Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Specialities > Neonatal medicine > Flashcards

Neonatal medicine Flashcards

1
Q

What are the signs of respiratory distress in a neonatal?

A

Intercostal recession

Subcostal recession

Nasal flaring

Tracheal tug

Head bobbing

Grunting
- trying to drive air into the lung

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

What is the management of respiratory distress in a neonatal?

A

Oxygen
CPAP
Artificial surfactant
Antenatal steroids

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

What are the signs and symptoms of intraventricular haemorrhage in a neonate, and how is it diagnosed?

A

Common in preterm or low birth weight.

  • Ultrasound used to diagnose
  • MRI may be used for more detailed imaging.
  • 4 grades, with grades 1 and 2 have favourable outcomes, grade3,4 having long term sequalae

Seizures
Apnoea’s
Bulging fontanelle
Cerebral irritability

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

What is the area within the ventricles that bleeds in a intraventricular haemorrhage.

A

Germinal matrix

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

Why are premature infants at risk of infection?

A 
Lack maternal IgG reserves 
Multiple lines in situ 
Hospitalisation for long periods 
Thin skin
Lack of physiological reserve - hypoglycaemia, hypothermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some signs of sepsis that are specifically seen in neonates?

A

Poor feeding

Lethargy/ constant sleeping/ difficult to maintain awake

Jaundice

Seizures

Crying

  • persistent
  • high pitched (cerebral irritation)

Fever/ hypothermia (more common in pre-term)

Fontella shrunken/ bulging

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

What is the antibiotic management in neonates with sepsis?

A

<72 hours old:
- IV penicillin + IV Gent
+
Aciclovir

> 72 hours old:
- IV Flucloxacillin + IV gent
+
Aciclovir

*based on the likely pathogens

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

Why are neonates more susceptible to jaundice?

A

Shorter life span RBCs

Lower levels of liver enzyme activity
- glucosyl transferase

Slower intestinal tract transit
- allow more reabsorption

Medications displacing albumin from bilirubin

Breast milk can lead to unconjugated jaundice

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

What are some of the causes of jaundice in neonates?

A

Conjugated:

  • biliary atresia
  • Cystic fibrosis
  • hepatitis
  • TPN

Early unconjugated:

  • sepsis
  • Rh incompatibility
  • ABO incompatibility
  • Haemoglobinopathies

> 24 hours:

  • physiological
  • breast milk

> 2 weeks:

  • biliary atresia
  • breast milk
  • congenital hypothyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the major complication of neonatal jaundice? and how does it present?

A

Kernicterus: bilirubin binds irreversibly to the neuroreceptors of the basal ganglia

early features:

  • poor feeding
  • lethargy

Late finding:

  • hypertonia
  • seizures
  • coma

Complications:

  • death
  • deafness
  • cerebral palsy
  • intellectual defects
  • athetoid movements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the management of a jaundice baby?

A

Conservative

  • monitor bilirubin levels
  • maintain hydration

Phototherapy

Exchange transfusion

*all guided by the threshold chart

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

What is the surgery used in biliary atresia?

A

Kasia Porto- enterotomy
or
Liver transplant

*give vitamin K

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

How should CPR be delivered in a neonatal/ child? and what is the heart rate at which you would start chest compression at?

A
  1. Immediately 5 rescue breaths
    (if baby cover both mouth and nose with your mouth)
    • Neonate: 3:1
    • Child: 15: 2

Chest compression for a neonate should be started at: <60bpm

*rate 100-120bpm

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

What is a complication that occur during birth that can lead to a swollen head of a child taking several months to resolve? and what is it typically associatted with?

A

Cephalohematoma

  • bleeding between the periosteum and skull
  • usually on parietal region

Can be associated with forceps delivery.

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

What is a common cause of seizure within the first 72 hours after birth?

A

Bleeding witihin the ventricular system causing hydrocephalus

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

What are the red flags for constipation in a child?

A

Present from birth

Delayed passage of meconium >48 hours

Ribbon stools

Neurological symptoms

Abdominal distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the average weight of a baby at term?

A

3.5kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In an adolescent history, what key things do you want to ask?

A

HEADS

Home
Environment/ employment 
Activities 
Drugs 
Sexual health/ Suicidal thought
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the most common cardiovascular defect in Down’s Syndrome?

A

Atrioventricular septal defect

2nd is ventricular septal defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What features may you see on physical examination of a newborn with Down’s Syndrome?

A

Generalised Hypotonia

Epicanthal folds

Upslating palpebral fissures

Brachycephaly

Excess skin on neck

Singel palmer crease

Sandal toe gap in feet

Short stature/ poor growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List 5 neurological complications of Down’s syndrome:

A

Learning difficulties

Hearing impairment
- Neurosensory

Strabismus

  • exotropia
  • exotropia

Increased incidence of epilepsy

Atlantoaxial instability

*Alzheimer’s risk in lalter life (3 copies of APP)

22
Q

List some of the features seen in a baby with Edwards syndrome:

A

Trisomy 18 - Edwards:

Microcephaly and small chin

Low set ears

Overlapping fingers in a clenched fist

Rocker Bottom feet

Cardiac:

  • VSD
  • ASD
  • PDA

**90% don’t survive past 1 year

23
Q

What are the features seen in Patau syndrome/ Trisomy 13?

A

Microcephaly

Small eyes

Renal abnormaliteis
- horse shoe

Polydactyly

24
Q

Name some symptoms and clinical signs of pyloric stenosis:

A

Effortless projectile vomiting following feeds
- no bile

Peristaltic waves in upper quadrant of stomach

Mass in epigastrium
- right upper quadrant

Hypokalemia

Metabolic alkalosis

25
Q

What Is the definitive diagnostic investigation and definitive management of pyloric stenosis?

A

Ultrasound

Ramstedt’s pyloromyotomy

26
Q

What are some signs and symptoms of bowel intussusception?

A

Symptoms:

  • Paroxysmal abdominal colic pain
  • Turns pale when bringing knees up

Signs:
Sausage sized mass in RUQ

Empty RLQ
- Dance sign

Redcurrant jelly discharge

Pallor patient

27
Q

What is the pathology that can arise with oedema on the head due to pressure passing through the birth canal?

A

Caput Succedaneum
- oedema: passing the suture lines

*disspears within days

28
Q

What is the resuscitation protocol of a neonate?

A
  1. Dry and warm baby >26 degrees.
  2. Calculate APGAR
    - neuro, HR, Breathes per min
  3. Simulate breathing
    - neutral position
    - rubbing
  4. Inflation breaths
    - 2 x 5 inflation breaths - 30 secs each
    - ventilation +/- oxygen (if preterm)
  5. Chest compression
    - 3:1
29
Q

What are some of the pros of breast feeding to the mother and baby?

A

Mother:

  • reduced breast cancer
  • reduced ovarian cancer
  • reduced diabetes
  • potentially reduced postnatal depression
  • reduce risk of PPH
Baby: 
Receives IgA and macrophages from mother which reduces a host of infections such as: 
- Reduced gut infection 
- reduced respiratory infection 
- reduced ear infection

Reduces risk of:
cardiovascular disease
autoimmune conditions
sudden infant death syndrome

increases

  • improved cognitive ability
  • mother - baby bonding
30
Q

Why are babies at risk of malnutrition?

A 
High growth rates 
Low reserves of store 
Small size - high metabolic rate 
High levels of activity 
Increased rates of infection 
Dependence on other for food
31
Q

List some causes of jaundice in the first 24 hours of life:

A

Rhesus Haemolytic disease of the new born
- reduced due to anti-D prophylaxis

ABO incompatibility
- weak immunological response so not as devastating as Rh disease

G6PD

Sepsis

32
Q

List some causes of prolonged jaundice (>14 days)

A

Biliary atresia

Hypothyroidism

UTI

Breast milk

Congenital infections
- toxoplasmosis

33
Q

What are the key features seen in Hirschsprung disease?

A

Failure to pass meconium in first 48 hours
Abdominal distension
Bilious vomiting
Explosive foul smelling faecal matter if digital rectal examination

*can become hirsprung related enterocolitis

34
Q

What are some signs indicative of hypoxic ischemic injury?

A

Poor cord gases

Irritability

Absent suckle reflex

Seizures

35
Q

What are some risk factors for neonatal sepsis and what are the most common organisms?

A

Maternal fever

Prolonged rupture of membranes

Prematurity

Low birth weight

  • group B strep
  • E. Coli
36
Q

What are the head injuries caused by forceps?

A

Cephalohematoma
- outwith the skull so will not cause raised ICP

Caput succedaneum

Subgaleal haematoma (due to rupture of the emissary veins) 
- this can be serious as it is below the galeal aponeauosis but above the suture lines to can enter into the cranium causing wide spread bleeding within the cranium
37
Q

What is the time peroid for neonatal death?

A

within the first 28 days of life

38
Q

Brachial plexus injuries can occur and are more common with breech deliveries. Name two types of brachial plexus injury and their nerve root injury and appearance:

A

Erb’s palsy:

  • C5-C6
  • weak arm flexion and supination
  • extended arm and pronated in

Klumpske’s palsy:

  • C8-T1
  • weakness of extensors and intrinsic finger muscles
  • flexed arm and weak hand.
  • associated with Horner’s syndrome
39
Q

List some differentials for bilious vomit:

A

Duodenal Atresia

  • double bubble sign
  • contrast study for diagnosis

Jejenal/ ileal atresia
- AXR with airfluid levels

Meconium ileus

  • AXR
  • check for CF

Necrotising enterocolitis

  • Dilated abdomen
  • Pneumoatosis
40
Q

Why is the pharmacokinetics in babies different to adults?

A

reduced pH of the stomach

Reduced bile secretion

Reduced intestinal mobility

High percentage of water
- increasing water solubility

Immature liver enzymes

Reduced bioavailability

41
Q

What is the most important aspect of pharmacokinetics in neonates?

A

Excretion

- increasing the half life

42
Q

What is Hutchison’s triad?

A

Set of symptoms relating to congenital syphilis, consisting of:

  • hearing loss
  • Mouth and nose deformities (saddle nose)
  • eye pathologies (glaucoma, corneal clouding)
43
Q

List some signs and symptoms associated with congenital rubella:

A

Congenital heart disease
- PDA

Blueberry muffin rash

Cataracts

Neurosensory hearing loss

Meningocephalitis

44
Q

Which TORCH infections cause calcification in the brain and what are the difference between the two?

A

Toxoplasmosis:
- diffuse intracranial calcification

CMV:
- Periventricular calcification

45
Q

List some risk factors for neonatal sepsis:

A 
GBS in the mother 
Early placental rupture 
Prolonged labour 
Preterm 
Small for gestational age
46
Q

List some causes of unconjugated hyperbilirubinemia and list the main cause of conjugated and describe how it presents:

A

Unconjugated:

  • Physiological
  • breast milk
  • Haemolytic disease
  • Infection
  • Congenital hypothyroidism

Conjugated:

  • biliary atresia
  • presents with pale stools and dark urine plus jaundice
  • TORCH infections
  • Hepatitis
47
Q

What two things determine the treatment for newborn jaundice and what is the complication of jaundice:

A

Gestational age and bilirubin level

Kernicterus

48
Q

What is prolonged jaundice of the neonate and what investigations should it trigger?

A

> 14 days
21days in preterms

should think about:

  • biliary atresia
  • hypothyroidism
  • Haemoglobinopathies (G6PD)
  • Neonatal hepatitis

*breast milk is the most common cause of prolonged jaundice.

49
Q

Define neonatal sepsis:

A

Sepsis that occurs in the first 28 days.

  • Early onset neonatal sepsis being <48 hours
  • Late onset neonatal sepsis being >48 hours
50
Q

What antibiotics are given in neonatal sepsis?

A 
Early onset: 
- IV Benzylpenicillin
\+ 
- IV Gentamicin  
\+/- 
Aciclovir 
Late onset: 
- IV flucloxacillin 
\+ 
- IV Gentamicin
\+/- 
Aciclovir

Specialities (63 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions