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Paediatrics > Neonatal medicine - term > Flashcards

Neonatal medicine - term Flashcards

1
Q

Neonatal life support - describe the sequence of resuscitation

A

1) Unresponsive? Shout for help!
2) Dry the baby
3) Check airway and breathing - give 5 rescue breaths
4) Check circulation - HR, brachial/femoral pulses
5) Start chest compressions - 3 compressions : 1 resuce breath (tips of two fingers)

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2
Q

Describe the APGAR scoring system

A 
A - activity
P - pulse
G - grimace
A - appearance
R - respiration

Each indicator is given 0, 1 or 2 points (max score is 10)

Activity:

  • Absent = 0
  • Flexed limbs = 1
  • Active = 2

Pulse:

  • Absent = 0
  • <100/min = 1
  • > 100/min = 2

Grimace:

  • No response to stimulation = 0
  • Minimal response to stimulation = 1
  • Prompt response to stimulation = 2

Appearance:

  • Blue or pale = 0
  • Pink body, blue peripheries = 1
  • Pink = 2

Respiration:

  • Absent = 0
  • Slow and irregular = 1
  • Vigorous cry = 2
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3
Q

Describe the interpretation of the APGAR score

A
  • Score of 7-10 is normal

- Anything below this is concerning

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4
Q

When should APGAR scoring be performed?

A

1, 5 and 10 minutes after birth

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5
Q

The newborn heel-prick test is also known as…

A
  • Guthrie test

- Newborn blood spot test

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6
Q

When is the newborn heel-prick test performed?

A

5-9 days

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7
Q

How many conditions does the newborn heel-prick test screen for?

Give 4 examples

A

9 conditions, including:

  • Congenital hypothyroidism
  • Cystic fibrosis
  • Sickle cell
  • PKU (phenylketonuria)
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8
Q

What are the ToRCH infections?

A

To - toxoplasmosis
R - rubella
C - CMV
H - HSV

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9
Q

Give 4 causes of respiratory distress in term infants

A
  • Transient tachypnoea of the newborn (TTN)
  • Infection
  • Meconium aspiration
  • Congenital diaphragmatic hernia
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10
Q

Describe the pathophysiology of transient tachypnoea of the newborn

A

Delay in resorption of lung fluid after birth

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11
Q

Give 1 risk factor for developing transient tachypnoea of the newborn

A

Caesarean section

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12
Q

Describe the investigation/diagnosis of transient tachypnoea of the newborn

A
  • Diagnosis of exclusion (r/o other differentials first)

- CXR may show fluid in horizontal fissure

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13
Q

Describe the management and prognosis of transient tachypnoea of the newborn

A
  • Oxygen and ventilatory support may be required

- Condition usually settles within 1st day of life

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14
Q

What is the most significant risk factor for meconium aspiration?

A

Risk increases with greater gestational age

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15
Q

Are there any signs which would point towards a diagnosis of meconium aspiration?

A

Presence of meconium/dark green staining of liquor

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16
Q

Describe the management of meconium aspiration

A
  • Suctioning

- Oxygen and ventilatory support may be required

17
Q

Are there any risk factors for neonatal infection/sepsis?

A
  • Maternal infection (usually Group B strep)
  • Prolonged rupture of membranes - PROM (more than 18 hours between ROM and onset of labour)
  • Prematurity
18
Q

Describe the investigation and management of neonatal infection/sepsis

A

Investigation:
- Septic screen (FBC, CRP, blood cultures, urine dip, LP)

Treatment:
- 1st line: benzylpenicillin + gentamicin

19
Q

What are the clinical signs on examination of a congenital diaphragmatic hernia?

A

On auscultation of the chest there is:

  • Displacement of apex beat/heart sounds (to the right side)
  • Poor air entry (left lung)
  • Tinkling bowel sounds
20
Q

Describe the immediate and definitive management of diaphragmatic hernia

A

Immediate:
- Intubation and ventilation

Definitive:
- Surgery

21
Q

Describe the classification of birth injuries (3 categories)

A

1) Soft tissue injuries:
- Head
- Bruises/abrasions

2) Nerve palsies:
- Brachial plexus (Erb’s palsy)
- Facial nerve palsy

3) Fractures:
- Clavicle

22
Q

What are the differentials for swelling of the head in a newborn?

A
  • Caput succedaneum

- Cephalohaematoma

23
Q

Describe the clinical features, management and prognosis of caput succedaneum

A

Clinical features:

  • Present at birth
  • Typically forms over vertex and crosses suture lines

Management:
- Conservative

Prognosis:
- Resolves within days

24
Q

Describe the clinical features, management and prognosis of cephalohaematoma

A

Clinical features:

  • Typically develops several hours after birth
  • Most commonly in the parietal region, doesn’t cross suture lines

Management:
- Conservative

Prognosis:
- May take months to resolve

Paediatrics (17 decks)

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