Care of the Newborn

Question 1

when is a baby term?

Answer 1

>37 weeks

Question 2

when is a baby post term?

Answer 2

>41 wks

Question 3

what size, in kg is SGA and LGA?

Answer 3

SGA <2.5kg LGA >4kg

Question 4

what does APGAR stand for? what is normal?

Answer 4

Appearance

Pulse

Grimace (reflexes)

Activity

Respiratory Effort

≥8 normal

Question 5

what screening is offered?

Answer 5

hearing

congenital dysplasia of the hip

CF

haemoglobinopathies

metabolic diseases

Question 6

normal temp range for newborns?

Answer 6

36.5-37.2

Question 7

signs of hypoglycaemia?

Answer 7

sleepy

poor tone

poor feeding

convulsions

cyanosis

Question 8

when is jaundice pathological?

Answer 8

if presenting within first 24hrs of life

Question 9

in babies, what type of jaundice is occuring?

Answer 9

prehepatic

Question 10

how is bilirubin produced and cleared usually?

Answer 10

haemoglobin is produced when RBC lyse

converted to bilirubin

bilirubin attaches to albumin

conjugated in liver

Question 11

signs of respiratory distress

Answer 11

nasal flare

head bop

abdominal breathing

sternal recession

intercostal recession

Question 12

when does jaundice become prolonged?

Answer 12

term - 14 days

pre term - 21 days

Question 13

what are features of biliary atresia? what is the Tx?

Answer 13

pale stools

dark urine

sick baby

Tx -> surgery

Question 14

what is ductus arteriosis a connection between?

Answer 14

pulmonary artery and aorta

Question 15

symptoms of PDA?

Answer 15

fatigue

sweating

high RR

disinterest in feeding

poor weight gain

Question 16

what is a complication of jaundice? why?

Answer 16

kernicterus

high levels of bilirubin cross BBB and damage CNS

Question 17

physiology of breast feeding?

Answer 17

suckling causes rise in PRL

breasts increase milk production

oxytocin acts on SM in breast to ejaculate milk

Question 18

health benefits of breast feeding for baby?

Answer 18

decreased D and V

decreased ear infections

decreased chance of constipation

decreased risk of obesity

decreased risk of eczema

Question 19

health benefits of breast feeding for mum?

Answer 19

decreased risk of breast and ovarian cancer

saves money

helps bonding

Question 20

what is necrotising enterocolitis?

Answer 20

widespread necrosis in small and large intestine

Question 21

features of necrotising enterocolitis?

Answer 21

premature

lethargic

bloody stool

temperature

decreased HR

SOB

Question 22

what is the cause of a ICH in premature infants?

Answer 22

bleeding into germinal matrix

Question 23

Ix and Tx for ICH in premature infants?

Answer 23

Ix - US

Tx - steroids

Question 24

features of VSD?

Answer 24

harsh pan systolic murmur

Question 25

what happens in pulmonary atresia?

Answer 25

blockage between RV and PA

Question 26

in transposition of the great arteries, describe the anatomical change?

Answer 26

aorta exits RV, pulmonary artery exits LV

Question 27

what happens in persistent pulmonary hypertension?

Answer 27

patent foramen ovale and ductus arteriosus

Question 28

features of coarctation of the aorta?

Answer 28

radiofemoral delay

Question 29

4 features of the tetralogy of fallot?

Answer 29

VSD pulmonary stenosis hypertrophy of RV over riding aorta

Question 30

when does surfactant production start and stop?

Answer 30

3rd trimester labour (28-birth)

Question 31

what causes foramen ovale to close

Answer 31

baby cries pulmonary resistance decreases systemic resistance increases prostaglandins decrease foramen ovale closes

Question 32

when is anaemia 'normal'? why?

Answer 32

8-10 wks adult made slower than fetal Hb

Question 33

Answer 33

Question 34

what does foramen ovale connect?

Answer 34

RA to LA

Question 35

what does ductus arteriousis connect? what does it turn into?

Answer 35

pulmonary bifurcation to descending aorta ligamentum arteriosus

Question 36

what does ductus venosus connect? what does it turn into?

Answer 36

umbilical vein to inferior vena cava ligamentum teres