Neonatal Flashcards
When is term?
37 - 42 weeks gestation
When is the neonatal period?
0 - 4 weeks old
What is normal birth weight? What is very low birth weight? What is extremely low birth weight?
Normal 2.5. - 4kg
VLBW <1.5kg
ELBW <1kg
Define small for gestational age
Below 10th centile for gestation
How is a normal neonatal HR and RR?
HR 110 - 160
RR <50/60
Is acrocyanosis a sign of heart disease?
No - blue hands/feet +- perioral blueness is normal in neonates
What type of ventilation is 1st line in neonates? What is an important side effect?
CPAP
SE pneumothorax
When is a red flag for passage of meconium?
> 24hr red flag
What age does the Babinski reflex disappear in infants?
1yr
What is a minimum Apgar score? What is a maximum socre? What is a normal score?
Min 0
Max 10
Normal 8+
What are the 5 domains of Apgar scoring and the points for them?
COLOUR: 2 pink, 1 peripheral cyanosis, 0 blue all over
RESPONSIVENESS: 2 strong cry, 1 weak cry,
RR: 2 strong cry, 1 slow/ irregular, 0 apnoeic
TONE: 2 flexion + resisting extension, 1 some flexion, 0 floppy
HR: 2 >100, 1<100, 0 = 0
When is extremely and very preterm?
Extremely <28
Very <32
Until what is age is a correct gestational age growth chart used in preterm babies?
2 years
What is the use of Mg sulfate in preterm infants?
Brain protection reduces cerebral palsy
Delayed cord clamping is for minimum how many seconds
Minimum 60secs
What is the use of antenatal steroids in preterm infants?
Reduces lung disease, brain haemorrhage, NEC, sepsis
What is a normal neonatal temperature?
36.5 - 37.5
What is the management of neonatal hypoglycemia?
10% IV dextrose
What type of brain haemorrhage can vit K deficiency cause?
Intraventricular
What is the cause of neonatal RDS?
Surfactant deficiency in preterm babies
What is seen on CXR in neonatal RDS?
Ground glass appearance
also small volume lungs, diffuse granular opacifications
What is the Mx of neonatal RDS?
Surfactant replacement + CPAP
What is given to mum to help prevent neonatal RDS?
Steroids
What is the main RF for transient tachypnoea of the newborn?
C/S
vaginal delivery helps squeeze fluid into interstitial space
What is the Mx of transient tachypnoea of the newborn?
Self resolves within 48hr
How is NEC diagnosed?
AXR thumbprinting gas in bowel
How does NEC initially present?
Feeding intolerance, abdo distension, bloody stools
Does NEC usually present in first day of life or few weeks after birth?
Few weeks after birth
Neonatal sepsis organisms
- GBS during or after delivery
- Staph during or after delivery
GBS during
Staph after
When is a TORCH screen done?
Neonatal sepsis
In neonatal sepsis babies may have a low temp - true or false
Have a high or low threshold for Dx
May have low temp
Low threshold
What is the antibiotic regime for neonatal sepsis?
IV amox + IV ceftriaxone
When is neonatal jaundice a red flag?
First 24hr
What investigation is done for neonatal haemolytic jaundice?
Direct Coombs test
What is kernicterus?
Bilirubin related brain damage
Name 4 causes of jaundice in the first 24hr of life
*mainly haemolytic disease* G6PD deficiency Rhesus haemolytic anaemia Spherocytosis ABO haemolytic anaemia
Breastfeeding is a risk factor for jaundice - true or false
True
Jaundice from 24hr - 2wk old is usually physiological - true or false
True
Jaundice should be investigated if it persists after 2wk - true or false
True
What congenital heart defect is strongly associated with Down’s syndrome?
AVSD
“Bicuspid aortic valve + coarctation of the aorta” is seen in what genetic syndrome?
Turner syndrome
“Dilatation of the aorta and mitral regurgitation / mitral valve prolapse” is seen and what congenital syndrome?
Marfan
What is a thrill / heave?
Thrill palpable murmur
Heave moves hand
What is prophylaxis for haemorrhagic disease of the newborn? Are all babies given this?
All babies get prophylactic IM vit K at birth
Is transposition of the great arteries cyanotic or acyantoic?
Cyanotic
Is coarctation of the aorta cyanotic or acyantoic?
Acyanotic
Is a VSD or ASD cyanotic or acyantoic?
Acyanotic
Is tetralogy of fallow cyanotic or acyanotic?
Cyanotic
Is patent ductus arteriosus cyanotic or acyanotic?
Acyanotic
What congenital heart defect causes a radio femoral delay?
Coarctation of the aorta
Which congenital heart defect causes a boot shaped heart on CXR?
Tetralogy of fallow
Patent foramen ovale is present in what percentage of the population?
20%
Which congenital heart defect causes a continuous machinery murmur?
Patent ductus arteriosus
What are the 4 components of tetralogy of fallot?
Over-riding aorta
VSD
RVH
Pulmonary stenosis
In patent ductus arteriosus, what drug opens and what closes the duct?
Indomethacin closes
Prostaglandin opens
In patent ductus arteriosus, there is a connection between what and what?
Pulmonary trunk and descending aorta
Which congenital heart defect causes a pain systolic murmur?
VSD
How many grades of murmur are there?
Graded 1 - 6
Innocent murmurs are systolic or diastolic?
Systolic
What causes a blueberry muffin rash?
CMV
A stork mark and salmon patch are both types of?
Birthmark capillary haemangioma
What are milia? What is the management?
Milk spots
Self resolve go away
Port wine stain v salmon patch - which is more likely to persist?
Port wine stain
Infantile spasms are also known as?
West syndrome
“baby lying flat gets reflux, looks like they’re fitting” also known as
Sandiffer syndrome
What age does infantile spasms usually present?
4 - 8 months
