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Paediatrics > Common Presentations in Neonates > Flashcards

Common Presentations in Neonates Flashcards

1
Q

What is there a close relationship in neonates

A

Hypothermia
Hypoglycaemia
Hypoxia

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2
Q

What can affect colour of skin

A

Jaundice - seen easiest in sclera, then periphery then palms
Pallor
Plethora
Cyanosis

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3
Q

What is plethora (deep rosy red) associated with

A

Polycythaemia

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4
Q

What is pallor associated with

A

Anaemia

  • Bleeding
  • Bone marrow failure
  • Destruction
  • DIC
  • Blood sampling
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5
Q

When do you not worry about cyanosis

A

Peripheral

Common in first 24 hours due to vasomotor changes

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6
Q

What type of rash do you worry about

A

Petechial (non-blanch)

Papular = fine

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7
Q

What other rashes do you get

A 
Milia
Milliari
Transient neonatal pustular melanosis
Erythema toxicum 
Sebaceous naves
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8
Q

What is milia

A

White papule on tip of nose

Hyperplastic sebaceous glands due to placenta hormone

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9
Q

What is miliari

A

Small vesicles and pustules over face / scalp and trunk

Due to immature sweat gland production

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10
Q

What is transient neonatal pustular melanosis

A

Pustules that heal with brown macules

Very common

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11
Q

What do you do if suspect staph infection

A

Start Ax

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12
Q

What is erythema toxicum

A

Maculopapular rash
Common in term babies
Rare in pre-term
Fades 1 week

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13
Q

What is sebaceous naevus and what do you do

A

Congenital plaque
Sensitive to androgen
Risk of malignancy into BCC so remove

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14
Q

What are common birth marks

A 
Capillary haemangioma (Strawberry naevus) 
Melanocytic naevi
Melanocytosis (Mongolian blue spot) 
- Document as can look like bruise 
Giant melanocytes naevus
Port Wine stain (Naevus Flameus) 
Strok Marks (Naevus simplex / salmon)
Cafe au last spots
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15
Q

What is a capillary haemangioma

A

Dilated capillaries that appear in 1st month
Red, raised, discrete edge
Regree 1 year
Rx
- Propranol to constrict
- Surgery if close to orbit or for cosmoses

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16
Q

What are melanocytes naevi

A

Moles

Round / oval / rough

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17
Q

What is melancoytosis

A

Mongolian blue spot

Blue / grey pigment on lower back due to accumulation of melanocyte

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18
Q

What is giant melanocytic naevus

A

Large area of dark pigmentation

Often hairy

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19
Q

What do you do if >1

A

MRI brain and spine

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20
Q

What are Naevus Flameus / Port Wine

A 
Port WIne
Present at birth
Flat or slightly raised on face
Dilated capillaries
Do not regress
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21
Q

What is associate

A

Struger-Weber

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22
Q

How do Naevus Simplex present

A

Light colour capillary dilatation
Back of neck and midline of face
Fades within 1st 2 years

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23
Q

When do you think of cafe au lait

A

> 6 or >0.5cm neurofibromatosis

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24
Q

What is a Ebstein pearl

A

White nodule on roof of mouth
Midline
Doesn’t interfere
Can look like teeth

25
Q

What is haemangioma

A

Eye lid tumor

Treat if vision under threat

26
Q

What is laryngomalacia

  • What does it cause
  • How do you treat
A

Floppy upper larynx which collapses during inhalation
Stridor and feeding problems
Worse when supine, feeding, crying
Normal cry unlike if unwell will be high pitched
Normal sats
Resolves without Rx

27
Q

What is tracheomalacia

A

Floppy trachea cartilage
Stridor worse when crying / cough
Improves by 2

28
Q

What is bronchomalacia

  • How does it present
  • How do you treat
A 
Weak bronchial cartilage 
Stridor
Wheeze
SOB 
Most likely need CPAP +- tracheostomy
29
Q

What is a tongue tie and how is it treated

A

Short thick frenulum attached anterior at base of tongue
Cause poor feeding
No treatment or frenotomy

30
Q

What causes cleft lip and what does it lead too

A

Maxillary and medial nasal process fail to merge
Leads to opening in top lip which can extend as far as the nose
Poor feeding
Poor swallowing
Poor speech
More prone to glue ear, ear infections and hearing problems

31
Q

What is associated with cleft lip

A 
Anti-epileptic use
Rubella
Smoking
Benzo's
Trisomy 13,18,15
32
Q

When do you Rx

A

Repair early - 3 months

33
Q

What causes cleft palate

A

2 palates of skull forming hard palate fail to merge
Palatine
Nasal septum

34
Q

When do you repair

A

6-12 months

35
Q

What are issues with cleft

A 
Poor feeding
Poor speach
Special bottles but attempt breast
Airway issues
Associated anomalies - do ECHO / hearing
Increased risk of otitis media
36
Q

How does chonal atresia present

A

If bilateral - soft tissue / bone block

Cyanosis worse when feeding and better when cries

37
Q

How do you Rx

A

Surgery

Look for other malformation

38
Q

What is a cataract and how does it present and what do you do

A

Lens opacification
Absence red reflex
No Rx or artificial lens
Lead to blindness

39
Q

What is retinoblastoma and how do you treat

A 
Urgent opthmology referral if absent red reflex
Rare eye cancer 
Absent red reflex 
Laser therapy 
Chemo
Surgery
40
Q

What is common after birth in the eye

A

Subconjunctival haemorrhage
Discharge due to immature ducts
Look for conjunctivitis

41
Q

What are the symptoms of facial palsy

A

Decreased facial movement and forehead wrinkling on one side and eyelid elevation
Flattening of nasolabial fold and corner of mouth
Side appearing to droop = normal

42
Q

What is asymmetric crying facies

A

Eye and forehead muscles unaffected

Caused by absence of depressor angel oris muscles

43
Q

What may you see on chest

A

Prominent xiphersternum as thin skin

44
Q

What might you see on skin

A

Blood vessels as thin skin

45
Q

What might you see on abdomen

A

Swelling / hernia as muscles not formed if premature

46
Q

What is a benign dimple

A

Lower back
Present at birth
Small and shallow
Can see the end

47
Q

What is a worrying dimple

A 
Large >2.5cm
Red
Swollen
Off midlien
Tender
Fluid
Higher than sacral
Hairy tuff 
Abnormal neuro exam
48
Q

What may it suggest

A

Spina bifida

Kidney issue

49
Q

What do you do

A

USS within 6 weeks

50
Q

If USS abnormal

A

MRI / MDT

51
Q

What is cephalohaematoma

A

Localised swelling over one or both sides of the head
Limited by sutures as between periosteum and skull
Reaches max 3rd or 4th day
May take months to resolve
Soft
Non-translucent

52
Q

When does cephalohaematoma form

A

After birth
Traumatic delivery
No intracranial bleed
Bleeding beneath pericrainium

53
Q

How do you Rx

A

No Rx

May prolonged jaundice (intermediate) and cause anaemia

54
Q

What is caput succadenum

A 
Subcutaneous collection of fluid outside the periosteum 
Collects on the scalp 
Cross Sutures as above scalp
Poorly defined
Present at birth
55
Q

What causes

A

Pressure of presenting part of scalp against cervix or forceps during traumatic labour

56
Q

How do you Rx

A

No Rx
No complications
Resolves within days

57
Q

What is Sub gleal haemorrhage

A 
Above periosteum 
Very rare but more dangerous 
Large bleed
Can cross suture as above bone 
Can cause anaemia and jaundice 
Do CT to distinguish from succadenum
58
Q

What aother haemorrhage

A

Extradural and intra-cranial

59
Q

Who gets USS of hips

A

All breech
FH of hip
+ve Ortalani or Barlow

Paediatrics (35 decks)

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