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Clinical- Week 5 Flashcards

1
Q

what 3 shunts are present in the foetus before birth?

A

ductus venosus
foramen ovale
ductus arteriosus

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2
Q

what is the neonatal period?

A

28 days

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3
Q

how long should gestational correction for growth charts be used for?

A

1 year for infants born 32-36 weeks

2 years for infants born under 32 weeks

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4
Q

where do you do the cap refill of a baby?

A

chest (sternum)

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5
Q

compare causes of early and late onset neonatal sepsis?

A

early onset sepsis: bacteria acquired before and during delivery
late onset sepsis: acquired after delivery

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6
Q

compare the content of foremilk and hindmilkd?

A

foremilk- rich in protein

hindmilk- rich in fat

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7
Q

what is gastroschisis?

A

a birth defect in the abdominal wall where the bowels are on the outside

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8
Q

how does lung aeration occur as babies take their first deep breaths?

A

fluid is pulled from alveolar tissue back into lymphatics

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9
Q

what ligaments do the ductus arteriosus and ductus venosus become?

A

ductus arteriosus becomes the ligamentum arteriosus

ductus venosus becomes the ligamentum teres

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10
Q

what happens if cataracts are not taken out within 4-6 weeks of life?

A

cortical blindness

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11
Q

what is the main source of heat production in a neonate?

A

breakdown of brown adipose tissue

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12
Q

why are preterm babies at a particular risk of hypothermia?

A

less brown adipose tissue

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13
Q

what is the normal apgar score?

A

8 or more out of 10

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14
Q

what is the period of time during pregnancy where there is greatest teratogenic risk? and why?

A

4th to 11th week

-organogenesis

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15
Q

in what case may you miss fetal hypothyroidism?

A

if hypopituitarism (secondary hypothyroidism(

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16
Q

how does the foramen ovale remain open in the fetus?

A

right atrium pressure is higher than left atrium pressure

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17
Q

what is the treatment of transient tachypnoea?

A

self-limiting

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18
Q

what is a diaphragmatic hernia?

A

when intestines protrude through a hole in the diphragm into the thoracic cavity

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19
Q

what is transient tachypnoea caused by?

A

failure to reabsorb lung fluid sufficiently

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20
Q

what is the most common neonatal surgical emergency?

A

necrotising enterocolitis

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21
Q

how much folic acid should be given pre-conceptually and for how long?

A

3 months preconception up to first 3 months of pregnancy

400mcg

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22
Q

what causes closure of the foramen ovale?

A

decreasing pulmonary vascular resistance and increasing systemic vascular resistance
leftt atrium pressure becomes higher than right atrium pressure

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23
Q

if a pregnant women has significant risk factor (2+)s for venous thromboembolism, what drug should be commenced?

A

low molecular weight heparin thromboprophylaxis

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24
Q

what 3 organisms are the main cause of sepsis in the newborn?

A

group B strep (main)
E. Coli
listeria

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25
when do most intraventricular haemorrhage take place?
first day of life
26
what domains does the Apgar score assess?
``` HR resp rate responsiveness tone colour ```
27
in the 3rd trimester, how does the baby prepare for the hypoxic phases of labour?
stores oxygen in liver, muscle and heart
28
what is the management of persistent pulmonary hypertension?
- sedate baby to reduce stess - keep warm - inotropes to increase systemic circulation pressure - NO to directly dilate vessels in lungs - ECLS (extra-corporeal life support) in extreme conditions
29
compare primary, secondary and tertiatry disease prevention?
primary prevention: stopping a disease before it starts secondary prevention: stopping a disease from being as bad as it could be or preventing recurrence tertiary prevention: stopping later complications from developing
30
what is the purpose of hysterosalpingography?
assessment of tubal patency in patients with infertility
31
what colour is bile?
green
32
what is exomphalos?
herniation of abdominal contents through a weakness in the abdominal wall where the umbilical cord attaches
33
if babies lose more than 10% of their birth weight what are they at risk of? what is the management?
hyponatraemia | admit
34
are obstructions in the newborn congenital or acquired?
congenital
35
what teratogenic risk does warfarin have?
limb, facial defects
36
in the newborn, what are most acquired problems due to?
prematurity
37
what is the name for a dead end of the bowel?
atresia
38
what are the 2 major risk factors of intraventricular haemorrhage?
prematurity | respiratory distress syndrome
39
what is the treatment of PDA?
echo evaluation of how big the duct is | give NSAID for days
40
are perforations in the newborn congenital or acquired?
acquired
41
what drug is safe to use in pregnancy for nausea and vomiting?
cyclizine
42
how long after birth does it take the ductus arteriosus to close?
a few hours | within a few weeks it will remodel into a ligament
43
why is vitamin K given to newborns?
to prevent haemorrhagic disease of the newborn
44
what is the normal heart rate of a newborn?
120-140 beats per minute
45
which antiepiletic drug is particularly associated with cleft lip and palate?
phenytoin
46
why does the ductus arteriosus close?
constricts in response to PO2 increasing and decreasing prostaglandins
47
what drug is safe to use in pregnancy for pain?
paracetamol
48
what is the current use of thalidomide?
treatment of leprosy and myeloma
49
when does the booking scan and when does the detail scan occur?
booking scan at 12 weeks | detailed scan at 20 weeks
50
why should pregnant ladies avoid taking NSAIDs?
NSAIDs decrease prostaglandin levels so can cause ductus arteriosus to close
51
what is vulvodynia?
painful vulva/perineum
52
how often should voids occur?
roughly every 3 hours when awake
53
what are the 4 congenital abnormalities tetralogy of fallot?
VSD overriding aorta pulmonary artery stenosis right ventricular hypertrophy
54
what is the function of the foramen ovale?
in the fetus, shunts oxygenated blood from right atrium to left atrium -bypasses lungs to go to systemic circulation
55
are babies born by vaginal delivery or C section at higher risk of transient tachypnoea?
C section
56
if a baby is vomiting bile, what is the diagnosis until proven otherwise?
malrotation
57
what is the normal weight of a term baby?
2.5kg - 4kg
58
what does an intraventricular haemorrhage first begin with?
germinal matrix haemorrhage
59
what teratogenic risk do ACE inhibitors/ARBs have?
renal hypoplasia
60
what drug exposure in mothers, is linked to vaginal adenocarcinomas and urological malignancies in 15-20 years old?
diethylstilbestrol
61
what is the function of phototherapy for excessive conjugated bilirubin (causing jaundice) in the blood of a newborn?
the blue light changes fat-soluble bilirubin into water-solubin bilirubin this can now be excreted by baby
62
what is the neonatal risk with giving labetalol for pregnancy-induced hypertension?
neonatal hypogylcaemia
63
when does retinopathy of prematurity usually occur?
usually 6-8 weeks after delivery
64
why is malrotation a very serious condition?
can cause bowel to wrap around SMA and cause ischaemia of the gut
65
what was disethylstilbestrol initially marketed for?
to prevent recurrent miscarriage
66
what test can determine whether the baby has persistent pulmonary hypertension?
there will be a PDA so using a saturation probe on right arm (supplied by pre-ductal blood) and foot (supplied by post-ducal blood) sats will be 20% lower
67
which antiepileptic drugs i particularly associated with neural tube defects (such as spina bifida and anencephaly)?
valproate
68
how can you monitor intraventricular haemorrhage?
US through anterior fontanelle
69
what test do you do for a possible gut malrotation?
upper GI contrast with follow through
70
in a diaphragmatic hernia, what can happen to the lung?
hypoplastic lung
71
why should yo uavoid the use of tetracyclines in pregnancy and up to 8 years of age?
stains teeth and bones
72
what test is done at birth to look for metabolise diseases?
guthries heel test
73
what drug is safe to use in pregnancy for heartburn?
antacids
74
are breast fed or formula fed babies more at risk of haemorrhagic disease of the newborn?
breast fed
75
what is a cephalohaematoma?
bleeding under periosteum
76
why are calcium and phosphate supplementation given to premature babies?
to prevent osteopenia of prematurity
77
what drug is safe to use in pregnancy for UTI?
nitrofurantoin or cefalexin | trimethoprim in 3rd trimester
78
what percentage of birth weight is normal to lose in the first 5 days?
10%
79
what is the function of the ductus venosus?
in the fetus, shunts oxygenated blood from umbilical vein to the IVC -bypasses liver to preferentially supply the brain
80
what is the normal respiratory rate of a newborn?
40-60/minute
81
what teratogenic risk does lithium have?
cardiovascular defects
82
what condition is meconium ileus commonly associated with?
CF
83
what happens do protein binding in pregnancy? what effect does this have on the amount of free drug?
protein binding decreases | free drug increases
84
what is the function of the ductus arteriosus?
in the fetus, shunts blood from pulmonary artery to descending aorta -bypasses lungs to go to systemic circulation
85
instead of using ACE I/ARBs in pregnancy, what should be used?
1st line- labetalol | then methyldopa
86
what can benzodiazepine use in the mother cause in a breastfeeding infant?
drowsiness
87
how long should you breast feed and when should you breast feed?
at least 6 months (exclusively) | on demand
88
what condition of the gut is common in preamture babies due to the gut not being developed enough?
necrotising enterocolitis

Reproduction (9 decks)

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