Neonates

Question 1

breastmilk is low in which vitamins

Answer 1

FeDK

Question 2

RF for BPD

Answer 2

barotrauma
prolonged ventilation

Question 3

cause of haemolytic disease of the newborn

Answer 3

IgG crosses the placenta –> AbAg agglutination –> extravascular haemolysis (spleen)

Question 4

direct vs indirect Coombs

Answer 4

direct diagnoses haemolysis

indirect shows ABO vs Rhesus, matches transfusions, identifies sensitised mums

Question 5

causes of neonatal hepatitis

Answer 5

idiopathic
Hep A/B/C
rubella
CMV

Question 6

omphalocele vs gastroschisis

Answer 6

omphalocele - covered, syndromes, poor survival

gastroschisis - uncovered, better survival unless bowel injury IU (foetal death)

Question 7

where to do sats

Answer 7

pre ductal (R hand or ear)

Question 8

pathophysiology of MAS

Answer 8

mechanical obstruction = atelectasis

chemical pneumonitis

Question 9

neonatal chlamydia

Answer 9

week 2 of life

give PO erythromycin as it covers pnuemonia too

Question 10

neonatal resus pressures

Answer 10

30/5 in 21% if term
25/5 in 30% if <32/40

Question 11

APGAR scores

Answer 11

aim 3 and 7 at 1 and 5 mins

Question 12

microcolon

Answer 12

meconium ileus or other small bowel obstruction

Question 13

location of meconium ileus

Answer 13

terminal ileum (SB)

Question 14

contraindications to breastfeeding

Answer 14

HIV with high viral load
galactosaemia in infant
current chemo or other unavoidable toxic drugs

Question 15

hyperoxia test results

Answer 15

improved oxygenation in PPHN or other pulmonary causes

continued poor oxygenation in cardiac conditions

Question 16

faltering growth cut offs

Answer 16

1 centile if <9th
2 centiles if 9-91
3 centiles if >91st

Question 17

red flags on fever <5yo

Answer 17

CRIB SCANS

Cry weak or high pitched
Recessions or grunting
Ill to healthcare professional
Breathing >60

Skin turgor
Colour off
Age <3months with fever >38
Neuro signs
Social cues/not easy to rouse

Question 18

small pale nodules in congenital infection

Answer 18

listeria

Question 19

next best step for ambiguous genitalia

Answer 19

U+Es for salt wasting
BM for hypoglycaemia

Question 20

petechial rash in a well neonate

Answer 20

localised - review in 24h
generalised - FBC to r/o alloimmune thrombocytopaenia

Question 21

red flags for neonatal sepsis

Answer 21

AMISS

Apnoea
Mechanical ventilation or CPR
Infection in twin
Seizure
Shock