Block 2 - Child Health Flashcards
State the definition of preterm
Conception to 36 weeks + 6 days
Very preterm
< 32 weeks
Extremely preterm
< 28 weeks
Post term
42-44 weeks
Low birth weight
< 2.5 kg or 5.5 pounds
VLBW
< 1.5kg or 3.3 pounds
ELBW
< 1kg or 2.2 pounds
SGA
< 9th centile in weight expected for gestation
AGA
between 9th and 91st centile
LGA
Greater than 91st centile
Name five risk factors for preterm birth.
- Multiple pregnancy
- Uterus or cervix problems
- Hypertension, diabetes and clotting disorders
- Infections in pregnancy
- Smoking, alcohol or illicit drug use
In preterm babies - what should you do at birth?
If baby can be kept warm, pause for at least a minute to allow placental transfusion.
What is the airway positioning for a preterm baby?
Neutral head position and jaw thrust
What can over inflation of the lungs in a preterm baby cause?
Broncho pulmonary dysplasia
What is gestational correction?`
Adjusts the plot of a measurement to account for the number of weeks a baby was born early.
number of weeks early = 40 - gestational age
When should gestational correction be continued until in 32-36 week babies?
1 year
When should gestational correction be contiued for in < 32 week babies?
2 years
Name two common early onset sepsis organisms?
Group B strep and E coli
Name three respiratory complications of prematurity?
- RDS
- Apnoea of prematurity
- Bronchopulmonary dysplasia
In apnoea of prematurity - what stimulates the resp centre?
Caffeien
Give two features of RDS primary pathology?
- Surfactant deficiency
2. Structural immaturity
How is RDS managed?
Maternal steroids
Surfacatant
Ventilation
In RDS: what xray features are present?
Ground glass appearance - looks hazy due to lack of surfactant resulting in poor aeration of alveoli
give a complication of RDS?
pneumothorax, tension
What does ductus arteriosus connect?
PA to aorta
What are the symptoms of PDA?
congestive heart failure symptoms e.g. ankle oedema, LHF and diastolic BP increase
What helps treat PDA?
NSAIDS like ibuprofen
Where does intracranial haemorrhage in preterm infacnts occur?
in germinal matrix. In 80% of cases this GMH leads to an intraventricular bleed
What should you do if you suspect an IVH?
Ultrasound
What are two risk factors for IVH?
- prematurity
2. RDS
When do most IVH occur?
1st day of life
How to prevent IVH?
Antenatal steroids
What does a grade 3 and 4 IVH bleed involve?
Parenchymal bleed - neurodevelopmental delay up to 80%
What is the most common neonatal surgical emergency?
NEC - widespread necrosis in the small and large intestine
usually recovering from RDS, lethargy and gastric residuals, blood stool, temperature instability, apnoea and brady cardia?
NEC!
Normal resp rate in 1-5 years?
20-30/min
noisy breathing that occurs during inhalation. It is a low-pitched, snoring type of sound that usually arises from the vibration of fluid, or the vibration of tissue that is relaxed or flabby. It usually arises from airway blockage in the throat (pharynx)
Stertor
Biphasic stridor (occuring on inhalation and exhalation) reflects what pathology?
Tracheal
Stridor at 2am?
Viral croup - parainfluenza
What condition which causes stridor is rare because of HiB vaccination?
Epiglottitis
What investigations can be done for recurrent stridor?
- CXR
- laryngobronchoscopy
- Blood tests
A whistling musical noise caused by turbulent airflow passing through narrowed medium-sized airways. Generally on expiration unless severe.
Wheeze
bleeding under periosteum on the parietal bones
does not cross the midline
Cephalohaematoma
Child goes blue when lying donw?
Choanal atresia
Prominent occiput and low set ears
Trisomy 18 - Edwards
When listening for murmurs of new born child - where must you remember to listen?
Midscapular area posteriorly - for coarctation
Large ventricular sepal defect
An overriding aorta
Stenosis of pulmonary valve
Right ventricular hypertrophy
Fallots tetrology
What might a hyperdynamic pulse suggest?
PDA
pulse is noticeably weaker in the legs or groin than it is in the arms or neck,
Coarctation of the aorta
What is normal range of HR for under 1 year old?
110-160
What is blood volume of children?
80mls/kg