Illness in full term baby

Question 1

What is perinatal asphyxia

Answer 1

Oxygen deprivation on birth (greek for pulseless)

Question 2

Another name for perinatal asphyxia

Answer 2

Hypoxic- ischaemic encephalopathy

Question 3

What are the consequences in the tissue from hypoxic-ischaemic encephalopathy

Answer 3

Hypoxaemia
Ischaemia
Metabolic acidosis

Question 4

`What are the warning for hypoxia-ischaemia

Answer 4

Decreased fetal movement

Sentinel events

Question 5

What sentinel events give warning for hypoxia-ischaemia

Answer 5

Placental abruption
Uterine rupture
Cord prolapse

Question 6

What structures are preserved in redistribution of blood supply

Answer 6

CNS
Myocardium
Adrenals

Question 7

What structures are left vulnerable due to redistribution of blood supply

Answer 7

Kidneys
GI tract
Liver
Muscle

Question 8

What does encephalopathy in new born refer to (4)

Answer 8

• Abnormal neurologic function and conciousness
• Abnormalities of tone and reflexes
• Autonomic dysfunction
• Seizures

Question 9

What brain injury is most common after HIE

Answer 9

Cerebral palsy

Question 10

Describe the sequence of events that occur after fetal hypoxia

Answer 10

Primary neuronal injury
Primary energy failure
Derangement of cellular function
Secondary energy failure
Secondary neuronal injury, further necrosis and apoptosis

Question 11

What causes secondary neuronal death

Answer 11

Cerebrovascular dysfunction
Glutamate releasde
Free radicals 
Calcium entry
Apoptosis

Question 12

Name some mechanisms of brain injury in hypoxia-ischaemia

Answer 12

Glucose and oxygen deprivation
Energy depletion
Glutamate receptor activation
Accumulation of intracellular calcium
Free radicals
Lipid peroxidation
Oligodendrogial death
Apoptosis

Question 13

Why may inducing hypothermia be neuroprotective

Answer 13

Reduces cerebral metabolism
Reduced energy use
Reduced accumulation of excitotoxic aa
reduced NO synthetase activity
Reduced free radical activity

Question 14

When do newborns acquire serious infections

Answer 14

Passage through birth canal and from outside environment

Question 15

What infections do newborns suffer

Answer 15

GBS

E. coli

Question 16

Name 3 groups of newborns which have higher rates of infection/ high mortality from infections

Answer 16

Infants requiring intensive care
Preterm infant
Newborns in developing world

Question 17

What is the onset of early onset sepsis

Answer 17

Within 48 hours

Question 18

What causes early onset sepsis

Answer 18

Microbes acquired from mother before/ during passage through birth canal

Question 19

What condition may early onset group b streptococcus mimic

Answer 19

Perinatal hypoxia-ischaemia

Question 20

What are the features of early onset GBS

Answer 20

Apnea
Severe hypoxia
Cardio resp failure
Hypotension
Metabolic acidosis
Tachycardia
Poor perfusion

Question 21

What does a full blood count show in GBS

Answer 21

Neutropenia

Question 22

Predisposing factors to GBS

Answer 22

Evidence of chorioamniotis
Prolonged labour
Prolonged rupture of membrane
Low birthweight

Question 23

What brain related complication can result from E. coli infection

Answer 23

Meningitis

Question 24

What is the time period for late onset sepsis in the newborn

Answer 24

> 48 hours after birth

Question 25

Name 2 organisms often responsible for late onset sepsis

Answer 25

Coagulase negative staph

Staph aureus