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Paeds > Common Presentations in Neonates > Flashcards

Common Presentations in Neonates Flashcards

1
Q

What is pallor associated with [6]

A

Anaemia secondary to

  • Bleeding
  • Bone marrow failure
  • Destruction
  • DIC
  • Blood sampling
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2
Q

When do you not worry about cyanosis

A

Peripheral

Common in first 24 hours due to vasomotor changes

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3
Q

What types of rash do you worry about [2]

A

Petechial (non-blanch)

Papular = fine

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4
Q

What other rashes do you get [5]

A 
Milia
Milliari
Transient neonatal pustular melanosis
Erythema toxic 
Sebaceous naves
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5
Q

What is milia [2]

A

White papule on tip of nose

Hyperplastic sebaceous glands due to placenta hormone

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6
Q

What is miliari [2]

A

Small vesicles and pustules over face / scalp and trunk

Due to immature sweat gland production

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7
Q

What is transient neonatal pustular melanosis

A

Pustules that heal with brown macules, Very common

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8
Q

What do you do if suspect staph infection

A

Start Ax

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9
Q

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

A

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

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10
Q

What are common birth marks [6]

A 
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
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11
Q

What is a capillary haemangioma or strawberry naevus?

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

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

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12
Q

What are melanocytes naevi [2]

A

Moles

Round / oval / rough

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13
Q

What is melancoytosis [2]

A

Mongolian blue spot

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

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14
Q

What is giant melanocytic naevus

A

Large area of dark pigmentation

Often hairy

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15
Q

What do you do if >1 giant melanocytes naevus

A

MRI brain and spine

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16
Q

What are Naevus Flameus [5]

A 
Port wine stains
Present at birth
Flat or slightly raised on face
Dilated capillaries
Do not regress
17
Q

What is associated with Naevus Flameus?

A

Struger-Weber

18
Q

How do Naevus Simplex present [3]

A

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

19
Q

What is an Ebstein pearl? [5]

A

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

20
Q

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

A

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

21
Q

What is laryngomalacia [3]

  • What does it cause
  • How do you treat
A

Floppy upper larynx
Stridor and feeding problems
Resolves without Rx

22
Q

What is tracheomalacia [3]

A

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

23
Q

What is bronchomalacia

  • How does it present
  • How do you treat
A 
Weak bronchial cartilage 
Stridor
Wheeze
SOB 
Most likely need CPAP +- tracheostomy
24
Q

What is associated with cleft lip? [5]

What Trisomies are associated with cleft lip? [3]

What is a complication of cleft lip/palate?

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

Cx: OM

25
Q

What are issues with cleft [3]

Definitive management [1]

A

Poor feeding
Poor speech
Airway issues

Surgical repair at 5 yo

26
Q

How does choanal atresia present [2]

A

If bilateral - soft tissue / bone block

Cyanosis

27
Q

What is common after birth in the eye [2]

A

Subconjunctival haemorrhage
Discharge due to immature ducts
Look for conjunctivitis

28
Q

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

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

29
Q

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

A

Eye and forehead muscles unaffected

Caused by absence of depressor angle oris muscles

30
Q

How do you treat hypoglycaemia [4]

A

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

31
Q

What may you see on chest

A

Prominent xiphersternum as thin skin

32
Q

What is craniocyntosis

A

Premature fusion of skull bones

33
Q

What is plagiocephaly

A

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

34
Q

What is a benign dimple [4]

A

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

35
Q

What do you do?

A

USS within 6 weeks

36
Q

If USS abnormal

A

MRI

37
Q

NTD
Risk factor [2]
Ax
Classification [3]

A

RF:

  • FHx (either parent or siblings)
  • maternal: anti-epileptic drugs, DM, thalassaemia trait, obesity

Aetiology: insufficient folic acid intake

Classification

  • Spina bifida
  • Encephalocele
  • Anencephaly
38
Q

NTD

Classification of spina bifida [3]

A
  • Occulta (benign): incomplete vertebral arch covered by skin
  • Meningocele: herniation of dura and arachnoid through bony defect; RARE
  • Myelomeningocele: meningocele + cord involvement
39
Q 
NTD Presentation of myelomeningocele
Urology [2]
Neuro [3]
MSK [7]
Other [2]
A

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)

Paeds (33 decks)

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