Neonatal Flashcards

1
Q

what are the risk factors for a premature baby

A

> 2 preterm previous deliveries
abnormally shaped uterus
multiple pregnancy
interval of <6 months between pregnancies
IVF conception
smoking, alcohol and illicit drug use
poor nutrition, some chronic conditions, high BP, diabetes, multiple miscarriages and abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

if the baby is okay and can be kept warm how long should you pause for to allow placental transfusion

A

one minute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

low admission temperature is a dependent or independent risk factor for neonatal death

A

it is an independent risk factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how does hypothermia affect preterm morbidities

A

it increases severity of all preterm morbidities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

why is thermal regulation ineffective in the preterm babies

A

low BMR
minimal muscular activity
subcutaneous fat insulation is negligible
high ratio of surface area to body mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how can a preterm baby be kept warm

A

wrap or bags, transwarmer mattress, skin to skin, prewarmed incubator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

why is there increased risk of potential nutritional compromise

A

limited nutrient reserves
immature metabolic pathways
increased nutrient demands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is gestational correction

A

adjusts the plot of a measurement to account for the number of weeks a baby was born early

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how long should gestational correction be used for

A

continued until 1 year for infants born 32-36 weeks

2 years for infants born before 32 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how is neonatal sepsis categorised

A

time of onset
EOS-early onset, mainly due to bacteria acquired before and during delivery
LOS-acquired after delivery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

RDS is also known as

A

hyaline membrane disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the primary and secondary pathology of RDS

A

primary-surfactant deficiency, structural immaturity

secondary pathology-alveolar damage, formation of exudate from leaky capillaries, inflammation, repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the clinical features of RDS

A

tachypnoea, grunting, intercostal recessions, nasal flaring, cyanosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how does RDS tend to progress

A

worsen over minutes to hours, gradual worsening to a nadir at 2-4 days then gradual improvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how does failure of PDA closure affect RDS

A

exacerbates RDS as symptoms of congestive heart failure, oxygen requirements are high which exacerbated RDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is an intraventricular haemorrhage

A

a form of intracranial haemorrhage that begins with bleeding into the germinal matrix

17
Q

what are the 2 major risk factors for intraventricular haemorrhage

A

prematurity, RDS

18
Q

when does intraventricular haemorrhage tend to occur

A

in the first day of life

19
Q

name some preventative measures for IVH

A

antenatal steroids
prompt and appropriate resuscitation
avoid haemodynamic instability
avoid-hypoxia, hypercarbia, hyperoxia and hypocarbia

20
Q

how is IVH graded

A

grade1-4
neurodevelopmental delay up to 20% in grade1-2 mortality 10%
grade 3-4 neurodevelopmental delay up to 80% mortality 50%

21
Q

what is the typical feature of NEC

A

usually after recovering from RDS
early signs-lethargy and gastric residuals
bloody stool, temperature instability, apnoea and bradycardia

22
Q

how do you treat NEC

A

nil by mouth
except for ?probiotics
broad spectrum antibiotics
consult surgeon

23
Q

what is pathognomic for NEC

A

pneumatosis intestinalis-gas in the gut wall seen on XR

24
Q

what is ROP

A

retinopathy of prematurity

25
Q

what is ROP

A

affects immature vasculature in the eyes of premature babies, it can be mild with no visual defects, or it may become aggressive with new blood vessel formation (neovascularization) and progress to retinal detachment and blindness

26
Q

NEC is more common in babies under what birth weight

A

1500g

27
Q

about what percentage of births are preterm

A

6%