Neonatal Presentations Flashcards

1
Q

Describe the different colors you could see a neonate?

A
  • Yellow (Jaundice - see separate deck)
  • Pale
  • Red (Plethora - Polycythaemia)
  • Cyanosed
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2
Q

It’s very common (50-70%) for babies to develop a red maculopapular rash after birth. What do we call this and how is it managed?

A

Erythema Toxicum

Reassure, it clears by it’s self within 1-2wks

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3
Q

Babies of races with pigmented skin are often born with blue-grey patches on lower back/buttocks, What is this?

A

Mongolian blue spots

Due to accumulation of melanocytes

Leave it an it will fade

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4
Q

Sometimes babies are born with light pink marks on the back of the neck or midline of face, what do we call this and what do we do?

A

Stork Marks (or Naevus Simplex)

It’s just dilated capillaries, leave it and it will disappear within 2 yrs

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5
Q

What are the major causes of hypoglycaemia in newborns?

A
  • Premature
  • Diabetic mum –> Hyperinsulinaemia
  • Hypothermia
  • Sepsis
  • Small/Large for Gestational Age
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6
Q

What might a hypoglycaemic baby look like?

A
Jittery or lethargic
Hypothermic
Hypotonic!
Apnoea or irregular breathing
Poor feed and vomiting
High pitched weak cry

If bad –> Seizures

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7
Q

How do we diagnose hypoglycaemia in a kid?

A

Bedside skin prick glucose. If its <2.6mmol/L we send for a lab sample to confirm

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8
Q

Babies often present hypothermic following birth, how do we prevent this?

A

During resuscitation:

  • Dry quickly
  • Remove wet linens
  • Use warmed towels
  • Provide a radiant warmer
  • Use heated/humidified O2
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9
Q

What is a “tongue Tie”

A

A short or thick frenulum, it may be attached too anteriorly to the base of tongue

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10
Q

What’s the problem of a tongue tie and how do we treat it?

A

They can make feeding difficult

In which case we would do a frenotomy

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11
Q

What are the types of Cleft lip/palate and what causes it?

A

Incomplete
Unilateral
Bilateral

Maxillary & Medial Nasal processes fail to fuse around wk 5

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12
Q

What do we do with a cleft lip baby?

A

Use special bottle/teat

Check for airway problems

Check for ass anomalies with hearing screen, cardio exam, echo & exam for signs of trisomies

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13
Q

What is the most common problem picked up on ophthalmology exam in babies?

A

Lack of red reflex, usually meaning cataracts

We can do lens removal and give an artificial lens

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14
Q

Mum finds some bloody mucousy discharge in her baby girls nappy?

A

Probably pseudomenstruation

Very common and due to hormones from mum. It’ll clear up itself

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15
Q

Spinal Dimples can be a sign of nothing or a sign of something more serious, when and how would we investigate?

A

US & MRI if:

  • Large
  • Red or swollen
  • Off midline
  • Above sacral area
  • Pigmented
  • Tender
  • Fluid
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16
Q

What are the 2 common benign causes of a newborn with a swollen head?

A

Cephalohaematoma (Haemorrhoage under pericranium)

Caput Seccedaneum (Serosanguinous fluid collecting subcu)

17
Q

What characterises a Cephalohaematoma?

A

Localised, soft, non-translucent
Peaks at DoL 3/4

Limited by cranial bones (usually parietal bone)

18
Q

How long does a cephalohaematoma take to disappear and does it have any complciations?

A

3-4wks

Can lead to jaundice via haemolysis of the haemorrhage

NOT associated with intracranial bleeds

19
Q

What characterises a Caput Succedaneum?

A

Serosanguinous fluid
Subcu
Poor margins

Over midline & suture lines
Ass with head moulding

20
Q

What causes caput succedaneum?

A

Pressure of scalp against dilating cervix

21
Q

What are the types of Talipes?

A

Physiological - I.e. you can straigten the foot - only needs physio
Fixed - Needs Ortho i.e. strapping, casting or surgery

22
Q

How do we confirm and treat a DDH?

A

US to confirm dislocation
Pavlik harness & Surgical reduction

All to relocate head of femur into acetabulum

23
Q

Name 5 causes of failure to pass stool in a newborn?

A
Constipation
Large bowel atresia
Imperforate anus
Hirshsprung's disease
Meconium Ileus (from CF)