Healthy, Sick and Preterm Infant

Question 1

What is the normal weight for a term infant?

Answer 1

2.5-4kg

Question 2

What is assessed in the Apgar score?

Answer 2

Heart rate
Respiratory rate
Responsiveness
Tone
Colour

Question 3

What is considered a normal Apgar score?

Answer 3

8 or above

Question 4

What occurs in haemorrhagic disease of the newborn?

Answer 4

The infant is vitamin K deficient leading to haemorrhage

Question 5

What screening tests are carried out on a newborn?

Answer 5

Hearing screening
Hip screening
CF
Haemoglobinopathies
Metabolic disease (PKU etc.)

Question 6

In a newborn examination, what is being looked at in the head?

Answer 6

Circumference
Overlapping sutures
Fontanelles
Forceps marks
Moulding

Question 7

In a newborn examination, what is being looked at in the eyes?

Answer 7

Size
Red reflex
Haemorrhage
Squints

Question 8

In a newborn examination, what is being looked at in the ears?

Answer 8

Position
External auditory canal
Tags/pits
Folding

Question 9

In a newborn examination, what is being looked at in the mouth?

Answer 9

Shape
Philtrum
Tongue tie
Palate
Teeth
Sucking/rooting reflex

Question 10

In a newborn examination, what aspects of the respiratory system are being looked at?

Answer 10

Chest shape
Nasal flaring
Grunting
Tachypnoea

Question 11

In a newborn examination, what aspects of the cardiovascular system are being looked at?

Answer 11

O2 sats
Femoral pulse
Apex beat
Thrills/heaves
Heart sounds

Question 12

In a newborn examination, what aspects of the abdominal system are being looked at?

Answer 12

Distention
Herniation
Umbilicus
Bile-stained vomiting
Passage of meconium
Anus

Question 13

In a newborn examination, what aspects of the genitourinary system are being looked at?

Answer 13

Normal urine passage
Normal genitalia
Undescended testes
Hypospadias

Question 14

In a newborn examination, what aspects of the musculoskeletal system are being looked at?

Answer 14

Movement and posture
Limbs and digits
Spine
Hip examination

Question 15

In a newborn examination, what aspects of the neurological system are being looked at?

Answer 15

Alertness
Crying
Tone
Posture
Movement
Primitive reflexes

Question 16

Give some primitive reflexes that may be elicited in a newborn

Answer 16

Suckling/Rooting
Moro
ATNR
Stepping
Grasp

Question 17

What is the normal respiratory and heart rate of a newborn?

Answer 17

RR = 40-60
HR = 120-140

Question 18

Give some common sites of infection in a newborn

Answer 18

Bloodstream (sepsis)
CNS (meningitis)
Respiratory (pneumonia)
GU (UTI)

Question 19

Which bacteria commonly infect newborns?

Answer 19

Group B strep
E. coli
Listeria
Staph aureus
Staph epidermidis

Question 20

Which viruses commonly infect newborns?

Answer 20

CMV
Parvovirus
Herpes viruses
Enteroviruses

Question 21

What occurs in hypoxic ischaemic encephalopathy?

Answer 21

Multi-organ damage due to tissue hypoxia

Question 22

What pregnancy/birth related respiratory problems can occur in newborns?

Answer 22

Transient tachypnoea of the newborn

Pneumothorax

Question 23

What pregnancy/birth-related cardiac problems can occur in newborns?

Answer 23

Heart failure

PPHN

Question 24

Give examples of congenital heart disease

Answer 24

Tetralogy of Fallot
Transposition of great arteries
Aortic coarctation
TAPVD

Question 25

Give examples of congenital respiratory disease

Answer 25

Tracheo-oesophageal fistula | Diaphragmatic hernia

Question 26

What initial management is made for sick newborns?

Answer 26

``` Temperature Airway and breathing Circulation Metabolic homeostasis Antibiotics ```

Question 27

Give some risk factors for preterm birth

Answer 27

``` Previous preterm delivery Abnormally shaped uterus Multiple pregnancy IVF Drug use Poor nutrition ```

Question 28

All preterm infants must be kept warm immediately. True/false?

Answer 28

True

Question 29

Why do preterm infants struggle to control their temperature?

Answer 29

Low basal metabolic rate Minimal muscular activity Low SC fat insulation

Question 30

Why are preterm infants at increased risk of nutritional compromise?

Answer 30

Limited nutrient reserves Immature gut/metabolic pathways Increased nutrient demands

Question 31

Which organisms tend to cause early onset neonatal sepsis?

Answer 31

Group B strep | Gram negatives

Question 32

Which organisms tend to cause late onset neonatal sepsis?

Answer 32

Coagulase negative staph Gram negatives Staph aurues

Question 33

How can neonatal sepsis be avoided?

Answer 33

Hand washing Infection screening Judicious use of antibiotics

Question 34

Give some respiratory complications of prematurity

Answer 34

Respiratory distress syndrome Apnoea of prematurity Bronchopulmonary dysplasia

Question 35

What is the primary pathology occurring in respiratory distress syndrome?

Answer 35

Surfactant deficiency

Question 36

Give some clinical features of RDS

Answer 36

``` Tachypnoea Grunting Intercostal recessions Nasal flaring Cyanosis ```

Question 37

How is RDS managed?

Answer 37

Maternal steroid Surfactant Ventilation

Question 38

What cardiovascular abnormality can occur in prematurity?

Answer 38

Patent ductus arteriosus

Question 39

What neurovascular abnormality can occur in prematurity?

Answer 39

Intraventricular haemorrhage

Question 40

What occurs in necrotising enterocolitis?

Answer 40

The intestine becomes inflamed and starts to necrose leading to a perforation