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Y3 Paediatrics > Neonatal Symposium > Flashcards

Neonatal Symposium Flashcards

1
Q

describe how the first breath after birth occurs?

A

hypoxic conditions trigger the respiratory centres which creates low pressure in the lungs and increases blood flow and reduces the fluid in the lungs

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2
Q

what is the normal heart rate in babies?

A

120-160

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3
Q

state some ways of measuring resp rate in babies?

A

blood gas determination
transcutaneous PCO2/O2 measurement
capnography
tidal volume

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4
Q

what is the normal RR in babies?

A

30-60

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5
Q

is babies BP lower or higher than adults?

A

lower

70/44

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6
Q

can new borns shiver ?

A

no

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7
Q

after birth how much weight loss is classed as normal ?

A

10%

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8
Q

what is weight loss in new borns caused by?

A

shift of interstitial fluid to intravascular
dieresis
- slower GFR, reduced Na reabsorption, decreased ability to concentrate urine
increased insensible water loss

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9
Q

does Hb increase or decrease after birth in the first 10 weeks?

A

decreases until week 10

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10
Q

after week 10, what is produced in the body to increase Hb?

A

erythropoietin

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11
Q

state some skin colours of newborns?

A

jaundice
pallor
cyanosis
plethora

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12
Q

what is plethora?

A

redness due to excess blood

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13
Q

at what level of deHb does cyanosis occur?

A

more than 5g/dl of deoxyhaemoglobin

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14
Q

state some skin rashes of newborns

A

milia
infections
sebaceous naevus

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15
Q

what is milia ?

A

white papules on nose due to hyperplastic sebaceous glands due to the effect of transplacental hormones

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16
Q

do sebaceous naevus have any complications?

A

risk of malignant change so consider elective removal

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17
Q

state some different birth marks?

A 
capillary haemangiomas 
mixed haemangioma 
mongolian blue spots 
port wine spots 
stork marks 
cafe au lait spots
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18
Q

if there are many large cafe au lait spots what DD should be considered?

A

neurofibromatosis

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19
Q

do capillary haemangioma need treatment?

A

no they disappear

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20
Q

what can cause stork marks to flare up?

A

crying

- gradually fades by 2 yrs

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21
Q

what causes cafe au lait spots?

A

melanin in melanocytes

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22
Q

what glucose level is hypoglycaemia?

A

<2.6mmol/l

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23
Q

what risk groups of hypoglycaemia?

A

premature newborns with low birth weight
diabetic mothers
hypothermia
sepsis

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24
Q

state some symptoms of hypoglycaemia in new borns

A 
irritable 
hypothermia 
lethargy 
hypotonia 
vomiting 
seizures
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25
Q

what problems can arise with tongue tied new borns/

A

feeding

- may require frenotomy

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26
Q

what evaluating respiratory function what can be measured?

A 
RR 
respiratory effect 
- retractions 
colour of skin 
O2 sats
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27
Q

state three causes of resp problems in new borns

A

laryngomalacia
trachaemalacia
bronchomalacia

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28
Q

state four locations where retraction of breathing can occur>

A

subcostal
substernal
suprasternal
intercostal

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29
Q

what is the main DD for cyanosis?

A

sepsis

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30
Q

what investigations should be done for cyanosis ?

A 
ECG
BP
O2 sats
CXR
Echo
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31
Q

what is Chonanal atresia

A

nasal obstruction

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32
Q

what signs are seen in pierre robin sequence ?

A

small jaw with tongue obstruction and possible cleft palate

33
Q

what examining the eyes of a newborn what always has be looked for?

A

red reflex

34
Q

what is the rare eye cancer that has no red reflex ?

A

retinoblastoma

35
Q

what is chordee?

A

ventral curvature of the penis

36
Q

what is hypospadias?

A

urethra opens in wrong place

37
Q

are inguinal hernias common ?

A

yes

38
Q

what investigations should be done for ambigious genitilia?

A

serum electrolytes and glucose
chromosome analysis
pelvis and abdo US (to look for testis or ovaries)
serum testosterone

39
Q

what is Cephalohaematomas ?

A

hemorrhage of blood between the skull and the periosteum

- contained between sutures

40
Q

what is Caput succedaneum ?

A

Subcutaneous fluid with poorly defined margins under the scalp caused by pressure to the presenting part of scalp to the dilated cervix

41
Q

state the two brachial plexus palsies?

A

erbs

klumpkes

42
Q

what is medial deviation of the foot called?

A

varus

43
Q

what is lateral deviation of the foot called?

A

valgus

44
Q

Does talipes require treatment ?

A

just PT

45
Q

state four ways in which heat can be lost?

A

convection
conduction
evaporation
radiation

46
Q

what causes developmental dysplasia of the hips?

A

shallow acetabulum resulting in femur slipping out of the socket

47
Q

state some risk factors for DDH?

A 
breech >36 weeks 
female 
1st child 
large birth weight 
multiple birth
48
Q

what two tests can be done for DDH?

A

ortolani

barlow

49
Q

is barlow or ortolani more gentle?

A

ortolani

50
Q

what happens during the ortolani test ?

A

• abduction of the hip while applying anterior force on the femur to reduce the joint

51
Q

what happens during the barlow test ?

A

• adduction of the hip while applying posterior force on femur to promote dislocation

52
Q

what is 21 trisomy?

A

downs

53
Q

what is 18 trisomy?

A

edwards

54
Q

what is 13 trisomy?

A

patau

55
Q

state some features of downs syndrome?

A 
hypotonia 
cardiac defect 
learning problems 
thyroid problems 
dysmorphism
56
Q

as well as ortolani and barlow test, what else can be examined for DDH?

A

leg length
general movements of the legs
groin creases
US

57
Q

state some causes of preterm labour?

A 
maternal smoking, pre eclampsia 
foetal chromosomal condition, infection 
placental abruption 
twin twin sydrome 
hypoglycaemia 
polycythaemia
58
Q

state some complications of being born premature?

A 
respiratory distress syndrome 
broncho-pulmonary dysplasia 
intraventricular haemorrhage 
post-haemorrhagic hydrocephalus 
PDA
necrotising entero-colitis
59
Q

state some long term problems of being pre term

A

reduced growth
obesity
ischaemic heart disease
polycythaemia

60
Q

what is the treatment for RDS?

A

antenatal steroids
surfactant
early extubation

61
Q

what is the treatment for IVH?

A

antenatal steroids

62
Q

what is a complication of polycythaemia?

A

Increased blood flow and the lungs want low blood flow so increase resistance and when muscles start to form, pulmonary stenosis can occur

63
Q

what is periventricular leucomalacia ?

A

ischemia of the white matter adjacent to the lateral ventricles.

64
Q

what is the prognosis of periventricular leucomalacia

A

very poor

65
Q

what is the treatment for jaundice in newborns?

A

blue light therapy

66
Q

state some organisms that can cause sepsis ?

A 
group B strep
E coli 
listeria 
coag negative staph 
haemophilus influenza
67
Q

state 3 risk factors for sepsis ?

A

PROM
maternal pyrexia
maternal group strep B carriage

68
Q

what investigations should be done for sepsis ?

A

FBC, CRP, blood culture, blood gases, CXR

69
Q

what is the treatment for sepsis?

A

penicillin and gentamicin

70
Q

what are some complications of sepsis?

A

DIC
shock and hypotension
meningitis
pneumonia

71
Q

state some risk factors for meconium aspiration ?

A

post date
maternal DM/hypotension
difficult labour

72
Q

what is the management of Hypoxic ischaemic encephalopathy ?

A
  • Treat seizures
  • Supportive (resp and cardio)
  • Fluid restriction
  • Monitor for renal and liver failure
  • Baby cooled to 33 degress for 72 hours then slowly rewarmed over 12 hours
73
Q

state some causes of failure to pass stool?

A
  • Constipation
  • Large bowel atresia
  • Imperforate anus
  • Hirschsprungs disease
  • Meconium ileus
74
Q

what condition is meconium ileum associated with?

A

CF

75
Q

what gender are diaphragmatic hernias associated with?

A

Males

76
Q

what is the purpose of ductus arteriosus?

A

Protects lungs against circulatory overload

77
Q

what is the purpose of ductus venosus?

A

Foetal blood vessel connecting the umbilical vein to the IVC

78
Q

what is miliaria?

A

immature sweat glands obstruction

79
Q

what is the commonest organism to cause skin infections?

A

staph aureus

Y3 Paediatrics (20 decks)

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