Brainscape's Knowledge GenomeTM

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


See full index

RACP Written > Neonates > Flashcards

Neonates Flashcards

1
Q

An elevated lactate to N-acetylaspartate ratio on MR spectroscopy is
consistent with HIE- True or false?

A

True

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

Injury to the grey matter is unusual in HIE- True or False?

A

FALSE

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

Prominent occipital white matter changes may indicate that the infant was
hypoglycaemic- true or false?

A

TRUE
White matter looks like sugar?

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

The current recommended target saturations for infants of less than 28 weeks
gestation during their NICU stay is closest to?

A

91-95%

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

What is prune belly syndrome?

A

Genitourinary tract abnormalities
include massive dilation of the ureters
and upper tracts and a very large
bladder, with a patent urachus, or a
urachal diverticulum and
cryptorchidism. Cardiac abnormalities.
Common in both genders.

Prune makes you pee into your bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is Bardet-Biedel syndrome?

A

This results in the characteristic retinal changes (retinitis pigmentosa), post-axil polydactyly, obesity, renal dysfunction, abnormalities of the genitalia and intellectual disability

Can’t read the takes of beetle and the bard because no vision and fingers cant hold book. Also not smart.

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

Side effects of Topiramate?

A

Kidney stones, metabolic acidosis and language impairment

Used to treat seizures. Your mate has kidney stones and lots of acid. + can’t talk

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

Common side effects of Levetiracetam

A

Behavioural side effects are the most common side effect of levetiracetam. Older children need to be warned about low mood and the risk of suicidal ideation.

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

Which congenital condition has the highest prevalence in Aus and Nz?

A

Bilateral hearing impairment. Approximately 1-2:1000 live newborns have congenital sensorineural hearing loss bilaterally.

Cystic fibrosis: 1:2,500
Galactosaemia: 1:70,000
Hypothyroidism: 1:3,500
Neuroblastoma: 1-2:100000 children aged <15 years, congenital incidence even less

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is G6PD a disorder of?

A

Disorder of NADPH production. Important for preventing oxidative injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mode of inheritance for congeinital chloride diarrhoea?

A

Autosomal recessive

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

What are the effects of impaired Cl absorption on bicarb and sodium in congenital chloride diarrhoea?

A

Impaired Cl abs = reduced bicarb and sodium absorption –> increased plasma renin-aldo ratio

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

A 2-month-old neonate presents for review of right upper quadrant abdominal mass, infantile haemangiomas and poor growth- > cause

A

Hypothyroidism

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

What bug is a spirochaete?

A

Treponema pallidum is a spirochaete, congenital syphilis is highly infectious and so contact precautions are vital. The treatment is with penicillin IV.

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

What happens to the vernix at 24, 38, 40 and >42 weeks

A

24 – 38 weeks: Thick layer over skin
38 – 39 weeks: Back, scalp, skin creases
40 – 41 weeks: Minimal, only in creases
>42 weeks: Not present

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

What happens to neonatal skin at 24, 32, 36, 40 and >42 weeks

A

24 – 31 weeks: Thin, translucent with visible veins on abdomen and may be oedematous
32 – 35 weeks: Thicker and smooth, no oedema
36 - 39 weeks: Pink
40 – 41: Early desquamation, more pale
>42: Thick, pale, desquamation

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

What happens to Lanugo at 22, 33, 38 and >42 weeks

A

22 – 32 weeks: Covering entire body
33 – 37 weeks: Covering body except face
38 – 41 weeks: Shoulders only
>42 weeks: Absent

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

What does parecovirus present with in babies

A

Septic shock picture
MRI shows white matter changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is the most common time period for CP injury to occur? Ie brain injury that causes CP

A

In Antenatal period

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

What accounts for 50% of SSNHL in kids? (non-syndromic)

A

Connexin 26 gene OR GJB2 mutation.

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

Lesion at optic chiasm will do what to your vision?

A

Bitemporal haeminopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Neopterin used for?

A

Marker of CNS inflammation. Catabolic product so gets worse with each day.
Measured in CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Can single gene testing be used for detecting triplet repeat disorders?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the most common genetically inherited peripheral neuropathy?

A

Charcot Marie Tooth Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Anterior location of a burn is most likely child abuse- true or false

A

FALSE.
Abuse generally younger kids and can be anywhere

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which CHD will give you cyanosis with a NORMAL examination on day 2 of life?

A

TAPVR
Normally an associated ASD but cyanosis once PDA closes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the first line treatment for gonococcal conjunctivitis?

A

IV Cefotaxime and PO azithro.
NOT BEN PEN due to increasing ressitance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the two mechanisms that cause physiological jaundice in neonates

A

Increased bilirubin production because of increased breakdown of fetal erythrocytes.

Hepatic excretory capacity is low both because of low concentrations of the binding protein ligandin in the hepatocytes and because of low activity of glucuronyl transferase, the enzyme responsible for binding bilirubin to glucuronic acid, thus making bilirubin water soluble (conjugation).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

In infants of a diabetic mother, what happens to the insulin, ketones an urine reducing sybstances at the time of a hypo

A

Insulin will be high because of the persistent hyperglycemia in pregnancy.
Low ketones as high insulin means FFA cant be utilised. This also means low reducing substances in the urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

When does the thymic shadow become less visible?

A

Age 2-8.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the greatest risk factor for GBS infection in neonates?

A

Pre term ROM.
Means the baby is smaller GA so higher risk of contracting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are immediate/short-term side effects of antenatal steroids for the baby?

A

IUGR
Reduced foetal movements
Increased risk of maternal chorio and hence early onset sepsis in babies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is dyskeratosis congenita?

A

Defect in telomere maintenance so EARLY AGEING.
Causes reticular skin rash, nail dystrophy and low white cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the formula for calculating cuffed and uncuffed ETT size in paeds?

A

age/4 + 4= uncuffed
age/4 + 3.5 = cuffed

Think in neonate, 4 cuffed and 3/5 uncuffed (age 0_

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Is Duschens and out or in frame mutation

A

OUT of frame.
If mutation is outside the frame, changes the whole thing vs in the frame.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What does a lesion in pituitary/optic chiasm cause in terms of visual disturbance?

A

Bitemporal haemanopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

At what gestational age do babies respond to light?

A

32 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which base pairs are pyrimadines and which ones are purines?

A

CYTOSINE and THYMINE are PYRIMADINES- they all have Y in them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What receptors take on COVID-19

A

ACE receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the inheritance for complete androgen insensitivity?

A

X linked recesive

41
Q

Which renal syndrome has renal stones? (barter vs gitelman)

A

Barter- bartender- drinks on the rocks- made of calcium- renal stones

42
Q

Name the downstream arteries of the aortic arch

A

Arch 1+2- Max you can get so maxillary
Arch 3- like abC- Carotid
Arch 4- 4 limbs- Subclavian
Arch 6- 26s look like bleomycin- lung- pulmonry

43
Q

What is the treatment for atrial flutter in neonates?

A

Cardioversion or Amiodarone if stable

44
Q

What is a common bug causing submandibular lymphadenopathy?

A

Mycobacterium

45
Q

What is an ECG finding for myocarditis post COVID

A

prolonged PR

46
Q

What is congenital hypoventilation syndrome associated with?

A

Hirschsprung disease

47
Q

Why is the plasma half life of nitric oxide so short

A

Broken down by nitrix oxide reductase which binds to Hb
That’s why the inhaled nitric oxide monitor is close to the ETT

48
Q

When is pressure swing the smallest? (What type of ventilation)

A

high frequency with volume gurantee

49
Q

In high frequency ventilation, what improves gas exchange

A

reduced MAP
Think of gas flow and pressures.

50
Q

What is the most important determinant of oxygenation during high frequency oscilaltion ventilation

A

MAP

51
Q

Which ventilation is best for CLD

A

High frequency ventilation because it reduces sheer pressure

52
Q

Mechanism of HIE

A

Essentially either reduction in SYSTEMIC oxygenation or reduced cerebral blood flow.
(Need hypoxia AND ischaemia)

Reduced oxygenation = increased BP and redistribution of blood to vital organs ie brain. Too much blood to brain= loss of regulation and reduced CBF = ischaemia.
(Also from the body, if hypoxia persists, BP will drop to preservation mode which also reduces cerebral blood flow)

53
Q

Out of glutamate, GABA (gamma acitobutarate) and NMDA- which neurotransmitters are good vs bad>

A

GAMMA= GOOD. (sa re ga ma is a good show)
Glutamate and NMDA= bad.

54
Q

Action of glutamate in the setting of hypoxia?

A

Essentially excess glutamate causes excitation of NMDA and AMPA which INCREASE cellular permeability to sodium and calcium (and water) leading to oedema and apoptosis

55
Q

Incidence of HIE and death rate

A

In the developed world, incidence is estimated at 1-8 per 1,000 live births, and in the developing world, estimates are as high as 26 per 1,000.

Death: 20-30% die in first year, and 50-60%have long term neurological disability

56
Q

Name factors that determine the degree of neuronal damage in HIE

A
  1. Duration of inttial insult
  2. Severity of initial insult
  3. Location of initial insult
  4. Effects of reperfusion injury
  5. Apoptosis
57
Q

What is the period of maximal neuronal injury in HIE

A

This is in the secondary phase- 6-72 hours posts injury.

58
Q

Timing of intervention to reduce long term effects of HIE

A

6 hours

59
Q

Name of staging system for HIE

A

SARNAT
Looks at level of consciousness, muscle tone, spontaneous activity, posture, complex reflexes and autonomic function

60
Q

Best imaging modality for HIE

A

MRI - loss of differentiation.
CT can be used if not stable for MRI

Video EEG is also good (brainz)

61
Q

Treatment for HIE

A

Main= therapeutic cooling. Maintain temp between 33-34 within few hours has evidence of mod-severe encephalopathy
Ideal is 33.5 for 72 hours

62
Q

Period of rewarming? Ie how long should you rewarm for AFTER THERAPEUTIC COOLING for HIE

A

Rewarm for 12 hours, too quickly–> seizures

63
Q

At what age is the LONG term effect of therapeutic cooling seeen

A

18 months

64
Q

Side effects of therapeutic cooling

A
  1. Bradycardia
  2. Fat necrosis
  3. Thrombocytopenia
  4. Potential overcooling
65
Q

Failure to establish spontaneous breaths at how many minutes= sign of bad outcome?

A

20 mins

66
Q

First and second line for seizures in HIE

A
  1. Phenobarbitol
  2. Keppra
67
Q

Why is an EEG not helpful for neonates seizures

A

Can arise from subcortical structures ie brainstem and limbus

68
Q

Name the syndrome.
AD inheriance.
Seizure onset day 2-3 of life, 10-20 a day
90% resolve by 6 months and developmentally normal

A

Benign familial neonatal seizures

69
Q

Myoclonic jerks on sleeping only
Normal EEG
Happens in first week of life

A

Benign neonatal sleep myoclonus

70
Q

Resus settings for PIP and PEEP in term vs prem

A

Term 30/5
Prem 21/5

71
Q

First and second most common timings for PIVH

A
  1. > 50% in first 24 hours
  2. 20-30% day 4-7
72
Q

Where is the germinal matrix layer

A

In the caudothalamic notch on the floor of the lateral ventricles.
Includes delicate later of capillaries that is prone to bleeds

73
Q

Describe the 4 grades of PIVH

A
  1. Germinal matrix - in the cuadothalmic groove
  2. IVH without ventricular dilatation
  3. IVH with blood distending to lateral ventricle
  4. Echogenic intraparenchymal lesion associated with PIVH ? extension of bleed vs venous infarction
74
Q

Which grade of PIVH is most associated with CP/

A

Grade 3
Also post bleed ventricular dilatation

75
Q

Presentation of Grade I - IV PIVH

A

Grade I and II asymptomatic
Grade III and IV= shock, can progress to seizures

76
Q

What is post-haemorrhagic ventricular dilatation

A

Dilatation of lateral ventricle post PIVH, happens in small minority and 50% get better and rest develop COMMUNICATION HYDROCEPHALUS

77
Q

Common long term outcome of periventricular leukomalacia

A

Due to haemorrhagic necrosis
90% have spastic diplegia

78
Q

How many and what are the stages of ROP

A

5
1- demaractation line
2- ridge
3- ridge with NEOVASCULARISATION
4- subtotal retinal detachment
5- total retinal detachment

79
Q

What is zone 1, 2 and 3 in ROP

A

1: central, posterior around optic disc
greatest risk

The rest is as you move out

80
Q

What does plus disease mean for ROP

A

tortuisity of retinal vessels, pupil rigidity and vitreous haze

81
Q

Calories per 100mls of breast milk

A

70kcal

82
Q

What is the most common risk factor for SNHL

A

low birth weight

83
Q

Which maternal antibodies are associated with high risk of recurrent miscarraige

A

antiphospholipid antibodies

84
Q

Medication for severe opiate withdrawal

A

Morphine

85
Q

Difference between perinatal and neonatal mortality rate

A

Perinatal: 20 weeks to 6 days of birth
Neonatal: 20 weeks to <28 days

Written as /1000 births

86
Q

Defn of infant mortality rate

A

Number of deaths in babies < 12 months per 1000 live births

87
Q

What is the Barker hypothesis

A

Effect of foetal nutrition on adults

88
Q

What is bronchopulmonary dysplasia and most common age of occurence

A

chronic lung disease
<32 weeks

89
Q

Definition of CLD

A

Premature and requiring oxygen at 28 days

90
Q

What vaccine substitute can you give to high risk patients for RSV

A

Palivizumab, provides passive immunity against RSV infection and has been shown to decrease hospitalisation for RSV related illness.

91
Q

Double bouble sign on AXR

A

Duodenal atresia
Associated with T21

92
Q

What is annular pancreas? what syndrome is it common in?

A

When pancreas squeezes on duodenum –> non billious vomiting.
Common in T21

93
Q

How much blood can be lost in a subgaleal

A

upto 80-90% of circualting blood volume.
This is ~90ml/kg in babies so can have upto 250mls in the scalp (a glass of water in subgaleal)

94
Q

What is maternal smoking (pre and post partum) associated with?

A

SIDS.
one of the highest modifiable risk factors

95
Q

Which type of branchial cyst is most common/

A

Type II, in STM muscle
B= second letter in the alphabet

96
Q

What condition (infection) can present with abnormal basal ganglia signalling on MRI

A

GBS
Can present with basal ganglia involvement.
Leigh disease also has this!

97
Q

Most common cause of infant mortality in Australia?

A

Congenital malformations

2nd is birth trauma nad asphyxia

98
Q

What is the most serious complication of giving surfactant

A

Pulmonary haemorrhage

99
Q

What is a scaphoid abdomen pathgneumoic of

A

CDH

RACP Written (18 decks)

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