Chemical Pathology - Paediatric Clinical Chemistry Flashcards
What are some common problems in low birthweight babies?
- Respiratory distress syndrome
- Retinopathy of prematurity
- Intraventricular haemorrhage
- Patent ductus arteriosus
- Necrotising enterocolitis
How does the renal function differ in a baby/child to that of an adult?
Generally functions less well than in adults
- Functional maturity of GFR only by 2yrs
- Low GFR for surface area
- Less resorption than adult due to shorter proximal tubule (usually adequate for small filtered load)
- Reduced concentrating ability due to short loops of Henle + DCT
- Persistent sodium loss due to DCT being relatively aldosterone-insensitive
Why is there high controllable water loss in a paediatric patient?
- High surface area to body weight ratio
- Skin blood flow is increased
- Metabolic/respiratory rate is higher than adults
- Transepidermal fluid loss (skin less of a good barrier as it’s immature)
What electrolyte disturbance is common in the first 2 weeks of life?
- Hypernatraemia
What can hypernatraemia be a marker of?
- Dehydration
- Overly concentrated milk formula
Why does hyponatraemia occur in the first 4-5 days of life?
- Excess total body water usually due to excessive intake
- Rarely may be SIADH secondary to infection or intraventricular haemorrhage
Why does hyponatraemia occur after the first 4-5 days of life?
Usually sodium loss due to immature tubular functino in pts on diueresis
How does Congenital adrenal hyperplasia present and when is it usually identified?
- Addisonian presentation
- Usually identified on Guthrie spot
What are the general causes of jaundice in the first 24hrs of life?
- Acute haemolysis
- Sepsis
What are the general causes of jaundice after 2wks of life?
- Hepatobiliary failure
What type of hyperbilirubinaemia can present at any stage of infancy?
Conjugated hyperbilirubinaemia
