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Neonatal Flashcards

1
Q

Where are calcifications in CMV?

A

periventricular

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2
Q

What are long term complications of CMV?

A

sensorineural deafness
learning disabilties

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3
Q

What is characteristic of herpes simplex infection?

A

Hepatosplenamegly
Cranail USS with diffuse oedema

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4
Q

What is fetal varicella syndrome?

A

Low birth weight
Cicatrical skin - pale yellow dermatomal scars
Limb hypoplasia
Microcephaly
Chorioretinitis

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5
Q

Which treatment should a non-immune pregnant woman receive if contacts chicken pox?

A

Varicella zoster immunoglobulin

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6
Q

When does polycyntheia occur in neonates?

A

Venous haematocrit >65%

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7
Q

When do you treat neonatal polycyaethmia ?

A

Symptomatic
Venous haematocrit > 70 with no symptoms

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8
Q

What is treatment for polycytheamia ?

A

partial exchange transfusion with removal of blood and replacement of 0.9% sodium chloride to reduce haemocrit to 50%

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9
Q

Which medication is first line to treat neonatal seizure

A

phenobarbital

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10
Q

What is phenobarbital MoA

A

activating the gamma-aminobutyric acid GABA A receptor

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11
Q

When and where is surfactant produced

A

lipoprotein syntethesize in type 11 pneumocystis from 24 weeks

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12
Q

What organisms cause early onset sepsis

A

Group B strep
E.coli
Listeria monocytes
Haemophilus

non-bacteria - herpes, enterovirus

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13
Q

Cause of late onset sepsis

A

coagulase-negative staphylococci
E.Coli
Klebsiella
S.aurues

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14
Q

Risk factors for sepsis

A

Forceps delivery
Chorioamniotisis
Intrauterine monitoring
Maternal GBS colonisation
Intrapartum fever
Preterm delivery
Prolonged rupture of membranes >18 hours
Meconium-stained fluid

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15
Q

What does a blood test in NEC show?

A

Metabolic acidosis

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16
Q

What causes respiratory distress syndrome?

A

Defiency of surfactant - higher surface tension at the alveolar surface
Preterm infant airways - lack sufficient cartilage to remain patent = collapse lungs an increased airway resistance

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17
Q

Prevention of RDS

A

Antenatal glucocorticoid to induce endogenous surfactant formation
Exogenous surfactant replacement therapy
Resp. support - CPAP

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18
Q

What benefits are there to human breast milk in neonates

A

Reduced risk of NEC
Reduced risk of systemic infection

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19
Q

What is patency of PDA maintained by

A

High blood flow
Hypoxia
Locally derived prostaglandin E2

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20
Q

What type of shunt is a PDA

A

left to right

Increased pulmonary blood flow
Pulmonary oedema a
CCF

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21
Q

What type of murmur is a PDA

A

pan systolic at left sternal edge \
loud second heart soul
gallop rhythm
bounding pulse from wide pulse pressure

22
Q

Management of pDA

A

Most close spontaneously
Restricted fluid
Indomethacin or ibuprofen - decrease production of pGE2

23
Q

What is indomethacin ass. with

A

more nephrotoxicity
NEC
GI heamorrhage
platelet dysfunction
Impaired cerebral blood flow

24
Q

Do neonates have more IgG antibodies then mum

A

Yes - transplacental transfer of antibodies

25
Which antibody does breast milk contain
IgA - passive immune protection No igG
26
What are the clinical diagnostic factors for NEC
Abdominal distension and tenderness Bilious aspirates Bloody stools Intramural air (pneumatosis intestinal) on abod Xray
27
WHAt are risk factors of NEC
Prematurity HIE - IUGR, PDA Feeding - rapid increase in enteral feeds, formula milk Infection
28
Management of NEC
Stop feeds and place lore bore nano tube for intestinal decompression Braod spectrum ABX Surgery - bowel perforation
29
What causes periventricular-intraventicular haemorrhage
Rupture of fragile capillary network in subependymal matriculates of developing brain
30
When is transient tachypnoea of newborn more common
C-section
31
Why is TTPN more common in c-sections
Absence of thoracic squeezing of lung liquid from chest Clearance of metal lung fluid dependent on rebasorption of alveolar flu via sodium channels - influcend by level of circulation catecholamines. There are lower catecholamines following elective delivery
32
What conditions increase risk of thoracic air leaks?
RDS Meconium aspiration syndrome Congenital diaphragmatic hernia Previous pneumothorax Pulmonary hypoplasia
33
Why do air leaks syndrome occur?
Damage to respiratory epithelium - allows the air to enter interstitial space causing pulmonary interstitial emphysema
34
What affects pulmonary development in gestational diabetes mums
IGF - 1 - potentiated undifferentiated cells In lungs
35
What is Hirchsprung disease
Congenital absence of submucosa or myenteric plexus Meissner - submuscosal Auerback - myenteric is muscular layer between circular and longitudinal layers
36
what are the conditions tested in newborn screening
sickle cell disease CF congenital hypothyroidism maple syrup urine disease phenylyketonuria MCADD isovaleric acidemia glutamic acuduria type 1 homocysturia
37
When does screening for CF on newborn screening test become unreliable
after 8 weeks can test others up to 1 year
38
What is forced vital capacity
total amount of air exhaled with forced expiration
39
what is forced expiratory in first second FEV1
measures large airway obstruction
40
Risk factors for hemorrhagic disease of newborn
Prematurity Complicated deliveries Delayed feeding Breast fed
41
Pathophysiology of hemorrhagic disease of newborn
Vit K dependent clotting factors are deficient at birth - don't cross placenta (2, 7, 9, 10) Vit K given to activate them
42
Clinical presentation of haemorrhagic disease of newborn
Bleeding - intracranial (Seizure) , meleana Umbilical stump bleeding
43
Management of hemorrhagic disease of newborn
Prevention - iM vit K Treatment - IV vit K +/- FFP if severe
44
Meconium aspiration syndrome cause
Causes mechanical obstruction of bronchioles preventing gas exchange Cause inflammatory pneumonitis
45
Types of congenital diaphragmatic hernias
Posterolateral Bockdarek hernia - most common, left side Anterior Morgani hernia Hiatus hernia
46
Clinical presentation of congenital diaphragmatic hernias
polyhydramnios significant respiratory depression reduced breath sounds on side of hernia pulmonary hypoplasia displaced heart sounds
47
How do you increase Co2 clearance on a ventilator
Decrease ventilator rate
48
What is the max of PIP in preterm and normal
not max 25 not max 30
49
When do cerebral blood vessels strengthen?
After 30 weeks
50
What results will neonatal allomune thrombocytopenia show
Low PLT Normal anticoagulant study
51
Types of ToF
A - oesophageal atresia B - proximal fistula, distal atresia C - proximal atresia, distal fistula - most common D - proximal and distal fistula with both atresia H - double fistula

TAS (18 decks)

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