35
Q

What is the Management of an Oesophageal Atresia / Fistula?

A
  1. I.V. Fluids and Suction

2. Surgical Repair

36
Q

What are some Causes of Failure to Pass Stool?

A
  1. Constpation
  2. Large Bowel Atrasia
  3. Imperforate Anus (+/- Fisula)
  4. Hirschsprungs Disease
  5. Meconium Ileus - Think Cystic Fibrosis
37
Q

What are the Common Abdominal Wall Defects?

A
  1. Exophalos

2. Gastroschisis

3rd Year - Paediatrics (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions