Common postnatal probs

Question 1

WHat is the energy triangle?

Answer 1

• Warm
• Pink
• Sweet

The close relationship between hypothermia, hypoglycaemia and hypoxia/anoxia must never be underestimated and understanding the interactions between these three factors and the impact on the newborn baby is paramount!

Question 2

If a baby has plethora, what are the likely causes?

Answer 2

• polycythaemia which has implications in terms of viscosity

Question 3

What is erythema toxicum?

Answer 3

• maculo-papular rash
• 30 – 70% of normal term neonates.
• very rare in the pre-term.
• rash fades by end of 1st wk
• no Rx is required.

Question 4

What are mongolian blue spots?

Answer 4

• Blue grey birth marks
• accumulation of melanocytes.
• very common : races with pigmented skin.
• less obvious as skin darkens.

Question 5

What is a stork mark?

Answer 5

• Naevus simplex
• light colour capillary dilatation
• commonly at back of neck.
• Maybe along midline of face.
• Gradually fades
• within the 1st 2 yrs.

Question 6

Chat’s about jaundice. Refer to jaundice brainscape.

Question 7

Which babies are at risk of hypoglycaemia?

Answer 7

• Limited glucose supply
  
  • pre term
• Hyperinsulinism
  
  • diabetic mama
• Increased glucose utilisation
  
  • hypothermia
  • sepsis

Question 8

SSx of hypoglycaemia?

Answer 8

• Hypoglycaemia defined as blood sugar <2.6mmol/l
• Jitteriness
• Hypothermia
• Temperature instability
• Lethargy
• Hypotonia
• Apnoea, irregular respirations

Question 9

Which bambinos are at risk of hypothermia?

Answer 9

Vulnerable babies include

• Low birth weight
• Babies requiring prolonged resusciation

Question 10

How can we stop risk of hypothermia?

Answer 10

• Dry quickly
• Remove wet linens
• Use warm towels/blankets
• Provide radiant warmer heat
• Use heated/humidified oxygen

Question 11

How do we evaluate resp distress in bambino?

Answer 11

• Respiratory rate
• Increased effort
  
  • Grunting
  • Retractions
  • Nasal flaring
• Colour
• Oxygen saturations

Question 12

What are issues in kiddos with cleft lip?

Answer 12

• Feeding issues
  
  • ◦Special bottles and teats
  • ◦Can still attempt breast feeding
• Airway problems
• Associated anomalies
  
  • ◦Need hearing screen
  • ◦Need cardiac echo
  • ◦Remember trisomies

Question 13

Why do we always check red eye reflex?

Answer 13

• Cataracts
  
  • lens opacification
  • If undetected early could lead to blindness
  • May require no treatment
  • May require lens removal and artificial lens
• Retinoblastoma
  
  • Rare eye cancer which can be successfully treated if picked up early
  • laser therapy, chemo, surgical removal of eye

Question 14

What is Cephalohaematomas?

Answer 14

Localised swelling over one or both sides of the head

no treatment is required and resolution occurs in 3-4 weeks

Question 15

What is Caput succedaneum?

Answer 15

serosanguinous, subcutaneous fluid collection with poorly defined margins

does not usually cause complications and resolves over the first few days.

Question 16

What is Talipes?

Answer 16

Medial (varus) or lateral (valgus) deviation of the foot is often positional and requires no treatment other than physiotherapy

Question 17

Features of Trisomy 21?

Answer 17

• Dysmorphism
  
  • Low set ears, downward slanting palpebral fissures, epicanthic folds, single palmar creases, wide sandal gap
• Hypotonia
• Cardiac defects
• Learning problems
• Haematological problems
• Thyroid problems