Common Presentations in Neonates Flashcards by Jia Ying Tan

What is pallor associated with [6]

Anaemia secondary to

Bleeding
Bone marrow failure
Destruction
DIC
Blood sampling

How well did you know this?

Not at all

Perfectly

When do you not worry about cyanosis

Peripheral

Common in first 24 hours due to vasomotor changes

How well did you know this?

Not at all

Perfectly

What types of rash do you worry about [2]

Petechial (non-blanch)

Papular = fine

How well did you know this?

Not at all

Perfectly

What other rashes do you get [5]

Milia
Milliari
Transient neonatal pustular melanosis
Erythema toxic 
Sebaceous naves

How well did you know this?

Not at all

Perfectly

What is milia [2]

White papule on tip of nose

Hyperplastic sebaceous glands due to placenta hormone

How well did you know this?

Not at all

Perfectly

What is miliari [2]

Small vesicles and pustules over face / scalp and trunk

Due to immature sweat gland production

How well did you know this?

Not at all

Perfectly

What is transient neonatal pustular melanosis

Pustules that heal with brown macules, Very common

How well did you know this?

Not at all

Perfectly

What do you do if suspect staph infection

Start Ax

How well did you know this?

Not at all

Perfectly

What is sebaceous naevus and what do you do [3]

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

How well did you know this?

Not at all

Perfectly

What are common birth marks [6]

Capillary haemangioma (Strawberry naevus) 
Melanocytic naevi
Melanocytosis (Mongolian blue spot) 
Giant melanocytes naevus
Port Wine stain (Naevus Flameus) 
Stork Marks (Naevus simplex / salmon)
Cafe au lait spots

How well did you know this?

Not at all

Perfectly

What is a capillary haemangioma or strawberry naevus?

Ax 
RF [3]
Sxs [5]
Prognosis
Management [2]

Ax: dilated capillaries

Risk factors: female, premature, mother underwent chorionic villus sampling

Sxs: Red, raised, discrete edge. Multi-lobed lesion can appear on any site in body. Appear in 1st month

Regress over next few years (95% by 10 yo)

Mx: no mx required unless visual field obstruction where can use PROPRANALOL or topical beta blocker TIMOLOL

How well did you know this?

Not at all

Perfectly

What are melanocytes naevi [2]

Moles

Round / oval / rough

How well did you know this?

Not at all

Perfectly

What is melancoytosis [2]

Mongolian blue spot

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

How well did you know this?

Not at all

Perfectly

What is giant melanocytic naevus

Large area of dark pigmentation

Often hairy

How well did you know this?

Not at all

Perfectly

What do you do if >1 giant melanocytes naevus

MRI brain and spine

How well did you know this?

Not at all

Perfectly

What are Naevus Flameus [5]

Port wine stains
Present at birth
Flat or slightly raised on face
Dilated capillaries
Do not regress

What is associated with Naevus Flameus?

Struger-Weber

How do Naevus Simplex present [3]

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

What is an Ebstein pearl? [5]

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

Hemangioma
What is the natural course? [2]
Site
Mx

Starts as flat red mark that grows into spongy rubbery bump
Rest phase then disappears
Site: anywhere
Mx: remove if obstructing vision

What is laryngomalacia [3]

What does it cause
How do you treat

Floppy upper larynx
Stridor and feeding problems
Resolves without Rx

What is tracheomalacia [3]

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

What is bronchomalacia

How does it present
How do you treat

Weak bronchial cartilage 
Stridor
Wheeze
SOB 
Most likely need CPAP +- tracheostomy

What is associated with cleft lip? [5]

What Trisomies are associated with cleft lip? [3]

What is a complication of cleft lip/palate?

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

Cx: OM

What are issues with cleft [3] Definitive management [1]

Poor feeding Poor speech Airway issues Surgical repair at 5 yo

How does choanal atresia present [2]

If bilateral - soft tissue / bone block | Cyanosis

What is common after birth in the eye [2]

Subconjunctival haemorrhage Discharge due to immature ducts Look for conjunctivitis

What are the symptoms of facial palsy in a neonate? [3]

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

What is asymmetric crying facies and what is it caused by? [2]

Eye and forehead muscles unaffected | Caused by absence of depressor angle oris muscles

How do you treat hypoglycaemia [4]

Breastfeed / formula feed Maintain skin to skin NG / IV dextrose / glucagon Hydrocortisone

What may you see on chest

Prominent xiphersternum as thin skin

What is craniocyntosis

Premature fusion of skull bones

What is plagiocephaly

Also known as flat head syndrome, is a condition characterized by an asymmetrical distortion (flattening of one side) of the skull. Ipsilateral forehead and ear forward

What is a benign dimple [4]

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

What do you do?

USS within 6 weeks

If USS abnormal

MRI

NTD Risk factor [2] Ax Classification [3]

RF: - FHx (either parent or siblings) - maternal: anti-epileptic drugs, DM, thalassaemia trait, obesity Aetiology: insufficient folic acid intake Classification - Spina bifida - Encephalocele - Anencephaly

NTD | Classification of spina bifida [3]

- Occulta (benign): incomplete vertebral arch covered by skin - Meningocele: herniation of dura and arachnoid through bony defect; RARE - Myelomeningocele: meningocele + cord involvement

``` NTD Presentation of myelomeningocele Urology [2] Neuro [3] MSK [7] Other [2] ```

Nerve roots in cyst are exposed and cause complications o Urology: urinary incontinence (affected above S1), urinary tract problems o Neuro: hydrocephalus, Chiari II malformation, tethered cord o MSK: kyphosis, lordosis, scoliosis, hip dislocation, reduced bone density and increased # risk, hip and knee contracture, calcaneomegavalgus, pes cavus, club foot, toe clawing, heel/foot ulcers o Other: LATEX ALLERGY (3/4), learning disability (1/5)