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Paediatrics > Neonatal > Flashcards

Neonatal Flashcards

1
Q

What are the RF of NEC?

A

Preterm
Hyperosmolar feeding
Inf, ABX use
Gut ischemia e.g. hypoxia, polycythemia

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2
Q

What is the age of onset of NEC?

A

Term: 7d
Preterm: 14d
Extreme preterm: 21d

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3
Q

What are the S/S of NEC?

A

General: poor feeding, lethargy, tachypnea, bradycardia, unstable temperature
Abdominal distention, everted umbilicus, dusky abdominal skin
Fecal blood

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4
Q

How to Ix NEC?

A

AXR: intramural gas, portal venous gas, pneumoperitoneum

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5
Q

How to Mx NEC?

A

NPO, TPN, fluid, NG tube suction
Broad-spectrum ABX: amp + gen + mtz
Surg

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6
Q

What are the Cx of NEC?

A

Acute: perforation, peritonitis, septicemia, shock, DIC

Long term: short gut syndrome, TPN-related cholestasis, FTT

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7
Q

What is prolonged jaundice?

A

Term: 14d
Preterm: 21d

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8
Q

What are the causes of prolonged jaundice?

A

Breast milk
GI: biliary obst, neonatal hepatitis syndrome, GI obst
Inf (UTI)
Endocrine: congenital hypothyroidism

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9
Q

What is early onset jaundice?

A

Within 24hr

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10
Q

What are the DDx of early onset jaundice?

A

Unconjugated: hemolysis -> G6PD, Rh, ABO incompatibiltiy
Conjugated: inf -> congenital, early onset sepsis

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11
Q

What is intermediate onset jaundice?

A

Between 2d & 2w

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12
Q

What are the DDx of intermediate onset jaundice?

A 
Physiological
Breast milk (ihb), breast-feeding (dehydration)
Hematoma, polycythemis
Liver disorder
Inf (UTI)
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13
Q

What is BPD?

A

O2 dependence at 36w of gestation or 28d post natal age

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14
Q

How to Ix BPD?

A

CXR: cystic & fibrotic changes, widespread areas of opacification

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15
Q

How to Mx BPD?

A

O2 supplement
Steroid (IV dexamethasone)
General: high calorie diet, restrict fluid + diuretics

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16
Q

What is considered significant conjugated hyperbilirubinemia?

A

Conjugated (direct) >20% of total

17
Q

What is kernicterus?

A

Encephalopathy caused by deposition of unconjugated bilirubin in BG

18
Q

What are the S/S of kernicterus?

A

Lethargy, poor feeding, seizure, ophisthotonus

19
Q

What are the Cx of kernicterus?

A

Choreoathetoid CP, SNHL

20
Q

What are the S/S of neonatal sepsis?

A

Fever / hypothermia
Apnea, bradycardia
Poor feeding, vomiting

21
Q

What is the cause of physiological jaundice?

A

Decreased glucoronyl transferase activity

Increased RBC turnover but immature liver function

22
Q

What is cephalohematoma

A

Epidural bleeding
Confined by sutures
Resolves spontaneously
Higher risk in ID

23
Q

What is caput succadenum?

A

Edema of scalp at subdural layer
Crosses sutures
Resolves spontaneously
Higher risk in prolonged labour & vacuum extraction

24
Q

What is subgaleal hemorrage?

A

Between periosteum & aponeurosis
Diffuse swelling, massive blood loss b/c large potential space
Mx: resuscitate, monitor, FFP
Higher risk in vacuum extraction

25
Q

What are the effects of GDM on neonate?

A

Macrosomia
Polycythemia
HypoCa -> jittery, apnea

26
Q

What is Erb’s palsy?

A

C5-7 nerve root injury

27
Q

What are the S/S of Erb’s palsy?

A

Waiter’s tip sx

Asymmetrical moro reflex & limb movement

28
Q

How to Mx Erb’s palsy?

A

Reassure (resolve by 3mo)

PT (prevent contracture)

29
Q

What is the cause of ARDS?

A

Surfactant deficiency (e.g. preterm, GDM)

30
Q

What are the S/S of ARDS?

A

Respiratory distress within 4hr of delivery

31
Q

How to Ix ARDS?

A

CXR: diffuse reticulogranular ground glass appearance w/ air bronchograms
SpO2, ABG

32
Q

How to Mx ARDS?

A

O2 supp
Surfactant
Assisted ventilation e.g. CPAP, BiPAP
Supportive care

33
Q

How to prevent ARDS?

A

AN steroids if risk of preterm <34w

34
Q

What is CDH?

A

Herniation of abdominal viscera into chest -> pulmonary hypoplasia

35
Q

How to Dx CDH?

A

AN: morphology scan
PN: PE, AXR/CXR

36
Q

What are the Sx of CDH?

A

Barrel chest
Scaphoid abdomen
Asymmetrical chest expansion
CN despite respiratory support

37
Q

How to Ix CDH?

A

AXR/CXR

  • bowel loop in thorax, x bowel loop in abdomen
  • shifting of heart shadow, NG tube, ET tube, umbilical arterial catheter
38
Q

How to Mx CDH?

A

NG tube suction
Intubation (low pressure ventilation to prevent PTX)
Surg

Paediatrics (10 decks)

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