Neonates

Question 1

APGAR - pulse scores

Answer 1

> 100 = 2
< 100 = 1
Absent = 0

Question 2

Second A in APGAR

score:

Answer 2

Activity
Active motion = 2
Some muscle tone = 1
Loose/floppy = 0

Question 3

Respiratory effort in APGAR

Answer 3

Cries well = 2
Slow irregular breathing = 1
Not breathing = 0

Question 4

Respiratory distress syndrome in preterm infant prevention

Answer 4

Pre-natal STEROIDS

2 doses, 12 hours apart

Question 5

Long term complication associated w/ ventilation of babies

Answer 5

Broncho-pulmonary dysplasia

Question 6

Necrotising enterocolitis px.

Answer 6

Poor feeding
Mucous and blood stained diarrhoea
Abdominal distension and tenderness

Question 7

Necrotising enterocolitis ix.

Answer 7

Abdominal X-ray

Question 8

Necrotising enterocolitis ix. findings:

Answer 8

Asymmetrical dilated loops of bowel

Oedema and pneumostasis intestinalis - air cysts in the bowel wall.

Question 9

Pre-term delivery head injury

Answer 9

Periventricular haemorrhage

Question 10

Periventricular haemorrhage may progress to:

Answer 10

Intra-ventricular and intra cerebral haemorrhage

Question 11

Neonatal sepsis antibiotics:

Answer 11

Benzyl penicillin

Gentamicin

Question 12

Antibiotics required for:
Neonatal pneumonia
Neonatal meningitis
UTI

Answer 12

Amoxicillin

Cefotaxime + Amoxicillin

Amoxicillin + Gentamicin

Question 13

Ophthalmia neonatorum causative organism

Answer 13

Chlamydia from mother to baby

Question 14

Transient tachypnoea of the newborn - main cause

Answer 14

C-section delivery

Failure to adequately clear fluid from the lungs following delivery.

Question 15

Mx. TTN

Answer 15

Rule out other causes of increased RR

Monitor - most resolve w/in 24 hours

Question 16

Meconium aspiration syndrome occurs due to either:

Answer 16

Fetal distress

Post-term baby

Question 17

Meconium aspiration syndrome mx:

Answer 17

Suctioning and supportive care

Question 18

Main causes of neonatal heart failure:

Answer 18

TORCH infections
Chromosome abnormalities
Rhesus Haemolytic disease

Question 19

Mx. Persistent pulmonary hypertension of newborn:

Answer 19

Supportive care

Inotropes to increase systemic pressure while foetal circulation naturally adapts

Question 20

Haemorrhagic disease of the newborn: px.

Answer 20

2-7 days post partum bleeding and bruising

Question 21

Haemorrhagic disease of the newborn: Mx

Answer 21

Vitamin K at birth - given by the midwife

Question 22

Physiological jaundice bilirubin level

Answer 22

Must be below 200

Question 23

Causes of pathological jaundice w/in the first 24 hours of life:

Answer 23

Sepsis
Haemorrhagic disease of the new born
Red cell incompatibility: Rhesus disease.
Inherited conditions: G6PD, Hereditary spherocytosis

Question 24

Prolonged jaundice duration:

Answer 24

> 14 days

Question 25

Prolonged jaundice causes:

Answer 25

Hypothyroidism Infection: UTI, TORCH Biliary atresia, CF, hypothyroidism

Question 26

Mx. of prolonged jaundice:

Answer 26

Plot bilirubin on graph High: Phototherapy Very high: Exhange transfusion

Question 27

Prolonged jaundice: investigate for conditions such as:

Answer 27

G6PD Galactosaemia Hypothyroidism

Question 28

What is Kernicterus

Answer 28

Bilirubin induced encephalopathy

Question 29

Kernicterus management:

Answer 29

Exchange transfusion + phototherapy

Question 30

Cyanotic congenital heart defects are associated with a ___ shunt

Answer 30

Right to left shunt

Question 31

Cyanotic defects examples:

Answer 31

``` Tricuspid atresia Pulmonary atresia Severe pulmonary stensosis Severe Ebstein's anomaly Tetralogy of Fallot Transposition of the great arteries ```

Question 32

Transposition of great vessels - shape of cardiomegaly:

Answer 32

'egg-shaped'

Question 33

Tetralogy of Fallot shape of cardiomegaly:

Answer 33

'Boot-shaped'

Question 34

Most common congenital heart defect: | Cyanotic or acyanotic

Answer 34

VSD Acyanotic

Question 35

Patent ductus arteriosus mx. To close To keep patency: before surgery:

Answer 35

Indomethacin will close Prostaglandins will keep patency

Question 36

Oesophageal atresia: describe -

Answer 36

Narrowing of oesophagus and formation of fistula w/ the trachea

Question 37

Oesophageal atresia px.

Answer 37

Frothy secretions, drooling and difficult passing catheter into stomach

Question 38

Gastrochisis vs. Exomphalos

Answer 38

``` Gastrochisis = Extrusion of abdominal viscera Exomphalos = herniation of viscera covered w/ peritoneum - para-umbilical ```

Question 39

Congenital adrenal hyperplasia raised marker:

Answer 39

17 - hydroxyprogesterone 21-a hydroxylase deficiency

Question 40

Meconium ileus commonest assoc.

Answer 40

CF

Question 41

Meconium ileus ix.

Answer 41

Large distended loops of small bowel on ABDOMINAL XRAY

Question 42

Mx. meconium ileus:

Answer 42

Conservative = wash-out and NG tube Surgical - removal of compacted bowel

Question 43

Jejunal atresia px.

Answer 43

Vomiting, unable to pass meconium

Question 44

Jejunal atresia px.

Answer 44

Few bowel loops w/ distended proximal small bowel

Question 45

Causes of jitteriness in baby

Answer 45

Hypoglycaemia | Hypernatraemia (dehydration)

Question 46

SUFE classically features loss of:

Answer 46

Internal rotation of the leg

Question 47

Undescended testes mx.

Answer 47

Review at 3 months | Refer for surgery at 6 months

Question 48

Chest compressions: rescue breaths for neonatal CPR

Answer 48

3:1 ratio